Revista Espanola de Cardiologia Suplementos最新文献_第7页

Tratamiento antitrombótico doble frente a triple 抗血栓治疗是双重还是三重

Revista Espanola de Cardiologia Suplementos Pub Date : 2019-01-01 DOI: 10.1016/S1131-3587(19)30032-9

Leslie Marisol Lugo , José Luis Ferreiro

{"title":"Tratamiento antitrombótico doble frente a triple","authors":"Leslie Marisol Lugo , José Luis Ferreiro","doi":"10.1016/S1131-3587(19)30032-9","DOIUrl":"10.1016/S1131-3587(19)30032-9","url":null,"abstract":"<div><p>The management of antithrombotic treatment in patients who are receiving oral anticoagulants for atrial fibrillation and who are scheduled for a percutaneous coronary intervention is particularly complex, mainly because they have an elevated risk of bleeding due to their combined use of antiplatelet and anticoagulant agents. Despite the lack of evidence available in this setting, a number of clinical trials carried out in recent years have attempted to evaluate the safety and efficacy of triple antithrombotic therapy (i.e. dual antiplatelet therapy plus an anticoagulant drug) and dual antithrombotic therapy (i.e. a single antiplatelet agent plus an anticoagulant drug), both potentially based on vitamin K antagonists or direct oral anticoagulants. The aim of this article was to provide an overview of what is currently known about different approaches to triple and dual antithrombotic therapy in patients who are undergoing anticoagulation for nonvalvular atrial fibrillation and who are scheduled for percutaneous coronary intervention. In addition, some practical recommendations for the clinical management of these patients are made.</p><p>Supplement information: this article is part of a supplement entitled “Treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: an update”, which is sponsored by Boehringer Ingelheim.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56634848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Después del DANISH, ¿a qué pacientes indicar un desfibrilador implantable? 在丹麦之后，哪些病人需要植入式除颤器?

Revista Espanola de Cardiologia Suplementos Pub Date : 2019-01-01 DOI: 10.1016/S1131-3587(20)30008-X

Carolina Ortiz Cortés

{"title":"Después del DANISH, ¿a qué pacientes indicar un desfibrilador implantable?","authors":"Carolina Ortiz Cortés","doi":"10.1016/S1131-3587(20)30008-X","DOIUrl":"10.1016/S1131-3587(20)30008-X","url":null,"abstract":"<div><p>One third of patients with non-ischemic dilated cardiomyopathy (NIDCM) experience sudden cardiac death (SCD). Current guidelines recommend that an implantable cardioverter‐defibrillator (ICD) is used in NIDCM patients with symptomatic heart failure and a left ventricular ejection fraction ≤35%. However, although there is clear evidence of prognostic benefits in patients with an ischemic etiology, findings are not so consistent in those whose symptoms have a non-coronary origin. Results from the DANISH study (Danish Study to Assess the Efficacy of ICDs in Patients with Non-Ischemic Systolic Heart Failure on Mortality) suggest that ICDs do not increase survival in patients with NIDCM. To date, left ventricular ejection fraction and New York Heart Association functional class have been the key indicators for identifying NIDCM patients who are candidates for primary prevention using an ICD. Today, there are new drugs that could provide a greater reduction in the risk of SCD and alternative, more-specific markers that could give better risk estimates in patients. The aims of this article were to review and discuss studies on the use of ICDs in patients with NIDCM and to analyze the application of classical and newly emergent risk markers. Finally, an individualized SCD risk stratification is proposed for future use.</p><p>Supplement information: this article is part of a supplement entitled \"Questions on a new era for heart failure treatment\" which is sponsored by Novartis.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56635988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beneficios y riesgos de los anticoagulantes orales en la fibrilación auricular 口服抗凝药物治疗心房颤动的益处和风险

Revista Espanola de Cardiologia Suplementos Pub Date : 2019-01-01 DOI: 10.1016/S1131-3587(19)30029-9

Vanessa Roldána , Francisco Marín

{"title":"Beneficios y riesgos de los anticoagulantes orales en la fibrilación auricular","authors":"Vanessa Roldána , Francisco Marín","doi":"10.1016/S1131-3587(19)30029-9","DOIUrl":"10.1016/S1131-3587(19)30029-9","url":null,"abstract":"<div><p>Atrial fibrillation is associated with high morbidity and mortality, which are principally due to an increased risk of thromboembolism – the risk of stroke and systemic embolism are elevated five-fold. Moreover, strokes secondary to atrial fibrillation are associated with higher mortality, greater dependency and poorer recovery, and there is a high rate of recurrence. Anticoagulant treatment decreases the risk of thrombotic events; compared with placebo, the rate of strokes is reduced by 64% and mortality is reduced by 26%.However, anticoagulant treatment is associated with an increased risk of hemorrhagic complications. In particular, the risk of intracranial hemorrhage, a fatal complication, is increased. The emergence of direct oral anticoagulants has not only improved the efficacy of anticoagulant treatment but, importantly, has also increased its safety. However, as patients do not all have the same thromboembolic and hemorrhagic risks, it is essential that these risks are evaluated in individual patients with atrial fibrillation and that potentially modifiable hemorrhagic risk factors are identified. Finally, it is important that anticoagulant drug treatment is adjusted to suit the individual patient to optimize the benefits of treatment whilesimultaneously reducing the risks.</p><p>Supplement information: this article is part of a supplement entitled “Treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: an update”, which is sponsored by Boehringer Ingelheim.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56634957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Sacubitrilo-valsartán e inhibidores del cotransportador de sodio-glucosa tipo 2 en insuficiencia cardiaca: ¿separación de poderes o bienes gananciales? 沙比三联-缬沙坦和2型钠葡萄糖共转运体抑制剂治疗心力衰竭:权力分离还是金钱?

Revista Espanola de Cardiologia Suplementos Pub Date : 2019-01-01 DOI: 10.1016/S1131-3587(20)30006-6

Alfonso Valle-Munoz, Herminio Morillas-Climent, Álvaro Vicedo-López

{"title":"Sacubitrilo-valsartán e inhibidores del cotransportador de sodio-glucosa tipo 2 en insuficiencia cardiaca: ¿separación de poderes o bienes gananciales?","authors":"Alfonso Valle-Munoz, Herminio Morillas-Climent, Álvaro Vicedo-López","doi":"10.1016/S1131-3587(20)30006-6","DOIUrl":"10.1016/S1131-3587(20)30006-6","url":null,"abstract":"<div><p>Heart failure with a reduced left ventricular ejection fraction (HFrEF) commonly coexists with diabetes. In recent years, sacubitril-valsartan and the family of sodium-glucose cotransporter-2 (SGLT2) inhibitors have become established as part of the routine therapeutic armamentarium for clinicians dealing with heart failure. In patients with HFrEF, sacubitril-valsartan has been associated with a substantially better prognosis and quality of life compared with enalapril. In addition, the family of SGLT2 inhibitors have demonstrated significant clinical benefits in a more varied patient population with a low prevalence of heart failure at baseline: they preserved renal function and reduced hospitalization for heart failure. The aim of this article was to review the evidence currently available on these two drugs classes and on their use in combination.</p><p>Supplement information: this article is part of a supplement entitled “Questions on a new era for heart failure treatment” which is sponsored by Novartis</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56635400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Tratamiento de la insuficiencia cardiaca en el paciente con insuficiencia renal avanzada 晚期肾衰竭患者心力衰竭的治疗

Revista Espanola de Cardiologia Suplementos Pub Date : 2019-01-01 DOI: 10.1016/S1131-3587(20)30007-8

Jose Luis Górriz , Miguel González Rico , Julio Nuñez

{"title":"Tratamiento de la insuficiencia cardiaca en el paciente con insuficiencia renal avanzada","authors":"Jose Luis Górriz , Miguel González Rico , Julio Nuñez","doi":"10.1016/S1131-3587(20)30007-8","DOIUrl":"10.1016/S1131-3587(20)30007-8","url":null,"abstract":"<div><p>Renal impairment is common in patients with heart failure (HF) and HF increases with decreasing estimated glomerular filtration. Furthermore, renal impairment has an impact on the prognosis in patients with HF. In general, recommendations for the treatment of patients with HF and concomitant chronic kidney disease (CKD) are not different from those for patients with normal renal function. However, patients with moderate- to-severe renal impairment have been excluded from most clinical trials, and evidence and safety data on the therapies to be used in such patients are scarce. In the present paper, existing evidences on currently available therapies for HF in patients with moderate-to-severe CKD, including ultrafiltration with peritoneal dialysis, are discussed. Therapy complications, such as hyperkalaemia and renal function impairment, are also described. Dual angiotensin receptor-neprilysin inhibitors appear promising as a therapy that could safely reduce the risk of HF among patients with CKD. Their benefit could be mediated, among other mechanisms, by their renal effects. Other therapies, such as sodium-glucose cotransporter-2 inhibitors, have proved beneficial in HF in diabetic patients showing various degrees of renal function.</p><p>Clinical trials are needed to obtain new evidence on the therapies for heart failure and to confidently reduce the excess risk of cardiovascular disease in renal disease.</p><p>Supplement information: this article is part of a supplement entitled \"Questions on a new era for heart failure treatment\" which is sponsored by Novartis</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56635931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Introducción 导言

Revista Espanola de Cardiologia Suplementos Pub Date : 2019-01-01 DOI: 10.1016/S1131-3587(19)30027-5

Ángel Cequier

引用次数: 0

Una historia resumida. Impacto de los avances en el control lipídico 一个简短的故事。脂质控制进展的影响

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30010-X

Fernando Sabatel Pérez, Joaquín Sánchez-Prieto Castillo, Luis Rodríguez Padial

引用次数: 0

Una historia resumida. Impacto de los avances en cardiopatía isquémica 一个简短的故事。缺血性心脏病进展的影响

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30009-3

José Ramón González-Juanatey , Rosa Agra Bermejo , José López-Sendón

引用次数: 1

Resultados clínicos del uso de los nuevos antiagregantes en la vida real 在现实生活中使用新型抗聚集剂的临床结果

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30026-3

Iván J. Núñez Gil , Francisco Marín

引用次数: 0

Efectos cardioprotectores del ticagrelor 替格瑞洛的心脏保护作用

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30017-2

Lina Badimona , Gemma Vilahur

{"title":"Efectos cardioprotectores del ticagrelor","authors":"Lina Badimona , Gemma Vilahur","doi":"10.1016/S1131-3587(19)30017-2","DOIUrl":"10.1016/S1131-3587(19)30017-2","url":null,"abstract":"<div><p>The development of platelet P2Y<sub>12</sub> receptor inhibitors has made a crucial difference to the treatment of patients with acute coronary syndrome. In recent years, extensive evidence from both laboratory and clinical studies has established that platelet P2Y<sub>12</sub> receptor inhibitors have pleiotropic effects as well as antiplatelet properties. One possible explanation is that the P2Y<sub>12</sub> receptor is found on a wide variety of cells in addition to platelets and could, therefore, modulate the inflammatory response, endothelial function, vascular tone, and ischemia–reperfusion injury. Studies in various animal models and a number of clinical trials have demonstrated that the cardioprotective potential of platelet P2Y<sub>12</sub> receptor inhibitors is mediated by a mechanism involving the activation of signaling pathways associated with endogenous myocardial protection (e.g. ischemic postconditioning). However, ticagrelor, unlike other P2Y<sub>12</sub> receptor inhibitors, has been shown to influence an additional cardioprotective pathway involving mechanisms associated with the increased bioavailability of adenosine, a molecule that is mainly produced by endothelial cells in response to ischemia and which has several beneficial cardiovascular effects. This article briefly reviews the different mechanisms of action of various platelet P2Y<sub>12</sub> receptor inhibitors and explores the cardioprotective effects exerted by these compounds in addition to their antiplatelet actions, particularly those effects associated with adenosine, which are uniquely induced by treatment with ticagrelor.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56634631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0