REC: CardioClinics最新文献

{"title":"Diagnostic accuracy of anatomic vs functional tests for coronary artery disease in patients with left bundle branch block and right ventricular pacing","authors":"","doi":"10.1016/j.rccl.2024.03.002","DOIUrl":"10.1016/j.rccl.2024.03.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>A lower accuracy of functional tests for the diagnosis of significant coronary disease in patients with left bundle branch block (LBBB) has been described, due to a greater number of false positives. The aim of this study was to evaluate whether an anatomic test such as computerized tomography coronary angiogram (CTCA) outperforms SPECT myocardial perfusion imaging (SPECT-MPI) or dobutamine stress echocardiography (DSE) in the diagnosis of significant coronary artery disease in patients with LBBB and right ventricular pacing.</div></div><div><h3>Methods</h3><div>Observational study of 149 patients with LBBB and right ventricular pacing referred to SPECT-MPI, DSE or CTCA at three centers. Diagnostic performance (predictive accuracy, sensitivity, specificity, positive and negative predictive value) was evaluated using coronary angiography as the benchmark.</div></div><div><h3>Results</h3><div>The study included 77 patients who underwent SPECT-MPI, 39 who performed DSE and 33 who performed CTCA. The prevalence of obstructive coronary disease was similar in the three cohorts, with a higher rate of abnormal results on SPECT-MPI (84% vs 64% vs 61%; <em>P</em> <!-->=<!--> <!-->.009). Predicted accuracy was significantly lower in the SPECT-MPI group (39% vs 64% vs 67%; <em>P</em> <!-->=<!--> <!-->.006). DSE and CTCA showed a similar rate of abnormal results, as well as similar predictive accuracy (64% vs 67%; <em>P</em> <!-->&gt;<!--> <!-->.999).</div></div><div><h3>Conclusions</h3><div>In patients with LBBB and right ventricular pacing, DSE and CTCA had similar accuracy and performed better than SPECT-MPI for the diagnosis of significant coronary artery disease.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 295-302"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140766134","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}

{"title":"Non-invasive multiparametric assessment of intracardiac tumor","authors":"","doi":"10.1016/j.rccl.2024.01.007","DOIUrl":"10.1016/j.rccl.2024.01.007","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 341-342"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463017","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}

{"title":"¿Es el policomprimido CNIC la solución para mejorar la adherencia terapéutica de los pacientes con síndrome coronario agudo?","authors":"Ana Viana Tejedor ,&nbsp;Cosme García García ,&nbsp;Rut Andrea Riba","doi":"10.1016/j.rccl.2024.07.003","DOIUrl":"10.1016/j.rccl.2024.07.003","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 261-263"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845727","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}

{"title":"Underuse of systemic thrombolysis in pulmonary embolism: A single center retrospective observational study","authors":"","doi":"10.1016/j.rccl.2024.03.006","DOIUrl":"10.1016/j.rccl.2024.03.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Acute pulmonary embolism (PE) is the third most frequent acute cardiovascular syndrome. Systemic thrombolysis is the treatment of choice in patients with high-risk PE. The aim of this study is to analyze the patients diagnosed with pulmonary embolism at the emergency department, acute treatment decisions and the main outcomes.</div></div><div><h3>Methods</h3><div>A single-center retrospective observational study was conducted in patients with the diagnosis of PE at the emergency department over a period of 3 years, followed by a one-year period of follow-up. Reported <em>P</em> values below .05 indicate statistical significance.</div></div><div><h3>Results</h3><div>A total of 240 patients presented the diagnosis of PE, with a mean age of 69.2 (± 17.4) years. Nearly a third of patients were classified with high or intermediate-high risk PE, but systemic thrombolysis was only performed in nine patients (3.8%). Among the high-risk PE subgroup, age (<em>P</em> <!-->=<!--> <!-->.06), gender (<em>P</em> <!-->=<!--> <!-->.54) and the existence of absolute and/or relative contraindications for thrombolysis (<em>P</em> <!-->=<!--> <!-->.99) were not predictors of the decision of non-revascularization. At the end of the follow-up period, 23.9% of the patients reported persisting symptoms, and chronic thromboembolic pulmonary hypertension was documented in 12.8% of the patients.</div></div><div><h3>Conclusions</h3><div>Acute treatment of pulmonary embolism is imperative to reduce mortality and prevent long-term sequelae. Systemic thrombolysis is the first line therapy in high-risk patients, but it is underused by medical population even in the absence of formal contraindications. It is necessary a new national-level model of actuation, implementing alternative strategies such as interventional ones to improve outcomes.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 278-284"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761644","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}

{"title":"Infrautilización del tratamiento de reperfusión en la embolia pulmonar: la capacidad para el cambio","authors":"Pablo Salinas","doi":"10.1016/j.rccl.2024.07.007","DOIUrl":"10.1016/j.rccl.2024.07.007","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 264-265"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526606","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}

{"title":"Uso de nuevas terapias hipolipemiantes en la práctica clínica. Consenso SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.","authors":"David Vivas ,&nbsp;Carlos Escobar ,&nbsp;Alberto Cordero ,&nbsp;Rosa Fernández-Olmo ,&nbsp;Armando Oterino ,&nbsp;Agustín Blanco-Echevarría ,&nbsp;Manuel Botana ,&nbsp;Daniel Escribano ,&nbsp;María del Mar Freijo ,&nbsp;Pedro Martínez-Losas ,&nbsp;Vicente Pascual ,&nbsp;Borja Quiroga ,&nbsp;Carmen Sánchez-Peinador ,&nbsp;Mónica Torres-Fonseca ,&nbsp;Román Freixa-Pamias ,&nbsp;Vivencio Barrios ,&nbsp;Gonzalo Barón-Esquivias","doi":"10.1016/j.rccl.2024.06.002","DOIUrl":"10.1016/j.rccl.2024.06.002","url":null,"abstract":"<div><div>Although in the last years a better control of vascular risk factors has been achieved, «real-world» data showed that only a few percentage of patients reach low-density lipoprotein-cholesterol goal levels. Recently, new therapies for the management of dyslipidaemias have emerged, and they could help to achieve the goal targets recommended by currents practical clinical guidelines so as to reduce vascular outcomes. Nevertheless, it is still uncertain in daily clinical practice the ideal timing of prescribing these new drugs, and what are the patients more benefited, compared to «classical» therapies such as statins and/or ezetimibe. In this complex scenario, this consensus document is proposed. It is certified by most of the scientific societies of clinical specialties that may play a role in the patient-healthcare process of atherosclerotic disease (SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.), and its aim is to recommend some practical and simple guidelines, based on current scientific evidence, for the management of new therapies for dyslipidaemias in different scenarios of daily clinical practice.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 310-321"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851580","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}

{"title":"Characterizing the “iceberg peak” in valvular heart disease: Outcomes and costs of in-hospital procedures in Spain","authors":"","doi":"10.1016/j.rccl.2024.02.006","DOIUrl":"10.1016/j.rccl.2024.02.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The aim was to describe the burden of disease of valvular heart disease (VHD) in-hospital interventions in Spain.</div></div><div><h3>Methods</h3><div>The analysis involved all cases between 2016 and 2019 in the Spanish Ministry of Health database under the International Classification of Diseases 10th Revision. Procedure rates by region and year (×10⁶), patient risk profile (comorbidities), health outcomes (death), length of stay (LoS), and costs were examined.</div></div><div><h3>Results</h3><div>A total of 57<!--> <!-->878 procedures were analyzed, representing a national rate from 292 in 2016 to 321 in 2019 (×10⁶ inhabitants). Comorbidities measured by the age-adjusted Charlson Comorbidity Index ranged between 3.47 and 3.77 and increased over the period. The in-hospital complications have remained constant over the years with some exceptions. Death rate (×10⁶ inhabitants) was 18.0, and the in-hospital mortality per year range was statistically constant and between 5.23% and 6.20%. The unadjusted LoS ranged from 14.68 to 15.34 days (standard deviations [SD], 16.03 and 15.79) including 2.68 to 3.27 days (SD, 6.57–7.82) in the intensive care unit. VHD procedures costs amounted to €1403.13 million in the period, representing an annual cost of €350.8 million. These costs decreased by 3.17% over the period. Per-procedure mean cost also decreased from €24<!--> <!-->801.81 (SD, €10<!--> <!-->231.91) to €24<!--> <!-->015.50 (SD, €9825.39).</div></div><div><h3>Conclusions</h3><div>VHD entails a large and increasing volume of procedures in Spain. While a decline in the per-procedure mean cost was noted, the overall annual cost increased. This underscores the substantial burden on the national health system, even when considering solely in-hospital procedures.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 285-294"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276223","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}

{"title":"Determinación de la lipoproteína (a) y prevalencia de valores elevados entre los asistentes a una reunión científica","authors":"Rosa Fernández Olmo ,&nbsp;Armando Oterino ,&nbsp;Miriam Martín Toro ,&nbsp;Javier Mora ,&nbsp;Mario Baquero ,&nbsp;Alberto Cordero","doi":"10.1016/j.rccl.2024.06.001","DOIUrl":"10.1016/j.rccl.2024.06.001","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 338-340"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703841","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}

{"title":"Recurrent stroke despite correct anticoagulation therapy with DOACs: Analysis of the real-life therapeutic approach","authors":"Hakan Gökalp Uzun ,&nbsp;Selim Ekinci ,&nbsp;Muhammed Ali Şahin ,&nbsp;Nazlıhan Ezgi Kavuk ,&nbsp;Demet Funda Baş ,&nbsp;Barış Kiliçaslan","doi":"10.1016/j.rccl.2024.05.004","DOIUrl":"10.1016/j.rccl.2024.05.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Recurrent strokes persist despite the use of guideline-recommended direct oral anticoagulants (DOACs). There is a scarcity of data concerning the current and optimal practices following a recurrent stroke while on DOACs. Consequently, our aim was to identify factors associated with this residual risk and to discern the current practice patterns among cardiologists and neurologists.</div></div><div><h3>Methods</h3><div>All consecutive patients with an acute cerebrovascular accident of any type and a diagnosis of atrial fibrillation (AF) were retrospectively screened at our stroke center. We gathered demographic information, clinical risk scores (CHA₂DS₂-VASc and HAS-BLED), echocardiographic and laboratory findings, risk factors, the modified Rankin score, and information about the treatment modality. DOAC usage was classified as either inappropriate (due to self-reported non-adherence and/or incorrect DOAC dosage) or appropriate.</div></div><div><h3>Results</h3><div>A total of 77 patients with stroke despite treatment with DOACs were included in the analysis. Of these, 28 (36%) had received inappropriate treatment (20 of them due to inadequate dosing). These patients tended to be older (<em>P</em> <!-->=<!--> <!-->.06) and had lower creatinine levels than the group receiving appropriate DOACs (0.9 vs 1; <em>P</em> <!-->=<!--> <!-->.01). At hospital discharge following the index stroke, various anticoagulants were administered to 75 patients (enoxaparin, n<!--> <!-->=<!--> <!-->5; warfarin, n<!--> <!-->=<!--> <!-->10; DOAC, n<!--> <!-->=<!--> <!-->60). Two patients died and 20 patients were given antiplatelet therapy in addition to anticoagulants. The preferred DOACs after stroke were apixaban (<em>n</em> <!-->=<!--> <!-->27), followed by rivaroxaban (<em>n</em> <!-->=<!--> <!-->16), dabigatran (<em>n</em> <!-->=<!--> <!-->14) and edoxaban (<em>n</em> <!-->=<!--> <!-->3).</div></div><div><h3>Conclusions</h3><div>There is no standardized model or consensus among physicians regarding anticoagulant management. Despite the intended use of the drugs, strokes continue to occur in some patients. The 25% of strokes are related to inadequate dosage.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 303-309"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526533","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}

{"title":"Gestión terapéutica con policomprimido CNIC al alta de un primer síndrome coronario agudo en España: el estudio PANDORA","authors":"Marisol Bravo Amaro ,&nbsp;Francisco Marín ,&nbsp;Joaquín Ruíz de Castroviejo ,&nbsp;Elizabet Méndez Eirín ,&nbsp;Lourdes García Bueno ,&nbsp;Raquel Marzoa Rivas ,&nbsp;Leopoldo Pérez de Isla ,&nbsp;en representación de los investigadores del Grupo PANDORA","doi":"10.1016/j.rccl.2024.03.004","DOIUrl":"10.1016/j.rccl.2024.03.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The polypill from the Spanish National Centre for Cardiovascular Diseases (CNIC) contains drugs (acetylsalicylic acid/atorvastatin/ramipril) for adequate secondary prevention after acute coronary syndrome (ACS). The aim was to describe the 6-month management of drugs with an effect on cardiovascular prognosis in patients treated with CNIC polypill as a baseline treatment at discharge after a first ACS.</div></div><div><h3>Methods</h3><div>Observational, ambispective, multicenter, national study, according to standard clinical practice. Changes in baseline and adjuvant treatment were evaluated, as well as cardiovascular risk factors.</div></div><div><h3>Results</h3><div>In total, 288 patients were included and 285 were valid for analysis. Among them, 17.9% were women and the mean age was 62.2 (12.4) years. The most prescribed formulation of the CNIC polypill was 100<!--> <!-->mg/40<!--> <!-->mg/2.5<!--> <!-->mg (55.8%). Of the participants, 76.5% maintained the baseline treatment prescribed at discharge. Also, in 8.8% of patients the dose was increased to optimize the treatment and in 3.5% decreased due to the need of therapeutic optimization or the appearance of side effects. All participants reported some adjuvant treatment, mainly antihypertensives (34.9%) and lipid-lowering agents (28.2%). A significant decrease in mean low-density lipoprotein cholesterol was observed between discharge and the following 2 visits (<em>P</em> <!-->&lt;<!--> <!-->.0001).</div></div><div><h3>Conclusions</h3><div>After a first ACS, the treatment with CNIC polypill at discharge is effective and safe. CNIC polypill therapy remained unchanged as baseline treatment in most patients. Dose was increased or, at least, an adjuvant treatment was added according to standard clinical practices when it was required.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 266-277"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}