REC: CardioClinics最新文献

{"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}

{"title":"Origen anómalo de la arteria pulmonar derecha en un adulto","authors":"","doi":"10.1016/j.rccl.2024.02.002","DOIUrl":"10.1016/j.rccl.2024.02.002","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 345-346"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274596","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":"Fibroelastoma papilar aórtico e ictus: un caso ilustrativo","authors":"","doi":"10.1016/j.rccl.2024.02.001","DOIUrl":"10.1016/j.rccl.2024.02.001","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 343-344"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466882","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":"Intervencionismo coronario percutáneo en pacientes con enfermedad del tronco coronario izquierdo o enfermedad multivaso","authors":"","doi":"10.1016/j.rccl.2024.05.003","DOIUrl":"10.1016/j.rccl.2024.05.003","url":null,"abstract":"<div><div>Patients with multivessel coronary disease or left main coronary artery disease represent a highly complex minority within ischemic heart disease. However, there is ongoing controversy over the best treatment approach in these cases: whether to opt for coronary artery bypass grafting or percutaneous coronary intervention. Current recommendations from the latest 2018 clinical practice guidelines are based on studies from the past decade, and since then, technological advancements in percutaneous coronary intervention have achieved significant improvements, offering a better clinical prognosis today. This has led to an increase in the annual number of procedures performed and has even opened the door to treating patients who in the past were clear candidates for coronary artery bypass grafting.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 322-333"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141399974","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":"Impact of education on aortic stenosis awareness in the general population","authors":"","doi":"10.1016/j.rccl.2024.05.002","DOIUrl":"10.1016/j.rccl.2024.05.002","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 334-338"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141389742","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":"Junta Directiva, Comité Organizador, Comité Científico y Comité Evaluador","authors":"","doi":"10.1016/S2605-1532(24)00124-9","DOIUrl":"10.1016/S2605-1532(24)00124-9","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 ","pages":"Pages i-ii"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441048","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":"Índice de autores","authors":"","doi":"10.1016/S2605-1532(24)00126-2","DOIUrl":"10.1016/S2605-1532(24)00126-2","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 ","pages":"Pages S32-S33"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441050","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":"Comunicaciones","authors":"","doi":"10.1016/S2605-1532(24)00125-0","DOIUrl":"10.1016/S2605-1532(24)00125-0","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 ","pages":"Pages S1-S31"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441049","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":"Microbiología clásica y molecular en el diagnóstico de la endocarditis infecciosa","authors":"","doi":"10.1016/j.rccl.2023.12.006","DOIUrl":"10.1016/j.rccl.2023.12.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>In recent years, molecular techniques for the aetiological diagnosis of infective endocarditis (IE) have attained relevance; however, they are not implemented in all laboratories. Our objective is to evaluate the usefulness of broad-spectrum polymerase chain reaction (PCR) technique followed by sequencing (universal PCR) on valve tissue as part of the IE diagnostic practice and to compare the results with classical methods.</p></div><div><h3>Results</h3><p>Universal PCR showed a higher sensitivity than valve culture (80.8 vs 27.1%, <em>P</em> <!-->&lt;<!--> <!-->.001) and allowed the identification of the causative agent or the confirmation of the aetiological diagnosis in case of discordance in 7.7% of patients. Regarding conventional diagnosis, blood culture stands out as the reference technique and Gram staining due to its high positive predictive value. The highest sensitivity and specificity was obtained considering classical and molecular microbiology together. The anatomopathological study presented a sensitivity of 83.9% and made it possible to assess the results of the microbiological diagnosis when there were discrepancies.</p></div><div><h3>Conclusions</h3><p>Universal PCR proved to be a valuable technique that completes the classical diagnosis. In an entity as complex as IE, it is necessary to use all the diagnostic tools at our disposal. All areas of laboratory diagnosis are complementary and not exclusive and should be assessed together.</p></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 3","pages":"Pages 191-200"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139635483","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}