Revista española de cardiología (English ed.)最新文献

{"title":"Fewer stents for STEMI. Are DCBs ready for prime time?","authors":"Bruno Scheller","doi":"10.1016/j.rec.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.rec.2025.08.007","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the win ratio approach to assess outcomes in the DapaTAVI trial.","authors":"Xavier Rossello, Rafael Gonzalez-Manzanares, Ignacio Amat-Santos, Vicente Peral Disdier, Luis Nieto Roca, Diego López Otero, Luis Nombela Franco, Livia Gheorge, Jorge Sanz-Sánchez, Javier Gómez Herrero, Rocío González Ferreiro, Antonio Jesús Muñoz García, Victoria Vilalta, Soledad Ojeda, Gabriela Veiga Fernández, Juan Gabriel Córdoba Soriano, Ander Regueiro, Miriam Sandín Rollán, Xacobe Flores Ríos, Aitor Uribarri, Roberto Martín Reyes, Rafael Romaguera, Pablo Avanzas, Sergio García Blas, Juan A Franco-Peláez, Javier Martín Moreiras, José Ramón González Juanatey, Gabriela Tirado, Germán Calle, José Luis Díez, Sandra Santos-Martínez, María Melendo Viu, Xavier Carrillo Suarez, Xoan Sanmartín, Nieves Gonzalo, Alejandro Gutiérrez Barrios, Inmaculada González Bermúdez, Carlos Real, Valentín Fuster, Borja Ibáñez, Sergio Raposeiras-Roubín","doi":"10.1016/j.rec.2025.08.003","DOIUrl":"10.1016/j.rec.2025.08.003","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The win ratio (WR) approach is used to assess composite endpoints in a hierarchical fashion. This novel method offers an excellent opportunity to assess the robustness of the findings yielded by landmark trials, such as the DapaTAVI trial.</p><p><strong>Methods: </strong>We applied the WR method to evaluate the treatment effect of dapagliflozin in hierarchically ordered clinical outcomes. Several combinations of outcomes were tested, including time-to-event, binary, and continuous endpoints.</p><p><strong>Results: </strong>The WR of the original primary endpoint was 1.36 (95%CI, 1.03-1.78; P=.028), comparable to the reciprocal of the original hazard ratio (1/HR, 1.38; 95%CI, 1.06-1.81). The win difference was 4.84% (95%CI, 0.55-9.12), confirming consistent findings in terms of absolute effect. Alternative combinations of the primary outcome with different prioritization of its components yielded similar treatment effects and statistical significance. Ignoring a time-to-event approach and including recurrent events did not substantially affect treatment efficacy and its statistical significance. In contrast, the inclusion of the total length of stay for heart failure hospitalizations in the hierarchy shifted the point estimate toward the null. Including New York Heart Association functional class improved the precision of the estimate (WR=1.31; 95%CI, 1.09-1.56; P=.003). Conversely, including quality of life through Kansas City Cardiomyopathy Questionnaire comparisons shifted the overall estimate toward the null (WR=1.10; 95%CI, 0.94-1.30; P=.236).</p><p><strong>Conclusions: </strong>The WR approach is a solid method to assess treatment efficacy. We observed consistent findings using this approach in the DapaTAVI trial.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes, health care resource utilization and costs by renal function in patients with heart failure.","authors":"Martín Romo, Claudia Yuste, Jorge Vélez, Miguel Hernández, Beatriz Palacios, Raquel Pita, Margarita Capel, Sandra Fernández Fernández, Nicolás Rosillo, Guillermo Moreno, Manuel Del Oro, Carmen Ortega, José L Bernal, Héctor Bueno","doi":"10.1016/j.rec.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.rec.2025.08.005","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Chronic kidney disease is highly prevalent in patients with heart failure (HF), increases clinical complexity, and worsens prognosis. This study quantitatively assessed the impact of renal dysfunction severity, including dialysis, on clinical outcomes, resource utilization, and costs in patients with HF.</p><p><strong>Methods: </strong>Retrospective cohort study in adult patients with 1 emergency department visit or hospitalization with an HF diagnosis in a university hospital in 2018. One-year clinical outcomes, resources, and costs were compared with the Clinical Outcomes, Health care Resource Utilization, and Related Costs (COHERENT) model according to estimated glomerular filtration rate (eGFR) ≥ 60, 30 to 59, 15 to 29, and < 15 (including patients on dialysis) mL/min/1.73 m².</p><p><strong>Results: </strong>Of 3274 patients with HF (median age, 84 years; 56% women), 1453 (44.4%) had eGFR ≥ 60. Lower eGFR levels were associated with higher 1-year mortality (20.4% in eGFR ≥ 60 vs 45.4% in eGFR 15 to 29; P < .001 for trend), rehospitalization, and new emergency department visits. Patients with eGFR < 15 had the highest readmission rate (50.8%; P < .001 for trend). Days out of hospital without dialysis decreased from 292 (80.0%) in eGFR ≥ 60 to 184 (50.3%) in eGFR < 15. Median cost per patient journey increased from 3960 (Q1-Q3, euro1750 to euro8410) with eGFR ≥ 60 to euro9590 (Q1-Q3, euro4140 to euro28 520; P < .001) with eGFR < 15, driven mainly by hospitalizations (84%-90% of total, except for eGFR < 15, 59.0%).</p><p><strong>Conclusions: </strong>Renal dysfunction severity was associated with progressively worse clinical outcomes, increased health resource utilization, and higher costs in patients with HF. Strategies are needed to improve outcomes and reduce costs in patients with HF and severe chronic kidney disease.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sézary syndrome as an unusual cause of Loeffler endocarditis.","authors":"Juan Manuel Serrano-Marcos, Miguel Morales-García, Sara Ruiz-Magaña","doi":"10.1016/j.rec.2025.07.011","DOIUrl":"10.1016/j.rec.2025.07.011","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of transcatheter aortic valve implantation depth on hemodynamic flow: a computational fluid dynamics study.","authors":"Luis Llamas-Fernández, Daniel Pinilla-García, José Sierra-Pallares, J Alberto San Román, Ignacio J Amat-Santos, Carlos Baladrón","doi":"10.1016/j.rec.2025.08.006","DOIUrl":"10.1016/j.rec.2025.08.006","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital platelet count dynamics in patients with acute coronary syndrome.","authors":"Andrea Zito, Antonio Landi, Andrea Milzi, Enrico Frigoli, Sergio Leonardi, Pascal Vranckx, Arnoud W J Vant'Hof, José M de la Torre Hernández, Gianluca Campo, Ferdinando Varbella, Paolo Calabrò, Giuseppe Andò, Giacomo Boccuzzi, Filippo Russo, Marco Valgimigli","doi":"10.1016/j.rec.2025.09.002","DOIUrl":"10.1016/j.rec.2025.09.002","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The prognostic role of platelet count dynamics in patients hospitalized with acute coronary syndromes (ACS) remains unclear. This study investigated the implications of platelet counts and their changes in ACS patients, using MATRIX trial data.</p><p><strong>Methods: </strong>In-hospital relative changes in platelet count were analyzed continuously and were categorized into groups. Associations with 1-year risks of mortality and major or clinically relevant nonmajor bleeding were modelled using Cox regression.</p><p><strong>Results: </strong>Among 7722 ACS patients, a platelet count drop >10% occurred in 47.5% of the patients and a platelet count increase >10% in 6.4%. Platelet count changes showed a U-shaped association with mortality and an L-shaped association with bleeding. Compared with the reference group (from 10% drop to 10% increase; rates: mortality 2.6%, bleeding 6.2%), platelet count drops were associated with an incremental mortality risk of approximately 30% (30%-50% drop: 9.5%; HR, 2.86; 95%CI, 1.93-4.23]; >50% drop: 21.4% HR, 3.86; 95%CI, 2.21-6.74) and a bleeding risk of approximately 10% (10%-30% drop: 8.2%, HR, 1.34; 95%CI, 1.11-1.61; 30%-50% drop: 13.8%, HR, 2.01; 95%CI, 1.48-2.72; >50% drop: 32.1%; HR, 4.59; 95%CI, 3.01-6.99). Platelet count increases were associated with an incremental mortality risk of approximately 10% (10%-30% increase: 5.8%; HR, 1.87; 95%CI, 1.18-2.98; 30%-50% increase: 8.5%; HR, 2.61; 95%CI, 1.05-6.44; >50% increase: 9.7%; HR, 3.51; 95%CI, 1.10-11.22) but not with bleeding.</p><p><strong>Conclusion: </strong>In ACS patients, platelet count drops were associated with incremental risks of mortality and bleeding, whereas platelet count increases were associated with an incremental risk of mortality but not bleeding.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights from the SUN cohort on the association between psychological well-being and cardiovascular risk.","authors":"Virginia Basterra-Gortari, Carmen Sayón-Orea, Carmen de la Fuente-Arrillaga, Miguel Á Álvarez-Mon, Miguel Á Martínez-González, Maira Bes-Rastrollo","doi":"10.1016/j.rec.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.rec.2025.08.004","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden death due to pulmonary embolism in young adults in Spain. Retrospective multicenter study of 128 forensic autopsy cases.","authors":"Pilar Molina, Benito Morentin, Paloma Hevia, Ana Monzó, Joaquín S Lucena","doi":"10.1016/j.rec.2025.04.013","DOIUrl":"10.1016/j.rec.2025.04.013","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Pulmonary embolism (PE) may debut as sudden death (SD) in young and middle-aged adults. This study aims to determine the epidemiological and clinicopathological characteristics involved in SD due to PE in this age group and the underlying risk factors.</p><p><strong>Methods: </strong>Multicenter retrospective noncontrolled study based on forensic autopsies performed in individuals aged 12 to 49 years at 3 forensic pathology services in Spain (Valencia, Biscay, and Seville) over an 8-year period (2010-2017).</p><p><strong>Results: </strong>A total of 1344 cardiac SD cases were recorded, of which 128 (9.5%) were due to PE (57% male, median age 42 years). The annual incidence was 0.56/100 000 inhabitants/y. The main risk factor was obesity (62%; 18.5% morbid obesity). The mean body mass index was 34.9±13.1. Psychiatric disorders were highly prevalent (44%). Immobilization (26%) and prior trauma (11%) were other relevant antecedents. Among women, 22% were receiving oral contraceptive therapy. Premortem symptoms were reported in 52% of cases, mainly dyspnea (56%). Although 22 individuals sought medical attention, only one was correctly diagnosed. Toxicological analysis was performed in 67% of cases, with positive results for psychotropic drugs (20%) and substances of abuse/alcohol (9%).</p><p><strong>Conclusions: </strong>PE is a common cause of SD in individuals younger than 50 years and is frequently clinically underdiagnosed. This study provides evidence supporting a strong association with obesity and psychiatric disorders, which facilitate immobilization, venous stasis, and a prothrombotic state. Forensic studies of sudden death due to PE offer complementary data to clinical research, revealing risk factors that are underrepresented in clinical cohorts. .</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spanish cardiac catheterization and coronary intervention registry. 34^th official report of the Interventional Cardiology Association of the Spanish Society of Cardiology (1990-2024).","authors":"Teresa Bastante, Dabit Arzamendi, Javier Martín-Moreiras, Ana Belén Cid-Álvarez","doi":"10.1016/j.rec.2025.07.009","DOIUrl":"10.1016/j.rec.2025.07.009","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>This report presents the 2024 activity data from the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC).</p><p><strong>Methods: </strong>All interventional cardiology laboratories in Spain were invited to complete an online survey. Data analysis was conducted by an external company and then reviewed and presented by the ACI-SEC board.</p><p><strong>Results: </strong>A total of 118 hospitals participated, with a marked increase in the number of catheterization laboratories. The number of diagnostic procedures rose by 3.6%. Percutaneous coronary interventions (PCI) also increased. Although PCI volumes grew compared with 2023, the trend toward a reduction in the number of stents used was confirmed, with greater use of drug-coated balloons both as standalone treatment and in hybrid strategies (14.3% of PCIs involved drug-coated balloons). Overall, the use of intracoronary diagnostic techniques increased, with 10.6% of PCIs guided by intracoronary imaging. Plaque modification techniques also continued to grow. Primary PCI increased slightly and remained the predominant treatment for myocardial infarction (98%). Structural interventions continued to expand, with substantial growth in transcatheter aortic valve implantation, percutaneous edge-to-edge mitral repair, tricuspid interventions, and left atrial appendage closure. Interventional treatment for acute pulmonary embolism increased again in 2024, especially with dedicated devices.</p><p><strong>Conclusions: </strong>The 2024 Spanish cardiac catheterization and interventional cardiology registry showed overall growth in all procedures, both coronary and structural.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key messages on subclinical atrial fibrillation from the ARTESiA and NOAH trials.","authors":"Juan Benezet-Mazuecos, Jeff S Healey","doi":"10.1016/j.rec.2025.07.010","DOIUrl":"10.1016/j.rec.2025.07.010","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}