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Introduction: Tubular damage is common in glomerular diseases (GD). Glycosuria is a marker of tubular dysfunction and may be used to detect tubular lesion and CKD progression. The aim of this study was to evaluate the prevalence and prognostic value of glycosuria at the time of diagnosis in primary glomerulopathies (PG)., Methods: We conducted a 24-month retrospective study in patients diagnosed with PG in our center between 2009 and 2020. We excluded diabetic patients, use of SGLT2 inhibitors, transplant patients, and secondary GD. Patients were divided in two groups according to their glycosuria status at diagnosis., Results: We studied 115 patients. Global prevalence of glycosuria was 10% (n=11) and membranous nephropathy (MN) had the highest prevalence (n=5, 17.9%). We found that patients with glycosuria had higher serum creatinine (2.4 vs. 1.2 mg/dL, p=0.030), higher albuminuria (4.8 vs. 1.9 g/g, p=0.004), and lower serum albumin (2.3 vs. 3.2 g/dL, p=0.021). We did not find association with histological prognostic factors. At the end of follow-up, patients with glycosuria had higher prevalence of the composite outcome of stage 5D CKD or 50% increase in basal SCr (45.5% vs. 17.3%, p=0.037). In patients with MN, results were similar but we were able to find an association of glycosuria with more severe interstitial fibrosis and tubular atrophy (25.0 vs. 0.0 %, p=0.032)., Conclusion: Ten percent of our patients with PG have glycosuria. Glycosuria at the time of diagnosis was associated with more severe clinical presentation and worst renal outcome. The association with higher albuminuria suggests that tubular function has an impact on the severity and outcomes of PG.

Introduction: Today's healthcare policies rely heavily on data that has been gathered from multiple small studies in intrinsically varied populations. We sought to describe the prevalence, comorbidities and outcomes of atrial fibrillation (AF) in the population of a specific region where all healthcare centers have implemented a common information technology (IT) structure., Methods: The total number of inhabitants was obtained from the healthcare area's IT system. Information pertaining to AF was derived from various datasets in the data warehouse of the Galician regional health service., Results: In the healthcare area of Santiago de Compostela (n=383000), the diagnosis of AF was coded in 7990 (2.08%) individuals in 2013. Mean age was 76.83±10.5 years, mean CHA 2 DS 2 -VASc score was 3.5, 4056 (50.8%) were female and 72.6% were receiving oral anticoagulants. Up until December 31, 2015, 1361 patients died from all causes (17%), 478 (6%) of them in-hospital, with 30 deaths secondary to intracranial bleeding (0.4%) and 125 to stroke (1.6%). On multivariate analysis, age, gender, heart failure, diabetes, previous thromboembolic events and dementia were independently associated with all-cause mortality. Similarly, age, gender and previous thromboembolic events were associated with future thromboembolic events. Oral anticoagulation was found to be protective against mortality and thromboembolic events., Conclusions: In this study, we report for the first time the true prevalence of diagnosed AF and its clinical characteristics, treatment and prognosis in a Spanish healthcare area, based on the systematic integration of data available from a universally adopted health IT system within the region., (Copyright © 2019 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: An arteriovenous (AV) access flow (Qa) of 400 mL/min is usually sufficient for an effective hemodialysis (HD), but some accesses continue developing and become high flow accesses (HFA). Some authors postulated that an HFA might shift a significant portion of dialyzed blood from the cardiac output, which could decrease HD efficiency and lead to volume overload., Objective: The aim of our study was to evaluate if HFA is associated with reduced HD efficiency and/or volume overload in prevalent HD patients., Methods: We performed a 1-year retrospective study and assessed HD efficiency by the percentage of sessions in which the Kt/V > 1.4 and volume overload by bioimpedance spectroscopy., Results: The study included 304 prevalent HD patients with a mean age of 67.5 years; 62.5% were males, 36.2% were diabetics, with a median HD vintage of 48 months. Sixteen percent of the patients had a HFA (defined as Qa > 2 L/min). In multivariate analysis, patients with HFA presented higher risk of volume overload (OR = 2.67, 95%CI = 1.06-6.71) and severe volume overload (OR = 4.06, 95%CI = 1.01-16.39) and attained dry weight less frequently (OR = 0.37, 95%CI = 0.14-0.94). However, HFA was not associated with lower Kt/V., Conclusion: Our results suggest that patients with HFA have higher risk of volume overload. However, contrarily to what has been postulated, HFA was not associated with less efficient dialysis, measured by Kt/V. Randomized controlled trials are needed to clarify these questions.

Introduction and Objectives: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been shown to reduce mortality after myocardial infarction (MI). Current guidelines recommend their prescription in all patients after MI. Limited data are available on whether ACEIs/ARBs still improve prognosis in the contemporary era of non-ST elevation MI (NSTEMI) management. We aimed to evaluate the mortality benefit of ACEIs/ARBs in NSTEMI patients treated successfully with percutaneous coronary intervention (PCI)., Methods: We analyzed 2784 patients with NSTEMI treated successfully with in-hospital PCI. Two groups were formed based on ACEI/ARB prescription at discharge. Two propensity score (PS) analyses were performed to control for differences in covariates: one with adjustment among the entire cohort, and the other with PS matching (n=1626). The outcome variable was all-cause mortality at four-year follow-up., Results: There were 1902 (68.3%) patients prescribed ACEIs/ARBs at discharge. When adjusted by PS, ACEI/ARB use was associated with a hazard ratio (HR) for mortality of 0.75 (0.60-0.94; absolute risk reduction [ARR] 4.0%) in the whole cohort (p=0.01). After one-to-one PS matching (n=813 in each group), the mortality rate was significantly lower in patients prescribed ACEIs/ARBs, with HR of 0.77 (0.63-0.94; ARR 3.8%) (p=0.03)., Conclusions: In this observational study of patients with NSTEMI, all of them treated successfully by PCI, the use of ACEIs/ARBs was significantly associated with a lower risk of four-year all-cause mortality., (Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Study Objective: to characterize the high mortality rate by ischemic heart disease in Azores, by evaluating the main coronary heart disease risk factors prevalence in the population., Design: sample study referring the population of 5 islands: 37 counties. Aleatory choose in the electoral lists., Setting: the selected individuals were convocated by mail to show up at the Hospital for evaluation., Patients: 1089 individuals selected by aleatory choose from the electoral lists., Interventions: the sample was stratified regarding rural (R) and urban (U), by sex feminine (F) and masculine (M), age 20-40 and 40 to 60 years old. All of them were determined three values of blood pressure, and was taken for exact value the medium of the three, inquired the smoking habits and serum lipids were determined. We considered risk factors (RF); blood pressure > 140/90 mmHg, total cholesterol > 200 mg/dl, HDL cholesterol < 35 mg/dl, triglycerides > 180 mg/dl and smoking habits were stratified in three scores: 1: 1-10, 2: 11-20, and 3: more than 20 cigarettes a day., Main Results: total prevalences; HBP 20.4%, smoking habits 33%, total hypercholesterolemia 47.3%, low HDL cholesterol 17.4% and triglycerides 30.5%., Conclusions: the values found for total cholesterol, triglycerides and smoking habits were high and superior to the national medium and to those found in reference studies. Preventive strategies are pointed out.

Study Objective: to determine the existence of circadian variability (CV) of single ventricular premature beats (VPBs) and study its relationship with the heart rate variation; to compare sub-groups of patients (Pts) with and without antiarrhythmic therapy and with ischemic cardiopathy versus a free structural cardiopathy group., Design: retrospective study., Patients and Methods: the CV of VPBs was analyzed by Holter monitoring in 147 Pts, 93 male and 54 female with a mean age of 59 +/- 14.6. Seventy seven Pts were not taking antiarrhythmic drugs while 70 were doing it: Amiodarone 23, Propafenone 30, B-Blockers 9, Quinidine and Disopyramide 7, Flecainide 1. Sixty five Pts had ischemic cardiopathy and 37 were free of any structural abnormality. The selection criteria consisted in: 1--more than 100 VPBs/24h; 2--distribution over more than 12 hours; 3--absence of any hour with more than 35% of the total VPBs in the recording. Data were presented in a percentage form and the results evaluation was made by using single and two-harmonic regression models., Main Results: a CV was found to the single VPBs, with minimum values during the nocturnal period and maximum values in the morning, with a significant adjustment to the two-harmonic regression model, defined by the equation y = 4.2 - Q,559 sen (2 pi T/24) - 0.604 cos (2 pi T/24) - 0.417 sen (4 pi T/24) + 0,272 cos (4 pi T/24) (p < 0.001). A strong positive correlation was observed between VPBs and heart rate variability (r = 0.95; p < 0.001). The sub-groups of Pts, whether taking antiarrhythmic drugs or not, also showed a CV with a statistically significant two-harmonic regression pattern, with a major morning increase of VPBs in the antiarrhythmic group. The free structural cardiopathy sub-group displayed a best adjustment to the single harmonic regression model while the ischemic group exhibited a two-harmonic regression pattern., Conclusions: a significant circadian variability of VPBs with a bi-modality expression was determined. The majority of the analyzed sub-groups showed the same kind of variation. A strong positive correlation with the heart rate variability was observed.