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54. Anticoagulantes orales directos frente a antagonistas de la vitamina K en pacientes del «mundo real» con fibrilación auricular no valvular. Estudio FANTASIIA

Author

Anguita Sánchez, Manuel, primary, Bertomeu Martínez, Vicente, additional, Ruiz Ortiz, Martín, additional, Cequier Fillat, Ángel, additional, Roldán Rabadán, Inmaculada, additional, Muñiz García, Javier, additional, Badimón Maestro, Lina, additional, Esteve Pastor, María Asunción, additional, and Marín Ortuño, Francisco, additional

Published
2020
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55. Direct oral anticoagulants versus vitamin K antagonists in real-world patients with nonvalvular atrial fibrillation. The FANTASIIA study

Author

Anguita Sánchez, Manuel, primary, Bertomeu Martínez, Vicente, additional, Ruiz Ortiz, Martín, additional, Cequier Fillat, Ángel, additional, Roldán Rabadán, Inmaculada, additional, Muñiz García, Javier, additional, Badimón Maestro, Lina, additional, Esteve Pastor, María Asunción, additional, and Marín Ortuño, Francisco, additional

Published
2020
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61. La diabetes mellitus en la práctica de la cardiología en España. Encuesta del Grupo de Trabajo de Corazón y Diabetes sobre la importancia de la diabetes mellitus en relación con las enfermedades cardiovasculares

Author

Palma Gámiz, José L., Hernández Madrid, Antonio, Bertomeu Martínez, Vicente, González-Juanatey, José R., García-Aranda, Víctor López, Calderón Montero, Alberto, Alegría Ezquerra, Eduardo, and Cadierno Carpintero, Moisés

Published
2004
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63. Direct oral anticoagulants versus vitamin K antagonists in real-world patients with nonvalvular atrial fibrillation: the FANTASIIA study

Author

Anguita-Sánchez, Manuel, Bertomeu-Martínez, Vicente, Ruiz-Ortiz, Martín, Cequier, Ángel, Roldán-Rabadán, Inmaculada, Muñiz, Javier, Badimón, Lina, Esteve-Pastor, María Asunción, Marín Ortuño, Francisco, Anguita-Sánchez, Manuel, Bertomeu-Martínez, Vicente, Ruiz-Ortiz, Martín, Cequier, Ángel, Roldán-Rabadán, Inmaculada, Muñiz, Javier, Badimón, Lina, Esteve-Pastor, María Asunción, and Marín Ortuño, Francisco

Abstract

[Abstract] Introduction and objectives: To compare the long-term results of direct oral anticoagulants (DOAC) vs vitamin K antagonists (VKA) in real-world-patients with nonvalvular atrial fibrillation (NVAF) in a nationwide, prospective study. Methods: The FANTASIIA registry prospectively included outpatients with AF anticoagulated with DOAC or VKA (per protocol, proportion of VKA and DOAC 4:1), consecutively recruited from June 2013 to October 2014 in Spain. The incidence of major events was analyzed and compared according to the anticoagulant treatment received. Results: A total of 2178 patients were included in the study (mean age 73.8±9.4 years), and 43.8% were women. Of these, 533 (24.5%) received DOAC and 1645 (75.5%) VKA. After a median follow up of 32.4 months, patients receiving DOAC vs those receiving VKA had lower rates of stroke-0.40 (95%CI, 0.17-0.97) vs 1.07 (95%CI,0.79-1.46) patients/y, P=.032-, severe bleedings-2.13 (95%CI, 1.45-3.13) vs 3.28 (95%CI, 2.75-3.93) patients/y; P = .044-, cardiovascular death-1.20 (95%CI, 0.72-1.99) vs 2.45 (95%CI, 2.00-3.00) patients/y; P = .009-, and all-cause death-3.77 (95%CI, 2.83-5.01) vs 5.54 (95%CI, 4.83-6.34) patients/y; P = .016-. In a modified Cox regression model by the Andersen-Gill method for multiple events, hazard ratios for patients receiving DOAC were: 0.42 (0.16-1.07) for stroke; 0.47 (0.20-1.16) for total embolisms; 0.76 (0.50-1.15) for severe bleedings; 0.67 (0.39-1.18) for cardiovascular death; 0.86 (0.62-1.19) for all-cause death, and 0.82 (0.64-1.05) for the combined event consisting of stroke, embolism, severe bleeding, and all-cause death. Conclusions: Compared with VKA, DOAC is associated with a trend to a lower incidence of all major events, including death, in patients with NVAF in Spain., [Resumen] Introducción y objetivos. Comparar los resultados a largo plazo de los anticoagulantes orales directos (ACOD) frente a los antagonistas de la vitamina K (AVK) en pacientes del mundo real con fibrilación auricular no valvular (FANV) en un estudio nacional prospectivo. Métodos. El estudio FANTASIIA incluyó consecutivamente a pacientes ambulatorios con FANV anticoagulados con ACOD o AVK desde junio de 2013 hasta octubre de 2014. Se compararon las tasas de eventos según el anticoagulante administrado. Resultados. Se incluyó a 2.178 pacientes (edad, 73,8 ± 9,4 años; el 43,8% mujeres); de ellos, 533 (24,5%) recibían ACOD y 1.645 (75,5%), AVK. Tras una mediana de seguimiento de 32,4 meses, los pacientes con ACOD tuvieron tasas más bajas de ictus —0,40 (IC95%, 0,17-0,97) frente a 1,07 (IC95%, 0,79-1,46) pacientes/año; p = 0,032—, hemorragias mayores —2,13 (IC95%, 1,45-3,13) frente a 3,28 (IC95%, 2,75-3,93) pacientes/año; p = 0,044—, muerte cardiovascular —1,20 (IC95%, 0,72-1,99) frente a 2,45 (IC95%, 2,00-3,00) pacientes/año; p = 0,009— y muerte total —3,77 (IC95%, 2,83-5,01) frente a 5,54 (IC95%, 4,83-6,34) pacientes/año; p = 0,016—. En el análisis de Cox modificado según el método de Andersen-Gill para datos con múltiples eventos, las razones de riesgos instantáneos para los pacientes con ACOD fueron 0,42 (0,16-1,07) para el ictus; 0,47 (0,20-1,16) para la embolia sistémica en general; 0,76 (0,50-1,15) para las hemorragias mayores; 0,67 (0,39-1,18) para la muerte cardiovascular; 0,86 (0,62-1,19) para la mortalidad total y 0,82 (0,64-1,05) para el combinado de ictus, embolias, hemorragias mayores y muerte. Conclusiones. El tratamiento con ACOD se asocia con una tendencia a una menor tasa de todos los eventos graves, incluida la mortalidad, en relación con los AVK en pacientes con FANV en España.

Published
2019

64. Association of body mass index with clinical outcomes in patients with atrial fibrillation: a report from the FANTASIIA Registry

Author

Bertomeu-González, Vicente, Moreno-Arribas, José, Esteve-Pastor, María Asunción, Roldán Rabadán, Inmaculada, Muñiz, Javier, Raña-Míguez, Paula, Ruiz Ortiz, Martín, Cequier, Ángel, Bertomeu-Martínez, Vicente, Badimón, Lina, Anguita, Manuel, Lip, Gregory, Marín, Francisco, Bertomeu-González, Vicente, Moreno-Arribas, José, Esteve-Pastor, María Asunción, Roldán Rabadán, Inmaculada, Muñiz, Javier, Raña-Míguez, Paula, Ruiz Ortiz, Martín, Cequier, Ángel, Bertomeu-Martínez, Vicente, Badimón, Lina, Anguita, Manuel, Lip, Gregory, and Marín, Francisco

Abstract

[Abstract] Background. Obesity and atrial fibrillation (AF) frequently coexist and independently increase mortality. We sought to assess the association between obesity and adverse events in patients receiving oral anticoagulants for AF. Methods and Results. Consecutive AF outpatients receiving anticoagulant agents (both vitamin K antagonists and direct oral anticoagulants) were recruited into the FANTASIIA (Atrial fibrillation: influence of the level and type of anticoagulation on the incidence of ischemic and hemorrhagic stroke) registry. This observational, multicenter, and prospective registry of AF patients analyzes the quality of anticoagulation, incidence of events, and differences between oral anticoagulant therapies. We analyzed baseline patient characteristics according to body mass index, normal: <25 kg/m2, overweight: 25–30 kg/m2, and obese: ≥30 kg/m2), assessing all‐cause mortality, stroke, major bleeding and major adverse cardiovascular events (a composite of ischemic stroke, myocardial infarction, and total mortality) at 3 years’ follow‐up. In this secondary prespecified substudy, the association of weight on prognosis was evaluated. We recruited 1956 patients (56% men, mean age 73.8±9.4 years): 358 (18.3%) had normal body mass index, 871 (44.5%) were overweight, and 727 (37.2%) were obese. Obese patients were younger (P<0.01) and had more comorbidities. Mean time in the therapeutic range was similar across body mass index categories (P=0.42). After a median follow‐up of 1070 days, 255 patients died (13%), 45 had a stroke (2.3%), 146 a major bleeding episode (7.5%) and 168 a major adverse cardiovascular event (8.6%). Event rates were similar between groups for total mortality (P=0.29), stroke (P=0.90), major bleeding (P=0.31), and major adverse cardiovascular events (P=0.24). On multivariate Cox analysis, body mass index was not independently associated with all‐cause mortality, cardiovascular mortality, stroke, major bleeding, or major adverse cardio

Published
2019

65. Valor del nivel de NTproBNP en población adulta extrahospitalaria

Author

Cosín Aguilar, Juan, Hernándiz Martínez, Amparo, Luis Díez Gil, José, Capdevila Carbonell, Carmen, Salvador Sanz, Antonio, Luis Diago Torrent, José, Rivera Otero, Miguel, Payá Serrano, Rafael, Bertomeu Martínez, Vicente, Sogorb Garri, Francisco, Jordán Torrent, Alejandro, Mainar Latorre, Luis, Grau Jornet, Guillermo, Martí Llinares, Segundo, and Miró Palau, Vicente

Published
2003
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66. Wytyczne ESC/ESH dotyczące postępowania w nadciśnieniu tętniczym (2018)

Author

Williams, Bryan, Mancia, Giuseppe, Spiering, Wilko, Agabiti Rosei, Enrico, Azizi, Michel, Burnier, Michel, Clement, Denis L, Coca, Antonio, de Simone, Giovanni, Dominiczak, Anna, Kahan, Thomas, Mahfoud, Felix, Redon, Josep, Ruilope, Luis, Zanchetti, Alberto, Kerins, Mary, Kjeldsen, Sverre E, Kreutz, Reinhold, Laurent, Stephane, Lip, Gregory Y H, McManus, Richard, Narkiewicz, Krzysztof, Ruschitzka, Frank, Schmieder, Roland E, Shlyakhto, Evgeny, Tsioufis, Costas, Aboyans, Victor, Desormais, Ileana, De Backer, Guy, Heagerty, Anthony M, Agewall, Stefan, Bochud, Murielle, Borghi, Claudio, Boutouyrie, Pierre, Brguljan, Jana, Bueno, Héctor, Caiani, Enrico G, Carlberg, Bo, Chapman, Neil, Cífková, Renata, Cleland, John G F, Collet, Jean-Philippe, Coman, Ioan Mircea, de Leeuw, Peter W, Delgado, Victoria, Dendale, Paul, Diener, Hans-Christoph, Dorobantu, Maria, Fagard, Robert, Farsang, Csaba, Ferrini, Marc, Graham, Ian M, Grassi, Guido, Haller, Hermann, Hobbs, F D Richard, Jelakovic, Bojan, Jennings, Catriona, Katus, Hugo A, Kroon, Abraham A, Leclercq, Christophe, Lovic, Dragan, Lurbe, Empar, Manolis, Athanasios J, McDonagh, Theresa A, Messerli, Franz, Muiesan, Maria Lorenza, Nixdorff, Uwe, Olsen, Michael Hecht, Parati, Gianfranco, Perk, Joep, Piepoli, Massimo Francesco, Polonia, Jorge, Ponikowski, Piotr, Richter, Dimitrios J, Rimoldi, Stefano F, Roffi, Marco, Sattar, Naveed, Seferovic, Petar M, Simpson, Iain A, Sousa-Uva, Miguel, Stanton, Alice V, van de Borne, Philippe, Vardas, Panos, Volpe, Massimo, Wassmann, Sven, Windecker, Stephan, Zamorano, Jose Luis, Barbato, Emanuele, Dean, Veronica, Fitzsimons, Donna, Gaemperli, Oliver, Hindricks, Gerhard, Iung, Bernard, Jüni, Peter, Knuuti, Juhani, Lancellotti, Patrizio, Rosei, Enrico Agabiti, Januszewics, Andrzej, Manolis, Athanasios, Benkhedda, Salim, Zelveian, Parounak, Siostrzonek, Peter, Najafov, Ruslan, Pavlova, Olga, De Pauw, Michel, Dizdarevic-Hudic, Larisa, Raev, Dimitar, Karpettas, Nikos, Linhart, Aleš, Shaker, Amin Fouad, Viigimaa, Margus, Metsärinne, Kaj, Vavlukis, Marija, Halimi, Jean-Michel, Pagava, Zurab, Schunkert, Heribert, Thomopoulos, Costas, Páll, Dénes, Andersen, Karl, Shechter, Michael, Mercuro, Giuseppe, Bajraktari, Gani, Romanova, Tatiana, Trušinskis, Kārlis, Saade, Georges A, Sakalyte, Gintare, Noppe, Stéphanie, DeMarco, Daniela Cassar, Caraus, Alexandru, Wittekoek, Janneke, Aksnes, Tonje Amb, Jankowski, Piotr, Vinereanu, Dragos, Baranova, Elena I, Foscoli, Marina, Dikic, Ana Djordjevic, Filipova, Slavomira, Fras, Zlatko, Bertomeu-Martínez, Vicente, Burkard, Thilo, Sdiri, Wissem, Aydogdu, Sinan, Sirenko, Yuriy, Brady, Adrian, Weber, Thomas, Lazareva, Irina, Backer, Tine De, Sokolovic, Sekib, Widimsky, Jiri, Pörsti, Ilkka, Denolle, Thierry, Krämer, Bernhard K, Stergiou, George S, Miglinas, Marius, Gerdts, Eva, Tykarski, Andrzej, de Carvalho Rodrigues, Manuel, Chazova, Irina, Segura, Julian, Gottsäter, Anders, Pechère-Bertschi, Antoinette, Erdine, Serap, Williams, Bryan, Mancia, Giuseppe, Spiering, Wilko, Rosei, Enrico Agabiti, Azizi, Michel, Burnier, Michel, Clement, Denis L., Coca, Antonio, De Simone, Giovanni, Dominiczak, Anna, Kahan, Thoma, Mahfoud, Felix, Redon, Josep, Ruilope, Lui, Zanchetti, Alberto, Kerins, Mary, Kjeldsen, Sverre E., Kreutz, Reinhold, Laurent, Stephane, Lip, Gregory Y. H., Mcmanus, Richard, Narkiewicz, Krzysztof, Ruschitzka, Frank, Schmieder, Roland E., Shlyakhto, Evgeny, Tsioufis, Costa, Aboyans, Victor, Desormais, Ileana, De Backer, Guy, Heagerty, Anthony M., Agewall, Stefan, Bochud, Murielle, Borghi, Claudio, Boutouyrie, Pierre, Brguljan, Jana, Bueno, Héctor, Caiani, Enrico G., Carlberg, Bo, Chapman, Neil, Cífková, Renata, Cleland, John G. F., Collet, Jean-Philippe, Coman, Ioan Mircea, De Leeuw, Peter W., Delgado, Victoria, Dendale, Paul, Diener, Hans-Christoph, Dorobantu, Maria, Fagard, Robert, Farsang, Csaba, Ferrini, Marc, Graham, Ian M., Grassi, Guido, Haller, Hermann, Hobbs, F. D. Richard, Jelakovic, Bojan, Jennings, Catriona, Katus, Hugo A., Kroon, Abraham A., Leclercq, Christophe, Lovic, Dragan, Lurbe, Empar, Manolis, Athanasios J., Mcdonagh, Theresa A., Messerli, Franz, Muiesan, Maria Lorenza, Nixdorff, Uwe, Olsen, Michael Hecht, Parati, Gianfranco, Perk, Joep, Piepoli, Massimo Francesco, Polonia, Jorge, Ponikowski, Piotr, Richter, Dimitrios J., Rimoldi, Stefano F., Roffi, Marco, Sattar, Naveed, Seferovic, Petar M., Simpson, Iain A., Sousa-Uva, Miguel, Stanton, Alice V., Van De Borne, Philippe, Vardas, Pano, Volpe, Massimo, Wassmann, Sven, Windecker, Stephan, Zamorano, Jose Luis, University College of London [London] (UCL), University College London Hospitals (UCLH), Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), CIC - HEGP (CIC 1418), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université de Lausanne = University of Lausanne (UNIL), Institut de Mathématiques de Marseille (I2M), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU), BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Danderyds sjukhus = Danderyd University Hospital, Universitätsklinikum des Saarlandes, Universitat de València (UV), Hospital 12 de Octubre, Oslo University Hospital [Oslo], Clinical Pharmacology, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), University of Liverpool, Aalborg University [Denmark] (AAU), Nuffield Department of Primary Care Health Sciences, University of Oxford, University of Oxford, Medical University of Gdańsk, University Heart Centre Freiburg - Bad Krozingen, Med Klinik IV, Univ.-Klinik Erlangen-Nürnberg, Almazov National Medical Research Centre (St. Petersburg), National and Kapodistrian University of Athens (NKUA), Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie [CHU Limoges], CHU Limoges, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], Agabiti Rosei, Enrico, Clement, Denis L, de Simone, Giovanni, Kjeldsen, Sverre E, Lip, Gregory Y H, McManus, Richard, Schmieder, Roland E, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet [Stockholm], Chercheur indépendant, Department of Cardiology, Birmingham City Hospital, Department of Public Health, University of Gent, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano [Milan] (POLIMI), 2nd Department of Internal Medicine, Hasselt University (UHasselt), Universität Duisburg-Essen [Essen], Australian Museum, Australian Museum [Sydney], Division of Nephrology and Hypertension, Department of Medicine, Hanover Medical School, Department of Earth Science, Durham University, School of Health and Caring Sciences, Linnaeus University, Department of Pathological Biochemistry, Royal Infirmary, Karolinska Institute, karolinska institute, 'Federico II' University of Naples Medical School, Hospital General Universitario 'Gregorio Marañón' [Madrid], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CHU de Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), St. Michael's Hospital, Heidelberg University Hospital [Heidelberg], Turku PET Centre, University of Turku, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, Wroclaw Medical University, Servicio de Pediatría, Consorcio Hospital General Universitario de Valencia, Institute of Social and Preventive Medicine, Lausanne university hospital, Department of Internal Medicine, Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO)-Aging and Clinical Nephrology, Food Science and Technology, Université Francois Rabelais [Tours], Medizinische Klinik II, Universität zu Lübeck [Lübeck], Warsaw University of Technology [Warsaw], Cardiology, University and Emergency Hospital, IRCELYON-Catalytic and Atmospheric Reactivity for the Environment (CARE), Institut de recherches sur la catalyse et l'environnement de Lyon (IRCELYON), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), University of Sheffield [Sheffield], Faculty of metals engineering and industrial computer science, Centre of Cardiology, North Estonia Medical Centre, Medical School, University of Tampere [Finland], Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], IRCCS Istituto Auxologico Italiano, University of Zurich, Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Charité - Universitätsmedizin Berlin / Charite - University Medicine Berlin, Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hasselt University, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], Università di Bologna [Bologna] (UNIBO)-Aging and Clinical Nephrology, Universität zu Lübeck [Lübeck] - University of Lübeck [Lübeck], IRCELYON-Caractérisation et remédiation des polluants dans l'air et l'eau (CARE), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie et maladies vasculaires [CHU de Rennes], Diener, Hans Christoph (Beitragende*r), Williams, B, Mancia, G, Spiering, W, Agabiti Rosei, E, Azizi, M, Burnier, M, Clement, D, Coca, A, de Simone, G, Dominiczak, A, Kahan, T, Mahfoud, F, Redon, J, Ruilope, L, Zanchetti, A, Kerins, M, Kjeldsen, S, Kreutz, R, Laurent, S, Lip, G, Mcmanus, R, Narkiewicz, K, Ruschitzka, F, Schmieder, R, Shlyakhto, E, Tsioufis, C, Aboyans, V, Desormais, I, and Grassi, G

Subjects
Male, Lifestyle intervention, [SDV]Life Sciences [q-bio], Medizin, Secondary hypertension, 030204 cardiovascular system & hematology, Guideline, Hypertension-mediated organ damage, Blood pressure treatment thresholds and targets, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Disease management (health), 610 Medicine & health, Lifestyle interventions, Societies, Medical, ComputingMilieux_MISCELLANEOUS, Disease Management, Blood pressure, Blood pressure measurement, Combination therapy, Device therapy, Drug therapy, Guidelines, Hypertension, Cardiology and Cardiovascular Medicine, Europe, Arterial hypertension, blood pressure control, guidelines, 10209 Clinic for Cardiology, Female, medicine.medical_specialty, Blood pressure treatment thresholds and target, MEDLINE, Cardiology, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, Pharmacotherapy, Blood pressure treatmentthresholds and targets, Journal Article, Humans, Hypertension diagnosis, Intensive care medicine, Antihypertensive Agents, business.industry, medicine.disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

International audience; : Document reviewers: Guy De Backer (ESC Review Co-ordinator) (Belgium), Anthony M. Heagerty (ESH Review Co-ordinator) (UK), Stefan Agewall (Norway), Murielle Bochud (Switzerland), Claudio Borghi (Italy), Pierre Boutouyrie (France), Jana Brguljan (Slovenia), Héctor Bueno (Spain), Enrico G. Caiani (Italy), Bo Carlberg (Sweden), Neil Chapman (UK), Renata Cifkova (Czech Republic), John G. F. Cleland (UK), Jean-Philippe Collet (France), Ioan Mircea Coman (Romania), Peter W. de Leeuw (The Netherlands), Victoria Delgado (The Netherlands), Paul Dendale (Belgium), Hans-Christoph Diener (Germany), Maria Dorobantu (Romania), Robert Fagard (Belgium), Csaba Farsang (Hungary), Marc Ferrini (France), Ian M. Graham (Ireland), Guido Grassi (Italy), Hermann Haller (Germany), F. D. Richard Hobbs (UK), Bojan Jelakovic (Croatia), Catriona Jennings (UK), Hugo A. Katus (Germany), Abraham A. Kroon (The Netherlands), Christophe Leclercq (France), Dragan Lovic (Serbia), Empar Lurbe (Spain), Athanasios J. Manolis (Greece), Theresa A. McDonagh (UK), Franz Messerli (Switzerland), Maria Lorenza Muiesan (Italy), Uwe Nixdorff (Germany), Michael Hecht Olsen (Denmark), Gianfranco Parati (Italy), Joep Perk (Sweden), Massimo Francesco Piepoli (Italy), Jorge Polonia (Portugal), Piotr Ponikowski (Poland), Dimitrios J. Richter (Greece), Stefano F. Rimoldi (Switzerland), Marco Roffi (Switzerland), Naveed Sattar (UK), Petar M. Seferovic (Serbia), Iain A. Simpson (UK), Miguel Sousa-Uva (Portugal), Alice V. Stanton (Ireland), Philippe van de Borne (Belgium), Panos Vardas (Greece), Massimo Volpe (Italy), Sven Wassmann (Germany), Stephan Windecker (Switzerland), Jose Luis Zamorano (Spain).The disclosure forms of all experts involved in the development of these Guidelines are available on the ESC website www.escardio.org/guidelines.

Published
2018

72. Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry.

Author

Bertomeu‐Gonzalez, Vicente, Moreno‐Arribas, José, Esteve‐Pastor, María Asunción, Roldán‐Rabadán, Inmaculada, Muñiz, Javier, Otero García, Déborah, Ruiz‐Ortiz, Martín, Cequier, Ángel, Bertomeu‐Martínez, Vicente, Badimón, Lina, Anguita, Manuel, Lip, Gregory Y. H., and Marín, Francisco

Subjects
PERIPHERAL vascular diseases, ATRIAL fibrillation, TREATMENT effectiveness, CARDIOVASCULAR diseases risk factors, REGRESSION analysis, MYOCARDIAL infarction
Abstract

Background: Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real‐world patients receiving oral anticoagulant therapy for nonvalvular AF. Methods: We prospectively included 1956 patients (mean age 73.8 ± 9.5 years, 44.0% women) receiving oral anticoagulant therapy for AF. Clinical characteristics were collected at baseline. Patients were followed for a period of 3 years. Survival analysis and multivariable regression analyses were performed to assess variables related to death, stroke, bleeding, myocardial infarction and major adverse cardiovascular events (MACE). Results: Patients with PAD (n = 118; 6%) exhibited higher rates of cardiovascular risk factors and cardiovascular diseases. After 3 years of follow‐up, there were a total of 255 deaths (no PAD 233, vs PAD 22), 45 strokes (43 vs 2), 146 major bleedings (136 vs 10) and 168 MACE (148 vs 20). On univariate analysis, there was a higher risk of cardiovascular mortality (2.02%/year no PAD vs 4.08%/year PAD, P =.02), myocardial infarction (0.99%/year no PAD vs 2.43%/year PAD, P =.02) and MACE (3.18%/year no PAD vs 6.99%/year PAD, P <.01). There was no statistically significant association with these events after multivariable adjustment. Conclusions: In a large cohort of anticoagulated patients with AF, the presence of PAD represents a higher risk subgroup and is associated with worse crude outcomes. The exact contribution of the PAD independently of other cardiovascular diseases or risk factors requires further investigation. [ABSTRACT FROM AUTHOR]

Published
2021
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73. Clinical effectiveness of a cardiology outpatient management plan to reduce inefficiency in consultations.

Author

González-Llopis, Francisco, Palazón-Bru, Antonio, Mares-García, Emma, Carbonell-Torregrosa, María De Los Ángeles, Bertomeu-Martínez, Vicente, and Gil-Guillén, Vicente Francisco

Subjects
CARDIOLOGY, DIAGNOSIS, OUTPATIENT medical care
Abstract

Objectives: Longer delays in carrying out complementary tests in cardiology services have resulted in patients arriving for consultation without these tests being performed (inefficient consultations). To ameliorate this situation, a management-based intervention was designed, optimizing the available resources and modifying the appointment system. Therefore, our objective was to determine the effectiveness of this intervention to reduce the number of inefficient consultations and improve the clinical care process. Methods: A non-randomized experimental study comparing two periods (pre- and post-intervention) was designed, analyzing a total of 473 outpatients attending cardiology consultations in a Spanish region in February 2014 (pre-intervention) and 441 patients attending cardiology consultations in November 2014 (post-intervention). The outcome of management measures aimed at optimizing coordination in outpatient care to reduce inefficient consultations was analyzed. After the visit, treatment modifications, requests for new examinations or tests, outpatient discharges, and new diagnoses were evaluated. Results: In the pre-intervention period, 37.2% of the patients had not had the tests performed, while in the post-intervention period, this figure dropped to 10.7% (p < 0.001). When the patients had all the tests completed, there was an increase in the number of new examinations (p < 0.001), outpatient discharges (p < 0.001) and new diagnoses (p = 0.004). Treatment modifications were not significant (p = 0.223). Conclusions: The intervention proved effective, clinically relevant, and statistically significant in reducing the proportion of inefficient consultations, thereby enabling continuation of the clinical care process. [ABSTRACT FROM AUTHOR]

Published
2021
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74. Differences in the Characteristics and Management of Patients With Atrial Fibrillation Followed-up by Cardiologists and Other Specialists

Author

Carnero Montoro, Lucía, Roldán Rabadán, Inmaculada, Marín Ortuño, Francisco, Bertomeu Martínez, Vicente, Muñiz García, Javier, Anguita Sánchez, Manuel, and FANTASIIA study investigators

Subjects
Adult, Male, medicine.medical_specialty, Decision Making, MEDLINE, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Cardiologists, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, Disease management (health), Intensive care medicine, Aged, business.industry, Follow up studies, Disease Management, Atrial fibrillation, General Medicine, Middle Aged, medicine.disease, Spain, Female, business, Follow-Up Studies
Published
2017

75. Association of Body Mass Index With Clinical Outcomes in Patients With Atrial Fibrillation: A Report From the FANTASIIA Registry.

Author

Bertomeu-Gonzalez, Vicente, Moreno-Arribas, José, Asunción Esteve-Pastor, María, Roldàn-Rabadàn, Inmaculada, Muñiz, Javier, Raña-Mígue, Paula, Ruiz-Ortiz, Martín, Cequier, Angel, Bertomeu-Martínez, Vicente, Badimón, Lina, Anguita, Manuel, Lip, Gregory Y. H., Marín, Francisco, Esteve-Pastor, María Asunción, Roldán-Rabadán, Inmaculada, Raña-Míguez, Paula, Cequier, Ángel, and FANTASIIA Study Investigators

Published
2020
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79. Prevalencia e incidencia tras el alta hospitalaria de neoplasias en pacientes con síndrome coronario agudo

Author

Cordero, Alberto, primary, López-Palop, Ramón, additional, Carrillo, Pilar, additional, Núñez, Julio, additional, Frutos, Araceli, additional, Bertomeu-González, Vicente, additional, Yépez, Fernando, additional, Alcantara, Nina, additional, Ribes, Francisco, additional, Juskova, Mària, additional, and Bertomeu-Martínez, Vicente, additional

Published
2018
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82. Estrategias diuréticas en insuficiencia cardiaca aguda con disfunción renal: terapia convencional frente a guiada por el antígeno carbohidrato 125. Diseño de ensayo clínico

Author

García-Blas, Sergio, primary, Bonanad, Clara, additional, Llàcer, Pau, additional, Ventura, Silvia, additional, Núñez, José María, additional, Sánchez, Ruth, additional, Chamorro, Carlos, additional, Fácila, Lorenzo, additional, de la Espriella, Rafael, additional, Vaquer, Juana María, additional, Cordero, Alberto, additional, Roqué, Mercè, additional, Ortiz, Víctor, additional, Racugno, Paolo, additional, Bodí, Vicent, additional, Valero, Ernesto, additional, Santas, Enrique, additional, Moreno, María del Carmen, additional, Miñana, Gema, additional, Carratalá, Arturo, additional, Bondanza, Lourdes, additional, Payá, Ana, additional, Cardells, Ingrid, additional, Heredia, Raquel, additional, Pellicer, Mauricio, additional, Valls, Guillermo, additional, Palau, Patricia, additional, Bosch, María José, additional, Raso, Rafael, additional, Sánchez, Andrés, additional, Bertomeu-González, Vicente, additional, Bertomeu-Martínez, Vicente, additional, Montagud-Balaguer, Vicente, additional, Albiach-Montañana, Cristina, additional, Pendás-Meneau, Jezabel, additional, Marcaida, Goitzane, additional, Cervantes-García, Sonia, additional, San Antonio, Rodolfo, additional, de Mingo, Elisabet, additional, Chorro, Francisco J., additional, Sanchis, Juan, additional, and Núñez, Julio, additional

Published
2017
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85. Proyecto RECALCAR. La atención al paciente en las unidades de cardiología del Sistema Nacional de Salud, 2011-2014

Author

Íñiguez Romo, Andrés, primary, Bertomeu Martínez, Vicente, additional, Rodríguez Padial, Luis, additional, Anguita Sánchez, Manuel, additional, Ruiz Mateas, Francisco, additional, Hidalgo Urbano, Rafael, additional, Bernal Sobrino, José Luis, additional, Fernández Pérez, Cristina, additional, Macaya de Miguel, Carlos, additional, and Elola Somoza, Francisco Javier, additional

Published
2017
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87. Choice of New Oral Anticoagulant Agents Versus Vitamin K Antagonists in Atrial Fibrillation: FANTASIIA Study

Author

Moreno-Arribas, José, Bertomeu-González, Vicente, Anguita-Sanchez, Manuel, Cequier, Ángel, Muñiz, Javier, Castillo, Jesús, Sanchis, Juan, Roldán, Inmaculada, Marín, Francisco, Bertomeu-Martínez, Vicente, and investigators of the FANTASIIA study

Subjects
Male, Vitamin K, Clinical Decision-Making, MEDLINE, Administration, Oral, Hemorrhage, 030204 cardiovascular system & hematology, Vitamin k, anticoagulant treatment, 03 medical and health sciences, 0302 clinical medicine, Clinical decision making, Fibrinolytic Agents, Atrial Fibrillation, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Aged, Pharmacology, Aged, 80 and over, business.industry, nonvitamin K antagonist oral anticoagulants, Anticoagulants, Atrial fibrillation, Middle Aged, medicine.disease, vitamin K antagonists, Increased risk, Anticoagulant therapy, Anesthesia, Oral anticoagulant, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction: Atrial fibrillation (AF) is associated with an increased risk of thromboembolic events. Many patients with AF receive chronic anticoagulation, either with vitamin K antagonists (VKAs) or with non-VKA oral anticoagulants (NOACs). We sought to analyze variables associated with prescription of NOAC. Methods: Patients with AF under anticoagulation treatment were prospectively recruited in this observational registry. The sample comprised 1290 patients under chronic anticoagulation for AF, 994 received VKA (77.1%) and 296 NOAC (22.9%). Univariate and multivariate analyses were performed to identify variables associated with use of NOAC. Results: Mean age was 73.8 ± 9.4 years, and 42.5% of the patients were women. The CHA2DS2-VASc score was 0 in 4.9% of the population, 1 in 24.1%, and ≥2 in 71% (median = 4, interquartile range = 2). Variables associated with NOAC treatment were major bleeding (odds ratio [OR] = 3.36; confidence interval [CI] 95%: 1.73-6.51; P < .001), hemorrhagic stroke (OR = 3.19; CI 95% 1.00-10.15, P = .049), university education (OR = 2.44; CI 95%: 1.55-3.84; P < .001), high diastolic blood pressure (OR = 1.02; CI 95%: 1.00-1.03; P = .006), and higher glomerular filtration rate (OR 1.01, CI 95% 1.00-1.01; P = .01). And variables associated with VKA use were history of cancer (OR = 0.46; CI 95%: 0.25-0.85; P = .013) and bradyarrhythmia (OR = 0.40; CI 95% 0.19-0.85; P = .020). Conclusion: Medical and social variables were associated with prescription of NOAC. Major bleeding, hemorrhagic stroke, university education, and higher glomerular filtration rate were more frequent among patients under NOAC. On the contrary, patients with history of cancer or bradyarrhythmias more frequently received VKA.

Published
2015

88. Quality of anticoagulation with vitamin K antagonists

Author

Bertomeu‐González, Vicente, Anguita, Manuel, Moreno‐Arribas, José, Cequier, Ángel, Muñiz, Javier, Castillo‐Castillo, Jesús, Sanchis, Juan, Roldán, Inmaculada, Marin, Francisco, and Bertomeu‐Martínez, Vicente

Subjects
Aged, 80 and over, Male, Vitamin K, Clinical Investigations, Anticoagulants, Middle Aged, Stroke, Atrial Fibrillation, Humans, Female, Prospective Studies, Registries, Aged, Quality of Health Care
Abstract

[Abstract] Background. Vitamin K antagonists (VKA) have a narrow therapeutic range, and literature analysis reveals poor quality of anticoagulation control. We sought to assess the prevalence of poor anticoagulant control in patients under VKA treatment in the prevention of stroke for atrial fibrillation (AF). Hypothesis.Control of anticoagulation with VKA is inadequate in a high percentage of patients with AF. Methods.Patients with AF under VKA treatment were prospectively recruited in this observational registry. The sample comprised 948 patients. The estimated time spent in the therapeutic range (TTR) was calculated, and variables related with a TTR >65% were analyzed. Results.Mean age was 73.8 ± 9.4 years, and 42.5% of the patients were women. Mean TTR was 63.77% ± 23.80% for the direct method and 60.27% ± 24.48% for the Rosendaal method. Prevalence of poor anticoagulation control was 54%. Variables associated with good anticoagulation control were university studies (odds ratio [OR]: 1.99, 95% confidence interval [CI]: 1.08-3.64), chronic hepatic disease (OR: 8.15, 95% CI: 1.57-42.24), low comorbidity expressed as Charlson index (OR: 0.87, 95% CI: 0.76-0.99), no previous cardiac disease (OR: 0.64, 95% CI: 0.41-0.98), lower risk of bleeding assessed as hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly age, and use of drugs or alcohol (HAS-BLED; OR: 0.81, 95% CI: 0.69-0.95), and lower heart rate (OR: 0.99, 95% CI: 0.98-0.99). Conclusions.Patients who receive VKA to prevent stroke for AF spend less than half the time within therapeutic range. Instituto de Salud Carlos III; RD12/0042/0068 Instituto de Salud Carlos III; RD12/0042/0010 Instituto de Salud Carlos III; RD12/0042/0069 Instituto de Salud Carlos III; RD12/0042/0049 Instituto de Salud Carlos III; RD12/0042/0063

Published
2015

91. Do physicians correctly calculate thromboembolic risk scores?: a comparison of concordance between manual and computer‐based calculation of CHADS2 and CHA2DS2‐VASc scores

Author

Esteve-Pastor, María Asunción, Marín, Francisco, Bertomeu-Martínez, Vicente, Roldán, Inmaculada, Cequier, Ángel, Badimón, Lina, Muñiz, Javier, Valdés, Mariano, Anguita, Manuel, Esteve-Pastor, María Asunción, Marín, Francisco, Bertomeu-Martínez, Vicente, Roldán, Inmaculada, Cequier, Ángel, Badimón, Lina, Muñiz, Javier, Valdés, Mariano, and Anguita, Manuel

Abstract

[Abstract] BACKGROUND: Clinical risk scores, CHADS2 and CHA2 DS2 -VASc scores, are the established tools for assessing stroke risk in patients with atrial fibrillation (AF). AIM: The aim of this study is to assess concordance between manual and computer-based calculation of CHADS2 and CHA2 DS2 -VASc scores, as well as to analyse the patient categories using CHADS2 and the potential improvement on stroke risk stratification with CHA2 DS2 -VASc score. METHODS: We linked data from Atrial Fibrillation Spanish registry FANTASIIA. Between June 2013 and March 2014, 1318 consecutive outpatients were recruited. We explore the concordance between manual scoring and computer-based calculation. We compare the distribution of embolic risk of patients using both CHADS2 and CHA2 DS2 -VASc scores RESULTS: The mean age was 73.8 ± 9.4 years, and 758 (57.5%) were male. For CHADS2 score, concordance between manual scoring and computer-based calculation was 92.5%, whereas for CHA2 DS2 -VASc score was 96.4%. In CHADS2 score, 6.37% of patients with AF changed indication on antithrombotic therapy (3.49% of patients with no treatment changed to need antithrombotic treatment and 2.88% of patients otherwise). Using CHA2 DS2 -VASc score, only 0.45% of patients with AF needed to change in the recommendation of antithrombotic therapy. CONCLUSION: We have found a strong concordance between manual and computer-based score calculation of both CHADS2 and CHA2 DS2 -VASc risk scores with minimal changes in anticoagulation recommendations. The use of CHA2 DS2 -VASc score significantly improves classification of AF patients at low and intermediate risk of stroke into higher grade of thromboembolic score. Moreover, CHA2 DS2 -VASc score could identify 'truly low risk' patients compared with CHADS2 score.

Published
2016

99. Quality of anticoagulation with vitamin K antagonists

Author

Bertomeu-González, Vicente, Anguita, Manuel, Moreno-Arribas, José, Cequier, Ángel, Muñiz, Javier, Castillo-Castillo, Jesús, Sanchis, Juan, Roldán, Inmaculada, Marín, Francisco, Bertomeu-Martínez, Vicente, Bertomeu-González, Vicente, Anguita, Manuel, Moreno-Arribas, José, Cequier, Ángel, Muñiz, Javier, Castillo-Castillo, Jesús, Sanchis, Juan, Roldán, Inmaculada, Marín, Francisco, and Bertomeu-Martínez, Vicente

Abstract

[Abstract] Background. Vitamin K antagonists (VKA) have a narrow therapeutic range, and literature analysis reveals poor quality of anticoagulation control. We sought to assess the prevalence of poor anticoagulant control in patients under VKA treatment in the prevention of stroke for atrial fibrillation (AF). Hypothesis.Control of anticoagulation with VKA is inadequate in a high percentage of patients with AF. Methods.Patients with AF under VKA treatment were prospectively recruited in this observational registry. The sample comprised 948 patients. The estimated time spent in the therapeutic range (TTR) was calculated, and variables related with a TTR >65% were analyzed. Results.Mean age was 73.8 ± 9.4 years, and 42.5% of the patients were women. Mean TTR was 63.77% ± 23.80% for the direct method and 60.27% ± 24.48% for the Rosendaal method. Prevalence of poor anticoagulation control was 54%. Variables associated with good anticoagulation control were university studies (odds ratio [OR]: 1.99, 95% confidence interval [CI]: 1.08-3.64), chronic hepatic disease (OR: 8.15, 95% CI: 1.57-42.24), low comorbidity expressed as Charlson index (OR: 0.87, 95% CI: 0.76-0.99), no previous cardiac disease (OR: 0.64, 95% CI: 0.41-0.98), lower risk of bleeding assessed as hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly age, and use of drugs or alcohol (HAS-BLED; OR: 0.81, 95% CI: 0.69-0.95), and lower heart rate (OR: 0.99, 95% CI: 0.98-0.99). Conclusions.Patients who receive VKA to prevent stroke for AF spend less than half the time within therapeutic range.

Published
2015

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