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1. Assessment of bleeding events in patients receiving DOACs with or without statins to treat venous thromboembolism: insights from the RIETE registry

Author

Dominique Farge-bancel, R Marqués, M Ortiz, Paolo Prandoni, J Roa, Manuel Monreal, F Couturaud, J Gutierrez, J Pagan, Peter Verhamme, A Aujayeb, Laurent Bertoletti, P Verhamme, M Monreal, S Fonseca, S Pinto, S Soler, A Lorenzo, R Lecumberri, R Otero, P DI MICCO, F Rivera-Cívico, A Molino, P Suchon, C Grange, JA Caprini, J Osorio, Henri Bounameaux, R Valle, F Negro, A Tufano, Remedios Otero, Aitor Ballaz, G Kenet, I Francisco, F Uresandi, G Barillari, Marijan Bosevski, F García-Bragado, E Grau, D Jiménez, A Maestre, A Visonà, J Criado, R Chopard, I Weinberg, M Lumbierres, B Leclercq, H Bounameaux, Farid Rashidi, Abílio Reis, Lucia Mazzolai, P Llamas, MJ Núñez-Fernández, F Dentali, O Espitia, C Siniscalchi, Rosaria Del Giorno, Sanjiv Keller, Carmine Siniscalchi, Luciano Lopez-Jimenez, Ana Cristina Montenegro, Benjamin Brenner, Raquel Barb, Pierpaolo Di Micco, Sebastian Schellong, Inna Tzoran, Radovan Malý, Joseph A. Caprini, Hanh My Bui, MD Adarraga, A Alberich-Conesa, J Aibar, A Alda-Lozano, J Alfonso, C Amado, M Angelina-García, JI Arcelus, A Ballaz, R Barba, C Barbagelata, M Barrón, B Barrón-Andrés, F Beddar-Chaib, A Blanco-Molina, JC Caballero, J Carrillo-Alonso, G Castellanos, L Chasco, C De Ancos, J Del Toro, P Demelo-Rodríguez, C De Juana-Izquierdo, MC Díaz-Pedroche, JA Díaz-Peromingo, A Dubois-Silva, JC Escribano, C Falgá, AI Farfán-Sedano, C Fernández-Aracil, C Fernández-Capitán, B Fernández-Jiménez, JL Fernández-Reyes, MA Fidalgo, C Gabara, F Galeano-Valle, C García-González, A García-Ortega, O Gavín-Sebastián, MA Gil-De Gómez, A Gil-Díaz, C Gómez-Cuervo, A González-Munera, L Guirado, L Hernández-Blasco, L Jara-Palomares, MJ Jaras, I Jou, MD Joya, JL Lobo, L López-Jiménez, P López-Miguel, H López-Brull, JJ López-Núñez, A López-Ruiz, JB LópezSáez, O Madridano, PJ Marchena, M Marcos, M Martín del Pozo, F Martín-Martos, R Martínez-Prado, JM Maza, E Mena, MI Mercado, J Moisés, MV Morales, MS Navas, JA Nieto, M Olid, L Ordieres-Ortega, S Otálora, N Pacheco-Gómez, AC Palomeque, E Paredes, P Parra-Caballero, P Parra-Rosado, JM Pedrajas, C Pérez-Ductor, M Pérez-Pinar, MA Pérez-Jacoiste, ML Peris, ML Pesce, JA Porras, R Puchades, A Rodríguez-Cobo, M Romero-Brugera, P Ruiz-Artacho, N Ruiz-Giménez, J Ruiz-Ruiz, G Salgueiro, T Sancho, V Sendín, P Sigüenza, A Steinherr, S Suárez-Fernández, R Tirado, A TorrentsVilar, MI Torres, J Trujillo-Santos, JF Varona, A Villalobos, P Villares, C Ay, S Nopp, I Pabinger, C Van Edom, A Verstraete, Yoo HHB, AC Montenegro, SN Morales, J Hirmerova, R Malý, L Bertoletti, A BuraRiviere, J Catella, R Le Mao, I Mahé, F Moustafa, L Plaisance, G Sarlon-Bartoli, E Versini, S Schellong, B Brenner, I Tzoran, P Sadeghipour, F Rashidi, A Abenante, M Basaglia, M Bertoni, F Bilora, B Brandolin, M Ciammaichella, D Colaizzo, E Grandone, E Imbalzano, R Pesavento, A Poz, P Prandoni, B Taflaj, B Zalunardo, A Skride, D Kigitovica, J Meireles, M Bosevski, M Zdraveska, L Mazzolai, and HM Bui

Subjects
Medicine
Abstract

Objective To evaluate the impact of coadministering statins with direct oral anticoagulants (DOACs) on the risk of major bleeding events in patients with venous thromboembolism (VTE).Design Observational cohort analysis based on a multicentre international registry.Setting Data were extracted from the Registro Informatizado de Enfermedad TromboEmbolica Registry, which involves 205 centres across 27 countries.Participants A total of 73 659 patients diagnosed with VTE were classified based on their anticoagulant therapy (DOACs) versus low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs) and concurrent use of statins.Methods Multivariable Cox proportional hazards models adjusted for confounding variables to assess the risk of major bleeding events stratified by the type of anticoagulant use and statin use.Results From October 2013 to February 2023, 73 659 patients were recruited: 2573 were statin users on DOACs, 14 090 were statin users on LMWH or VKA therapy, 10 088 were non-statin users on DOACs and 46 908 were non-statin users on LMWH or VKA therapy. Statin users were 10 years older and more likely to have hypertension, diabetes, renal failure or prior artery disease. During anticoagulation (median, 187 days), 1917 patients (2.6%) suffered major bleeding. Rates of major bleeding per 100 patient-years were 2.33 (95% CI 1.72 to 3.09), 3.75 (95% CI 3.43 to 4.10), 1.39 (95% CI 1.13 to 1.69) and 3.10 (95% CI 2.93 to 3.27), respectively. On multivariable analysis, patients treated with DOACs had a significantly lower risk of major bleeding compared with those on LMWH or VKA therapy (adjusted HR 0.59; 95% CI 0.48 to 0.74). The adjusted HR in statin users versus non-users was 1.03 (95% CI 0.92 to 1.14), while in statin users on DOACs versus the rest of patients, it was 1.18 (95% CI 0.79 to 1.76).Conclusions In patients with VTE receiving statins, long-term anticoagulation with DOACs was associated with a reduced risk of major bleeding, regardless of the statin use. These findings support the safety profile of DOACs over VKAs or LMWH in the management of VTE in patients requiring statins.

Published
2024
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2. Venous thromboembolism characteristics and outcomes among RIETE patients tested and untested for inherited thrombophilia

Author

Adarraga, MD, Alberich-Conesa, A, Aibar, J, Alda-Lozano, A, Alfonso, J, Amado, C, Angelina-García, M, Arcelus, JI, Ballaz, A, Barba, R, Barbagelata, C, Barrón, M, Barrón-Andrés, B, Beddar-Chaib, F, Blanco-Molina, A, Caballero, JC, Castellanos, G, Criado, J, De Ancos, C, Del Toro, J, Demelo-Rodríguez, P, De Juana-Izquierdo, C, Díaz-Peromingo, JA, Dubois-Silva, A, Escribano, JC, Falgá, C, Farfán-Sedano, AI, Fernández-Aracil, C, Fernández-Capitán, C, Fernández-Jiménez, B, Fernández-Reyes, JL, Fidalgo, MA, Francisco, I, Gabara, C, Galeano-Valle, F, García-Bragado, F, García-Ortega, A, Gavín-Sebastián, O, Gil-Díaz, A, Gómez-Cuervo, C, González-García, C, González-Munera, A, Grau, E, Guirado, L, Gutiérrez-Guisado, J, Hernández-Blasco, L, Herreros, M, Jara-Palomares, L, Jaras, MJ, Jiménez, D, Jou, I, Joya, MD, Lecumberri, R, Llamas, P, Lobo, JL, López-Jiménez, L, López-Miguel, P, López-Brull, H, López-Núñez, JJ, López-Ruiz, A, López-Sáez, JB, Lorenzo, A, Lumbierres, M, Madridano, O, Maestre, A, Marchena, PJ, Marcos, M, Martín del Pozo, M, Martín-Martos, F, Martínez-Prado, R, Maza, JM, Mena, E, Mercado, MI, Moisés, J, Molino, A, Monreal, M, Morales, MV, Navas, MS, Nieto, JA, Núñez-Fernández, MJ, Olid, M, Ordieres-Ortega, L, Ortiz, M, Osorio, J, Otálora, S, Otero, R, Pacheco-Gómez, N, Pagán, J, Palomeque, AC, Paredes, E, Parra-Caballero, P, Pedrajas, JM, Pérez-Ductor, C, Pérez-Pinar, M, Peris, ML, Pesce, ML, Porras, JA, Puchades, R, Rivera-Cívico, F, Rodríguez-Cobo, A, Romero-Brugera, M, Ruiz-Artacho, P, Ruiz-Giménez, N, Ruiz-Ruiz, J, Salgueiro, G, Sancho, T, Sendín, V, Sigüenza, P, Soler, S, Steinherr, A, Suárez-Fernández, S, Tirado, R, Torrents-Vilar, A, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valle, R, Varona, JF, Villalobos, A, Villares, P, Ay, C, Nopp, S, Pabinger, I, Vanassche, T, Verhamme, P, Verstraete, A, Yoo, HHB, Montenegro, AC, Morales, SN, Roa, J, Hirmerova, J, Malý, R, Bertoletti, L, Bura-Riviere, A, Catella, J, Chopard, R, Couturaud, F, Espitia, O, Grange, C, Le Mao, R, Leclercq, B, Mahé, I, Morange, P, Moustafa, F, Plaisance, L, Sarlon-Bartoli, G, Suchon, P, Versini, E, Schellong, S, Brenner, B, Dally, N, Kenet, G, Tzoran, I, Sadeghipour, P, Rashidi, F, Abenante, A, Barillari, G, Basaglia, M, Bertoni, M, Bilora, F, Brandolin, B, Ciammaichella, M, Colaizzo, D, Dentali, F, Di Micco, P, Grandone, E, Imbalzano, E, Negro, F, Pesavento, R, Poz, A, Prandoni, P, Siniscalchi, C, Taflaj, B, Tufano, A, Visonà, A, Zalunardo, B, Skride, A, Kigitovica, D, Zicans, M, Fonseca, S, Marques, R, Meireles, J, Pinto, S, Bosevski, M, Trajkova, M, Zdraveska, M, Bounameaux, H, Mazzolai, L, Aujayeb, A, Caprini, JA, Weinberg, I, Bui, HM, Cohen, Omri, Waldman Radinsky, Liat, Kenet, Gili, Mahé, Isabelle, Barillari, Giovanni, Soler, Silvia, Sigüenza, Patricia, Del Valle Morales, María, Villares, Paula, and Monreal, Manuel

Published
2024
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4. Clinical outcomes after discontinuing anticoagulant therapy in patients with first unprovoked venous thromboembolism

Author

Agudo, P., Aibar, J., Alberich-Conesa, A., Alda-Lozano, A., Alfonso, J., Amado, C., Angelina-García, M., Arcelus, J.I., Ballaz, A., Barba, R., Barbagelata, C., Barreiro, B., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Beddar-Chaib, F., Blanco-Molina, A., Caballero, J.C., Cañas, I., Castellanos, G., Chasco, L., Claver, G., Criado, J., De Juana-Izquierdo, C., Del Toro, J., Demelo-Rodríguez, P., Díaz-Pedroche, M.C., Díaz-Peromingo, J.A., Dubois-Silva, A., Escribano, J.C., Falgá, C., Fernández-Aracil, C., Fernández-Capitán, C., Fernández-Jiménez, B., Fernández-Reyes, J.L., Fidalgo, M.A., Francisco, I., Gabara, C., Galeano-Valle, F., García-Bragado, F., García-Ortega, A., Gavín-Sebastián, O., Gil-Díaz, A., Gómez-Cuervo, C., González-Munera, A., Grau, E., Guirado, L., Gutiérrez-Guisado, J., Hernández-Blasco, L., Hernández-Molina, A., Hernández-Vidal, M.J., Jara-Palomares, L., Jiménez, D., Jou, I., Joya, M.D., Lalueza, A., Lecumberri, R., Llamas, P., Lobo, J.L., López-Brull, H., López-De la Fuente, M., López-Jiménez, L., López-Miguel, P., López-Núñez, J.J., López-Ruiz, A., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Lumbierres, M., Madridano, O., Maestre, A., Marchena, P.J., Marcos, M., Martín del Pozo, M., Martín-Martos, F., Martínez-Prado, R., Maza, J.M., Mercado, M.I., Moisés, J., Molino, A., Monreal, M., Monzón, L., Morales, M.V., Muñoz-Gamito, G., Navas, M.S., Nieto, J.A., Núñez-Fernández, M.J., Olid, M., Ordieres-Ortega, L., Ortiz, M., Osorio, J., Otálora, S., Otero, R., Pacheco-Gómez, N., Pagán, J., Palomeque, A.C., Paredes, E., Parra-Rosado, P., Pedrajas, J.M., Pérez-Ductor, C., Pérez-Pinar, M., Peris, M.L., Pesce, M.L., Porras, J.A., Puchades, R., Rivas, A., Rivera-Cívico, F., Rivera-Gallego, A., Rodríguez-Cobo, A., Romero-Bruguera, M., Ruiz-Artacho, P., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Steinherr, A., Suárez-Fernández, S., Tirado, R., Torrents-Vilar, A., Torres, M.I., Trujillo-Santos, J., Uresandi, F., Valle, R., Varona, J.F., Villalobos, A., Villares, P., Ay, C., Nopp, S., Pabinger, I., Vanassche, T., Verhamme, P., Verstraete, A., Yoo, H.H.B., Montenegro, A.C., Morales, S.N., Roa, J., Hirmerova, J., Malý, R., Varhaník, F., Bertoletti, L., Bura-Riviere, A., Catella, J., Chopard, R., Couturaud, F., Espitia, O., Le Mao, R., Leclerq, B., Mahé, I., Moustafa, F., Plaisance, L., Sarlon-Bartoli, G., Suchon, P., Versini, E., Schellong, S., Brenner, B., Dally, N., Kenet, G., Tzoran, I., Rashidi, F., Sadeghipour, P., Tahmasbi, F., Abenante, A., Barillari, G., Bilora, F., Bissacco, D., Brandolin, B., Casana, R., Ciammaichella, M., Colaizzo, D., Dentali, F., Di Micco, P., Giorgi-Pierfranceschi, M., Grandone, E., Imbalzano, E., Lambertenghi-Deliliers, D., Martini, R., Meschi, T., Negro, F., Poz, A., Prandoni, P., Simioni, P., Siniscalchi, C., Taflaj, B., Ticinesi, A., Tufano, A., Visonà, A., Zalunardo, B., Kalnina, P., Kigitovica, D., Skride, A., Zicans, M., Nishimoto, Y., Yamashita, Y., Tazi-Mezalek, Z., Fonseca, S., Marques, R., Meireles, J., Pinto, S., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Aujayeb, A., Bikdeli, B., Caprini, J.A., Khalil, A., Tafur, J., Weinberg, I., Bui, H.M., Nguyen, S.T., Pham, K.Q., Tran, G.B., Gabara, Cristina, Aibar, Jesus, Nishimoto, Yuji, Yamashita, Yugo, Prandoni, Paolo, Barnes, Geoffrey D., Bikdeli, Behnood, Jiménez, David, Demelo-Rodríguez, Pablo, Peris, Ma Luisa, Nguyen, Son Truong, and Monreal, Manuel

Published
2024
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5. Risk of recurrence after discontinuing anticoagulation in patients with COVID-19- associated venous thromboembolism: a prospective multicentre cohort studyResearch in context

Author

Luis Jara-Palomares, Behnood Bikdeli, David Jiménez, Alfonso Muriel, Pablo Demelo-Rodríguez, Farès Moustafa, Aurora Villalobos, Patricia López-Miguel, Luciano López-Jiménez, Sonia Otálora, María Luisa Peris, Cristina Amado, Romain Chopard, Francisco Rivera-Cívico, Manuel Monreal, María Dolores Adarraga, Ana Alberich Conesa, Jesús Aibar, Alicia Alda Lozano, Joaquín Alfonso, Jesús Alonso Carrillo, María Angelina García, Juan Ignacio Arcelus, Aitor Ballaz, Raquel Barba, María Barca Hernando, Cristina Barbagelata, Manuel Barrón, Belén Barrón Andrés, Fahd Beddar Chaib, María Ángeles Blanco Molina, Juan Carlos Caballero, Gonzalo Castellanos, Leyre Chasco, Juan Criado, Cristina de Ancos, Jorge del Toro, Pablo Demelo Rodríguez, Cristina de Juana Izquierdo, Ana María Díaz Brasero, José Antonio Díaz Peromingo, Álvaro Dubois Silva, Juan Carlos Escribano, Concepción Falgá, Ana Isabel Farfán Sedano, Cleofe Fernández Aracil, Carmen Fernández Capitán, Begoña Fernández Jiménez, José Luis Fernández Reyes, María Ángeles Fidalgo, Iria Francisco, Cristina Gabara, Francisco Galeano Valle, Francisco García Bragado, Alberto García Ortega, Olga Gavín Sebastián, María Allende Gil de Gómez, Aída Gil Díaz, Covadonga Gómez Cuervo, Adriana González Munera, Enric Grau, Leticia Guirado, Javier Gutiérrez, Luis Hernández Blasco, Luis Jara Palomares, María Jesús Jaras, Rafael Jiménez, Inés Jou, María Dolores Joya, Sara Lainez Justo, Antonio Lalueza, Ramón Lecumberri, José Manuel León Ramírez, Pilar Llamas, José Luis Lobo, Luciano López Jiménez, Patricia López Miguel, Juan José López Núñez, Antonio López Ruiz, Juan Bosco López Sáez, Alicia Lorenzo, Marina Lumbierres, Olga Madridano, Ana Maestre, Pablo Javier Marchena, María Marcos, Mar Martín del Pozo, Francisco Martín Martos, Jorge Manuel Maza, Elisabeth Mena, Maria Isabel Mercado, Jorge Moisés, María del Valle Morales, Maria Sierra Navas, José Antonio Nieto, Manuel Jesús Núñez Fernández, Mónica Olid, Lucía Ordieres Ortega, María Ortiz, Jeisson Osorio, Remedios Otero, Nazaret Pacheco Gómez, Javier Pagán, Andrea Catalina Palomeque, Ezequiel Paredes, Pedro Parra Caballero, José María Pedrajas, Cristina Pérez Ductor, Montserrat Pérez Pinar, María Lourdes Pesce, José Antonio Porras, Ramón Puchades, Francisco Rivera Cívico, Ana Rodríguez Cobo, Vladimir Rosa, Marta Romero Brugera, Pedro Ruiz Artacho, Nuria Ruiz Giménez, Justo Ruiz Ruiz, Georgina Salgueiro, Teresa Sancho, Vanesa Sendín, Patricia Sigüenza, Silvia Soler, Susana Suárez Fernández, Raimundo Tirado, Ana Torrents Vilar, María Isabel Torres, Javier Trujillo Santos, Fernando Uresandi, Reina Valle, José Felipe Varona, Paula Villares, Cihan Ay, Stephan Nopp, Ingrid Pabinger, Matthias Engelen, Thomas Vanassche, Peter Verhamme, Hugo Hyung Bok Yoo, Ana Cristina Montenegro, Silvia Natalia Morales, Jairo Roa, Jana Hirmerova, Radovan Malý, Laurent Bertoletti, Alessandra Bura-Riviere, Judith Catella, Francis Couturaud, Olivier Espitia, Claire Grange, Barbara Leclercq, Raphael Le Mao, Isabelle Mahé, Ludovic Plaisance, Gabrielle Sarlon Bartoli, Pierre Suchon, Edouard Versini, Sebastian Schellong, Benjamin Brenner, Najib Dally, Inna Tzoran, Parham Sadeghipour, Fahrid Rashidi, Alessia Abenante, Giovanni Barillari, Manuela Basaglia, Franca Bilora, Daniele Bissacco, Cristiano Bortoluzzi, Barbara Brandolin, Renato Casana, Maurizio Ciammaichella, Donatella Colaizzo, Francesco Dentali, Pierpaolo Di Micco, Elvira Grandone, Egidio Imbalzano, Daniela Lambertenghi Deliliers, Federica Negro, Raffaele Pesavento, Alessandra Poz, Paolo Prandoni, Paolo Scarinzi, Carmine Siniscalchi, Beldisa Taflaj, Antonella Tufano, Adriana Visonà, Ngoc Vo Hong, Beniamino Zalunardo, Andris Skride, Dana Kigitovica, Samuel Fonseca, Rafael Marques, José Meireles, Sara Barbosa Pinto, Marijan Bosevsky, Aleksandra Eftimova, Marijan Zdraveska, Henri Bounameaux, Lucia Mazzolai, Avinash Aujayeb, Joseph Caprini, Ido Weinberg, and Hanh My Bui

Subjects
Pulmonary embolism, Venous thromboembolism, Anticoagulation, COVID-19, SARS-CoV-2, Medicine (General), R5-920
Abstract

Summary: Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain.

Published
2024
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6. Age-Related Differences in the Presentation, Management, and Clinical Outcomes of 100,000 Patients With Venous Thromboembolism in the RIETE Registry

Author

Adarraga, M.D., Alberich-Conesa, A., Aibar, J., Alda-Lozano, A., Alfonso, J., Amado, C., Angelina-García, M., Arcelus, J.I., Ballaz, A., Barba, R., Barbagelata, C., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Beddar-Chaib, F., Blanco-Molina, A., Caballero, J.C., Castellanos, G., Chasco, L., Criado, J., De Ancos, C., Del Toro, J., Demelo-Rodríguez, P., De Juana-Izquierdo, C., Díaz-Brasero, A.M., Díaz-Peromingo, J.A., Dubois-Silva, A., Escribano, J.C., Falgá, C., Farfán-Sedano, A.I., Fernández-Aracil, C., Fernández-Capitán, C., Fernández-Jiménez, B., Fernández-Reyes, J.L., Fidalgo, M.A., Francisco, I., Gabara, C., Galeano-Valle, F., García-Bragado, F., García-Ortega, A., Gavín-Sebastián, O., Gil De Gómez, M.A., Gil-Díaz, A., Gómez-Cuervo, C., González-Munera, A., Grau, E., Guirado, L., Gutiérrez, J., Hernández-Blasco, L., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Jiménez, R., Jou, I., Joya, M.D., Lainez-Justo, S., Lecumberri, R., León-Ramírez, J.M., Llamas, P., Lobo, J.L., López-Jiménez, L., López-Miguel, P., López-Núñez, J.J., López-Ruiz, A., López-Sáez, J.B., Lorenzo, A., Lumbierres, M., Madridano, O., Maestre, A., Marchena, P.J., Marcos, M., Martín del Pozo, M., Martín-Martos, F., Maza, J.M., Mena, E., Mercado, M.I., Moisés, J., Monreal, M., Morales, M.V., Navas, M.S., Nieto, J.A., Núñez-Fernández, M.J., Olid, M., Ordieres-Ortega, L., Ortiz, M., Osorio, J., Otálora, S., Otero, R., Pacheco-Gómez, N., Pagán, J., Palomeque, A.C., Paredes, E., Parra-Caballero, P., Parra-Rosado, P., Pedrajas, J.M., Pérez-Ductor, C., Pérez-Pinar, M., Peris, M.L., Pesce, M.L., Porras, J.A., Puchades, R., Rivera-Cívico, F., Rodríguez-Cobo, A., Rosa, V., Romero-Brugera, M., Ruiz-Artacho, P., Ruiz-Giménez, N., Ruiz-Ruiz, J., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Suárez-Fernández, S., Tirado, R., Torrents-Vilar, A., Torres, M.I., Trujillo-Santos, J., Uresandi, F., Valle, R., Varona, J.F., Villalobos, A., Villares, P., Ay, C., Nopp, S., Pabinger, I., Vanassche, T., Verhamme, P., Verstraete, A., Yoo, H.H.B., Montenegro, A.C., Morales, S.N., Roa, J., Hirmerova, J., Malý, R., Bertoletti, L., Bura-Riviere, A., Catella, J., Chopard, R., Couturaud, F., Espitia, O., Grange, C., Leclercq, B., Le Mao, R., Mahé, I., Moustafa, F., Plaisance, L., Sarlon-Bartoli, G., Suchon, P., Versini, E., Schellong, S., Brenner, B., Dally, N., Tzoran, I., Sadeghipour, P., Rashidi, F., Abenante, A., Barillari, G., Basaglia, M., Bilora, F., Bissacco, D., Bortoluzzi, C., Brandolin, B., Casana, R., Ciammaichella, M., Colaizzo, D., Dentali, F., Di Micco, P., Grandone, E., Imbalzano, E., Lambertenghi-Deliliers, D., Negro, F., Pesavento, R., Poz, A., Prandoni, P., Scarinzi, P., Siniscalchi, C., Taflaj, B., Tufano, A., Visonà, A., Vo Hong, N., Zalunardo, B., Paluga, R., Skride, A., Kigitovica, D., Fonseca, S., Marques, R., Meireles, J., Pinto, S., Bosevski, M., Trajkova, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Aujayeb, A., Caprini, J.A., Weinberg, I., Bui, H.M., Ortega, Alberto García, Jiménez, David, Pedro-Tudela, Ana, Pérez-Ductor, Cristina, Fernández-Capitán, Carmen, Falgá, Conxita, Skride, Andris, Siniscalchi, Carmine, Weinberg, Ido, and Monreal, Manuel

Published
2024
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8. Adalimumab for the Treatment of Non-Infectious Uveitis: A Real Life Experience

Author

Raad, Fátima, primary, Luque, Paula, additional, García Ledo, Sofía, additional, Alda Lozano, Alicia, additional, Llorens, Víctor, additional, Espejo, Antonio, additional, Heras, Henar, additional, Santana, Lucía, additional, Trapiella, Luis, additional, Fanlo, Patricia, additional, Adán, Alfredo, additional, Espinosa, Gerard, additional, and Navarrete, Nuria, additional

Published
2024
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9. The prognostic value of blood cellular indices in pulmonary embolism.

Author

Siddiqui, Fakiha, Tafur, Alfonso, Hussain, Mushtaq, García‐Ortega, Alberto, Darki, Amir, Fareed, Jawed, Jiménez, David, Bikdeli, Behnood, Galeano‐Valle, Francisco, Fernández‐Reyes, José Luis, Pérez‐Pinar, Montserrat, Monreal, Manuel, Adarraga, MD, Alberich‐Conesa, A, Aibar, J, Alda‐Lozano, A, Alfonso, J, Amado, C, Angelina‐García, M, and Arcelus, JI

Published
2024
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10. Age-Related Differences in the Presentation, Management, and Clinical Outcomes of 100,000 Patients With Venous Thromboembolism in the RIETE Registry

Author

Ortega, Alberto García, primary, Jiménez, David, additional, Pedro-Tudela, Ana, additional, Pérez-Ductor, Cristina, additional, Fernández-Capitán, Carmen, additional, Falgá, Conxita, additional, Skride, Andris, additional, Siniscalchi, Carmine, additional, Weinberg, Ido, additional, Monreal, Manuel, additional, Adarraga, M.D., additional, Alberich-Conesa, A., additional, Aibar, J., additional, Alda-Lozano, A., additional, Alfonso, J., additional, Amado, C., additional, Angelina-García, M., additional, Arcelus, J.I., additional, Ballaz, A., additional, Barba, R., additional, Barbagelata, C., additional, Barrón, M., additional, Barrón-Andrés, B., additional, Bascuñana, J., additional, Beddar-Chaib, F., additional, Blanco-Molina, A., additional, Caballero, J.C., additional, Castellanos, G., additional, Chasco, L., additional, Criado, J., additional, De Ancos, C., additional, Del Toro, J., additional, Demelo-Rodríguez, P., additional, De Juana-Izquierdo, C., additional, Díaz-Brasero, A.M., additional, Díaz-Peromingo, J.A., additional, Dubois-Silva, A., additional, Escribano, J.C., additional, Falgá, C., additional, Farfán-Sedano, A.I., additional, Fernández-Aracil, C., additional, Fernández-Capitán, C., additional, Fernández-Jiménez, B., additional, Fernández-Reyes, J.L., additional, Fidalgo, M.A., additional, Francisco, I., additional, Gabara, C., additional, Galeano-Valle, F., additional, García-Bragado, F., additional, García-Ortega, A., additional, Gavín-Sebastián, O., additional, Gil De Gómez, M.A., additional, Gil-Díaz, A., additional, Gómez-Cuervo, C., additional, González-Munera, A., additional, Grau, E., additional, Guirado, L., additional, Gutiérrez, J., additional, Hernández-Blasco, L., additional, Jara-Palomares, L., additional, Jaras, M.J., additional, Jiménez, D., additional, Jiménez, R., additional, Jou, I., additional, Joya, M.D., additional, Lainez-Justo, S., additional, Lecumberri, R., additional, León-Ramírez, J.M., additional, Llamas, P., additional, Lobo, J.L., additional, López-Jiménez, L., additional, López-Miguel, P., additional, López-Núñez, J.J., additional, López-Ruiz, A., additional, López-Sáez, J.B., additional, Lorenzo, A., additional, Lumbierres, M., additional, Madridano, O., additional, Maestre, A., additional, Marchena, P.J., additional, Marcos, M., additional, Martín del Pozo, M., additional, Martín-Martos, F., additional, Maza, J.M., additional, Mena, E., additional, Mercado, M.I., additional, Moisés, J., additional, Monreal, M., additional, Morales, M.V., additional, Navas, M.S., additional, Nieto, J.A., additional, Núñez-Fernández, M.J., additional, Olid, M., additional, Ordieres-Ortega, L., additional, Ortiz, M., additional, Osorio, J., additional, Otálora, S., additional, Otero, R., additional, Pacheco-Gómez, N., additional, Pagán, J., additional, Palomeque, A.C., additional, Paredes, E., additional, Parra-Caballero, P., additional, Parra-Rosado, P., additional, Pedrajas, J.M., additional, Pérez-Ductor, C., additional, Pérez-Pinar, M., additional, Peris, M.L., additional, Pesce, M.L., additional, Porras, J.A., additional, Puchades, R., additional, Rivera-Cívico, F., additional, Rodríguez-Cobo, A., additional, Rosa, V., additional, Romero-Brugera, M., additional, Ruiz-Artacho, P., additional, Ruiz-Giménez, N., additional, Ruiz-Ruiz, J., additional, Salgueiro, G., additional, Sancho, T., additional, Sendín, V., additional, Sigüenza, P., additional, Soler, S., additional, Suárez-Fernández, S., additional, Tirado, R., additional, Torrents-Vilar, A., additional, Torres, M.I., additional, Trujillo-Santos, J., additional, Uresandi, F., additional, Valle, R., additional, Varona, J.F., additional, Villalobos, A., additional, Villares, P., additional, Ay, C., additional, Nopp, S., additional, Pabinger, I., additional, Vanassche, T., additional, Verhamme, P., additional, Verstraete, A., additional, Yoo, H.H.B., additional, Montenegro, A.C., additional, Morales, S.N., additional, Roa, J., additional, Hirmerova, J., additional, Malý, R., additional, Bertoletti, L., additional, Bura-Riviere, A., additional, Catella, J., additional, Chopard, R., additional, Couturaud, F., additional, Espitia, O., additional, Grange, C., additional, Leclercq, B., additional, Le Mao, R., additional, Mahé, I., additional, Moustafa, F., additional, Plaisance, L., additional, Sarlon-Bartoli, G., additional, Suchon, P., additional, Versini, E., additional, Schellong, S., additional, Brenner, B., additional, Dally, N., additional, Tzoran, I., additional, Sadeghipour, P., additional, Rashidi, F., additional, Abenante, A., additional, Barillari, G., additional, Basaglia, M., additional, Bilora, F., additional, Bissacco, D., additional, Bortoluzzi, C., additional, Brandolin, B., additional, Casana, R., additional, Ciammaichella, M., additional, Colaizzo, D., additional, Dentali, F., additional, Di Micco, P., additional, Grandone, E., additional, Imbalzano, E., additional, Lambertenghi-Deliliers, D., additional, Negro, F., additional, Pesavento, R., additional, Poz, A., additional, Prandoni, P., additional, Scarinzi, P., additional, Siniscalchi, C., additional, Taflaj, B., additional, Tufano, A., additional, Visonà, A., additional, Vo Hong, N., additional, Zalunardo, B., additional, Paluga, R., additional, Skride, A., additional, Kigitovica, D., additional, Fonseca, S., additional, Marques, R., additional, Meireles, J., additional, Pinto, S., additional, Bosevski, M., additional, Trajkova, M., additional, Zdraveska, M., additional, Bounameaux, H., additional, Mazzolai, L., additional, Aujayeb, A., additional, Caprini, J.A., additional, Weinberg, I., additional, and Bui, H.M., additional

Published
2024
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12. Venous thromboembolism characteristics and outcomes among RIETE patients tested and untested for inherited thrombophilia

Author

Cohen, Omri, Waldman Radinsky, Liat, Kenet, Gili, Mahé, Isabelle, Barillari, Giovanni, Soler, Silvia, Sigüenza, Patricia, Del Valle Morales, María, Villares, Paula, Monreal, Manuel, Adarraga, MD, Alberich-Conesa, A, Aibar, J, Alda-Lozano, A, Alfonso, J, Amado, C, Angelina-García, M, Arcelus, JI, Ballaz, A, Barba, R, Barbagelata, C, Barrón, M, Barrón-Andrés, B, Beddar-Chaib, F, Blanco-Molina, A, Caballero, JC, Castellanos, G, Criado, J, De Ancos, C, Del Toro, J, Demelo-Rodríguez, P, De Juana-Izquierdo, C, Díaz-Peromingo, JA, Dubois-Silva, A, Escribano, JC, Falgá, C, Farfán-Sedano, AI, Fernández-Aracil, C, Fernández-Capitán, C, Fernández-Jiménez, B, Fernández-Reyes, JL, Fidalgo, MA, Francisco, I, Gabara, C, Galeano-Valle, F, García-Bragado, F, García-Ortega, A, Gavín-Sebastián, O, Gil-Díaz, A, Gómez-Cuervo, C, González-García, C, González-Munera, A, Grau, E, Guirado, L, Gutiérrez-Guisado, J, Hernández-Blasco, L, Herreros, M, Jara-Palomares, L, Jaras, MJ, Jiménez, D, Jou, I, Joya, MD, Lecumberri, R, Llamas, P, Lobo, JL, López-Jiménez, L, López-Miguel, P, López-Brull, H, López-Núñez, JJ, López-Ruiz, A, López-Sáez, JB, Lorenzo, A, Lumbierres, M, Madridano, O, Maestre, A, Marchena, PJ, Marcos, M, Martín del Pozo, M, Martín-Martos, F, Martínez-Prado, R, Maza, JM, Mena, E, Mercado, MI, Moisés, J, Molino, A, Monreal, M, Morales, MV, Navas, MS, Nieto, JA, Núñez-Fernández, MJ, Olid, M, Ordieres-Ortega, L, Ortiz, M, Osorio, J, Otálora, S, Otero, R, Pacheco-Gómez, N, Pagán, J, Palomeque, AC, Paredes, E, Parra-Caballero, P, Pedrajas, JM, Pérez-Ductor, C, Pérez-Pinar, M, Peris, ML, Pesce, ML, Porras, JA, Puchades, R, Rivera-Cívico, F, Rodríguez-Cobo, A, Romero-Brugera, M, Ruiz-Artacho, P, Ruiz-Giménez, N, Ruiz-Ruiz, J, Salgueiro, G, Sancho, T, Sendín, V, Sigüenza, P, Soler, S, Steinherr, A, Suárez-Fernández, S, Tirado, R, Torrents-Vilar, A, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valle, R, Varona, JF, Villalobos, A, Villares, P, Ay, C, Nopp, S, Pabinger, I, Vanassche, T, Verhamme, P, Verstraete, A, Yoo, HHB, Montenegro, AC, Morales, SN, Roa, J, Hirmerova, J, Malý, R, Bertoletti, L, Bura-Riviere, A, Catella, J, Chopard, R, Couturaud, F, Espitia, O, Grange, C, Le Mao, R, Leclercq, B, Mahé, I, Morange, P, Moustafa, F, Plaisance, L, Sarlon-Bartoli, G, Suchon, P, Versini, E, Schellong, S, Brenner, B, Dally, N, Kenet, G, Tzoran, I, Sadeghipour, P, Rashidi, F, Abenante, A, Barillari, G, Basaglia, M, Bertoni, M, Bilora, F, Brandolin, B, Ciammaichella, M, Colaizzo, D, Dentali, F, Di Micco, P, Grandone, E, Imbalzano, E, Negro, F, Pesavento, R, Poz, A, Prandoni, P, Siniscalchi, C, Taflaj, B, Tufano, A, Visonà, A, Zalunardo, B, Skride, A, Kigitovica, D, Zicans, M, Fonseca, S, Marques, R, Meireles, J, Pinto, S, Bosevski, M, Trajkova, M, Zdraveska, M, Bounameaux, H, Mazzolai, L, Aujayeb, A, Caprini, JA, Weinberg, I, and Bui, HM

Abstract

•In a RIETE registry analysis of 103 818 patients with VTE, 20.3% were tested for IT, showing a substantial variance in outcomes.•A thoughtful IT testing approach should consider patients’ VTE risk factors and comorbidities.

Published
2024
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13. Real life results of direct-acting oral anticoagulants recommended-dose in obese vs normal-weight patients with venous thromboembolism

Author

Rueda-Camino, José Antonio, primary, Barba, Raquel, additional, Otálora, Sonia, additional, Bura-Riviere, Alessandra, additional, Visonà, Adriana, additional, Mahé, Isabelle, additional, Alda-Lozano, Alicia, additional, Alfonso Megido, Joaquín, additional, Pacheco-Gómez, Nazaret, additional, rosovsky, Rachel P., additional, and Monreal, Manuel, additional

Published
2023
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14. Outcomes of venous thromboembolism in patients with inherited thrombophilia treated with direct oral anticoagulants: insights from the RIETE registry.

Author

Cohen, Omri, Kenet, Gili, Levy-Mendelovich, Sarina, Tzoran, Inna, Brenner, Benjamin, De Ancos, Cristina, López-Miguel, Patricia, Varona, José F., Catella, Judith, Monreal, Manuel, Adarraga, M. D., Alberich-Conesa, A., Aibar, J., Alda-Lozano, A., Alfonso, J., Amado, C., Angelina-García, M., Arcelus, J. I., Ballaz, A., and Barba, R.

Abstract

While direct oral anticoagulants (DOACs) are frequently used to treat venous thromboembolism (VTE), the outcomes of patients with inherited thrombophilia (IT) receiving DOACs for VTE remain understudied. We used data from the international RIETE registry to compare the rates of VTE recurrences, major bleeding, and mortality during anticoagulant treatment in VTE patients with and without IT, grouped by the use of DOACs or standard anticoagulant therapy. Among 103,818 enrolled patients, 21,089 (20.3%) were tested for IT, of whom 8422 (39.9%) tested positive: Protein C deficiency 294, Protein S deficiency 726, Antithrombin deficiency 240, Factor V Leiden 2248, Prothrombin gene mutation 1434, combined IT 3480. Overall, 14,189 RIETE patients (6.2% with IT) received DOACs, and 89,629 standard anticoagulation (8.4% with IT), mostly with heparins followed by vitamin K antagonists. Proportions of patients receiving DOACs did not differ between IT-positive and IT-negative patients. Rates of VTE recurrence on anticoagulant treatment were highest in patients with AT deficiency (P < 0.01). Rates of on-treatment major bleeding and all-cause mortality were lowest among patients with Factor V Leiden (FVL) or PT G20210A mutations, compared with patients who tested negative. Patients with IT who received DOACs had lower rates of major bleeding than those receiving standard anticoagulation. Excluding FVL and Protein S deficiency, patients with IT had lower rates of VTE recurrence with DOACs than with standard anticoagulation. DOACs are equally safe and effective in VTE patients with IT, with lower bleeding rates than those on standard anticoagulation. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Management of COVID-19 pandemic in hospital at home in two regional Spanish hospitals. what it meant, who we cared for, who died and how assistance has evolved over time

Author

David Sánchez Fabra, Tina Herrero Jordán, Alicia Alda Lozano, Victoria Duro Suárez, Nuria Saura Blasco, and Isabel Torres Courchoud

Subjects
Microbiology (medical), Pharmacology, General Medicine
Abstract

Introduction. Home Hospitalization (HH) is an alternative hospitalization modality that can be very useful in times of health stress such as the COVID-19 pandemic. This paper includes the management of patients admitted with COVID-19 in HH in two county spanish hospitals for two years. Methods. A descriptive, observational and retrospective study of all patients admitted at HH with a diagnosis of COVID-19 disease was carried out. Subsequently, further analysis was carried out to characterize the patients who died in HH or 30 days after discharge and another to compare the management between the first phase of the study (2020) and the second one (2021 and part of 2022). Results. A total of 167 patients were recruited. A 52.1% moved to watch that the recovery continued compared to 40.7% in which it was done to watch that they did not worsen. The patients who died in HAD were older (mean 87.5 years), more comorbid and more likely to have do-not resucitate orders (DNR) in case of cardiac arrest (85%). In the second phase of the study, older patients, more comorbid patients and with a greater degree of DNR orders were admitted than those admitted throughout 2020. Conclusions. HAD is a useful resource to increase the resilience of health systems in cases of stress such as the disease caused by COVID-19. The development and growth of existing units, as well as the creation of new ones where they do not exist, could be a basic tool for the medicine of the future.

Published
2023
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17. Anticoagulation and venous thromboembolism in patients aged 90 years and older: Data from the RIETE registry.

Author

Lafaie, Ludovic, Poenou, Géraldine, Hanon, Olivier, López‐Jiménez, Luciano, Nieto, José Antonio, Lorenzo, Alicia, Porras, José Antonio, Lumbierres, Marina, Bertoletti, Laurent, Monreal, Manuel, Adarraga, MD, Alberich‐Conesa, A, Aibar, J, Alda‐Lozano, A, Alonso‐Carrillo, J, Alfonso, J, Amado, C, Arcelus, JI, Ballaz, A, and Bascuñana, J

Subjects
HEMORRHAGE risk factors, REPORTING of diseases, EVALUATION of medical care, VEINS, KIDNEY failure, ANTICOAGULANTS, MOVEMENT disorders, TREATMENT effectiveness, DISEASE relapse, THROMBOEMBOLISM, ANEMIA, DEMENTIA, DRUG side effects, ELDER care, HEART failure, OLD age
Abstract

Background: Age is a major risk factor for venous thromboembolism (VTE), yet patients aged ≥90 years are under‐represented in clinical trials of anticoagulant therapy. The objectives were to describe and compare patient clinical characteristics, treatments, and outcomes (VTE recurrence, bleeding, and mortality) during the first 3 months of anticoagulation between VTE patients aged ≥90 years and those aged <90 years. Methods: We analyzed data from the Registro Informatizado Enfermedad TromboEmbὀlica (RIETE), an ongoing global observational registry of patients with objectively confirmed acute VTE. Results: From January 2001 to October 2022, 96,701 patients were registered in RIETE, of whom 3262 (3.4%) were aged ≥90 years. Patients aged ≥90 years were less likely to be men, and to have experienced cancer or recent surgery, but more likely to manifest immobility, chronic heart failure, anemia, renal insufficiency, or dementia than those aged <90 years. Most (99.6%) patients aged ≥90 years were receiving anticoagulant therapy. During the first 3 months, 26 patients aged ≥90 years developed VTE recurrences, 116 experienced major bleeding, and 564 died. Among patients initially presenting with pulmonary embolism (PE), deaths due to PE exceeded those due to fatal bleeding (76 vs. 19). Among those initially presenting with isolated deep‐vein thrombosis (DVT), it was the reverse (2 vs. 11 deaths). Conclusions: In patients aged ≥90 years, the difference in the outcome of anticoagulant treatment depending on the initial presentation of VTE could suggest a need for different management approaches. Clinical trials evaluating the optimal duration of anticoagulation according to initial VTE presentation are warranted to limit excess deaths in this particular population. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Manejo de la pandemia de COVID-19 en hospitalización domiciliaria en dos hospitales comarcales españoles: qué significó, quiénes atendimos, quién falleció y como evolucionó la asistencia a lo largo del tiempo.

Author

Sánchez Fabra, David, Herrero Jordán, Tina, Alda Lozano, Alicia, Duro Suárez, Victoria, Blasco, Nuria Saura, and Torres Courchoud, Isabel

Abstract

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Published
2023
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23. Análisis del índice Triglicéridos/Glucosa en una muestra de pacientes ingresados por descompensación de insuficiencia cardíaca

Author

Alda Lozano, Alicia and Garcés Horna, Vanesa

Abstract

Introducción: La insuficiencia cardíaca (IC) es un problema de Salud Pública con una prevalencia entorno al 1-2% en países desarrollados y con una elevada mortalidad a pesar de los avances terapéuticos alcanzados. Se han estudiado diversos biomarcadores en IC con utilidad diagnóstica y pronóstica, siendo el péptido natriurético cerebral (BNP) el de mayor importancia clínica. Luego existen otros muchos biomarcadores con potencial utilidad fisiopatológica, pero de escasa aplicación práctica, por lo que siguen siendo necesarios nuevos biomarcadores que ayuden en el manejo de IC. La DM y la resistencia a la insulina (RI) son factores de riesgo independientes para el desarrollo de IC. Para la medición de RI se están desarrollando nuevos métodos indirectos, entre ellos destaca el índice triglicéridos/glucosa (TyG). Hipótesis: Dada la elevada prevalencia de DM y resistencia a la insulina en pacientes con IC, se plantea si el índice TyG podría utilizarse como marcador pronóstico en los pacientes con IC. Objetivos: Calcular los valores del índice TyG en una cohorte de pacientes con IC. Y analizar si dichos valores se correlacionan con diferencias pronósticas en términos de mortalidad y reingresos. Material y métodos: Estudio observacional y retrospectivo, constituido por una muestra de 278 pacientes que habían sufrido un episodio de descompensación de IC que había motivado ingreso en servicio de Medicina Interna de HCU Lozano Blesa desde 2010 hasta febrero de 2018. Se analizaron diversas variables basales de los pacientes en fase de descompensación y se realizó un seguimiento con un control al mes y al año del primer episodio de descompensación. Se intentó relacionar el índice TyG con el riesgo de exitus y de descompensaciones durante el período de tiempo analizado. Resultados: Se calculó el índice TyG, obteniendo un valor medio 8,56 ± 0,57. No se encontraron diferencias significativas en los valores ni según sexo ni según FEVI. En cambio, sí fueron significativas las diferencias encontradas en el porcentaje de exitus al mes, siendo mayor en los pacientes con valores inferiores (p: 0,045). En el análisis de supervivencia se objetivó una mayor supervivencia de forma significativa en el grupo con niveles superiores (log-rank: 0,035). Discusión: Los resultados obtenidos podrían explicarse con la paradoja de la obesidad, ya que se ha visto que en pacientes con IC crónica la obesidad y el sobrepeso se asocian a una mayor supervivencia, en comparación con aquellos con normopeso. Conclusión: El índice TyG es un marcador subrogado de resistencia a la insulina que se ha visto que es más elevado en individuos con diabetes y obesidad. En la muestra estudiada se ha observado que aquellos pacientes con valores superiores presentaban una menor tasa de exitus al mes y una mayor supervivencia al año de seguimiento. Parece conveniente dada la sencillez para su cálculo en seguir investigando en su potencial valor como biomarcador en IC, así como analizar si las variaciones en su valor proporcionan mayor información pronóstica

Published
2018

24. Evaluación clínica, microbiológica y epidemiológica de una nueva consulta multidisciplinar de infecciones de transmisión sexual (ITS)

Author

Alda Lozano, Alicia and Amiguet García, Juan Antonio

Abstract

Estamos asistiendo a una irrupción de las infecciones de transmisión sexual (ITS) que muestran una tendencia creciente desde el año 2000, incluso excluyendo la infección por VIH. Destacan las infecciones causadas por Chlamydia trachomatis, Neisseria gonorrhoeae y sífilis. La situación es similar en EEUU, Europa y España, siendo la primera más frecuente entre mujeres jóvenes y las otras dos entre hombres, debido al mayor incremento entre hombres que tienen relaciones sexuales con hombres (HSH). Ante esta situación la OMS ha alertado y ha elaborado una Estrategia para la prevención y control de las ITS, consiguiéndose un alcance universal de las medidas. A nivel nacional se ha elaborado el Plan estratégico para la Prevención y Control de la infección VIH y otras ITS, proponiéndose varias medidas. Entre ellas destaca la creación de consultas de ITS, importantes para controlar estas infecciones y prevenir el VIH. Ante este panorama se ha elaborado un protocolo de actuación frente a las ITS para el Hospital Lozano Blesa. El primer paso ha consistido en la creación de una consulta de ITS, destinada a la población perteneciente al sector Zaragoza III, mayor de 14 años y con sospecha de ITS. Tras el análisis de las características epidemiológicas, clínicas y otros aspectos relacionados con el manejo de los 42 pacientes valorados en los primeros 6 meses, se ha observado que existe predominio de varones (67%), de edad media (74% 26-52 años) e inmigrantes (64%). Los principales motivos de consulta son sífilis y condilomas acuminados. El 31% de los pacientes pertenecen a grupos de mayor susceptibilidad (HSH, bisexuales o prostitución). Son aspectos destacables: escasa proporción de jóvenes, predominio de inmigrantes, pocos casos de clamidia y gonorrea y escasa derivación desde Atención primaria y servicios como Ginecología y Urología. El período de tiempo desde inicio de síntomas hasta la valoración en consulta (mediana de 85 días) y la complejidad que supone la valoración de contactos. Propuestas de mejora: Ampliar la difusión sobre la existencia de esta consulta y su disponibilidad. Asegurar el conocimiento de técnicas apropiadas para recogida de muestras. Y promover el diagnóstico precoz y el manejo de contactos.

Published
2016

25. Clinical outcomes after discontinuing anticoagulant therapy in patients with first unprovoked venous thromboembolism

Author

Gabara, Cristina, Aibar, Jesus, Nishimoto, Yuji, Yamashita, Yugo, Prandoni, Paolo, Barnes, Geoffrey D., Bikdeli, Behnood, Jiménez, David, Demelo-Rodríguez, Pablo, Peris, Ma Luisa, Nguyen, Son Truong, Monreal, Manuel, Agudo, P., Aibar, J., Alberich-Conesa, A., Alda-Lozano, A., Alfonso, J., Amado, C., Angelina-García, M., Arcelus, J.I., Ballaz, A., Barba, R., Barbagelata, C., Barreiro, B., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Beddar-Chaib, F., Blanco-Molina, A., Caballero, J.C., Cañas, I., Castellanos, G., Chasco, L., Claver, G., Criado, J., De Juana-Izquierdo, C., Del Toro, J., Demelo-Rodríguez, P., Díaz-Pedroche, M.C., Díaz-Peromingo, J.A., Dubois-Silva, A., Escribano, J.C., Falgá, C., Fernández-Aracil, C., Fernández-Capitán, C., Fernández-Jiménez, B., Fernández-Reyes, J.L., Fidalgo, M.A., Francisco, I., Gabara, C., Galeano-Valle, F., García-Bragado, F., García-Ortega, A., Gavín-Sebastián, O., Gil-Díaz, A., Gómez-Cuervo, C., González-Munera, A., Grau, E., Guirado, L., Gutiérrez-Guisado, J., Hernández-Blasco, L., Hernández-Molina, A., Hernández-Vidal, M.J., Jara-Palomares, L., Jiménez, D., Jou, I., Joya, M.D., Lalueza, A., Lecumberri, R., Llamas, P., Lobo, J.L., López-Brull, H., López-De la Fuente, M., López-Jiménez, L., López-Miguel, P., López-Núñez, J.J., López-Ruiz, A., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Lumbierres, M., Madridano, O., Maestre, A., Marchena, P.J., Marcos, M., Martín del Pozo, M., Martín-Martos, F., Martínez-Prado, R., Maza, J.M., Mercado, M.I., Moisés, J., Molino, A., Monreal, M., Monzón, L., Morales, M.V., Muñoz-Gamito, G., Navas, M.S., Nieto, J.A., Núñez-Fernández, M.J., Olid, M., Ordieres-Ortega, L., Ortiz, M., Osorio, J., Otálora, S., Otero, R., Pacheco-Gómez, N., Pagán, J., Palomeque, A.C., Paredes, E., Parra-Rosado, P., Pedrajas, J.M., Pérez-Ductor, C., Pérez-Pinar, M., Peris, M.L., Pesce, M.L., Porras, J.A., Puchades, R., Rivas, A., Rivera-Cívico, F., Rivera-Gallego, A., Rodríguez-Cobo, A., Romero-Bruguera, M., Ruiz-Artacho, P., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Steinherr, A., Suárez-Fernández, S., Tirado, R., Torrents-Vilar, A., Torres, M.I., Trujillo-Santos, J., Uresandi, F., Valle, R., Varona, J.F., Villalobos, A., Villares, P., Ay, C., Nopp, S., Pabinger, I., Vanassche, T., Verhamme, P., Verstraete, A., Yoo, H.H.B., Montenegro, A.C., Morales, S.N., Roa, J., Hirmerova, J., Malý, R., Varhaník, F., Bertoletti, L., Bura-Riviere, A., Catella, J., Chopard, R., Couturaud, F., Espitia, O., Le Mao, R., Leclerq, B., Mahé, I., Moustafa, F., Plaisance, L., Sarlon-Bartoli, G., Suchon, P., Versini, E., Schellong, S., Brenner, B., Dally, N., Kenet, G., Tzoran, I., Rashidi, F., Sadeghipour, P., Tahmasbi, F., Abenante, A., Barillari, G., Bilora, F., Bissacco, D., Brandolin, B., Casana, R., Ciammaichella, M., Colaizzo, D., Dentali, F., Di Micco, P., Giorgi-Pierfranceschi, M., Grandone, E., Imbalzano, E., Lambertenghi-Deliliers, D., Martini, R., Meschi, T., Negro, F., Poz, A., Prandoni, P., Simioni, P., Siniscalchi, C., Taflaj, B., Ticinesi, A., Tufano, A., Visonà, A., Zalunardo, B., Kalnina, P., Kigitovica, D., Skride, A., Zicans, M., Nishimoto, Y., Yamashita, Y., Tazi-Mezalek, Z., Fonseca, S., Marques, R., Meireles, J., Pinto, S., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Aujayeb, A., Bikdeli, B., Caprini, J.A., Khalil, A., Tafur, J., Weinberg, I., Bui, H.M., Nguyen, S.T., Pham, K.Q., and Tran, G.B.

Abstract

The duration of anticoagulation for a first episode of unprovoked venous thromboembolism (VTE) should balance the likelihood of VTE recurrence against the risk of major bleeding.

Published
2024
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