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1. Influence of sex on long-term prognosis in patients with atrial fibrillation treated with oral anticoagulants. Results from the prospective, nationwide FANTASIIA study

Author

Roldán Rabadán, Inmaculada, Esteve-Pastor, María Asunción, Anguita Sánchez, Manuel, Muñiz, Javier, Ruiz Ortiz, Martín, Marín, Francisco, Roldán, Vanessa, Quesada, María Angustias, Camacho Siles, José, Cequier Fillat, Angel, Bertomeu Martinez, Vicente, Martínez Sellés, Manuel, and Badimón, Lina

Published
2020
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11. Diuretic Strategies in Acute Heart Failure and Renal Dysfunction: Conventional vs Carbohydrate Antigen 125-guided Strategy. Clinical Trial Design

Author

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

Published
2017
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15. Carbohydrate Antigen-125–Guided Therapy in Acute Heart Failure: CHANCE-HF: A Randomized Study

Author

Núñez, Julio, Garcia-Blas, Sergio, Sanchis, Juan, Bodí, Vicent, Santas, Enrique, Olivares, Miryam, Bonanad, Clara, Bondanza, Lourdes, Llàcer, Angel, Chorro, Francisco J., Bosch, Maria José, Merlos, Pilar, Gallego, Jorge, Palau, Patricia, Llàcer, Pau, Mendizabal, Andrea, Miñana, Gema, Pedrosa, Valle, Salvador, Montserrat, Camps, Antonio, Salvador, Gonzalo, Bertomeu-González, Vicente, Bertomeu-Martínez, Vicente, Cordero, Alberto, Moreno, José, Quiles, Juan, López Pineda, Adriana, Fácila, Lorenzo, Montagud, Vicente, Fonfria, Rosa, Jareño, Maria Teresa, Belchi, Joaquina, Rumiz, Eva, Morell, Salvador, García-Blas, Sergio, and Mendizábal, Andrea

Published
2016
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24. A comparison of front-line oral anticoagulants for the treatment of non-valvular atrial fibrillation: effectiveness and safety of direct oral anticoagulants in the FANTASIIA registry

Author

Esteve-Pastor, María Asunción, primary, Rivera-Caravaca, José Miguel, additional, Ruiz-Ortiz, Martín, additional, Muñiz, Javier, additional, Roldán-Rabadán, Inmaculada, additional, Otero, Déborah, additional, López-Gálvez, Raquel, additional, Cequier, Ángel, additional, Bertomeu-Martínez, Vicente, additional, Badimón, Lina, additional, Anguita, Manuel, additional, Lip, Gregory Y.H., additional, and Marín, Francisco, additional

Published
2022
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27. Impact of Integrated Care Management on Clinical Outcomes in Atrial Fibrillation Patients: A Report From the FANTASIIA Registry

Author

Esteve Pastor, María Asunción, Ruiz Ortiz, Martín, Muñiz, Javier, Roldán Rabadán, Inmaculada, Otero, Déborah, Cequier Fillat, Àngel R., Bertomeu Martínez, Vicente, Badimón, Lina, 1953, Anguita, Manuel, Lip, Gregory Y. H., Marín, Francisco, and FANTASIIA Study Investigators

Subjects
Medical care, Factors de risc en les malalties, Risk factors in diseases, Patient adherence, Atrial fibrillation, Fibrilación auricular, Risk factors, Assistència sanitària, Fibril·lació auricular, ABC-Pathway, Enfoque integrado, Integrated approach, Cardiology and Cardiovascular Medicine, Factores de riesgo
Abstract

BackgroundAn integrated and holistic approach is increasingly advocated in patients with atrial fibrillation (AF), based on the “Atrial fibrillation Better Care (ABC) pathway: A, Avoid stroke with anticoagulation; B, better symptom management; C, cardiovascular and comorbidity risk management.” The aim of this study was to examine the prevalence of adherence to each component of the ABC pathway and to analyze its impact on long-term prognosis in the “real-world” cohort of AF patients from the FANTASIIA registry.MethodsThis prospective study included consecutive AF outpatients anticoagulated with direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA) from June 2013 to October 2014. From the ABC pathway, adherence to the “A criterion” was defined by a time in the therapeutic range (TTR) ≥ 70% or correct dose with DOAC; “B criterion” adherence was defined by a European Heart Rhythm Association (EHRA) Symptom Scale I-II; and “C criterion” adherence was defined as optimized risk factors and comorbidity management. Baseline features and embolic events, severe bleeding, and all-cause and cardiovascular mortality rates up to 3 years of follow-up were analyzed, and a Cox multivariate analysis was performed to investigate the role of each component of the ABC pathway in predicting major events.ResultsA total of 1,955 AF patients (age: 74.4 ± 9.4 years; 43.2% female patients) were included in this study: adherence to A criterion was observed in 920 (47.1%) patients; adherence to B criterion was observed in 1,791 (91.6%) patients; and adherence to C criterion was observed in 682 (34.8%) patients. Only 394 (20.2%) of the whole population had good control of AF according to the ABC pathway. After a median follow-up of 1,078 days (IQR: 766–1,113), adherence to A criterion was independently associated with reduced cardiovascular mortality [HR: 0.67, 95%CI (0.45–0.99); p = 0.048] compared with non-adherence. Adherence to the B criterion was independently associated with reduced stroke [HR: 0.28, 95%CI (0.14–0.59); p < 0.001], all-cause mortality [HR: 0.49, 95%CI (0.35–0.69); p < 0.001], cardiovascular mortality [HR: 0.39, 95%CI (0.25–0.62); p < 0.001], and major adverse cardiovascular events (MACE) [HR: 0.41, 95%CI (0.28–0.62); p < 0.001] compared with non-adherence. AF patients with C criterion adherence had a significantly lower risk of myocardial infarction [HR: 0.31, 95%CI (0.15–0.66); p < 0.001]. Fully adherent ABC patients had a significant reduction in MACE [HR: 0.64, 95%CI (0.42–0.99); p = 0.042].ConclusionIn real-world anticoagulated AF patients from FANTASIIA registry, we observed a lack of adherence to integrated care management of AF following the ABC pathway. AF managed according to the ABC pathway was associated with a significant reduction in adverse outcomes during long follow-up, suggesting the benefit of a holistic and integrated approach to AF management.

Published
2022

28. Impact of integrated care management on clinical outcomes in atrial fibrillation patients: a report from the FANTASIIA Registry

Author

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

Abstract

[Abstract] Background: An integrated and holistic approach is increasingly advocated in patients with atrial fibrillation (AF), based on the “Atrial fibrillation Better Care (ABC) pathway: A, Avoid stroke with anticoagulation; B, better symptom management; C, cardiovascular and comorbidity risk management.” The aim of this study was to examine the prevalence of adherence to each component of the ABC pathway and to analyze its impact on long-term prognosis in the “real-world” cohort of AF patients from the FANTASIIA registry. Methods: This prospective study included consecutive AF outpatients anticoagulated with direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA) from June 2013 to October 2014. From the ABC pathway, adherence to the “A criterion” was defined by a time in the therapeutic range (TTR) ≥ 70% or correct dose with DOAC; “B criterion” adherence was defined by a European Heart Rhythm Association (EHRA) Symptom Scale I-II; and “C criterion” adherence was defined as optimized risk factors and comorbidity management. Baseline features and embolic events, severe bleeding, and all-cause and cardiovascular mortality rates up to 3 years of follow-up were analyzed, and a Cox multivariate analysis was performed to investigate the role of each component of the ABC pathway in predicting major events. Results: A total of 1,955 AF patients (age: 74.4 ± 9.4 years; 43.2% female patients) were included in this study: adherence to A criterion was observed in 920 (47.1%) patients; adherence to B criterion was observed in 1,791 (91.6%) patients; and adherence to C criterion was observed in 682 (34.8%) patients. Only 394 (20.2%) of the whole population had good control of AF according to the ABC pathway. After a median follow-up of 1,078 days (IQR: 766–1,113), adherence to A criterion was independently associated with reduced cardiovascular mortality [HR: 0.67, 95%CI (0.45–0.99); p = 0.048] compared with non-adherence. Adherence to the B criterion was independently

Published
2022

34. Evolution and Scientific Impact of Research Grants From the Spanish Society of Cardiology and Spanish Heart Foundation (2000-2006)

Author

Aleixandre Benavent, Rafael, Alonso Arroyo, Adolfo, Anguita Sánchez, Manuel, Bolaños Pizarro, Máxima, Heras, Magda, González Alcalde, Gregorio, Macaya Miguel, Carlos, Navarro Molina, Carolina, Castelló Cogollos, Lourdes, Valderrama Zurián, Juan Carlos, Chorro Gascó, Francisco Javier, Bertomeu Martínez, Vicente, Salvador Taboada, María Jesús, Plaza Celemín, Leandro, Pérez-Villacastín, Julián, Cequier Fillat, Ángel, Varela Román, Alfonso, Laraudogoitia Zaldumbide, Eva, and Morell Cabedo, Salvador

Published
2011
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42. Relationship between multimorbidity and outcomes in atrial fibrillation

Author

Proietti, Marco, primary, Esteve-Pastor, María Asunción, additional, Rivera-Caravaca, José Miguel, additional, Roldán, Vanessa, additional, Roldán Rabadán, Inmaculada, additional, Muñiz, Javier, additional, Cequier, Ángel, additional, Bertomeu-Martínez, Vicente, additional, Badimón, Lina, additional, Anguita, Manuel, additional, Lip, Gregory Y.H., additional, and Marín, Francisco, additional

Published
2021
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45. Relationship between multimorbidity and outcomes in atrial fibrillation

Author

Proietti, Marco, Esteve-Pastor, María Asunción, Rivera-Caravaca, José Miguel, Roldán, Vanessa, Roldán Rabadán, Inmaculada, Muñiz, Javier, Cequier, Ángel, Bertomeu-Martínez, Vicente, Badimón, Lina, Anguita, Manuel, Lip, Gregory Y.H., Marín, Francisco, Proietti, Marco, Esteve-Pastor, María Asunción, Rivera-Caravaca, José Miguel, Roldán, Vanessa, Roldán Rabadán, Inmaculada, Muñiz, Javier, Cequier, Ángel, Bertomeu-Martínez, Vicente, Badimón, Lina, Anguita, Manuel, Lip, Gregory Y.H., and Marín, Francisco

Abstract

[Abstract] Background: Multimorbidity is common in atrial fibrillation (AF) patients. Charlson comorbidity index (CCI) is used to evaluate multimorbidity in the general population. Limited long-term data are available on the relationship between CCI and AF. We examined the association between CCI, anticoagulation control and outcomes in AF patients. Methods: We studied 1956 from the FANTASIIA registry, an observational Spanish nationwide study on anticoagulated AF patients. Time in therapeutic range (TTR) was used to evaluate anticoagulation control. Stroke/TIA, major bleeding, cardiovascular (CV) death and all-cause death were study outcomes. Results: Mean ± SD CCI was 1.1 ± 1.2. Based on CCI quartiles, patients were categorised in four groups: 676 (34.6%) in Q1 (CCI 0); 683 (34.9%) in Q2 (CCI 1); 345 (17.6%) in Q3 (CCI 2); and 252 (12.9%) in Q4 (CCI ≥3). In vitamin K antagonist treated patients, the highest CCI quartile was inversely associated with TTR >70% (odds ratio:0.67, 95% confidence interval (CI):0.45-0.99). During observation, a progressively higher rate of major bleeding, CV death and all-cause death was found across the quartiles (all p < 0.001). The final Cox multivariable regression analysis showed an association with increasing risk for major bleeding occurrence in Q3 and Q4 (hazard ratio (HR):1.69, 95%CI:1.00-2.87 and HR:1.92, 95%CI:1.08-3.41). An increasing risk for all-cause death and CV death was found across CCI quartiles. Conclusions: In a nationwide contemporary cohort of AF anticoagulated patients, multimorbidity was inversely associated with good anticoagulation control. A progressively higher risk for major bleeding, CV death and all-cause death was found across CCI quartiles.

Published
2021

47. Peripheral artery disease and 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, Otero García, Deborah, Ruiz-Ortiz, Martín, Cequier, Ángel, Bertomeu-Martínez, Vicente, Badimón, Lina, Anguita, Manuel, Lip, Gregory Y.H., Marín, Francisco, Bertomeu-González, Vicente, Moreno-Arribas, José, Esteve-Pastor, María Asunción, Roldán-Rabadán, Inmaculada, Muñiz, Javier, Otero García, Deborah, Ruiz-Ortiz, Martín, Cequier, Ángel, Bertomeu-Martínez, Vicente, Badimón, Lina, Anguita, Manuel, Lip, Gregory Y.H., and Marín, Francisco

Abstract

[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.

Published
2020

48. Relationship of Adverse Events to Quality of Anticoagulation Control in Atrial Fibrillation Patients With Diabetes: Real-World Data From the FANTASIIA Registry

Author

García-Fernández, Amaya, Esteve-Pastor, María Asunción, Roldán Rabadán, Inmaculada, Muñiz, Javier, Ruiz Ortiz, Martín, Cequier, Ángel, Bertomeu- Martínez, Vicente, Badimón, Lina, Otero, Déborah, Anguita, Manuel, Lip, Gregory, Marín, Francisco, García-Fernández, Amaya, Esteve-Pastor, María Asunción, Roldán Rabadán, Inmaculada, Muñiz, Javier, Ruiz Ortiz, Martín, Cequier, Ángel, Bertomeu- Martínez, Vicente, Badimón, Lina, Otero, Déborah, Anguita, Manuel, Lip, Gregory, and Marín, Francisco

Abstract

[Abstract] Background: Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. Purpose: To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status. Methods: AF patients from FANTASIIA registry were included. Baseline characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and DM was evaluated. Results: 1956 patients (mean age 73.8 ± 9.5 years, 56% male) were analyzed; 574 (29.3%) had DM. Diabetic patients had also high prevalence of hypertension (90.6% vs 76.1%; p <.001) or renal disease (21.4% vs 15.9%; p <.001). After median follow-up of 1077 days (IQR 766–1113 days), diabetic patients had high total mortality (16.9%/year vs 11.4%/year; p <.001), cardiovascular mortality (9.1%/year vs 3.9%/year; p <.001) and MACE (12.9%/year vs 6.8%/year; p <.001). DM patients had poor anticoagulation control (time in therapeutic range: 58.52 ± 24.37% vs 62.68 ± 25.31%; p =.002). DM with lower TTR showed higher cardiovascular death and MACE. Multivariate analysis showed an independent association between DM and cardiovascular mortality [HR 1.73 (IC95% 1.07–2.80); p =.024]. Conclusion: AF Diabetic patients have higher comorbidities and poorer TTR than nondiabetic patients. Low TTR was associated with adverse events. The risk of cardiovascular outcomes was higher in DM patients, with independent association between DM and mortality risk. © 2020 Informa UK Limited, trading as Taylor & Francis Group.

Published
2020

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