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2. Wytyczne ESC/ESH dotyczace postȩpowania w nadciśnieniu tȩtniczym (2018): Grupa Robocza Europejskiego Towarzystwa Kardiologicznego (ESC) i Europejskiego Towarzystwa Nadciśnienia Tȩtniczego (ESH) do spraw postȩpowania w nadciśnieniu tȩtniczym

Author

Williams, B, Mancia, G, Spiering, W, 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, Windecker, S, Agewall, S, Barbato, E, Bueno, H, Collet, J, Coman, I, Dean, V, Delgado, V, Fitzsimons, D, Gaemperli, O, Hindricks, G, Iung, B, Juni, P, Katus, H, Knuuti, J, Lancellotti, P, Leclercq, C, Mcdonagh, T, Piepoli, M, Ponikowski, P, Richter, D, Roffi, M, Simpson, I, Sousa-Uva, M, Zamorano, J, Lurbe, E, Bochud, M, Jelakovic, B, Januszewicz, A, Polonia, J, Van De Borne, P, Borghi, C, Parati, G, Manolis, A, Lovic, D, Benkhedda, S, Zelveian, P, Siostrzonek, P, Najafov, R, Pavlova, O, De Pauw, M, Dizdarevic-Hudic, L, Raev, D, Karpettas, N, Olsen, M, Shaker, A, Viigimaa, M, Baranova, E, Metsarinne, K, Halimi, J, Pagava, Z, Thomopoulos, C, Bertomeu-Martinez, V, Wittekoek, J, Andersen, K, Shechter, M, Romanova, T, Bajraktari, G, Saade, G, Sakalyte, G, Noppe, S, Trusinskis, K, Vavlukis, M, Demarco, D, Caraus, A, Schunkert, H, Aksnes, T, Jankowski, P, Linhart, A, Vinereanu, D, Foscoli, M, Dikic, A, Filipova, S, Fras, Z, Burkard, T, Carlberg, B, Sdiri, W, Aydogdu, S, Sirenko, Y, Pall, D, Brady, A, Mercuro, G, Weber, T, Lazareva, I, De Backer, T, Sokolovic, S, Chazova, I, Porsti, I, Denolle, T, Stergiou, G, Segura, J, Miglinas, M, Kramer, B, Gerdts, E, Tykarski, A, De Carvalho Rodrigues, M, Widimsky, J, Dorobantu, M, Brguljan, J, Pechere-Bertschi, A, Gottsater, A, Erdine, S, Williams B., Mancia G., Spiering W., Rosei E. A., Azizi M., Burnier M., Clement D. L., Coca A., De Simone G., Dominiczak A., Kahan T., Mahfoud F., Redon J., Ruilope L., Zanchetti A., Kerins M., Kjeldsen S. E., Kreutz R., Laurent S., Lip G. Y. H., McManus R., Narkiewicz K., Ruschitzka F., Schmieder R. E., Shlyakhto E., Tsioufis C., Aboyans V., Desormais I., Windecker S., Agewall S., Barbato E., Bueno H., Collet J. -P., Coman I. M., Dean V., Delgado V., Fitzsimons D., Gaemperli O., Hindricks G., Iung B., Juni P., Katus H. A., Knuuti J., Lancellotti P., Leclercq C., McDonagh T. A., Piepoli M. F., Ponikowski P., Richter D. J., Roffi M., Simpson I. A., Sousa-Uva M., Zamorano J. L., Lurbe E., Bochud M., Jelakovic B., Januszewicz A., Polonia J., Van De Borne P., Borghi C., Parati G., Manolis A., Lovic D., Benkhedda S., Zelveian P., Siostrzonek P., Najafov R., Pavlova O., De Pauw M., Dizdarevic-Hudic L., Raev D., Karpettas N., Olsen M. H., Shaker A. F., Viigimaa M., Baranova E. I., Metsarinne K., Halimi J. -M., Pagava Z., Thomopoulos C., Bertomeu-Martinez V., Wittekoek J., Andersen K., Shechter M., Romanova T., Bajraktari G., Saade G. A., Sakalyte G., Noppe S., Trusinskis K., Vavlukis M., DeMarco D. C., Caraus A., Schunkert H., Aksnes T. A., Jankowski P., Linhart A., Vinereanu D., Foscoli M., Dikic A. D., Filipova S., Fras Z., Burkard T., Carlberg B., Sdiri W., Aydogdu S., Sirenko Y., Pall D., Brady A., Mercuro G., Weber T., Lazareva I., De Backer T., Sokolovic S., Chazova I., Porsti I., Denolle T., Stergiou G. S., Segura J., Miglinas M., Kramer B. K., Gerdts E., Tykarski A., De Carvalho Rodrigues M., Widimsky J., Dorobantu M., Brguljan J., Pechere-Bertschi A., Gottsater A., Erdine S., Williams, B, Mancia, G, Spiering, W, 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, Windecker, S, Agewall, S, Barbato, E, Bueno, H, Collet, J, Coman, I, Dean, V, Delgado, V, Fitzsimons, D, Gaemperli, O, Hindricks, G, Iung, B, Juni, P, Katus, H, Knuuti, J, Lancellotti, P, Leclercq, C, Mcdonagh, T, Piepoli, M, Ponikowski, P, Richter, D, Roffi, M, Simpson, I, Sousa-Uva, M, Zamorano, J, Lurbe, E, Bochud, M, Jelakovic, B, Januszewicz, A, Polonia, J, Van De Borne, P, Borghi, C, Parati, G, Manolis, A, Lovic, D, Benkhedda, S, Zelveian, P, Siostrzonek, P, Najafov, R, Pavlova, O, De Pauw, M, Dizdarevic-Hudic, L, Raev, D, Karpettas, N, Olsen, M, Shaker, A, Viigimaa, M, Baranova, E, Metsarinne, K, Halimi, J, Pagava, Z, Thomopoulos, C, Bertomeu-Martinez, V, Wittekoek, J, Andersen, K, Shechter, M, Romanova, T, Bajraktari, G, Saade, G, Sakalyte, G, Noppe, S, Trusinskis, K, Vavlukis, M, Demarco, D, Caraus, A, Schunkert, H, Aksnes, T, Jankowski, P, Linhart, A, Vinereanu, D, Foscoli, M, Dikic, A, Filipova, S, Fras, Z, Burkard, T, Carlberg, B, Sdiri, W, Aydogdu, S, Sirenko, Y, Pall, D, Brady, A, Mercuro, G, Weber, T, Lazareva, I, De Backer, T, Sokolovic, S, Chazova, I, Porsti, I, Denolle, T, Stergiou, G, Segura, J, Miglinas, M, Kramer, B, Gerdts, E, Tykarski, A, De Carvalho Rodrigues, M, Widimsky, J, Dorobantu, M, Brguljan, J, Pechere-Bertschi, A, Gottsater, A, Erdine, S, Williams B., Mancia G., Spiering W., Rosei E. A., Azizi M., Burnier M., Clement D. L., Coca A., De Simone G., Dominiczak A., Kahan T., Mahfoud F., Redon J., Ruilope L., Zanchetti A., Kerins M., Kjeldsen S. E., Kreutz R., Laurent S., Lip G. Y. H., McManus R., Narkiewicz K., Ruschitzka F., Schmieder R. E., Shlyakhto E., Tsioufis C., Aboyans V., Desormais I., Windecker S., Agewall S., Barbato E., Bueno H., Collet J. -P., Coman I. M., Dean V., Delgado V., Fitzsimons D., Gaemperli O., Hindricks G., Iung B., Juni P., Katus H. A., Knuuti J., Lancellotti P., Leclercq C., McDonagh T. A., Piepoli M. F., Ponikowski P., Richter D. J., Roffi M., Simpson I. A., Sousa-Uva M., Zamorano J. L., Lurbe E., Bochud M., Jelakovic B., Januszewicz A., Polonia J., Van De Borne P., Borghi C., Parati G., Manolis A., Lovic D., Benkhedda S., Zelveian P., Siostrzonek P., Najafov R., Pavlova O., De Pauw M., Dizdarevic-Hudic L., Raev D., Karpettas N., Olsen M. H., Shaker A. F., Viigimaa M., Baranova E. I., Metsarinne K., Halimi J. -M., Pagava Z., Thomopoulos C., Bertomeu-Martinez V., Wittekoek J., Andersen K., Shechter M., Romanova T., Bajraktari G., Saade G. A., Sakalyte G., Noppe S., Trusinskis K., Vavlukis M., DeMarco D. C., Caraus A., Schunkert H., Aksnes T. A., Jankowski P., Linhart A., Vinereanu D., Foscoli M., Dikic A. D., Filipova S., Fras Z., Burkard T., Carlberg B., Sdiri W., Aydogdu S., Sirenko Y., Pall D., Brady A., Mercuro G., Weber T., Lazareva I., De Backer T., Sokolovic S., Chazova I., Porsti I., Denolle T., Stergiou G. S., Segura J., Miglinas M., Kramer B. K., Gerdts E., Tykarski A., De Carvalho Rodrigues M., Widimsky J., Dorobantu M., Brguljan J., Pechere-Bertschi A., Gottsater A., and Erdine S.

Published
2019

3. Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries

Author

Vicente-Ibarra N, Feliu E, Bertomeu-Martinez V, Cano-Vivar P, Carrillo-Saez P, Morillas P, and Miguel Ruiz-Nodar J

Subjects
Cardiovascular magnetic resonance, Adverse cardiovascular events, Myocardial infarction, Myocardial infarction with no obstructive coronary arteries, cardiovascular diseases
Abstract

BACKGROUND: It is estimated that 5% to 10% of patients with myocardial infarction (MI) present with no obstructive coronary artery lesions. Until now, most studies have focused on acute coronary syndrome, including different clinical entities with a similar presentation encompassed under the term MINOCA (MI with non-obstructive coronary arteries). The aim of this study is to assess the prognosis of patients diagnosed with true infarction, confirmed by cardiovascular magnetic resonance (CMR), in the absence of significant coronary lesions. METHODS: Prospective multicenter registry study, including 120 consecutive patients with a CMR-confirmed MI without obstructive coronary artery lesions. The primary clinical outcome was major adverse cardiovascular events (MACE: death, non-fatal infarction, stroke, or cardiac readmission), assessed over three years. RESULTS: Seventy-six patients (63.3%) were admitted with a diagnosis of acute coronary syndrome, and 44 (36.6%) for other causes (mainly heart failure); the definitive diagnosis was established by CMR. Most patients (64.2%) were men, and the mean age was 58.8 ± 13.5 years. Patients presented with small infarcts: 83 (69.1%) showed late gadolinium enhancement (LGE) in one or two myocardial segments, mainly transmural (in 77.5% of patients) and with a preserved left ventricular ejection fraction (median 54.8%, interquartile range 37-62). The most frequent infarct location was inferolateral (n = 38, 31.7%). During follow-up, 43 patients (35.8%) experienced a MACE, including 9 (7.5%) who died. In multivariable analysis, LGE in two versus one myocardial segment doubled the risk of adverse cardiac events (hazard ratio [HR] 2.32, 95% confidence interval [CI] 0.97-5.83, p = 0.058). Involvement of three or more myocardial segments almost tripled the risk (HR 2.71, 95% CI 1.04-7.04, p = 0.040 respectively). CONCLUSIONS: Patients with true MI but without significant coronary artery lesions predominantly had small infarcts. Myocardial 3-segment LGE involvement is associated with a significantly higher risk of adverse cardiac events.

Published
2021

4. Wytyczne ESC/ESH dotyczace postȩpowania w nadciśnieniu tȩtniczym (2018): Grupa Robocza Europejskiego Towarzystwa Kardiologicznego (ESC) i Europejskiego Towarzystwa Nadciśnienia Tȩtniczego (ESH) do spraw postȩpowania w nadciśnieniu tȩtniczym

Author

Williams B., Mancia G., Spiering W., Rosei E. A., Azizi M., Burnier M., Clement D. L., Coca A., De Simone G., Dominiczak A., Kahan T., Mahfoud F., Redon J., Ruilope L., Zanchetti A., Kerins M., Kjeldsen S. E., Kreutz R., Laurent S., Lip G. Y. H., McManus R., Narkiewicz K., Ruschitzka F., Schmieder R. E., Shlyakhto E., Tsioufis C., Aboyans V., Desormais I., Windecker S., Agewall S., Barbato E., Bueno H., Collet J. -P., Coman I. M., Dean V., Delgado V., Fitzsimons D., Gaemperli O., Hindricks G., Iung B., Juni P., Katus H. A., Knuuti J., Lancellotti P., Leclercq C., McDonagh T. A., Piepoli M. F., Ponikowski P., Richter D. J., Roffi M., Simpson I. A., Sousa-Uva M., Zamorano J. L., Lurbe E., Bochud M., Jelakovic B., Januszewicz A., Polonia J., Van De Borne P., Borghi C., Parati G., Manolis A., Lovic D., Benkhedda S., Zelveian P., Siostrzonek P., Najafov R., Pavlova O., De Pauw M., Dizdarevic-Hudic L., Raev D., Karpettas N., Olsen M. H., Shaker A. F., Viigimaa M., Baranova E. I., Metsarinne K., Halimi J. -M., Pagava Z., Thomopoulos C., Bertomeu-Martinez V., Wittekoek J., Andersen K., Shechter M., Romanova T., Bajraktari G., Saade G. A., Sakalyte G., Noppe S., Trusinskis K., Vavlukis M., DeMarco D. C., Caraus A., Schunkert H., Aksnes T. A., Jankowski P., Linhart A., Vinereanu D., Foscoli M., Dikic A. D., Filipova S., Fras Z., Burkard T., Carlberg B., Sdiri W., Aydogdu S., Sirenko Y., Pall D., Brady A., Mercuro G., Weber T., Lazareva I., De Backer T., Sokolovic S., Chazova I., Porsti I., Denolle T., Stergiou G. S., Segura J., Miglinas M., Kramer B. K., Gerdts E., Tykarski A., De Carvalho Rodrigues M., Widimsky J., Dorobantu M., Brguljan J., Pechere-Bertschi A., Gottsater A., Erdine S., Williams, B, Mancia, G, Spiering, W, 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, Windecker, S, Agewall, S, Barbato, E, Bueno, H, Collet, J, Coman, I, Dean, V, Delgado, V, Fitzsimons, D, Gaemperli, O, Hindricks, G, Iung, B, Juni, P, Katus, H, Knuuti, J, Lancellotti, P, Leclercq, C, Mcdonagh, T, Piepoli, M, Ponikowski, P, Richter, D, Roffi, M, Simpson, I, Sousa-Uva, M, Zamorano, J, Lurbe, E, Bochud, M, Jelakovic, B, Januszewicz, A, Polonia, J, Van De Borne, P, Borghi, C, Parati, G, Manolis, A, Lovic, D, Benkhedda, S, Zelveian, P, Siostrzonek, P, Najafov, R, Pavlova, O, De Pauw, M, Dizdarevic-Hudic, L, Raev, D, Karpettas, N, Olsen, M, Shaker, A, Viigimaa, M, Baranova, E, Metsarinne, K, Halimi, J, Pagava, Z, Thomopoulos, C, Bertomeu-Martinez, V, Wittekoek, J, Andersen, K, Shechter, M, Romanova, T, Bajraktari, G, Saade, G, Sakalyte, G, Noppe, S, Trusinskis, K, Vavlukis, M, Demarco, D, Caraus, A, Schunkert, H, Aksnes, T, Jankowski, P, Linhart, A, Vinereanu, D, Foscoli, M, Dikic, A, Filipova, S, Fras, Z, Burkard, T, Carlberg, B, Sdiri, W, Aydogdu, S, Sirenko, Y, Pall, D, Brady, A, Mercuro, G, Weber, T, Lazareva, I, De Backer, T, Sokolovic, S, Chazova, I, Porsti, I, Denolle, T, Stergiou, G, Segura, J, Miglinas, M, Kramer, B, Gerdts, E, Tykarski, A, De Carvalho Rodrigues, M, Widimsky, J, Dorobantu, M, Brguljan, J, Pechere-Bertschi, A, Gottsater, A, and Erdine, S

Subjects
Antihypertensive Agent, Cardiology, Disease Management
Published
2019

5. Relationship of adverse events to quality of anticoagulation control in atrial fibrillation patients with diabetes: real-world data from the FANTASIIA Registry

Author

Garcia-Fernandez A, Esteve-Pastor M, Roldan-Rabadan I, Muniz J, Ortiz M, Cequier A, Bertomeu-Martinez V, Badimon L, Otero D, Anguita M, Lip G, Marin F, and FANTASIIA Investigators

Subjects
oral anticoagulation, diabetes mellitus, risk factors, Atrial fibrillation
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.

Published
2020

9. Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study (vol 12, e0186196, 2017)

Author

Orozco D, Gil V, Redon, J, Martin-Moreno, J, Pallares-Carratala, V, Navarro-Perez, J, Valls-Roca, F, Sanchis-Domenech, C, Fernandez-Gimenez, A, Perez-Navarro, A, Bertomeu-Martinez, V, Bertomeu-Gonzalez, V, Cordero, A, de la Torre, M, Trillo, J, Carratala-Munuera, C, Pita-Fernandez, S, Uso, R, Durazo-Arvizu, R, Cooper, R, Sanz, G, Castellano, J, Ascaso, J, Carmena, R, Tellez-Plaza, M, and ESCARVAL Study Grp

Abstract

[This corrects the article DOI: 10.1371/journal.pone.0186196.].

Published
2018

11. Relation of Renal Dysfunction to Quality of Anticoagulation Control in Patients with Atrial Fibrillation: The FANTASIIA Registry

Author

Esteve-Pastor, MA, Rivera-Caravaca, JM, Roldan-Rabadan, I, Roldan, V, Muniz, J, Rana-Miguez, P, Ruiz-Ortiz, M, Cequier, A, Bertomeu-Martinez, V, Badimon, L, Anguita, M, Lip, GYH, Marin, F, and FANTASIIA Study Investigators

Subjects
vitamin K antagonists, time in therapeutic range, acenocoumarol, renal function, atrial fibrillation, urologic and male genital diseases, chronic kidney disease
Abstract

Background One-third of atrial fibrillation (AF) patients have chronic kidney disease (CKD), a condition that itself increases thromboembolic and major bleeding risks, especially in patients with severe CKD. Bleeding would be accentuated by suboptimal anticoagulation control with vitamin K antagonists (VKA). Purpose This article aimed to investigate the incidence of cardiovascular events, mortality and quality of anticoagulation in relation to CKD in a 'real-world' prospective cohort of AF patients included in the FANTASIIA registry. Methods We analysed consecutive AF patients who were prospectively recruited with a year of follow-up. The quality of anticoagulation was estimated by time in therapeutic range (TTR). The annual incidence of events was analysed. Results We studied 1,936 patients (male: 55.7%, mean: 73.8 +/- 9.4 years): 445 (22.9%) had normal function, 698 (36.1%) had mild CKD, 713 (36.8%) had moderate CKD and 80 (4.2%) had severe CKD. Patients with estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m(2) (severe CKD) had lower TTR (53.3 +/- 25.6% vs. 61.8 +/- 25.1%, p = 0.007) and higher proportion of poor TTR (67.2 vs. 51.8%; p = 0.014) than patients with eGFR >= 30 mL/min/1.73 m2. Severe CKD was significantly associated with cardiovascular mortality (hazard ratio [HR]: 9.33; p = 0.002), major bleeding (HR: 2.94; p = 0.036) and major adverse cardiovascular events (MACE) (HR: 4.93; p = 0.004). Importantly, 375 patients (21.1%) showed a deteriorating eGFR of >= 10mL/min during the follow-up, with significantly higher mortality and cardiovascular events. Conclusion In a prospective and real-world AF registry, approximately 67% of patients with severe CKD had poor anticoagulation control while taking VKA. The presence of severe CKD was an independent factor for cardiovascular mortality, MACE and major bleeding. Worsening eGFR of only >= 10 mL/min during follow-up was significantly associated with mortality and major bleeding.

Published
2018

13. 5132Effect of PCSK9 inhibitors treatment on acute coronary syndrome and stroke incidence: a metanalysis of currently available clinical trials

Author

Cordero, A, primary, Facila, L, additional, Rodriguez-Manero, M, additional, Gomez-Martinez, M, additional, Bertomeu-Gonzalez, V, additional, Martinez, R, additional, Seijas, S, additional, Valle, A, additional, Moreno-Arribas, J, additional, Agra-Bermejo, R, additional, Martin Toro, M, additional, Bertomeu Martinez, V, additional, and Gonzalez Juanatey, J R, additional

Published
2019
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14. P4800Estimated effect of NOACs compared to Vitamin K Antagonists in real-world atrial fibrillation patients: Data from FANTASIA Registry

Author

Esteve Pastor, M A, primary, Rivera-Caravaca, J M, additional, Roldan, V, additional, Roldan Rabadan, I, additional, Muniz, J, additional, Cequier, A, additional, Bertomeu-Martinez, V, additional, Badimon, L, additional, Rana-Miguez, P, additional, Ruiz-Ortiz, M, additional, Anguita, M, additional, Lip, G Y H, additional, and Marin, F, additional

Published
2019
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15. P1223Attributable risk proportion of uncontrolled low-density lipoprotein cholesterol in recurrent acute coronary syndromes

Author

Cordero, A, primary, Rodriguez Manero, M, additional, Bertomeu Gonzalez, V, additional, Agra Bermejo, R, additional, Garcia Acuna, J M, additional, Moreno Arribas, J, additional, Moreno, M J, additional, Alvarez, B, additional, Martinez Rey-Ranal, E, additional, Bertomeu Martinez, V, additional, and Gonzalez-Juanatey, J R, additional

Published
2019
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17. Optimal pharmacological treatment and adherence to medication in secondary prevention of cardiovascular events in Spain: Results from the CAPS study

Author

Cordero, A, Padial, L, Batalla, A, Barreiro, L, Calvo, F, Castellano, J, Ruiz, E, Bertomeu-Martinez, V, and CAPS Study Investigators

Subjects
Adherence, Secondary prevention, Cardiovascular, Optimal treatment
Abstract

IntroductionDespite the large amount of evidence supporting the use of antiplatelet agents, beta-blockers, angiotensin antagonists, and lipid-lowering statins in patients with stable coronary artery disease, several studies have documented underprescription of optimal medical treatment (OMT) in Spain. AimsThe present study aimed to describe the current trend of pharmacological prescription in secondary prevention treatment for cardiovascular diseases (CVDs) in a Spanish cohort. MethodsThis study was a multicenter, observational, cross-sectional study (CAPS study, FER-CAR-2014-01) in the context of only one visit. Adherence levels to the prescribed medication, the reasons for not prescription of each medication, the existence of possible associations between sociodemographic features, different CVDs, and different drugs with treatment compliance were also analyzed in patients who have suffered cardiovascular effects. ResultsSix hundred and twelve patients (68.510.7years old; 78% males) were included. OMT was prescribed in 40.8% of the patients. The main reason for not prescribing was due to the physician's discretion. Adherence to medication, measured by the Morisky-Green questionnaire, was 45.8%, and it was positively related to the presence of coronary events (OR 1.80; 95% CI: 1.05-3.21) but not with any drug type. Moreover, a higher educational background implied a higher percentage of adherence to medication. Finally, nonadherent patients were prescribed more daily medicine intakes. ConclusionsLow adherence to guideline-oriented treatment as well as low adherence to medication was found by a self-reported questionnaire. Enhancing adherence to guideline-recommended therapy and reducing treatment complexity seem to be reasonable strategies to improve adherence to secondary prevention medications.

Published
2017

19. Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study

Author

Orozco-Beltran D, GIL V, Redon J, Martin-Moreno JM, Pallares-Carratala V, Navarro-Perez J, Valls-Roca F, Sanchis-Domenech C, Fernandez-Gimenez A, Perez-Navarro A, Bertomeu-Martinez V, Bertomeu-Gonzalez V, Cordero A, Pascual de la Torre M, Trillo JL, Carratala-Munuera C, Pita-Fernandez S, Uso R, Durazo-Arvizu R, Cooper R, Sanz G, Castellano JM, Ascaso JF, Carmena R, and Tellez-Plaza M

Abstract

Introduction The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with allcause mortality and hospitalization due to cardiovascular events in a high-risk population. Methods This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008-2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to coronary heart disease or stroke. We estimated adjusted rate ratios (aRR), absolute risk differences and population attributable risk associated with adverse lipid profiles. Results 51,462 subjects were included with a mean age of 62.6 years (47.6% men). During an average follow-up of 3.2 years, 919 deaths, 1666 hospitalizations for coronary heart disease and 1510 hospitalizations for stroke were recorded. The parameters that showed an increased rate for total mortality, coronary heart disease and stroke hospitalization were, respectively, low HDL-Cholesterol: aRR 1.25, 1.29 and 1.23; high Total/HDL-Cholesterol: aRR 1.22, 1.38 and 1.25; and high Triglycerides/HDL-Cholesterol: aRR 1.21, 1.30, 1.09. The parameters that showed highest population attributable risk (%) were, respectively, low HDL-Cholesterol: 7.70, 11.42, 8.40; high Total/HDL-Cholesterol: 6.55, 12.47, 8.73; and high Triglycerides/HDL-Cholesterol: 8.94, 15.09, 6.92. Conclusions In a population with cardiovascular risk factors, HDL-cholesterol, Total/HDL-cholesterol and triglycerides/HDL-cholesterol ratios were associated with a higher population attributable risk for cardiovascular disease compared to other common biomarkers.

Published
2017

21. P6620Relationship between charlson comorbidity index and risk of adverse outcomes in patients with atrial fibrillation: an analysis from the FANTASIIA registry

Author

Proietti, M, primary, Esteve-Pastor, M A, additional, Rivera-Caravaca, J M, additional, Roldan, V, additional, Roldan Rabadan, I, additional, Muniz, J, additional, Cequier, A, additional, Bertomeu-Martinez, V, additional, Badimon, L, additional, Anguita, M, additional, Lip, G Y H, additional, and Marin, P, additional

Published
2018
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23. P807Prevalence, long-term prognosis and medical alternatives for patients admitted for acute coronary syndromes and prasugrel contraindication

Author

Cordero, A, primary, Rodriguez-Manero, M, additional, Garcia-Acuna, J M, additional, Agra-Bermejo, R, additional, Cid-Alvarez, B, additional, Alvarez, B, additional, Bertomeu-Gonzalez, V, additional, Frutos, A, additional, Lopez-Palop, R, additional, Bertomeu-Martinez, V, additional, and Gonzalez-Juanatey, J R, additional

Published
2018
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24. Carbohydrate Antigen-125-Guided Therapy in Acute Heart Failure: CHANCE-HF: A Randomized Study

Author

Nunez, J, Llacer, P, Bertomeu-Gonzalez, V, Jose Bosch, M, Merlos, P, Garcia-Blas, S, Montagud, V, Bodi, V, Bertomeu-Martinez, V, Pedrosa, V, Mendizabal, A, Cordero, A, Gallego, J, Palau, P, Minana, G, Santas, E, Morell, S, Llacer, A, Chorro, F, Sanchis, J, Facila, L, and CHANCE-HF Investigators

Subjects
Male, endocrine system diseases, Adrenergic beta-Antagonists, heart failure, Angiotensin-Converting Enzyme Inhibitors, Patient Readmission, Patient Care Planning, Angiotensin Receptor Antagonists, Sodium Potassium Chloride Symporter Inhibitors, Cause of Death, Natriuretic Peptide, Brain, Myocardial Revascularization, Humans, Ivabradine, Mortality, Aged, Mineralocorticoid Receptor Antagonists, Monitoring, Physiologic, Aged, 80 and over, Heart Failure, biomarker guided-therapy, Cardiac Pacing, Artificial, clinical trial, Cardiovascular Agents, Benzazepines, Middle Aged, clinical outcomes, Peptide Fragments, Defibrillators, Implantable, Treatment Outcome, Spain, CA-125 Antigen, Acute Disease, carbohydrate antigen-125, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors
Abstract

OBJECTIVES This study sought to evaluate the prognostic effect of carbohydrate antigen-125 (CA125)-guided therapy (CA125 strategy) versus standard of care (SOC) after a hospitalization for acute heart failure (AHF). BACKGROUND CA125 has emerged as a surrogate of fluid overload and inflammatory status in AHF. After an episode of AHF admission, elevated values of this marker at baseline as well as its longitudinal profile relate to adverse outcomes, making it a potential tool for treatment guiding. METHODS In a prospective multicenter randomized trial, 380 patients discharged for AHF and high CA125 were randomly assigned to the CA125 strategy (n = 187) or SOC (n = 193). The aim in the CA125 strategy was to reduce CA125 to U/ml by up or down diuretic dose, enforcing the use of statins, and tightening patient monitoring. The primary endpoint was 1-year composite of death or ARE readmission. Treatment strategies were compared as a time to first event and longitudinally. RESULTS Patients allocated to the CA125 strategy were more frequently visited, and treated with ambulatory intravenous loop diuretics and statins. Likewise, doses of oral loop diuretics and atdosterone receptor blockers were more frequently modified. The CA125 strategy resulted in a significant reduction of the primary endpoint, whether evaluated as time to first event (66 events vs. 84 events; p = 0.017) or as recurrent events (85 events vs. 165 events; incidence rate ratio: 0.49; 95% confidence interval: 0.28 to 0.82; p = 0.008). The effect was driven by significantly reducing rehospitalizations but not mortality. CONCLUSIONS The CA125 strategy was superior to the SOC in terms of reducing the risk of the composite of 1-year death or AHF readmission. This effect was mainly driven by significantly reducing the rate of rehospitalizations. (Carbohydrate Antigen-125-guided Therapy in Heart Failure [CHANCE-HF]; NCT02008110) (C) 2016 by the American College of Cardiology Foundation.

Published
2016

25. Changes in Acute Coronary Syndrome Treatment and Prognosis After Implementation of the Infarction Code in a Hospital With a Cardiac Catheterization Unit

Author

Cordero A, Lopez-Palop R, Carrillo P, Frutos A, Miralles S, Gunturiz C, Garcia-Carrilero M, and Bertomeu-Martinez V

Subjects
Revascularization, Infarction code, Acute coronary syndrome, Mortality
Abstract

Introduction and objectives: Emergency care systems have been created to improve treatment and revascularization in myocardial infarction but they may also improve the management of all patients with acute coronary syndrome. Methods: A comparative study of all patients admitted with acute coronary syndrome before and after implementation of an infarction protocol. Results: The study included 1210 patients. While the mean age was the same in both periods, the patient group admitted after implementation of the protocol had a lower prevalence of diabetes mellitus and hypertension but more active smokers and higher GRACE scores. The percentage of ST-segment elevation acute coronary syndrome (29.8%-39.5%) and coronary revascularizations (82.1%-90.1%) significantly increased among patients admitted with acute coronary syndrome, and primary angioplasty became routine (51.9%-94.9%); there was also a reduction in time to catheterization and an increase in early revascularization. The mean hospital stay was significantly shorter after implementation of the infarction protocol. In-hospital mortality was unchanged, except in high-risk patients (38.8%-22.4%). After discharge, no differences were observed between the 2 periods in cardiovascular mortality, all-cause mortality, reinfarction, or major cardiovascular complications. Conclusions: After implementation of the infarction protocol, the percentage of patients admitted with ST-segment elevation acute coronary syndrome and the mean GRACE score increased among patients admitted with acute coronary syndrome. Hospital stay was reduced, and primary angioplasty use increased. In-hospital mortality was reduced in high-risk patients, and prognosis after discharge was the same in both periods. (C) 2016 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Published
2016

26. Comparison of Long-Term Mortality for Cardiac Diseases in Patients With Versus Without Diabetes Mellitus

Author

Cordero A, Lopez-Palop R, Carrillo P, Moreno-Arribas J, Bertomeu-Gonzalez V, Frutos A, Garcia-Carrilero M, Gunturiz C, and Bertomeu-Martinez V

Abstract

Diabetes mellitus confers the highest mortality risk in primary and secondary cardiovascular prevention, but long-term prognosis differences between different forms of cardiovascular disease have not been assessed. We hypothesized that acute heart failure (HF) could have poorer outcomes than acute coronary heart disease (CHD) in patients with diabetes. We performed a prospective study of all consecutive patients admitted in a single year. Patients were categorized according to main cardiologic diagnosis: acute HF, acute CHD, rhythm disorders, or noncardiac disease. A total of 1,293 patients were included, 31.8% had diabetes and had higher mean age, more risk factors, previous cardiovascular disease, and co-morbidities. Hospital mortality (5.6% vs 1.7%; p

Published
2016

27. Is the ORBIT Bleeding Risk Score Superior to the HAS-BLED Score in Anticoagulated Atrial Fibrillation Patients?

Author

Esteve-Pastor MA, Garcia-Fernandez A, Macias M, Sogorb F, Valdes M, Roldan V, Muniz J, Badimon L, Roldan I, Bertomeu-Martinez V, Cequier A, Lip GY, Anguita M, Marin F, and FANTASIIA Investigators

Subjects
Acenocoumarol, Bleeding risk scores, ORBIT, Atrial fibrillation, Electrical cardioversion
Abstract

Background: Several bleeding risk scores have been validated in patients with atrial fibrillation (AF). The ORBIT score has been recently proposed as a simple score with the best ability to predict major bleeding. The present study aimed to test the hypothesis that the ORBIT score was superior to the HAS-BLED score for predicting major bleeding and death in "real world" anticoagulated AF patients. Methods and Results: We analyzed the predictive performance for bleeding and death of 406 AF patients who underwent 571 electrical cardioversion procedures and 1,276 patients with permanent/persistent AF from the FANTASIIA registry. In the cardioversion population, 21 patients had major bleeding events and 26 patients died. The predictive performance for major bleeding of HAS-BLED and ORBIT were not significantly different (c-statistics 0.77 (95% CI 0.66-0.88) and 0.82 (95% CI 0.77-0.93), respectively; P=0.080). For the FANTASIIA population, 46 patients had major bleeding events and 50 patients died. The predictive performances for major bleeding of HASBLED and ORBIT were not significantly different (c-statistics 0.63 (95% CI 0.56-0.71) and 0.70 (95% CI 0.62-0.77), respectively; P=0.116). For death, the predictive performances of HAS-BLED and ORBIT were not significantly different in both populations. The ORBIT score categorized most patients as "low risk". Conclusions: Despite the original claims in its derivation paper, the ORBIT score was not superior to HAS-BLED for predicting major bleeding and death in a "real world" oral anticoagulated AF population.

Published
2016

30. P6210Relation of renal dysfunction to quality of anticoagulation control in patients with atrial fibrillation: The FANTASIIA registry

Author

Esteve Pastor, M.A., primary, Rivera-Caravaca, J.M., additional, Roldan, V., additional, Roldan Rabadan, I., additional, Muniz, J., additional, Cequier, A., additional, Bertomeu-Martinez, V., additional, Badimon, L., additional, Rana Miguez, P., additional, Anguita, M., additional, Lip, G.Y.H., additional, and Marin, F., additional

Published
2017
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32. P5342The 2MACE score predicts cardiovascular events in real-world patients with atrial fibrillation: The FANTASIIA registry

Author

Esteve Pastor, M.A., primary, Perez-Copete, J., additional, Rivera-Caravaca, J.M., additional, Roldan, V., additional, Roldan Rabadan, I., additional, Muniz, J., additional, Cequier, A., additional, Bertomeu-Martinez, V., additional, Badimon, L., additional, Rana Miguez, P., additional, Anguita, M., additional, Lip, G.Y.H., additional, and Marin, F., additional

Published
2017
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36. P1085Serum hyperuricemia determination improves risk prediction of GRACE score in people with acute coronary syndrome

Author

Lopez-Pineda, A., primary, Cordero, A., additional, Carratala-Munuera, C., additional, Orozco-Beltran, D., additional, Bertomeu-Gonzalez, V., additional, Quesada, J.A., additional, Gil-Guillen, V.F., additional, Frutos, A., additional, Lopez-Palop, R., additional, Carrillo, P., additional, and Bertomeu-Martinez, V., additional

Published
2017
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37. P1514Predictive value of the INTERHEART-cholesterol score for long-term prognosis of patients with acute coronary syndrome

Author

Cordero, A., primary, Lopez-Palop, R., additional, Moreno-Arribas, J., additional, Yepez, F., additional, Ribes, F., additional, Juskova, M., additional, Gunturiz, C., additional, Carrillo, P., additional, Bertomeu-Gonzalez, V., additional, Garcia-Carrilero, M., additional, Marco, A., additional, Sanchez, A., additional, and Bertomeu-Martinez, V., additional

Published
2017
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38. 5743Clinical determinants of time in therapeutic range and the role of SAMe-TT2R2 score in atrial fibrillation patients receiving oral anticoagulation: data from FANTASIIA registry

Author

Esteve Pastor, M.A., primary, Roldan Rabadan, I., additional, Muniz, J., additional, Cequier, A., additional, Bertomeu-Martinez, V., additional, Badimon, L., additional, Rana Miguez, P., additional, Anguita, M., additional, Lip, G.Y.H., additional, and Marin, F., additional

Published
2017
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39. Quality of Anticoagulation With Vitamin K Antagonists

Author

Bertomeu-Gonzalez, V, Anguita, M, Moreno-Arribas, J, Cequier, A, Muniz, J, Castillo-Castillo, J, Sanchis, J, Roldan, I, Marin, F, Bertomeu-Martinez, V, and FANTASIIA Study Investigators

Abstract

BackgroundVitamin 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). HypothesisControl of anticoagulation with VKA is inadequate in a high percentage of patients with AF. MethodsPatients 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. ResultsMean 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

40. Prognostic Effect of Carbohydrate Antigen 125-guided Therapy in Patients Recently Discharged for Acute Heart Failure (CHANCE-HF). Study Design

Author

Nunez, J, Merlos, P, Facila, L, Llacer, P, Bosch, M, Bertomeu-Martinez, V, Garcia-Blas, S, Montagud, V, Pedrosa, V, Mendizabal, A, Cordero, A, Minana, G, Sanchis, J, Bertomeu-Gonzalez, V, and CHANCE-HF Investigators

Subjects
Clinical trial, Biomarker guided-therapy, Carbohydrate antigen 125, Clinical outcomes, Heart failure
Abstract

Introduction and objectives: Morbidity and mortality after admission for acute heart failure remain prohibitively high. In that setting, plasma levels of antigen carbohydrate 125 have shown to correlate with the severity of fluid overload and the risk of mortality and readmission. Preliminary data suggests a potential role of antigen carbohydrate 125 to guide therapy. The objective of this study is to evaluate the prognostic effect of an antigen carbohydrate 125-guided management strategy vs standard therapy in patients recently discharged for acute heart failure. Methods: This is a multicenter, randomized, single-blind, efficacy trial study of patients recently discharged from acute heart failure (< 180 days), New York Heart Association functional class II-IV and antigen carbohydrate 125 > 35 U/ml. A randomization scheme was used to allocate participants (in a 1:1 ratio) to receive therapy guided by antigen carbohydrate 125 (aiming to keep normal values) or standard treatment. Mainly, antigen carbohydrate 125-guided therapy is focused on the frequency of monitoring and titration of decongestive therapies and statins. As of December 10, 2013, there were 383 patients enrolled. The primary outcome was the composite of 1-year all-cause mortality or rehospitalization for acute heart failure. Analysis was planned to be intention-to-treat. Conclusions: Discovering novel therapeutic strategies or finding better ways of optimizing established treatments have become a health care priority in heart failure. This study will add important knowledge about the potential of antigen carbohydrate 125 as a management tool for monitoring and titration of therapies where optimal utilization has not been well defined, such as diuretics and statins. (C) 2014 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Published
2015

43. 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, M. A., Marín, F., Bertomeu‐Martinez, V., Roldán‐Rabadán, I., Cequier‐Fillat, Á., Badimon, L., Muñiz‐García, J., Valdés, M., and Anguita‐Sánchez, M.

Subjects
ANTICOAGULANTS, THERAPEUTIC use of fibrinolytic agents, THROMBOEMBOLISM risk factors, STROKE risk factors, ATRIAL fibrillation, PHYSICIANS
Abstract

Background Clinical risk scores, CHADS2 and CHA2DS2-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 CHA2DS2-VASc scores, as well as to analyse the patient categories using CHADS2 and the potential improvement on stroke risk stratification with CHA2DS2-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 CHA2DS2-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 CHA2DS2-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 CHA2DS2-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 CHA2DS2-VASc risk scores with minimal changes in anticoagulation recommendations. The use of CHA2DS2-VASc score significantly improves classification of AF patients at low and intermediate risk of stroke into higher grade of thromboembolic score. Moreover, CHA2DS2-VASc score could identify 'truly low risk' patients compared with CHADS2 score. [ABSTRACT FROM AUTHOR]

Published
2016
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46. 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 I, Esteve-Pastor MA, Anguita Sánchez M, Muñiz J, Ruiz Ortiz M, Marín F, Roldán V, Quesada MA, Camacho Siles J, Cequier Fillat A, Bertomeu Martinez V, Martínez Sellés M, and Badimón L

Subjects
Aged, Aged, 80 and over, Anticoagulants therapeutic use, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Registries, Risk Assessment, Risk Factors, Atrial Fibrillation drug therapy, Atrial Fibrillation epidemiology, Stroke
Abstract

Background: While many risk factors for Atrial Fibrillation (AF) have been identified, there are important differences in their relative impact between sexes. The aim of our study was to investigate the influence of sex as a long-term predictor of adverse events in "real world" AF patients treated with direct oral anticoagulants., Methods: The FANTASIIA registry is a prospective, national and multicentric study including outpatients with anticoagulated AF patients. Baseline characteristics and adverse events at 3 years of follow-up were collected and classified by sex. Cox multivariate analysis was performed to investigate the role of sex in major events and composite outcomes., Results: A total of 1956 patients were included in the study. 43.9% of them were women, with a mean age of 73.8 ± 9.4 years (women were older 76.5 ± 7.9 vs 71.7 ± 10.1, p<0.001). Women had higher rate of cardiovascular risk factors and higher mean of CHA 2 DS 2 -VASc (4.4 ± 1.4 vs 3.7 ± 1.6, p<0.001) and HAS-BLED (2.1 ± 1.0 vs 1.9 ± 1.1, p<0.001) than men. After 3 years of follow-up, rates of major events were similar in both groups with limit difference for all-cause mortality (4.4%/year in women vs 5.6%/year in men; p = 0.056). However, all the composite events were more frequent in women. We observed in the non-adjusted adverse events lower rate of all-cause mortality (HR 0.62, 95%CI 0.47-0.81; p<0.001), composite 1 outcomes (HR 0.80, 95%CI 0.65-0.98; p = 0.029) and composite 2 (HR 0.77, 95%CI 0.64-0.94; p = 0.010) in women compared with men. In multivariate Cox regression analysis observed that female sex was an independently protector factor for all-cause mortality and for the composite outcomes 1 and 2., Conclusions: In this "real world" study of anticoagulated AF patients, women could have a protective role against development of adverse events, mainly on all-cause mortality and combined events., Competing Interests: Declaration of Competing Interest The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)

Published
2020
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47. Correction: Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study.

Author

Orozco-Beltran D, Gil-Guillen VF, Redon J, Martin-Moreno JM, Pallares-Carratala V, Navarro-Perez J, Valls-Roca F, Sanchis-Domenech C, Fernandez-Gimenez A, Perez-Navarro A, Bertomeu-Martinez V, Bertomeu-Gonzalez V, Cordero A, de la Torre MP, Trillo JL, Carratala-Munuera C, Pita-Fernandez S, Uso R, Durazo-Arvizu R, Cooper R, Sanz G, Castellano JM, Ascaso JF, Carmena R, and Tellez-Plaza M

Abstract

[This corrects the article DOI: 10.1371/journal.pone.0186196.].

Published
2018
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48. Prognosis and lipid profile improvement by a specialized outpatient clinic for acute coronary syndrome patients.

Author

Cordero A, Bertomeu-González V, Moreno-Arribas J, Castillo J, Quiles J, and Bertomeu-Martinez V

Subjects
Acute Coronary Syndrome blood, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome mortality, Aged, Aged, 80 and over, Biomarkers blood, Dyslipidemias blood, Dyslipidemias diagnosis, Dyslipidemias mortality, Female, Humans, Hypolipidemic Agents adverse effects, Male, Middle Aged, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Acute Coronary Syndrome prevention & control, Ambulatory Care, Cholesterol, LDL blood, Dyslipidemias drug therapy, Hypolipidemic Agents therapeutic use, Outpatient Clinics, Hospital, Secondary Prevention methods
Abstract

Background and Aims: Prognosis variations in patients discharged after an acute coronary syndrome (ACS) according to the professionals involved has not been clearly outlined. The aim of our study was to assess the impact on a specific outpatient clinic (SOC)., Methods: We included all consecutive patients admitted for an ACS in a single center. We performed a propensity score matching with all patients discharged from hospital according to whether they were referred to the SOC or not., Results: From the 1822 patients discharged, 260 couples of well-balanced ACS patients were obtained after propensity score matching. Median follow-up was 43.3 months and cardiovascular mortality rate was 10.4%, all-cause mortality was 13.9% and any MACE 38.2%. Patients attended the SOC had significantly lower rates at all three endpoints. Multivariate analysis results showed how the follow-up in the SOC was associated with significantly lower risk at all endpoints. SOC patients also had significantly lower rate at hospital readmissions and the multivariate analysis identified a negative association between the first cardiovascular readmission and SOC (sHR: 0.26 95%CI 0.18-0.367; p < 0.01). Mean LDLc levels at the time of ACS admission was 99.0 (36.7) mg/dl and no difference was observed in patients referred to SOC vs. non-referred. Patients followed at the SOC achieved significantly lower LDLc and higher percentage of LDLc <70 mg/dl (56.7% vs. 36.7%; p < 0.01). SOC follow-up was associated with 44% higher probability of final LDLc <70 mg/dl., Conclusions: An SOC for ACS patients was independently associated with higher LDLc control and long-term survival., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Published
2018
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49. Hyperuricemia as a prognostic factor after acute coronary syndrome.

Author

Lopez-Pineda A, Cordero A, Carratala-Munuera C, Orozco-Beltran D, Quesada JA, Bertomeu-Gonzalez V, Gil-Guillen VF, and Bertomeu-Martinez V

Subjects
Acute Coronary Syndrome blood, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome mortality, Aged, Aged, 80 and over, Biomarkers blood, Decision Support Techniques, Female, Humans, Hyperuricemia diagnosis, Hyperuricemia mortality, Male, Middle Aged, Predictive Value of Tests, Prevalence, Prospective Studies, Registries, Risk Assessment, Risk Factors, Spain epidemiology, Time Factors, Treatment Outcome, Up-Regulation, Acute Coronary Syndrome therapy, Hyperuricemia blood, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, Uric Acid blood
Abstract

Background and Aims: Many studies have reported the independent association between uric acid and cardiovascular disease, its role as a risk predictor for outcomes in people with acute coronary syndrome remains controversial. This study aims to assess the association between hyperuricemia and medium/long-term clinical outcomes in people with acute coronary syndrome and determine whether adding hyperuricemia to the GRACE score improves its predictive capability., Methods: This cohort study included patients admitted for acute coronary syndrome between 2008 and 2013. Outcomes were cardiovascular and total mortality, and major cardiovascular events. We used a multivariate model to adjust for potential confounding covariates and presented event rates with Kaplan-Meier curves. After adding hyperuricemia to the GRACE score, we compared scores from the reclassification table and the net reclassification improvement., Results: 1119 participants were included and followed-up for a mean of 36 months. Multivariate models showed hyperuricemia was independently associated with higher cardiovascular mortality (HR:1.91; 95% CI:1.32-2.76; p < 0.01), higher all-cause mortality (HR:1.59; 95% CI:1.18-2.15; p < 0.01) and higher major cardiovascular event rates (HR:1.36; 95% CI:1.11-1.67; p < 0.01). The hyperuricemia addition to GRACE score led to reclassifying 26% of the participants, and net reclassification improvement was 34%. However, the area under the curve increase was 0.009 and not statistically significant (p > 0.05)., Conclusions: Hyperuricemia is associated with higher medium/long-term mortality and major cardiovascular event rates in patients following acute coronary syndrome. The addition of hyperuricemia to the GRACE score seems to improve risk classification but the discrimination of the new predictive model did not change. Hyperuricemic patients had higher all-cause mortality in medium and high-risk score categories., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Published
2018
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50. Clinical Perspective on Antihypertensive Drug Treatment in Adults With Grade 1 Hypertension and Low-to-Moderate Cardiovascular Risk: An International Expert Consultation.

Author

Morales Salinas A, Coca A, Olsen MH, Sanchez RA, Sebba-Barroso WK, Kones R, Bertomeu-Martinez V, Sobrino J, Alcocer L, Pineiro DJ, Lanas F, Machado CA, Aguirre-Palacios F, Ortellado J, Perez G, Sabio R, Landrove O, Rodriguez-Leyva D, Duenas-Herrera A, Rodriguez Portelles A, Parra-Carrillo JZ, Piskorz DL, Bryce-Moncloa A, Waisman G, Yano Y, Ventura H, Orias M, Prabhakaran D, Sundström J, Wang J, Burrell LM, Schutte AE, Lopez-Jaramillo P, Barbosa E, Redon J, Weber MA, Lavie CJ, Ramirez A, Ordunez P, Yusuf S, and Zanchetti A

Subjects
Adult, Female, Heart Diseases etiology, Humans, Hypertension complications, Male, Risk, Antihypertensive Agents therapeutic use, Hypertension drug therapy
Abstract

Hypertension is a leading risk factor for disease burden globally. An unresolved question is whether grade 1 hypertension (140-159/90-99mmHg) with low (cardiovascular mortality <1% at 10 years) to moderate (cardiovascular mortality ≥1% and <5% at 10 years) absolute total cardiovascular risk (CVR) should be treated with antihypertensive agents. A virtual international consultation process was undertaken to summarize the opinions of select experts. After holistic analysis of all epidemiological, clinical, psychosocial, and public health elements, this consultation process reached the following consensus in hypertensive adults aged <80 years: (1) The question of whether drug treatment in grade 1 should be preceded by a period of some weeks or months during which only lifestyle measures are recommended cannot be evidence based, but the consensus opinion is to have a period of lifestyle alone reserved only to patients with grade 1 "isolated" hypertension (grade 1 uncomplicated hypertension with low absolute total CVR, and without other major CVR factors and risk modifiers). (2) The initiation of antihypertensive drug therapy in grade 1 hypertension with moderate absolute total CVR should not be delayed. (3) Men ≥55 years and women ≥60 years with uncomplicated grade 1 hypertension should automatically be classified within the moderate absolute total CVR category, even in the absence of other major CVR factors and risk modifiers. (4) Statins should be considered along with blood-pressure lowering therapy, irrespective of cholesterol levels, in patients with grade 1 hypertensive with moderate CVR., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Published
2017
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