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5. Coronavirus: the geriatric emergency of 2020. Joint document of the Section on Geriatric Cardiology of the Spanish Society of Cardiology and the Spanish Society of Geriatrics and Gerontology

Author

Bonanad, C., García-Blas, S., Díez-Villanueva, P., Ayesta, A., Sanchis Forés, J., Ariza-Solé, A., Martínez-Sellés, M., Tarazona-Santabalbina, F.J., Vidán-Austiz, M.T., Formiga, F., Bonanad, Clara, García-Blas, Sergio, Tarazona-Santabalbina, Francisco José, Díez-Villanueva, Pablo, Ayesta, Ana, Sanchis Forés, Juan, Vidán-Austiz, María Teresa, Formiga, Francesc, Ariza-Solé, Albert, and Martínez-Sellés, Manuel

Published
2020
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7. Coronavirus: la emergencia geriátrica de 2020. Documento conjunto de la Sección de Cardiología Geriátrica de la Sociedad Española de Cardiología y la Sociedad Española de Geriatría y Gerontología

Author

Bonanad, C., García-Blas, S., Díez-Villanueva, P., Ayesta, A., Sanchis Forés, J., Ariza-Solé, A., Martínez-Sellés, M., Tarazona-Santabalbina, F.J., Vidán-Austiz, M., Formiga, F., Bonanad, Clara, García-Blas, Sergio, Tarazona-Santabalbina, Francisco José, Díez-Villanueva, Pablo, Ayesta, Ana, Sanchis Forés, Juan, Vidán-Austiz, María Teresa, Formiga, Francesc, Ariza-Solé, Albert, and Martínez-Sellés, Manuel

Published
2020
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11. Short- and Long-Term Prognostic Relevance of Cardiogenic Shock in Takotsubo Syndrome: Results From the RETAKO Registry

Author

Figueras, J., Barrabes, J.A., Andrés, M., Núñez Gil, I.J., Mejía, H.D., Vedia, O., Feltes, Gisela, Worner, F., Bascompte Claret, R., Pereyra, E., Jiménez Candil, J., García Sánchez, M.J., Martín García, A.C., Martín García, A., Bodi, V., Bonanad, C., Bastante, T., Cruz Aguilera, M., Palazuelos, J., Sancho Carmona, D., López Pais, J., Alonso, J.J., Almendro Delia, M., Lobo, M., Rodríguez de Leiras, S., García Rubira, J.C., Corbí-Pascual, M., Córdoba Soriano, J.G., De Mora Martín, M., Pérez, B., Martín Asensio, R., Rueda Sobella, F., Santos Pardo, I., Manzano Nieto, M.C., Escudier Villa, J.M., Fabregat Andrés, O., Ridocci-Soriano, F., Parias Ángel, M.N., Gaebelt, H.P., Aceña, A., Martin Reyes, R., Bergua, C., Sanz Puértolas, P., Echeverria Lucotti, I., Vidal Pérez, R., Sionis, A., Duran Cambra, A., Tómas Ortiz, J., Bosch Genover, X., Guillen Marzo, M., Bardají, R.A., García Acuña, J.M., Sánchez Grande Flecha, A., García González, M.J., García de la Villa Redondo, G., Pérez Castellanos, A., Piqueras-Flores, J., Ruíz Valdepeas Herrero, L., Linares Vicente, J.A., Ruiz Arroyo, J.R., García, J., Giner Caro, J.A., Martínez Selles, M., Martín de Miguel, I., Almendro-Delia, Manuel, Núñez-Gil, Iván J., Lobo, Manuel, Andrés, Mireia, Vedia, Oscar, Sionis, Alessandro, Martin-García, Ana, Cruz Aguilera, María, Pereyra, Eduardo, Martín de Miguel, Irene, Linares Vicente, José A., Corbí-Pascual, Miguel, Bosch, Xavier, Fabregat Andrés, Oscar, Sánchez Grande Flecha, Alejandro, Pérez-Castellanos, Alberto, Pais, Javier López, De Mora Martín, Manuel, Escudier Villa, Juan María, Martín Asenjo, Roberto, Guillen Marzo, Marta, Rueda Sobella, Ferrán, Aceña, Álvaro, García Acuña, José María, and García-Rubira, Juan C.

Published
2018
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24. Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis

Author

Jackson, Colette E., Castagno, Davide, Maggioni, Aldo P., Køber, Lars, Squire, Iain B., Swedberg, Karl, Andersson, Bert, Richards, A. Mark, Bayes-Genis, Antoni, Tribouilloy, Christophe, Dobson, Joanna, Ariti, Cono A., Poppe, Katrina K., Earle, Nikki, Whalley, Gillian, Pocock, Stuart J., Doughty, Robert N., McMurray, John J.V., Berry, C., Doughty, R., Granger, C., Køber, L., Massie, B., McAlister, F., McMurray, J., Pocock, S., Poppe, K., Swedberg, K., Somaratne, J., Whalley, G., Ahmed, A., Andersson, B., Bayes-Genis, A., Berry, C., Cowie, M., Cubbon, R., Doughty, R., Ezekowitz, J., Gonzalez-Juanatey, J., Gorini, M., Gotsman, I., Grigorian-Shamagian, L., Guazzi, M., Kearney, M., Køber, L., Komajda, M., di Lenarda, A., Lenzen, M., Lucci, D., Macín, S., Madsen, B., Maggioni, A., Martínez-Sellés, M., McAlister, F., Oliva, F., Poppe, K., Rich, M., Richards, M., Senni, M., Squire, I., Taffet, G., Tarantini, L., Tribouilloy, C., Troughton, R., Tsutsui, H., Whalley, G., Doughty, R., Earle, N., Gamble, G.D., Poppe, K., Whalley, G., Ariti, C., Dobson, J., Pocock, S., Poppe, K., Doughty, R.N., Whalley, G., Andersson, B., Hall, C., Richards, A.M., Troughton, R., Lainchbury, J., Berry, C., Hogg, K., Norrie, J., Stevenson, K., Brett, M., McMurray, J., Pfeffer, M.A., Swedberg, K., Granger, C.B., Held, P., McMurray, J.J.V., Michelson, E.L., Olofsson, B., Östergren, J., Yusuf, S., Køber, L., Torp-Pedersen, C., Lenzen, M.J., Scholte op Reimer, W.J.M., Boersma, E., Vantrimpont, P.J.M.J., Follath, F., Swedberg, K., Cleland, J., Komajda, M., Gotsman, I., Zwas, D., Planer, D., Azaz-Livshits, T., Admon, D., Lotan, C., Keren, A., Grigorian-Shamagian, L., Varela-Roman, A., Mazón-Ramos, P., Rigeiro-Veloso, P., Bandin-Dieguez, M.A., Gonzalez-Juanatey, J.R., Guazzi, M., Myers, J., Arena, R., McAlister, F.A., Ezekowitz, J., Armstrong, P.W., Cujec, Bibiana, Paterson, Ian, Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Suresh, V., Poole-Wilson, P.A., Sutton, G.C., Martínez-Sellés, M., Robles, J.A.G., Prieto, L., Muñoa, M.D., Frades, E., Díaz-Castro, O., Almendral, J., Tarantini, L., Faggiano, P., Senni, M., Lucci, D., Bertoli, D., Porcu, M., Opasich, C., Tavazzi, L., Maggioni, A.P., Kirk, V., Bay, M., Parner, J., Krogsgaard, K., Herzog, T.M., Boesgaard, S., Hassager, C., Nielsen, O.W., Aldershvile, J., Nielsen, H., Kober, L., Macín, S.M., Perna, E.R., Cimbaro Canella, J.P., Alvarenga, P., Pantich, R., Ríos, N., Farias, E.F., Badaracco, J.R., Madsen, B.K., Hansen, J.F., Stokholm, K.H., Brons, J., Husum, D., Mortensen, L.S., Bayes-Genis, A., Vazquez, R., Puig, T., Fernandez-Palomeque, C., Bardají, A., Pascual-Figal, D., Ordoñez-Llanos, J., Valdes, M., Gabarrus, A., Pavon, R., Pastor, L., Gonzalez-Juanatey, J.R., Almendral, J., Fiol, M., Nieto, V., Macaya, C., Cinca, J., Cygankiewitz, I., Bayes de Luna, A., Newton, J.D., Blackledge, H.M., Squire, I.B., Wright, S.P., Whalley, G.A., Doughty, R.N., Kerzner, R., Gage, B.F., Freedland, K.E., Rich, M.W., Huynh, B.C., Rovner, A., Freedland, K.E., Carney, R.M., Rich, M.W., Taffet, G.E., Teasdale, T.A., Bleyer, A.J., Kutka, N.J., Luchi, R.J., Tribouilloy, C., Rusinaru, D., Mahjoub, H., Soulière, V., Lévy, F., Peltier, M., Tsutsui, H., Tsuchihashi, M., Takeshita, A., MacCarthy, P.A., Kearney, M.T., Nolan, J., Lee, A.J., Prescott, R.J., Shah, A.M., Brooksby, W.P., Fox, K.A.A., Varela-Roman, A., Gonzalez-Juanatey, J.R., Basante, P., Trillo, R., Garcia-Seara, J., Martinez-Sande, J.L., and Gude, F.

Published
2015
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29. Heart failure in younger patients: the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

Author

Wong, Chih M., Hawkins, Nathaniel M., Petrie, Mark C., Jhund, Pardeep S., Gardner, Roy S., Ariti, Cono A., Poppe, Katrina K., Earle, Nikki, Whalley, Gillian A., Squire, Iain B., Doughty, Robert N., McMurray, John J.V., Berry, C., Doughty, R., Granger, C., Køber, L., Massie, B., McAlister, F., McMurray, J., Pocock, S., Poppe, K., Swedberg, K., Somaratne, J., Whalley, G., Ahmed, A., Andersson, B., Bayes-Genis, A., Berry, C., Cowie, M., Cubbon, R., Doughty, R., Ezekowitz, J., Gonzalez-Juanatey, J., Gorini, M., Gotsman, I., Grigorian-Shamagian, L., Guazzi, M., Kearney, M., Køber, L., Komajda, M., di Lenarda, A., Lenzen, M., Lucci, D., Macín, S., Madsen, B., Maggioni, A., Martínez-Sellés, M., McAlister, F., Oliva, F., Poppe, K., Rich, M., Richards, M., Senni, M., Squire, I., Taffet, G., Tarantini, L., Tribouilloy, C., Troughton, R., Tsutsui, H., Whalley, G., Doughty, R., Earle, N., Gamble, G.D., Poppe, K., Whalley, G., Ariti, C., Dobson, J., Pocock, S., Poppe, K., Doughty, R.N., Whalley, G., Andersson, B., Hall, C., Richards, A.M., Troughton, R., Lainchbury, J., Berry, C., Hogg, K., Norrie, J., Stevenson, K., Brett, M., McMurray, J., Pfeffer, M.A., Swedberg, K., Granger, C.B., Held, P., McMurray, J.J.V., Michelson, E.L., Olofsson, B., Östergren, J., Yusuf, S., Køber, L., Torp-Pedersen, C., Ahmed, Ali, Lenzen, M.J., Scholte op Reimer, W.J.M., Boersma, E., Vantrimpont, P.J.M.J., Follath, F., Swedberg, K., Cleland, J., Komajda, M., Gotsman, I., Zwas, D., Planer, D., Azaz-Livshits, T., Admon, D., Lotan, C., Keren, A., Grigorian-Shamagian, L., Varela-Roman, A., Mazón-Ramos, P., Rigeiro-Veloso, P., Bandin-Dieguez, M.A., Gonzalez-Juanatey, J.R., Guazzi, M., Myers, J., Arena, R., McAlister, F.A., Ezekowitz, J., Armstrong, P.W., Cujec, Bibiana, Paterson, Ian, Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Suresh, V., Poole-Wilson, P.A., Sutton, G.C., Martínez-Sellés, M., Robles, J.A.G., Prieto, L., Muñoa, M.D., Frades, E., Díaz-Castro, O., Almendral, J., Tarantini, L., Faggiano, P., Senni, M., Lucci, D., Bertoli, D., Porcu, M., Opasich, C., Tavazzi, L., Maggioni, A.P., Kirk, V., Bay, M., Parner, J., Krogsgaard, K., Herzog, T.M., Boesgaard, S., Hassager, C., Nielsen, O.W., Aldershvile, J., Nielsen, H., Kober, L., Macín, S.M., Perna, E.R., Cimbaro Canella, J.P., Alvarenga, P., Pantich, R., Ríos, N., Farias, E.F., Badaracco, J.R., Madsen, B.K., Hansen, J.F., Stokholm, K.H., Brons, J., Husum, D., Mortensen, L.S., Bayes-Genis, A., Vazquez, R., Puig, T., Fernandez-Palomeque, C., Bardají, A., Pascual-Figal, D., Ordoñez-Llanos, J., Valdes, M., Gabarrus, A., Pavon, R., Pastor, L., Gonzalez-Juanatey, J.R., Almendral, J., Fiol, M., Nieto, V., Macaya, C., Cinca, J., Bayes de Luna, A., Newton, J.D., Blackledge, H.M., Squire, I.B., Wright, S.P., Whalley, G.A., Doughty, R.N., Kerzner, R., Gage, B.F., Freedland, K.E., Rich, M.W., Huynh, B.C., Rovner, A, Freedland, KE, Carney, RM, Rich, MW, Taffet, GE, Teasdale, T.A., Bleyer, A.J., Kutka, N.J., Luchi, R.J., Tribouilloy, C., Rusinaru, D., Mahjoub, H., Soulière, V., Lévy, F., Peltier, M., Tsutsui, H., Tsuchihashi, M., Takeshita, A., MacCarthy, P.A., Kearney, M.T., Nolan, J., Lee, A.J., Prescott, R.J., Shah, A.M., Brooksby, W.P., Fox, K.A.A., Varela-Roman, A., Gonzalez-Juanatey, J.R., Basante, P., Trillo, R., Garcia-Seara, J., Martinez-Sande, J.L., and Gude, F.

Published
2014
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30. Role of age and comorbidities in mortality of patients with infective endocarditis

Author

Armiñanzas, C., Fariñas-Alvarez, C., Zarauza, J., Muñoz, P., González Ramallo, V., Martínez Sellés, M., Miró Meda, J.M., Pericás, J.M., Goenaga, M.Á., Ojeda Burgos, G., Rodríguez Álvarez, R., Castelo Corral, L., Gálvez-Acebal, J., Martínez Marcos, F.J., Fariñas, M.C., Fernández Sánchez, F., Noureddine, M., Rosas, G., de la Torre Lima, J., Aramendi, J., Bereciartua, E., Blanco, M.J., Blanco, R., Boado, M.V., Campaña Lázaro, M., Crespo, A., Goikoetxea, J., Iruretagoyena, J.R., Irurzun Zuazabal, J., López-Soria, L., Montejo, M., Nieto, J., Rodrigo, D., Rodríguez, D., Rodríguez, R., Vitoria, Y., Voces, R., García López, M.V., Georgieva, R.I., Ojeda, G., Rodríguez Bailón, I., Ruiz Morales, J., Cuende, A.M., Echeverría, T., Fuerte, A., Gaminde, E., Idígoras, P., Iribarren, J.A., Izaguirre Yarza, A., Kortajarena Urkola, X., Reviejo, C., Carrasco, R., Climent, V., Llamas, P., Merino, E., Plazas, J., Reus, S., Álvarez, N., Bravo-Ferrer, J.M., Castelo, L., Cuenca, J., Llinares, P., Miguez Rey, E., Rodríguez Mayo, M., Sánchez, E., Sousa Regueiro, D., Martínez, F.J., Alonso, M.D.M., Castro, B., García Rosado, D., Durán, M.D.C., Miguel Gómez, M.A., Lacalzada, J., Nassar, I., Plata Ciezar, A., Reguera Iglesias, J.M., Asensi Álvarez, V., Costas, C., de la Hera, J., Fernández Suárez, J., Iglesias Fraile, L., León Arguero, V., López Menéndez, J., Mencia Bajo, P., Morales, C., Moreno Torrico, A., Palomo, C., Paya Martínez, B., Rodríguez Esteban, Á., Rodríguez García, R., Telenti Asensio, M., Almela, M., Ambrosioni, J., Azqueta, M., Brunet, M., Bodro, M., Cartañá, R., Falces, C., Fita, G., Fuster, D., García de la Mària, C., Hernández-Meneses, M., Llopis Pérez, J., Marco, F., Miró, J.M., Moreno, A., Nicolás, D., Ninot, S., Quintana, E., Paré, C., Pereda, D., Pomar, J.L., Ramírez, J., Rovira, I., Sandoval, E., Sitges, M., Soy, D., Téllez, A., Tolosana, J.M., Vidal, B., Vila, J., Adán, I., Bermejo, J., Bouza, E., Celemín, D., Cuerpo Caballero, G., Delgado Montero, A., Fernández Cruz, A., García Mansilla, A., García Leoni, M.E., Kestler Hernández, M., Hualde, A.M., Marín, M., Martínez-Sellés, M., Menárguez, M.C., Rincón, C., Rodríguez-Abella, H., Rodríguez-Créixems, M., Pinilla, B., Pinto, Á., Valerio, M., Vázquez, P., Verde Moreno, E., Antorrena, I., Loeches, B., Martín Quirós, A., Moreno, M., Ramírez, U., Rial Bastón, V., Romero, M., Saldaña, A., Agüero Balbín, J., Amado, C., Armiñanzas Castillo, C., Arnaiz García, A., Cobo Belaustegui, M., Fariñas-Álvarez, C., Gómez Izquierdo, R., García, I., González-Rico, C., Gutiérrez-Cuadra, M., Gutiérrez Díez, J., Pajarón, M., Parra, J.A., Sarralde, A., Teira, R., Domínguez, F., García Pavía, P., González, J., Orden, B., Ramos, A., Centella, T., Hermida, J.M., Moya, J.L., Martín-Dávila, P., Navas, E., Oliva, E., del Río, A., Ruiz, S., Hidalgo Tenorio, C., Almendro Delia, M., Araji, O., Barquero, J.M., Calvo Jambrina, R., de Cueto, M., Gálvez Acebal, J., Méndez, I., Morales, I., and Matamala Adell, M.

Abstract

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups

Published
2020

33. Impact of intrapatient blood level variability of calcineurin inhibitors on heart transplant outcomes

Author

González-Vílchez F., Crespo-Leiro M.G., Delgado-Jiménez J., Pérez-Villa F., Segovia-Cubero J., Díaz-Molina B., Mirabet-Pérez S., Arizón del Prado J.M., Blasco-Peiró T., Martínez-Sellés M., Almenar-Bonet L., Garrido-Bravo I., Rábago G., and Vázquez de Prada J.A.

Subjects
Adult, Graft Rejection, all cause mortality, Adolescent, retrospective study, Calcineurin Inhibitors, education, mortality rate, treatment free survival, heart transplantation, blood level, behavioral disciplines and activities, Article, Tacrolimus, male, genetic variability, middle aged, mental disorders, calcineurin inhibitor, Humans, controlled study, cyclosporine, human, Retrospective Studies, Blood levels, Calcineurin inhibitors, Coefficient of variation, Coeficiente de variación, Concentración sanguínea, Heart transplant, Inhibidores de la calcineurina, Trasplante cardiaco, Variabilidad, Variability, cardiac graft rejection, disease association, immunosuppressive treatment, social sciences, immunosuppressive agent, major clinical study, human tissue, drug formulation, female, surgical procedures, operative, treatment outcome, heart graft, Immunosuppressive Agents
Abstract

Introduction and objectives: Intrapatient blood level variability (IPV) of calcineurin inhibitors has been associated with poor outcomes in solid-organ transplant, but data for heart transplant are scarce. Our purpose was to ascertain the clinical impact of IPV in a multi-institutional cohort of heart transplant recipients. Methods: We retrospectively studied patients aged = 18 years, with a first heart transplant performed between 2000 and 2014 and surviving = 1 year. IPV was assessed by the coefficient of variation of trough levels from posttransplant months 4 to 12. A composite of rejection or mortality/graft loss or rejection and all-cause mortality/graft loss between years 1 to 5 posttransplant were analyzed by Cox regression analysis. Results: The study group consisted of 1581 recipients (median age, 56 years; women, 21%). Cyclosporine immediate-release tacrolimus and prolonged-release tacrolimus were used in 790, 527 and 264 patients, respectively. On multivariable analysis, coefficient of variation > 27.8% showed a nonsignificant trend to association with 5-year rejection-free survival (HR, 1.298; 95%CI, 0.993-1.695; P =.056) and with 5-year mortality (HR, 1.387; 95%CI, 0.979-1.963; P =.065). Association with rejection became significant on analysis of only those patients without rejection episodes during the first year posttransplant (HR, 1.609; 95%CI, 1.129-2.295; P =.011). The tacrolimus-based formulation had less IPV than cyclosporine and better results with less influence of IPV. Conclusions: IPV of calcineurin inhibitors is only marginally associated with mid-term outcomes after heart transplant, particularly with the tacrolimus-based immunosuppression, although it could play a role in the most stable recipients. Full English text available from:www.revespcardiol.org/en © 2021 Sociedad Española de Cardiología

Published
2021

34. Comorbidity burden and revascularization benefit in elderly patients with acute coronary syndrome

Author

Sanchis J, García Acuña JM, Raposeiras S, Barrabés JA, Cordero A, Martínez-Sellés M, Bardají A, Díez-Villanueva P, Marín F, Ruiz-Nodar JM, Vicente-Ibarra N, Alonso Salinas GL, Rigueiro P, Abu-Assi E, Formiga F, Núñez J, Núñez E, and Ariza-Solé A

Subjects
Elderly, Revascularization, Anciano, Síndrome coronario agudo, Revascularización, Acute coronary syndrome, Comorbilidades, Comorbidities
Abstract

Introduction and objectives: To evaluate the interaction between comorbidity burden and the benefits of in-hospital revascularization in elderly patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Methods: This retrospective study included 7211 patients aged >= 70 years from 11 Spanish NSTEACS registries. Six comorbidities were evaluated: diabetes, peripheral artery disease, cerebrovascular disease, chronic pulmonary disease, renal failure, and anemia. A propensity score was estimated to enable an adjusted comparison of in-hospital revascularization and conservative management. The end point was 1-year all-cause mortality. Results: In total, 1090 patients (15%) died. The in-hospital revascularization rate was 60%. Revascularization was associated with lower 1-year mortality; the strength of the association was unchanged by the addition of comorbidities to the model (HR, 0.61; 95%CI, 0.53-0.69; P = .0001). However, the effects of revascularization were attenuated in patients with renal failure, peripheral artery disease, and chronic pulmonary disease (P for interaction = .004, .007, and .03, respectively) but were not modified by diabetes, anemia, and previous stroke (P = .74, .51, and .28, respectively). Revascularization benefits gradually decreased as the number of comorbidities increased (from a HR of 0.48 [95%CI, 0.39-0.61] with 0 comorbidities to 0.83 [95%CI, 0.62-1.12] with >= 5 comorbidities; omnibus P = .016). The results were similar for the propensity score model. The same findings were obtained when invasive management was considered the exposure variable. Conclusions: In-hospital revascularization improves 1-year mortality regardless of comorbidities in elderly patients with NSTEACS. However, the revascularization benefit is progressively reduced with an increased comorbidity burden. Renal failure, peripheral artery disease, and chronic lung disease were the comorbidities with the most detrimental effects on revascularization benefits. (C) 2020 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Published
2021

35. Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome

Author

Díez-Villanueva P, García-Acuña JM, Raposeiras-Roubin S, Barrabés JA, Cordero A, Martínez-Sellés M, Bardají A, Marín F, Ruiz-Nodar JM, Vicente-Ibarra N, Alonso Salinas GL, Cid-Alvárez B, Abu Assi E, Formiga F, Núñez J, Núñez E, Ariza-Solé A, and Sanchis J

Subjects
non-ST-segment elevation acute coronary syndromes, diabetes mellitus, women, elderly
Abstract

Few studies have addressed to date the interaction between sex and diabetes mellitus (DM) in the prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Our aim was to address the role of DM in the prognosis of non-selected elderly patients with NSTEACS according to sex. A retrospective analysis from 11 Spanish NSTEACS registries was conducted, including patients aged =70 years. The primary end point was one-year all-cause mortality. A total of 7211 patients were included, 2,770 (38.4%) were women, and 39.9% had DM. Compared with the men, the women were older (79.95 ± 5.75 vs. 78.45 ± 5.43 years, p < 0.001) and more often had a history of hypertension (77% vs. 83.1%, p < 0.01). Anemia and chronic kidney disease were both more common in women. On the other hand, they less frequently had a prior history of arteriosclerotic cardiovascular disease or comorbidities such as peripheral artery disease and chronic pulmonary disease. Women showed a worse clinical profile on admission, though an invasive approach and in-hospital revascularization were both more often performed in men (p < 0.001). At a one-year follow-up, 1090 patients (15%) had died, without a difference between sexes. Male sex was an independent predictor of mortality (HR = 1.15, 95% CI 1.01 to 1.32, p = 0.035), and there was a significant interaction between sex and DM (p = 0.002). DM was strongly associated with mortality in women (HR: 1.45, 95% CI = 1.18-1.78; p < 0.001), but not in men (HR: 0.98, 95% CI = 0.84-1.14; p = 0.787). In conclusion, DM is associated with mortality in older women with NSTEACS, but not in men.

Published
2021

36. Direct Oral Anticoagulants versus Warfarin in Octogenarians with Nonvalvular Atrial Fibrillation: A Systematic Review and Meta-Analysis

Author

Bonanad C, García-Blas S, Torres Llergo J, Fernández-Olmo R, Díez-Villanueva P, Ariza-Solé A, Martínez-Sellés M, Raposeiras S, Ayesta A, Bertomeu-González V, Tarazona Santabalbina F, Facila L, Vivas D, Gabaldón-Pérez A, Bodi V, Nuñez J, and Cordero A

Subjects
myocardial infarction, vitamin-K antagonist, elderly, direct oral anticoagulants, acute coronary syndrome
Abstract

Direct oral anticoagulants (DOACs) have been demonstrated to be more effective and safer than vitamin-K antagonist (VKA) for stroke prevention in patients with nonvalvular atrial fibrillation (AF). This meta-analysis aims to assess the effect of DOACS vs. VKA in patients >= 80 and AF. Primary endpoints were stroke or systemic embolism and all-cause death. Secondary endpoints included major bleeding, intracranial bleeding, and gastrointestinal bleeding. A random-effects model was selected due to significant heterogeneity. A total of 147,067 patients from 16 studies were included, 71,913 (48.90%) treated with DOACs and 75,154 with VKA (51.10%). The stroke rate was significantly lower in DOACs group compared with warfarin group (Relative risk (RR): 0.72; 95% confidence interval (CI): 0.63-0.82; p < 0.001). All-cause mortality was significantly lower in DOACs group compared with warfarin group (RR: 0.82; 95% CI: 0.70-0.96; p = 0.012). Compared to warfarin, DOACs were not associated with reductions in major bleeding (RR: 0.85, 95% CI 0.69-1.04; p = 0.108) or gastrointestinal bleeding risk (RR: 1.08, 95% CI 0.76-1.53; p = 0.678) but a 43% reduction of intracranial bleeding (RR: 0.47, IC 95% 0.36-0.60; p < 0.001) was observed. Our meta-analysis demonstrates that DOACs are effective and safe with statistical superiority when compared with warfarin in octogenarians with AF.

Published
2021

37. Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

Author

Alves, M. (Mariana), Fernandes, M. A. (Marília Andreia), Bahat, G. (Gülistan), Benetos, A. (Athanase), Clemente, H. (Hugo), Grodzicki, T. (Tomasz), Martínez-Sellés, M. (Manuel), Mattace-Raso, F. (Francesco), Rajkumar, C. (Chakravarthi), Ungar, A. (Andrea), Werner, N. (Nikos), Strandberg, T. E. (Timo E.), E. S. (EuGMS Special Interest Group in Cardiovascular Medicine (Chairpersons A. Ungar and A. Benetos)), Alves, M. (Mariana), Fernandes, M. A. (Marília Andreia), Bahat, G. (Gülistan), Benetos, A. (Athanase), Clemente, H. (Hugo), Grodzicki, T. (Tomasz), Martínez-Sellés, M. (Manuel), Mattace-Raso, F. (Francesco), Rajkumar, C. (Chakravarthi), Ungar, A. (Andrea), Werner, N. (Nikos), Strandberg, T. E. (Timo E.), and E. S. (EuGMS Special Interest Group in Cardiovascular Medicine (Chairpersons A. Ungar and A. Benetos))

Abstract

Purpose: In the pathogenesis of severe COVID-19 complications, derangements of renin–angiotensin–aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods: We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results: Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions: Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.

Published
2021

38. Prognosis impact of diabetes in elderly women and men with non-st elevation acute coronary syndrome

Author

Universitat Rovira i Virgili, Díez-Villanueva P; García-Acuña JM; Raposeiras-Roubin S; Barrabés JA; Cordero A; Martínez-Sellés M; Bardají A; Marín F; Ruiz-Nodar JM; Vicente-Ibarra N; Alonso Salinas GL; Cid-Alvárez B; Assi EA; Formiga F; Núñez J; Núñez E; Ariza-Solé A; Sanchis J, Universitat Rovira i Virgili, and Díez-Villanueva P; García-Acuña JM; Raposeiras-Roubin S; Barrabés JA; Cordero A; Martínez-Sellés M; Bardají A; Marín F; Ruiz-Nodar JM; Vicente-Ibarra N; Alonso Salinas GL; Cid-Alvárez B; Assi EA; Formiga F; Núñez J; Núñez E; Ariza-Solé A; Sanchis J

Abstract

Few studies have addressed to date the interaction between sex and diabetes mellitus (DM) in the prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Our aim was to address the role of DM in the prognosis of non-selected elderly patients with NSTEACS according to sex. A retrospective analysis from 11 Spanish NSTEACS registries was conducted, including patients aged ≥70 years. The primary end point was one-year all-cause mortality. A total of 7211 patients were included, 2,770 (38.4%) were women, and 39.9% had DM. Compared with the men, the women were older (79.95 ± 5.75 vs. 78.45 ± 5.43 years, p < 0.001) and more often had a history of hypertension (77% vs. 83.1%, p < 0.01). Anemia and chronic kidney disease were both more common in women. On the other hand, they less frequently had a prior history of arteriosclerotic cardiovascular disease or comorbidities such as peripheral artery disease and chronic pulmonary disease. Women showed a worse clinical profile on admission, though an invasive approach and in-hospital revascularization were both more often performed in men (p < 0.001). At a one-year follow-up, 1090 patients (15%) had died, without a difference between sexes. Male sex was an independent predictor of mortality (HR = 1.15, 95% CI 1.01 to 1.32, p = 0.035), and there was a significant interaction between sex and DM (p = 0.002). DM was strongly associated with mortality in women (HR: 1.45, 95% CI = 1.18–1.78; p < 0.001), but not in men (HR: 0.98, 95% CI = 0.84–1.14; p = 0.787). In conclusion, DM is associated with mortality in older women with NSTEACS, but not in men.

Published
2021

45. Direct Anticoagulants Versus Vitamin K Antagonists in Patients Aged 80 Years or Older With Atrial Fibrillation in a 'Real-world' Nationwide Registry: Insights From the FANTASIIA Study

Author

Ortiz MR, Muñiz J, Esteve-Pastor MA, Marín F, Roldán I, Cequier A, Martínez-Sellés M, Saldivar HG, Bertomeu V, and Anguita M

Subjects
vitamin K antagonists, octogenarians, FANTASIIA registry, atrial fibrillation, direct oral anticoagulants
Abstract

Objective: To describe major events at follow up in octogenarian patients with atrial fibrillation (AF) according to anticoagulant treatment: direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs). Methods: A total of 578 anticoagulated patients aged >= 80 years with AF were included in a prospective, observational, multicenter study. Basal features, embolic events (stroke and systemic embolism), severe bleedings, and all-cause mortality at follow up were investigated according to the anticoagulant treatment received. Results: Mean age was 84.0 +/- 3.4 years, 56% were women. Direct oral anticoagulants were prescribed to 123 (21.3%) patients. Compared with 455 (78.7%) patients treated with VKAs, those treated with DOACs presented a lower frequency of permanent AF (52.9% vs 61.6%, P = .01), cancer history (4.9% vs 10.9%, P = .046), renal failure (21.1% vs 32.2%, P = .02), and left ventricular dysfunction (2.4% vs 8.0%, P = .03); and higher frequency of previous stroke (26.0% vs 16.6%, P = .02) and previous major bleeding (8.1% vs 3.6%, P = .03). There were no significant differences in Charlson, CHA2DS2VASc, nor HAS-BLED scores. At 3-year follow up, rates of embolic events, severe bleedings, and all-cause death (per 100 patients-year) were similar in both groups (DOACs vs VKAs): 0.34 vs 1.35 (P = .15), 3.45 vs 4.41 (P = .48), and 8.2 vs 11.0 (P = .18), respectively, without significant differences after multivariate analysis (hazard ratio [HR]: 0.25, 95% confidence interval [CI]: 0.03-1.93, P = .19; HR: 0.88, 95% CI: 0.44-1.76, P = .72 and HR: 0.84, 95% CI: 0.53-1.33, P = .46, respectively). Conclusion: In this "real-world" registry, the differences in major events rates in octogenarians with AF were not statistically significant in those treated with DOACs versus VKAs.

Published
2020

46. Spanish Heart Transplant Registry. 31th Official Report of the Heart Failure Association of the Spanish Society of Cardiology

Author

González-Vilchez F, Almenar-Bonet L, Crespo-Leiro MG, Gómez-Bueno M, González-Costello J, Pérez-Villa F, Delgado-Jiménez J, Arizón Del Prado JM, Sobrino-Márquez JM, Sousa Casasnovas I, Spanish Heart Transplant Teams, Segovia-Cubero J, Hernández-Pérez F, Martínez Penades S, Cebrián Pinar M, López Vilella R, Sánchez-Lázaro I, Martínez-Dolz L, Paniagua-Martín MJ, Barge-Caballero E, Barge-Caballero G, Couto-Mallón D, López Granados A, Segura Saintgerons C, Menjíbar Pareja V, Carrasco Ávalos F, Cobo M, Llano-Cardenal M, Vázquez de Prada JA, Nistal Herrera F, Blázquez Z, Jesús Valero M, Ortiz C, Zataraín E, Villa A, Navas P, Martínez-Sellés M, Dolores García Cosío M, Morán Fernández L, Caravaca P, Brossa Loidi V, Roig Minguell E, Mirabet Pérez S, López López L, Zegrí I, Rangel Sousa D, Manito Lorite N, Díez Lopez C, Roca Elias J, García Romero E, Rábago Juan-Aracil G, Castel MÁ, Farrero M, Lambert Rodríguez JL, Díaz Molina B, Bernardo Rodríguez MJ, Fidalgo Muñiz C, Camino López M, Gil Jaurena JM, Gil Villanueva N, Garrido-Bravo I, Pascual Figal DA, Pastor Pérez FJ, Blasco-Peiró T, Portoles Ocampo A, Sanz Julve M, de la Fuente Galán L, Tobar Ruiz J, Recio Platero A, García-Guereta Silva L, González Rocafort Á, Labradero de Lera C, Polo López L, Gran Ipiña F, Albert Brotons DC, Abella Antón R, García Quintana A, and Groba Marco MDV

Subjects
Cardiac transplant, Registro, Registry, Supervivencia, Survival, Trasplante cardiaco
Abstract

The present report describes the clinical characteristics and outcomes of heart transplants in Spain and updates the data to 2019.

Published
2020

48. Palliative Care for people living with heart failure - European Association for Palliative Care Task Force expert position statement.

Author

Sobanski, PZ, Alt-Epping, B, Currow, DC, Goodlin, SJ, Grodzicki, T, Hogg, K, Janssen, DJA, Johnson, MJ, Krajnik, M, Leget, C, Martínez-Sellés, M, Moroni, M, Mueller, PS, Ryder, M, Simon, ST, Stowe, E, Larkin, PJ, Sobanski, PZ, Alt-Epping, B, Currow, DC, Goodlin, SJ, Grodzicki, T, Hogg, K, Janssen, DJA, Johnson, MJ, Krajnik, M, Leget, C, Martínez-Sellés, M, Moroni, M, Mueller, PS, Ryder, M, Simon, ST, Stowe, E, and Larkin, PJ

Abstract

Contrary to common perception, modern palliative care (PC) is applicable to all people with an incurable disease, not only cancer. PC is appropriate at every stage of disease progression, when PC needs emerge. These needs can be of physical, emotional, social or spiritual nature. This document encourages the use of validated assessment tools to recognise such needs and ascertain efficacy of management. PC interventions should be provided alongside cardiologic management. Treating breathlessness is more effective, when cardiologic management is supported by PC interventions. Treating other symptoms like pain or depression requires predominantly PC interventions. Advance Care Planning aims to ensure that the future treatment and care the person receives is concordant with their personal values and goals, even after losing decision-making capacity. It should include also disease specific aspects, such as modification of implantable device activity at the end of life. The Whole Person Care concept describes the inseparability of the physical, emotional and spiritual dimensions of the human being. Addressing psychological and spiritual needs, together with medical treatment, maintains personal integrity and promotes emotional healing. Most PC concerns can be addressed by the usual care team, supported by a PC specialist if needed. During dying, the persons' needs may change dynamically and intensive PC is often required. Following the death of a person, bereavement services benefit loved ones. The authors conclude that the inclusion of PC within the regular clinical framework for people with heart failure results in a substantial improvement in quality of life as well as comfort and dignity whilst dying.

Published
2020

50. Clinical and prognostic implications of delirium in elderly patients with non-ST-segment elevation acute coronary syndromes

Author

Vives-Borrás M, Martínez-Sellés M, Ariza-Solé A, Vidán MT, Formiga F, Bueno H, Sanchís J, Alegre O, Durán-Cambra A, López-Palop R, Abu-Assi E, and Sionis A

Subjects
The elderly, Delirium, Acute coronary syndromes, Prognosis
Abstract

Background Elderly patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) may present delirium but its clinical relevance is unknown. This study aimed at determining the clinical associated factors, and prognostic implications of delirium in old-aged patients admitted for NSTE-ACS. Methods LONGEVO-SCA is a prospective multicenter registry including unselected patients with NSTE-ACS aged. 80 years. Clinical variables and a complete geriatric evaluation were assessed during hospitalization. The association between delirium and 6-month mortality was assessed by a Cox regression model weighted for a propensity score including the potential confounding variables. We also analysed its association with 6-month bleeding and cognitive or functional decline. Results Among 527 patients included, thirty-seven (7%) patients presented delirium during the hospitalization. Delirium was more frequent in patients with dementia or depression and in those from nursing homes (27.0% vs. 3.1%, 24.3% vs. 11.6%, and 11.1% vs. 2.2%, respectively; all P < 0.05). Delirium was significantly associated with in-hospital infections (27.0% vs. 5.3%, P < 0.001) and usage of diuretics (70.3% vs. 49.8%, P = 0.02). Patients with delirium had longer hospitalizations [median 8.5 (5.5-14) vs. 6.0 (4.0-10) days, P = 0.02] and higher incidence of 6-month bleeding and mortality (32.3% vs. 10.0% and 24.3% vs. 10.8%, respectively; both P < 0.05) but similar cognitive or functional decline. Delirium was independently associated with 6-month mortality (HR = 1.47, 95% CI: 1.02-2.13, P = 0.04) and 6-month bleeding events (OR = 2.87; 95% CI: 1.98. 4.16, P < 0.01). Conclusions In-hospital delirium in elderly patients with NSTE-ACS is associated with some preventable risk factors and it is an independent predictor of 6-month mortality.

Published
2019

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