Pub Date : 2025-09-05DOI: 10.1016/j.recesp.2025.08.012
Ana Viana-Tejedor , Pedro Martínez Losas , Rut Andrea-Riba , Miguel Corbí-Pascual , Sandra Rosillo , Joaquín J. Alonso , Alessandro Sionís , Pablo Pastor , Pablo Jorge-Pérez , Cosme García-García
Intermediate cardiac care units (IMCU) provide a level of care between hospital wards and cardiac acute care units. They are designed for patients who require close monitoring or noncritical support, such as those with acute coronary syndromes, acute heart failure (HF), arrhythmias, monitoring after structural interventional cardiology or electrophysiology procedures, or postoperative care following cardiac surgery. IMCU help optimize resources and relieve pressure on cardiac acute care units, thereby improving specialized care. Two levels of IMCU are defined: level 1, which offers noninvasive monitoring and basic life support, and level 2, which incorporates invasive arterial pressure monitoring, noninvasive mechanical ventilation, and equipment for complex procedures. Their structure should be functional, with single-patient rooms, effective communication with other services, and dedicated areas for health care personnel. Care is led by cardiologists with specific training, supported by highly specialized nursing staff, and requires continuous medical coverage (24 hours a day, 7 days a week) based on well-defined clinical protocols. This model aims to provide efficient, safe, and excellence-driven care. The Spanish Society of Cardiology (SEC) promotes its development through this position statement of the SEC Ischemic Heart Disease and Acute Cardiovascular Care Association (SEC-ACICAC), intended to guide the implementation of IMCU in Spain.
{"title":"Unidades de cuidados intermedios cardiológicos: base racional, dotación e indicaciones de ingreso. Posicionamiento de la SEC-ACICAC","authors":"Ana Viana-Tejedor , Pedro Martínez Losas , Rut Andrea-Riba , Miguel Corbí-Pascual , Sandra Rosillo , Joaquín J. Alonso , Alessandro Sionís , Pablo Pastor , Pablo Jorge-Pérez , Cosme García-García","doi":"10.1016/j.recesp.2025.08.012","DOIUrl":"10.1016/j.recesp.2025.08.012","url":null,"abstract":"<div><div>Intermediate cardiac care units (IMCU) provide a level of care between hospital wards and cardiac acute care units. They are designed for patients who require close monitoring or noncritical support, such as those with acute coronary syndromes, acute heart failure (HF), arrhythmias, monitoring after structural interventional cardiology or electrophysiology procedures, or postoperative care following cardiac surgery. IMCU help optimize resources and relieve pressure on cardiac acute care units, thereby improving specialized care. Two levels of IMCU are defined: level 1, which offers noninvasive monitoring and basic life support, and level 2, which incorporates invasive arterial pressure monitoring, noninvasive mechanical ventilation, and equipment for complex procedures. Their structure should be functional, with single-patient rooms, effective communication with other services, and dedicated areas for health care personnel. Care is led by cardiologists with specific training, supported by highly specialized nursing staff, and requires continuous medical coverage (24<!--> <!-->hours a day, 7 days a week) based on well-defined clinical protocols. This model aims to provide efficient, safe, and excellence-driven care. The Spanish Society of Cardiology (SEC) promotes its development through this position statement of the SEC Ischemic Heart Disease and Acute Cardiovascular Care Association (SEC-ACICAC), intended to guide the implementation of IMCU in Spain.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 165-172"},"PeriodicalIF":5.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-02DOI: 10.1016/j.recesp.2025.07.004
Eun-Seok Shin , Sunwon Kim , Dong Oh Kang , Bitna Kim , Ae-Young Her
Introduction and objectives
There are limited data on drug-coated balloon (DCB) treatment for de novo diffuse coronary artery disease (CAD). This study aimed to evaluate the clinical impact of DCB-based percutaneous coronary intervention (PCI) in patients with de novo diffuse long CAD.
Methods
We retrospectively included 623 patients with single de novo diffuse CAD (≥ 30 mm). These patients underwent PCI exclusively for the target lesion and were successfully treated with DCB-based PCI. They were compared with 623 propensity-matched patients who underwent conventional PCI with second-generation drug-eluting stents (DES) for diffuse CAD (DES-only group). The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac death, myocardial infarction, stent or target lesion thrombosis, target vessel revascularization, and major bleeding at 2 years.
Results
In the DCB-based group, 73.7% of patients were treated with DCB alone. The MACE rate was significantly lower in the DCB-based group than in the DES-only group (4.6% vs 14.6%; HR, 0.29; 95%CI, 0.18-0.47; P < .001). Rates of target vessel revascularization (3.1% vs 9.7%; P < .001) and major bleeding events (0.8% vs 2.7%; P = .008) were also lower with DCB-based PCI than with DES-only PCI. In a multivariable model, DCB-based PCI was independently associated with a lower risk of 2-year MACE, target vessel revascularization, and major bleeding.
Conclusions
In patients with de novo diffuse CAD, DCB-based PCI was associated with a significant reduction in MACE compared with DES-only PCI
药物包被球囊（DCB）治疗新发弥漫性冠状动脉疾病（CAD）的数据有限。本研究旨在评估基于dbc的经皮冠状动脉介入治疗（PCI）对新发弥漫性长时间冠心病患者的临床影响。方法回顾性分析623例新发弥漫性冠心病（≥30 mm）患者。这些患者接受了专门针对目标病变的PCI，并成功地接受了基于dbc的PCI治疗。他们与623名倾向匹配的接受常规PCI +第二代药物洗脱支架（DES）治疗弥漫性CAD的患者（DES组）进行比较。主要终点是主要心血管不良事件（MACE），定义为心脏性死亡、心肌梗死、支架或靶病变血栓形成、靶血管重建术和2年大出血的复合。结果在DCB联合治疗组中，73.7%的患者单用DCB治疗。dcb组的MACE率明显低于仅des组（4.6% vs 14.6%； HR, 0.29; 95%CI, 0.18-0.47; P < 0.001）。靶血管重建率（3.1% vs 9.7%; P < 0.001）和大出血事件发生率（0.8% vs 2.7%; P = 0.008）也低于仅des的PCI。在多变量模型中，基于dbc的PCI与2年MACE、靶血管重建术和大出血的风险较低独立相关。结论在新发弥漫性CAD患者中，基于dbc的PCI与仅des的PCI相比，MACE显著降低
{"title":"Tratamiento con balón farmacoactivo frente a tratamiento con stent farmacoactivo para lesiones coronarias únicas difusas de novo","authors":"Eun-Seok Shin , Sunwon Kim , Dong Oh Kang , Bitna Kim , Ae-Young Her","doi":"10.1016/j.recesp.2025.07.004","DOIUrl":"10.1016/j.recesp.2025.07.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>There are limited data on drug-coated balloon (DCB) treatment for de novo diffuse coronary artery disease (CAD). This study aimed to evaluate the clinical impact of DCB-based percutaneous coronary intervention (PCI) in patients with de novo diffuse long CAD.</div></div><div><h3>Methods</h3><div>We retrospectively included 623 patients with single de novo diffuse CAD (≥ 30<!--> <!-->mm). These patients underwent PCI exclusively for the target lesion and were successfully treated with DCB-based PCI. They were compared with 623 propensity-matched patients who underwent conventional PCI with second-generation drug-eluting stents (DES) for diffuse CAD (DES-only group). The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac death, myocardial infarction, stent or target lesion thrombosis, target vessel revascularization, and major bleeding at 2 years.</div></div><div><h3>Results</h3><div>In the DCB-based group, 73.7% of patients were treated with DCB alone. The MACE rate was significantly lower in the DCB-based group than in the DES-only group (4.6% vs 14.6%; HR, 0.29; 95%<span>C</span>I, 0.18-0.47; <em>P</em> <!--><<!--> <!-->.001). Rates of target vessel revascularization (3.1% vs 9.7%; <em>P</em> <!--><<!--> <!-->.001) and major bleeding events (0.8% vs 2.7%; <em>P</em> <!-->=<!--> <!-->.008) were also lower with DCB-based PCI than with DES-only PCI. In a multivariable model, DCB-based PCI was independently associated with a lower risk of 2-year MACE, target vessel revascularization, and major bleeding.</div></div><div><h3>Conclusions</h3><div>In patients with de novo diffuse CAD, DCB-based PCI was associated with a significant reduction in MACE compared with DES-only PCI</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 108-116"},"PeriodicalIF":5.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-19DOI: 10.1016/j.recesp.2025.08.001
Eduardo Arana-Rueda , José Manuel Rubio-Campal , Bieito Campos , Felipe Rodríguez-Entem , David Calvo , en representación de los colaboradores del Registro español de ablación con catéter
Introduction
This report presents the results of the Spanish catheter ablation registry for 2024.
Methods
A retrospective analysis of ablation procedures performed at participating hospitals in Spain. Data were collected through the REDCap platform using a dedicated form.
Results
There was a significant increase in both the number of participating centers (117 centers, + 12.5%) and the total number of ablations performed (32 406, + 23%). The most common arrhythmogenic substrate was atrial fibrillation (13 395 cases, + 35%, accounting for 41% of all cases), with the single-shot technique being the most widely used (55%). There was also a marked increase in the use of electroporation (21% in 2024 vs 10.3% in 2023). Other substrates showed smaller increases, with cavotricuspid isthmus ablation maintaining its position as the second most common procedure (6084 cases, 19%). Overall acute success rates remained high (95%), and complication (1.5%) and mortality (0.04%) rates were stable. The use of electroanatomical navigation remained consistent (54% of cases), with 17% of procedures performed without fluoroscopy. Outpatient procedures accounted for 18% of the total, with notable percentages for atrioventricular nodal re-entrant tachycardia (39%) and cavotricuspid isthmus ablation (33%). A total of 523 pediatric ablations were performed in 44 centers, predominantly for accessory pathways (66.5%), with a 92.5% success rate. Accreditation activity showed 41 centers and 250 professionals involved.
Conclusions
The number of centers and procedures increased, mainly due to atrial fibrillation ablation. Despite the growing complexity of cases, the rates of success, complications, and mortality remained stable. The accreditation process for both centers and professionals is now firmly established, with steady annual accreditation numbers.
{"title":"Registro español de ablación con catéter. XXIV informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2024)","authors":"Eduardo Arana-Rueda , José Manuel Rubio-Campal , Bieito Campos , Felipe Rodríguez-Entem , David Calvo , en representación de los colaboradores del Registro español de ablación con catéter","doi":"10.1016/j.recesp.2025.08.001","DOIUrl":"10.1016/j.recesp.2025.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>This report presents the results of the Spanish catheter ablation registry for 2024.</div></div><div><h3>Methods</h3><div>A retrospective analysis of ablation procedures performed at participating hospitals in Spain. Data were collected through the REDCap platform using a dedicated form.</div></div><div><h3>Results</h3><div>There was a significant increase in both the number of participating centers (117 centers,<!--> <!-->+<!--> <!-->12.5%) and the total number of ablations performed (32 406,<!--> <!-->+<!--> <!-->23%). The most common arrhythmogenic substrate was atrial fibrillation (13 395 cases,<!--> <!-->+<!--> <!-->35%, accounting for 41% of all cases), with the single-shot technique being the most widely used (55%). There was also a marked increase in the use of electroporation (21% in 2024 vs 10.3% in 2023). Other substrates showed smaller increases, with cavotricuspid isthmus ablation maintaining its position as the second most common procedure (6084 cases, 19%). Overall acute success rates remained high (95%), and complication (1.5%) and mortality (0.04%) rates were stable. The use of electroanatomical navigation remained consistent (54% of cases), with 17% of procedures performed without fluoroscopy. Outpatient procedures accounted for 18% of the total, with notable percentages for atrioventricular nodal re-entrant tachycardia (39%) and cavotricuspid isthmus ablation (33%). A total of 523 pediatric ablations were performed in 44 centers, predominantly for accessory pathways (66.5%), with a 92.5% success rate. Accreditation activity showed 41 centers and 250 professionals involved.</div></div><div><h3>Conclusions</h3><div>The number of centers and procedures increased, mainly due to atrial fibrillation ablation. Despite the growing complexity of cases, the rates of success, complications, and mortality remained stable. The accreditation process for both centers and professionals is now firmly established, with steady annual accreditation numbers.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1088-1099"},"PeriodicalIF":5.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Modelando el pronóstico en la insuficiencia tricuspídea grave a través del acoplamiento entre el ventrículo derecho y la arteria pulmonar","authors":"Dalila Nappa , Rocío Hinojar , Covadonga Fernández-Golfín","doi":"10.1016/j.recesp.2025.06.012","DOIUrl":"10.1016/j.recesp.2025.06.012","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 46-48"},"PeriodicalIF":5.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-12DOI: 10.1016/j.recesp.2025.06.008
María Valverde-Gómez , Luis De La Higuera-Romero , Marlene Pérez-Barbeito , Soledad García-Hernández , Ivonne Cárdenas-Reyes , Juan Pablo Ochoa
{"title":"Miocardiopatía por TTN: expandiendo la relevancia clínica más allá de la banda A","authors":"María Valverde-Gómez , Luis De La Higuera-Romero , Marlene Pérez-Barbeito , Soledad García-Hernández , Ivonne Cárdenas-Reyes , Juan Pablo Ochoa","doi":"10.1016/j.recesp.2025.06.008","DOIUrl":"10.1016/j.recesp.2025.06.008","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 184-186"},"PeriodicalIF":5.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-31DOI: 10.1016/j.recesp.2025.07.009
Juan Manuel Serrano-Marcos, Miguel Morales-García, Sara Ruiz-Magaña
{"title":"Síndrome de Sézary como causa inusual de endocarditis de Loeffler","authors":"Juan Manuel Serrano-Marcos, Miguel Morales-García, Sara Ruiz-Magaña","doi":"10.1016/j.recesp.2025.07.009","DOIUrl":"10.1016/j.recesp.2025.07.009","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 95-96"},"PeriodicalIF":5.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-29DOI: 10.1016/j.recesp.2025.07.008
David Vivas , Raquel Ferrandis , Manuel Anguita-Sánchez , María Anguita-Gámez , Juan Ignacio Arcelus , Marysol Echeverri , Isabel Egocheaga , María Asunción Esteve-Pastor , José Luis Ferreiro , Juan Vicente Llau , Vanessa Roldán , Juan Miguel Ruiz-Nodar , David González-Casal , Mónica Torres-Fonseca , José López-Menéndez , Míriam Ciria , Francisco Leyva , Enrique Rodríguez de Santiago , María Teresa Vidán , Loida Pamplona , Nora Palomo-López
In recent years, the use of anticoagulant and antiplatelet medications has significantly increased, along with rising life expectancy. As a result, many patients on antithrombotic therapy will eventually require invasive procedures. This necessitates decisions on the appropriateness and timing of discontinuing anticoagulation and/or antiplatelet therapy in each case. Although a key multidisciplinary consensus document was published in 2018 to guide this process, its practical application has been limited. Furthermore, adherence to its recommendations has been low, leading to a higher incidence of both thrombotic and hemorrhagic adverse events. To address these issues and reflect advances in knowledge, it has been decided to update the previous consensus document to include developments since 2018. The aim is to simplify clinical decision-making and gain support from a broader range of scientific societies. Ultimately, the goal is to improve the dissemination and practical application of these recommendations to optimize the safety and effectiveness of antithrombotic treatment in patients requiring invasive procedures, reduce complications associated with inappropriate treatment, and enhance clinical outcomes in this increasingly complex scenario.
Full English text available from:www.revespcardiol.org/en
{"title":"Abordaje del tratamiento antitrombótico durante el perioperatorio y el periprocedimiento: documento de consenso 2025 de SEC, SEDAR, SEACV, SECCE, AEC, SECOM CYC, SECPRE, SEPD, SEGG, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEN, S.E.N., SENEC, SEPAR, SEO, SEORL-CCC, SEPA, SERVEI, SECOT y AEU","authors":"David Vivas , Raquel Ferrandis , Manuel Anguita-Sánchez , María Anguita-Gámez , Juan Ignacio Arcelus , Marysol Echeverri , Isabel Egocheaga , María Asunción Esteve-Pastor , José Luis Ferreiro , Juan Vicente Llau , Vanessa Roldán , Juan Miguel Ruiz-Nodar , David González-Casal , Mónica Torres-Fonseca , José López-Menéndez , Míriam Ciria , Francisco Leyva , Enrique Rodríguez de Santiago , María Teresa Vidán , Loida Pamplona , Nora Palomo-López","doi":"10.1016/j.recesp.2025.07.008","DOIUrl":"10.1016/j.recesp.2025.07.008","url":null,"abstract":"<div><div>In recent years, the use of anticoagulant and antiplatelet medications has significantly increased, along with rising life expectancy. As a result, many patients on antithrombotic therapy will eventually require invasive procedures. This necessitates decisions on the appropriateness and timing of discontinuing anticoagulation and/or antiplatelet therapy in each case. Although a key multidisciplinary consensus document was published in 2018 to guide this process, its practical application has been limited. Furthermore, adherence to its recommendations has been low, leading to a higher incidence of both thrombotic and hemorrhagic adverse events. To address these issues and reflect advances in knowledge, it has been decided to update the previous consensus document to include developments since 2018. The aim is to simplify clinical decision-making and gain support from a broader range of scientific societies. Ultimately, the goal is to improve the dissemination and practical application of these recommendations to optimize the safety and effectiveness of antithrombotic treatment in patients requiring invasive procedures, reduce complications associated with inappropriate treatment, and enhance clinical outcomes in this increasingly complex scenario.</div><div><em>Full English text available from</em>:<span><span>www.revespcardiol.org/en</span><svg><path></path></svg></span></div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 68-79"},"PeriodicalIF":5.9,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-26DOI: 10.1016/j.recesp.2025.05.009
Julián Rodríguez-García , Rafel Ramos , Anna Ponjoan , Jordi Blanch , Miguel Cainzos-Achirica , Paolo D. Dallaglio , Rodolfo San Antonio , Marcos Rodríguez-García , Jordi Mercé , Valentina Faga , Javier Sanaú , Ismael Almonte , Jesús Rodríguez-Silva , Josep Comín-Colet , Ignasi Anguera , Andrea Di Marco
Introduction and objectives
The association between atrial fibrillation (AF) and dementia remains debated, and data from Mediterranean populations are scarce. We aimed to evaluate the relationship between AF and dementia in a large Catalan cohort, with a particular focus on identifying subgroups with the strongest associations.
Methods
We conducted a population-based observational study including individuals aged ≥ 45 years without prior diagnosis of dementia. Data were obtained from the System for the Development of Research in Primary Care, which covers more than 80% of the Catalan population. Dementia was identified using ICD-10-CM codes and prescription records. Early-onset dementia (EOD) was defined as diagnosis before age 65 years. Participants were followed up from 2009 to 2021. Cox regression models were used to identify predictors of incident dementia.
Results
A total of 2 520 839 individuals were included (mean follow-up: 13 years), of whom 79820 (3.25%) had AF at baseline. On univariate analysis, AF was a strong predictor of dementia (HR, 3.39; P < .001). However, after multivariable adjustment, the association was modest (HR, 1.04; P < .001). AF was a stronger independent predictor in individuals aged < 70 years (HR, 1.21; P < .001), whereas the association was not significant in those aged ≥70. The strongest association was observed for EOD (HR, 1.36; P < .001). All associations remained consistent in analyses restricted to individuals without prior stroke.
Conclusions
In a large Mediterranean cohort, AF was independently associated with a modest increase in dementia risk, regardless of stroke. This association was stronger in younger individuals and in EOD. These findings highlight the need for studies assessing the impact of early identification and management of AF on dementia incidence in younger populations.
前言和目的房颤（AF）和痴呆之间的关系仍然存在争议，来自地中海人群的数据很少。我们的目的是在一个大型的加泰罗尼亚队列中评估房颤和痴呆之间的关系，特别关注识别与最强关联的亚组。方法：我们进行了一项以人群为基础的观察性研究，纳入了年龄≥45岁、既往无痴呆诊断的个体。数据来自初级保健研究发展系统，该系统覆盖了加泰罗尼亚80%以上的人口。使用ICD-10-CM代码和处方记录识别痴呆。早发性痴呆（EOD）被定义为65岁之前的诊断。参与者从2009年到2021年进行了随访。Cox回归模型用于确定痴呆发生的预测因素。结果共纳入2 520 839例（平均随访13年），其中79820例（3.25%）基线时患有房颤。单因素分析显示，房颤是痴呆的强预测因子（HR, 3.39; P < .001）。然而，在多变量调整后，相关性不大（HR, 1.04; P < .001）。房颤在70岁的个体中是一个更强的独立预测因子（HR, 1.21; P < .001），而在≥70岁的个体中相关性不显著。与EOD的相关性最强（HR, 1.36; P < .001）。所有的关联在仅限于没有中风史的个体的分析中保持一致。结论：在一个大型地中海队列中，心房颤动与痴呆风险适度增加独立相关，与卒中无关。这种关联在年轻人和EOD中更为明显。这些发现强调需要进行研究，评估早期识别和管理房颤对年轻人群痴呆发病率的影响。
{"title":"Asociación entre fibrilación auricular y demencia en un estudio poblacional a gran escala en el sur de Europa","authors":"Julián Rodríguez-García , Rafel Ramos , Anna Ponjoan , Jordi Blanch , Miguel Cainzos-Achirica , Paolo D. Dallaglio , Rodolfo San Antonio , Marcos Rodríguez-García , Jordi Mercé , Valentina Faga , Javier Sanaú , Ismael Almonte , Jesús Rodríguez-Silva , Josep Comín-Colet , Ignasi Anguera , Andrea Di Marco","doi":"10.1016/j.recesp.2025.05.009","DOIUrl":"10.1016/j.recesp.2025.05.009","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The association between atrial fibrillation (AF) and dementia remains debated, and data from Mediterranean populations are scarce. We aimed to evaluate the relationship between AF and dementia in a large Catalan cohort, with a particular focus on identifying subgroups with the strongest associations.</div></div><div><h3>Methods</h3><div>We conducted a population-based observational study including individuals aged ≥<!--> <!-->45 years without prior diagnosis of dementia. Data were obtained from the System for the Development of Research in Primary Care, which covers more than 80% of the Catalan population. Dementia was identified using ICD-10-CM codes and prescription records. Early-onset dementia (EOD) was defined as diagnosis before age 65 years. Participants were followed up from 2009 to 2021. Cox regression models were used to identify predictors of incident dementia.</div></div><div><h3>Results</h3><div>A total of 2 520 839 individuals were included (mean follow-up: 13 years), of whom 79820 (3.25%) had AF at baseline. On univariate analysis, AF was a strong predictor of dementia (HR, 3.39; <em>P</em> <!--><<!--> <!-->.001). However, after multivariable adjustment, the association was modest (HR, 1.04; <em>P</em> <!--><<!--> <!-->.001). AF was a stronger independent predictor in individuals aged <<!--> <!-->70 years (HR, 1.21; <em>P</em> <!--><<!--> <!-->.001), whereas the association was not significant in those aged ≥70. The strongest association was observed for EOD (HR, 1.36; <em>P</em> <!--><<!--> <!-->.001). All associations remained consistent in analyses restricted to individuals without prior stroke.</div></div><div><h3>Conclusions</h3><div>In a large Mediterranean cohort, AF was independently associated with a modest increase in dementia risk, regardless of stroke. This association was stronger in younger individuals and in EOD. These findings highlight the need for studies assessing the impact of early identification and management of AF on dementia incidence in younger populations.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 24-34"},"PeriodicalIF":5.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-24DOI: 10.1016/j.recesp.2025.06.007
Salvatore Brugaletta
{"title":"Impacto de la exclusión de accesos transapicales en los resultados por sexos del implante percutáneo de válvula aórtica: ¿una limitación metodológica? Respuesta","authors":"Salvatore Brugaletta","doi":"10.1016/j.recesp.2025.06.007","DOIUrl":"10.1016/j.recesp.2025.06.007","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Page 931"},"PeriodicalIF":5.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-24DOI: 10.1016/j.recesp.2025.07.011
Alberto Domínguez-Rodríguez , Daniel Hernández-Vaquero , Néstor Baéz-Ferrer
{"title":"La amenaza invisible: la contaminación del aire ya es el segundo factor de riesgo de mortalidad en la población general","authors":"Alberto Domínguez-Rodríguez , Daniel Hernández-Vaquero , Néstor Baéz-Ferrer","doi":"10.1016/j.recesp.2025.07.011","DOIUrl":"10.1016/j.recesp.2025.07.011","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 128-130"},"PeriodicalIF":5.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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