Pub Date : 2026-02-01Epub Date: 2025-09-16DOI: 10.1016/j.recesp.2025.08.016
Fernando A. Navarro
{"title":"Inteligencia artificial (IA): …y otra de cal","authors":"Fernando A. Navarro","doi":"10.1016/j.recesp.2025.08.016","DOIUrl":"10.1016/j.recesp.2025.08.016","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Page 99"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034446","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 : 2026-02-01Epub Date: 2025-07-03DOI: 10.1016/j.recesp.2025.05.006
Jorge Sanz-Sánchez , Sandra Santos Martínez , Eva Rumiz González , Juan Francisco Oteo Domínguez , David Tejada Ponce , Antonio Gómez Menchero , Guillermo Sánchez Elvira , Georgina Fuertes Ferre , Fernando Rivero Crespo , Antonela Lukic Otanovic , José Díaz Fernández , Eladio Galindo Fernández , Cristóbal Urbano Carrillo , Neus Salvatella Giralt , Mauricio Torres Sánchez , Arturo García Touchard , Borja Ibáñez Cabeza , Giulio Stefanini , Fernando Alfonso Manterola , Héctor García García , Ignacio J. Amat-Santos
Introduction and objectives
Primary percutaneous coronary intervention (PCI) with drug-eluting stent implantation (DES) is the standard of treatment in patients presenting with ST-segment elevation myocardial infarction (STEMI). However, target lesion failure can occur due to stent underexpansion, malapposition, hypersensitivity, fracture, and neoatherosclerosis. Drug-coated balloons (DCB) represent a potential alternative supported by the concept of “leaving nothing behind.” The aim is to compare a reduced stent strategy based on DCB- with DES-PCI in patients presenting with STEMI.
A total of 1 272 patients presenting with STEMI will be randomized to any paclitaxel-DCB vs any sirolimus-DES (both with CE approval) for all culprit and nonculprit lesions during PCI. The primary endpoint will be target-lesion failure: cardiac death, target-vessel myocardial infarction, or ischemia-driven target lesion revascularization at 12-month follow-up. An independent clinical events committee masked to treatment allocation will adjudicate all suspected events. Clinical follow-up will be performed after 1 month (30 days ± 5 days) and 1 year (365 days ± 30 days). An extended follow-up at 3, 5, and 10 years is planned.
Conclusions
The COPERNICAN trial will be the first randomized study comparing clinical outcomes of DCB vs DES in STEMI patients.
{"title":"Estrategia de reducción de stents frente a revascularización coronaria percutánea convencional en el IAMCEST: diseño del ensayo COPERNICAN","authors":"Jorge Sanz-Sánchez , Sandra Santos Martínez , Eva Rumiz González , Juan Francisco Oteo Domínguez , David Tejada Ponce , Antonio Gómez Menchero , Guillermo Sánchez Elvira , Georgina Fuertes Ferre , Fernando Rivero Crespo , Antonela Lukic Otanovic , José Díaz Fernández , Eladio Galindo Fernández , Cristóbal Urbano Carrillo , Neus Salvatella Giralt , Mauricio Torres Sánchez , Arturo García Touchard , Borja Ibáñez Cabeza , Giulio Stefanini , Fernando Alfonso Manterola , Héctor García García , Ignacio J. Amat-Santos","doi":"10.1016/j.recesp.2025.05.006","DOIUrl":"10.1016/j.recesp.2025.05.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Primary percutaneous coronary intervention (PCI) with drug-eluting stent implantation (DES) is the standard of treatment in patients presenting with ST-segment elevation myocardial infarction (STEMI). However, target lesion failure can occur due to stent underexpansion, malapposition, hypersensitivity, fracture, and neoatherosclerosis. Drug-coated balloons (DCB) represent a potential alternative supported by the concept of “leaving nothing behind.” The aim is to compare a reduced stent strategy based on DCB- with DES-PCI in patients presenting with STEMI.</div></div><div><h3>Methods</h3><div>Prospective, pragmatic, multicenter, noninferiority, randomized clinical trial.</div></div><div><h3>Results</h3><div>A total of 1 272 patients presenting with STEMI will be randomized to any paclitaxel-DCB vs any sirolimus-DES (both with CE approval) for all culprit and nonculprit lesions during PCI. The primary endpoint will be target-lesion failure: cardiac death, target-vessel myocardial infarction, or ischemia-driven target lesion revascularization at 12-month follow-up. An independent clinical events committee masked to treatment allocation will adjudicate all suspected events. Clinical follow-up will be performed after 1 month (30 days<!--> <!-->±<!--> <!-->5 days) and 1 year (365 days<!--> <!-->±<!--> <!-->30 days). An extended follow-up at 3, 5, and 10 years is planned.</div></div><div><h3>Conclusions</h3><div>The COPERNICAN trial will be the first randomized study comparing clinical outcomes of DCB vs DES in STEMI patients.</div><div>ClinicalTrials.gov: <span><span>NCT06353594</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 100-105"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039956","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 : 2026-02-01Epub Date: 2025-10-04DOI: 10.1016/j.recesp.2025.07.010
Marco Vitolo , Marco Proietti , Marta Mantovani , Jacopo Francesco Imberti , Davide Antonio Mei , Niccolò Bonini , Giulio Francesco Romiti , Bernadette Corica , Igor Diemberger , Laurent Fauchier , Francisco Marín , Gheorghe-Andrei Dan , Tatjana S. Potpara , Gregory Y.H. Lip , Giuseppe Boriani
Introduction and objectives
Increased physical activity may improve outcomes in patients with atrial fibrillation (AF), but available data are limited. This study aimed to analyze the association between physical activity and major adverse outcomes in a large European AF cohort.
Methods
We used data from a prospective, observational, large-scale multicenter study of AF in European patients, involving 27 countries and 250 centers. Patients self-reported their physical activity levels during the preceding 2 years, categorized as none (physically inactive), occasional, regular, or intense. The primary outcome was a composite of major adverse cardiovascular (CV) events and all-cause mortality.
Results
A total of 9525 patients with AF were included (median age 71 years; 41% female). Overall, 43% reported being physically inactive. Among those who reported physical activity, 56.9% described it as occasional, 36.5% as regular, and 6.6% as intense. Inactive patients had a higher burden of both CV and non-CV comorbidities. Over a median follow-up of 728 days, 16.2% of the patients experienced the primary composite endpoint. Physical activity was independently associated with a lower risk of the primary endpoint (adjusted HR, 0.68; 95% CI, 0.59-0.76), with a progressively lower incidence as activity levels increased. Interaction analyses showed that the beneficial effect of physical activity was consistent among several subgroups, with no significant interactions.
Conclusions
Physical activity, even at low levels, was associated with a reduced incidence of CV events and all-cause mortality. These benefits appear to be independent of CV risk factors and comorbidities, highlighting the importance of incorporating physical activity into holistic AF management strategies.
{"title":"Actividad física en pacientes con fibrilación auricular y eventos adversos: resultados de un estudio de cohortes prospectivo multicéntrico europeo","authors":"Marco Vitolo , Marco Proietti , Marta Mantovani , Jacopo Francesco Imberti , Davide Antonio Mei , Niccolò Bonini , Giulio Francesco Romiti , Bernadette Corica , Igor Diemberger , Laurent Fauchier , Francisco Marín , Gheorghe-Andrei Dan , Tatjana S. Potpara , Gregory Y.H. Lip , Giuseppe Boriani","doi":"10.1016/j.recesp.2025.07.010","DOIUrl":"10.1016/j.recesp.2025.07.010","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Increased physical activity may improve outcomes in patients with atrial fibrillation (AF), but available data are limited. This study aimed to analyze the association between physical activity and major adverse outcomes in a large European AF cohort.</div></div><div><h3>Methods</h3><div>We used data from a prospective, observational, large-scale multicenter study of AF in European patients, involving 27 countries and 250 centers. Patients self-reported their physical activity levels during the preceding 2 years, categorized as none (physically inactive), occasional, regular, or intense. The primary outcome was a composite of major adverse cardiovascular (CV) events and all-cause mortality.</div></div><div><h3>Results</h3><div>A total of 9525 patients with AF were included (median age 71 years; 41% female). Overall, 43% reported being physically inactive. Among those who reported physical activity, 56.9% described it as occasional, 36.5% as regular, and 6.6% as intense. Inactive patients had a higher burden of both CV and non-CV comorbidities. Over a median follow-up of 728 days, 16.2% of the patients experienced the primary composite endpoint. Physical activity was independently associated with a lower risk of the primary endpoint (adjusted HR, 0.68; 95% CI, 0.59-0.76), with a progressively lower incidence as activity levels increased. Interaction analyses showed that the beneficial effect of physical activity was consistent among several subgroups, with no significant interactions.</div></div><div><h3>Conclusions</h3><div>Physical activity, even at low levels, was associated with a reduced incidence of CV events and all-cause mortality. These benefits appear to be independent of CV risk factors and comorbidities, highlighting the importance of incorporating physical activity into holistic AF management strategies.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 151-164"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039951","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 : 2026-02-01Epub Date: 2025-06-04DOI: 10.1016/j.recesp.2025.04.014
Zhangyu Lin , Xuejing Duan , Yuetang Wang , Qian Wang , Lei Jia , Kefei Dou
{"title":"Recurrencia rápida de reestenosis coronaria inexplicada en el stent (RECUR): una nueva enfermedad inflamatoria coronaria con evidencia patológica","authors":"Zhangyu Lin , Xuejing Duan , Yuetang Wang , Qian Wang , Lei Jia , Kefei Dou","doi":"10.1016/j.recesp.2025.04.014","DOIUrl":"10.1016/j.recesp.2025.04.014","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 180-184"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039698","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 : 2026-02-01Epub 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":"2026-02-01","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}
Pub Date : 2026-02-01Epub Date: 2025-09-29DOI: 10.1016/j.recesp.2025.08.002
Margarida G. Figueiredo, José Miguel Viegas, Sílvia Aguiar Rosa
{"title":"Miocardiopatía hipertrófica con obstrucción intracavitaria secuencial resuelta con mavacamten","authors":"Margarida G. Figueiredo, José Miguel Viegas, Sílvia Aguiar Rosa","doi":"10.1016/j.recesp.2025.08.002","DOIUrl":"10.1016/j.recesp.2025.08.002","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 187-188"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039700","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":"Validación de la secuencia de resonancia magnética 3D de única apnea ESSOS para el estudio de la dilatación aórtica","authors":"Sandra Gómez-Talavera , Álvaro Navarro-Guzmán , Rodrigo Fernández-Jiménez , Valentín Fuster , Javier Sánchez-González , Borja Ibáñez","doi":"10.1016/j.recesp.2025.04.009","DOIUrl":"10.1016/j.recesp.2025.04.009","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 175-178"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039955","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 : 2026-02-01Epub Date: 2025-10-03DOI: 10.1016/j.recesp.2025.07.007
Fernando Civeira , Estíbaliz Jarauta , Victoria Marco-Benedí , Ana M. Bea , Rocío Mateo-Gallego , Itziar Lamiquiz-Moneo , Irene Gracia-Rubio , Daniel Bello-Álvarez , Martín Laclaustra , María Teresa Tejedor , Salvador Olmos , Ana Cenarro
Introduction and objectives
The frequency, clinical characteristics and risk of atherosclerotic cardiovascular disease (ASCVD) of the different types of hypercholesterolemia are not well established. The primary and secondary objectives of this study were to determine the cause of hypercholesterolemia and whether the cause confers a different ASCVD prognosis.
Methods
The analysis included 3474 probands with primary hypercholesterolemia, of whom 3283 (94.8%) were followed up for 9.33 ± 5.8 years for ASCVD. Genetic analysis of familial hypercholesterolemia (FH) genes, polygenic risk score for hypercholesterolemia, and lipid concentrations, including lipoprotein(a), were used to classify hypercholesterolemia.
Results
The diagnoses were heterozygous FH, n = 400 (11.5%); hyperlipoproteinemia(a), n = 181 (5.2%); polygenic hypercholesterolemia, n = 434 (12.5%); hyperlipoproteinemia(a) plus polygenic hypercholesterolemia, n = 128 (3.7%); multifactorial, n = 1562 (45.0%); and idiopathic, n = 769 (22.1%). At baseline, low-density lipoprotein cholesterol levels were higher in heterozygous FH, and the prevalence of ASCVD was higher in hyperlipoproteinemia(a). Other clinical and biochemical characteristics did not differ among hypercholesterolemia subgroups. The survival rate was lower in participants with hyperlipoproteinemia(a) than in the other hypercholesterolemia groups (P = .001). Variables independently associated with ASCVD events during follow-up were age, male sex, the presence of ASCVD, diabetes or hypertension at baseline, current smoking, lipoprotein(a) concentration, and high-density lipoprotein cholesterol concentration, the latter being inversely associated with ASCVD events. Total mortality was independent of the type of hypercholesterolemia.
Conclusions
Genetic hypercholesterolemia has a worse prognosis for ASCVD than nongenetic hypercholesterolemia. Among individuals with genetic hypercholesterolemia, those with elevated lipoprotein(a) have the worst prognosis. Conventional lipid-lowering treatment for low-density lipoprotein cholesterol appears to be less effective in hypercholesterolemia due to hyperlipoproteinemia(a) than in other forms of hypercholesterolemia.
{"title":"Clasificación, prevalencia y riesgo cardiovascular de los diferentes tipos de hipercolesterolemia","authors":"Fernando Civeira , Estíbaliz Jarauta , Victoria Marco-Benedí , Ana M. Bea , Rocío Mateo-Gallego , Itziar Lamiquiz-Moneo , Irene Gracia-Rubio , Daniel Bello-Álvarez , Martín Laclaustra , María Teresa Tejedor , Salvador Olmos , Ana Cenarro","doi":"10.1016/j.recesp.2025.07.007","DOIUrl":"10.1016/j.recesp.2025.07.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The frequency, clinical characteristics and risk of atherosclerotic cardiovascular disease (ASCVD) of the different types of hypercholesterolemia are not well established. The primary and secondary objectives of this study were to determine the cause of hypercholesterolemia and whether the cause confers a different ASCVD prognosis.</div></div><div><h3>Methods</h3><div>The analysis included 3474 probands with primary hypercholesterolemia, of whom 3283 (94.8%) were followed up for 9.33<!--> <!-->± 5.8 years for ASCVD. Genetic analysis of familial hypercholesterolemia (FH) genes, polygenic risk score for hypercholesterolemia, and lipid concentrations, including lipoprotein(a), were used to classify hypercholesterolemia.</div></div><div><h3>Results</h3><div>The diagnoses were heterozygous FH, n<!--> <!-->=<!--> <!-->400 (11.5%); hyperlipoproteinemia(a), n<!--> <!-->=<!--> <!-->181 (5.2%); polygenic hypercholesterolemia, n<!--> <!-->=<!--> <!-->434 (12.5%); hyperlipoproteinemia(a) plus polygenic hypercholesterolemia, n<!--> <!-->=<!--> <!-->128 (3.7%); multifactorial, n<!--> <!-->=<!--> <!-->1562 (45.0%); and idiopathic, n<!--> <!-->=<!--> <!-->769 (22.1%). At baseline, low-density lipoprotein cholesterol levels were higher in heterozygous FH, and the prevalence of ASCVD was higher in hyperlipoproteinemia(a). Other clinical and biochemical characteristics did not differ among hypercholesterolemia subgroups. The survival rate was lower in participants with hyperlipoproteinemia(a) than in the other hypercholesterolemia groups (<em>P</em> <!-->=<!--> <!-->.001). Variables independently associated with ASCVD events during follow-up were age, male sex, the presence of ASCVD, diabetes or hypertension at baseline, current smoking, lipoprotein(a) concentration, and high-density lipoprotein cholesterol concentration, the latter being inversely associated with ASCVD events. Total mortality was independent of the type of hypercholesterolemia.</div></div><div><h3>Conclusions</h3><div>Genetic hypercholesterolemia has a worse prognosis for ASCVD than nongenetic hypercholesterolemia. Among individuals with genetic hypercholesterolemia, those with elevated lipoprotein(a) have the worst prognosis. Conventional lipid-lowering treatment for low-density lipoprotein cholesterol appears to be less effective in hypercholesterolemia due to hyperlipoproteinemia(a) than in other forms of hypercholesterolemia.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 131-141"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039953","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 : 2026-02-01Epub Date: 2025-10-21DOI: 10.1016/j.recesp.2025.08.007
Bruno Scheller
{"title":"Menos stents para el IAMCEST: ¿está listo el balón farmacoactivo para su gran momento?","authors":"Bruno Scheller","doi":"10.1016/j.recesp.2025.08.007","DOIUrl":"10.1016/j.recesp.2025.08.007","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 106-107"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039957","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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