Revista espanola de cardiologia最新文献

英文中文

Inhibición dual del SGLT1 y SGLT2: algo más que su suma SGLT1 和 SGLT2 的双重抑制作用：超过两者之和。

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.recesp.2024.01.005

Enrique Sánchez-Muñoz , Juan Antonio Requena-Ibáñez , Juan José Badimón

引用次数: 0

Grupos de morbilidad ajustada y valoración geriátrica integral en el paciente mayor con síndrome coronario agudo 急性冠状动脉综合征老年患者的调整发病率分组和老年综合评估

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.recesp.2024.01.008

Albert Ariza-Solé , Francesc Formiga , David Monterde , Emili Vela , Elena Calvo , Josep Comín-Colet

引用次数: 0

En reconocimiento del origen español del CRISPR/Cas9. Implicaciones para el tratamiento de las cardiopatías familiares 纪念 CRISPR/Cas9 的西班牙起源。对治疗家族性心脏病的意义。

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.recesp.2024.01.012

María Sabater Molina , Juan Ramón Gimeno Blanes

引用次数: 0

Balón liberador de sirolimus en el tratamiento del síndrome coronario agudo y crónico: el estudio PEACE, un subanálisis del registro EASTBOURNE 治疗急慢性冠状动脉综合征的西罗莫司涂层球囊：EASTBOURNE 研究的子分析

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.recesp.2023.11.013

Alessandra Laricchia , Irene Bossi , Roberto A. Latini , Chuey Y. Lee , Ignacio S. Pérez , Fabrizio Tomai , Amin A. Nuruddin , Dario Buccheri , Giuseppe Seresini , Raymundo Ocaranza , Gunasekaran Sengottvelu , Nicola Pesenti , Antonio Mangieri , Bernardo Cortese , en representación de los investigadores del estudio EASTBOURNE

Introduction and objectives

The PEACE study (Performance of a sirolimus-eluting balloon strategy in acute and chronic coronary syndromes) investigated for the first time whether a sirolimus-coated balloon (SCB) (Magic Touch, Concept Medical, India) is associated with different outcomes depending on whether it is used in acute coronary syndromes (ACS) or chronic coronary syndromes (CCS).

Methods

This was a post-hoc analysis from the all-comers EASTBOURNE Registry (NCT03085823). Out of 2083 patients enrolled, an SCB was used to treat 968 (46.5%) ACS and 1115 (53.5%) CCS patients. The primary endpoint was target lesion revascularization at 12 months, while secondary endpoints were angiographic success and major adverse cardiovascular events.

Results

Baseline demographics, mean reference vessel diameter and mean lesion length were comparable between ACS and CCS. Predilatation was more commonly performed in ACS (P = .007). SCB was inflated at a standard pressure in both groups with a slight trend toward longer inflation time in ACS. Angiographic success was high in both groups (ACS 97.4% vs CCS 97.7%, P = .820) with limited bailout stenting. Similarly, at 12 months the cumulative incidence of target lesion revascularization (ACS 6.6% vs CCS 5.2%, P = .258) was comparable between ACS and CCS. Conversely, a higher rate of major adverse cardiovascular events in acute presenters was mainly driven by myocardial infarction recurrencies (ACS 10.4% vs CCS 8.3%, P = .009). In-stent restenosis showed a higher proportion of target lesion revascularization and major adverse cardiovascular events than de novo lesions, independently of the type of presentation at the index procedure.

Conclusions

This SCB shows good performance in terms of acute and 1-year outcomes independently of the clinical presentation.

简介和目的 PEACE 研究（西罗莫司洗脱球囊在急性和慢性冠状动脉综合征中的应用）首次调查了西罗莫司涂层球囊（SCB）（Magic Touch，印度 Concept Medical 公司）在急性冠状动脉综合征（ACS）和慢性冠状动脉综合征（CCS）中的应用是否会导致不同的结果。方法这是对所有患者的 EASTBOURNE 登记（NCT03085823）进行的一项事后分析。在入组的2083名患者中，968名（46.5%）ACS患者和1115名（53.5%）CCS患者接受了SCB治疗。结果 ACS和CCS的基线人口统计学、平均参考血管直径和平均病变长度相当。ACS 患者更常进行扩张术（P = .007）。两组患者均以标准压力对 SCB 进行充气，但 ACS 患者的充气时间略有延长。两组的血管造影成功率都很高（ACS 97.4% vs CCS 97.7%，P = .820），保送支架的成功率有限。同样，在 12 个月时，ACS 和 CCS 的靶病变血运重建累积发生率相当（ACS 6.6% vs CCS 5.2%，P = .258）。相反，急性期患者的主要不良心血管事件发生率更高，主要原因是心肌梗死复发（ACS 10.4% vs CCS 8.3%，P = .009）。支架内再狭窄的靶病变血运重建比例和主要不良心血管事件发生率均高于新生病变，与指数手术时的表现类型无关。

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引用次数: 0

Impacto del uso previo de antiagregantes plaquetarios en la susceptibilidad, la progresión y la gravedad de la COVID-19: un estudio poblacional 先前使用抗血小板药物对 COVID-19 易感性、进展和严重程度的影响：一项基于人群的研究。

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.recesp.2023.12.012

Ángela Prieto-Campo , Maruxa Zapata-Cachafeiro , Manuel Portela-Romero , María Piñeiro-Lamas , Adolfo Figueiras , Ángel Salgado-Barreira

Introduction and objectives

Hypercoagulability and thromboembolism are processes that arise from severe acute respiratory syndrome coronavirus 2 infection and are responsible for a high degree of coronavirus disease 2019 (COVID-19)-related morbidity and mortality. This study sought to assess the effect of antiplatelet drugs on COVID-19 severity (risk of hospitalization and mortality), susceptibility to severe acute respiratory syndrome coronavirus 2 infection, and progression to severe COVID-19.

Methods

We conducted a population-based case-control study in a northwestern region of Spain in 2020. The study involved 3060 participants with a positive polymerase chain reaction test who were hospitalized, 26 757 participants with a positive polymerase chain reaction test who were not hospitalized, and 56 785 healthy controls.

Results

Triflusal seemed to be associated with a significant increase in risk of hospitalization (aOR, 1.97; 95%CI, 1.27-3.04) and susceptibility to infection (OR, 1.45; 95%CI, 1.07-1.96). It also appeared to lead to a nonsignificant increase in the risk of mortality (OR, 2.23; 95%CI, 0.89-5.55) and/or progression to more severe disease stages (OR, 1.42; 95%CI, 0.8-2.51). Aspirin seemed to be associated with a statistically significant decrease in susceptibility to severe acute respiratory syndrome coronavirus 2 infection (OR, 0.92; 95%CI, 0.86-0.98).

Conclusions

Triflusal use appears to increase the risk of susceptibility to COVID-19 infection and an even higher risk of hospitalization, whereas the other antiplatelets could be associated with a reduction in the risk of the various outcomes or have no effect on risk. These findings could support reconsideration of triflusal prescription in COVID-19 pandemic situations.

引言和目的高凝状态和血栓栓塞是严重急性呼吸综合征冠状病毒2感染引起的过程，也是冠状病毒2019病（COVID-19）相关发病率和死亡率居高不下的原因。本研究旨在评估抗血小板药物对 COVID-19 严重程度（住院和死亡风险）、严重急性呼吸综合征冠状病毒 2 感染易感性以及进展为严重 COVID-19 的影响。方法我们于 2020 年在西班牙西北部地区开展了一项基于人群的病例对照研究。结果三氟草胺似乎与住院风险（aOR，1.97；95%CI，1.27-3.04）和感染易感性（OR，1.45；95%CI，1.07-1.96）的显著增加有关。阿司匹林似乎也会导致死亡风险的非显著性增加（OR，2.23；95%CI，0.89-5.55）和/或疾病发展到更严重阶段（OR，1.42；95%CI，0.8-2.51）。阿司匹林似乎与严重急性呼吸系统综合征冠状病毒 2 感染的易感性显著降低有关（OR，0.92；95%CI，0.86-0.98）。结论使用三氟片似乎会增加 COVID-19 感染的易感性风险，甚至会增加住院风险，而其他抗血小板药物可能会降低各种结果的风险或对风险没有影响。这些发现可支持在COVID-19大流行的情况下重新考虑三氟沙星的处方。

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引用次数: 0

Tiempo de realización de la resonancia magnética cardiaca y valor diagnóstico en pacientes con infarto de miocardio sin obstrucción de arterias coronarias 心脏核磁共振成像的时机和对无冠状动脉阻塞的心肌梗死患者的诊断价值

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.recesp.2023.11.009

Gladys Juncà , Albert Teis , Gizem Kasa , Elena Ferrer-Sistach , Nuria Vallejo , Jorge López-Ayerbe , Germán Cediel , Antoni Bayés-Genís , Victoria Delgado

Introduction and objectives

The present study sought to establish the diagnostic yield of cardiovascular magnetic resonance (CMR) in a large cohort of patients admitted with myocardial infarction (MI) with nonobstructive coronary artery disease (MINOCA) based on the timing of referral to CMR.

Methods

Consecutive patients referred to CMR from January 2009 to February 2022 with a working diagnosis of MINOCA were retrospectively evaluated. Cine, T₂-weighted, early, and late gadolinium-enhanced images were acquired and analyzed. The frequency of the underlying diagnosis and the association between timing of CMR and relative frequency of each diagnosis were assessed.

Results

We included 207 patients (median age 50 years, 60% men). Final diagnosis after CMR was achieved in 91% of the patients (myocarditis in 45%, MI in 20%, tako-tsubo cardiomyopathy in 19%, and other cardiomyopathies in 7%). The performance of CMR within 7 days of admission with MINOCA (median, 5 days; 117 patients) allowed a higher diagnostic yield compared with CMR performed later (median, 10 days; 88 patients) (96% vs 86%, P = .02). Although myocarditis was the most frequent diagnosis in both groups according to time to CMR, its frequency was higher among patients with a CMR performed within the first 7 days (53% vs 35%, P = .02). The frequency of other underlying diagnoses was not influenced by CMR timing.

Conclusions

CMR led to an underlying diagnosis of MINOCA in 91% of patients and its diagnostic yield increased to 96% when CMR was performed within 7 days of admission. The most frequent diagnosis was myocarditis.

方法回顾性评估了 2009 年 1 月至 2022 年 2 月期间转诊至 CMR 并确诊为 MINOCA 的连续患者。采集并分析了Cine、T2加权、早期和晚期钆增强图像。结果我们纳入了 207 名患者（中位年龄 50 岁，60% 为男性）。91%的患者在进行CMR检查后获得了最终诊断（45%为心肌炎，20%为心肌梗死，19%为拓扑次氏心肌病，7%为其他心肌病）。在入院 7 天内使用 MINOCA 进行 CMR（中位数为 5 天，117 名患者）与之后进行 CMR（中位数为 10 天，88 名患者）相比，诊断率更高（96% vs 86%，P = .02）。虽然根据接受 CMR 的时间，心肌炎是两组患者中最常见的诊断，但在头 7 天内接受 CMR 的患者中，心肌炎的发生率更高（53% 对 35%，P = .02）。结论 91%的患者通过CMR确诊为MINOCA，入院后7天内进行CMR的诊断率提高到96%。最常见的诊断是心肌炎。

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引用次数: 0

Métodos de aprendizaje automático para el desarrollo de un modelo predictivo de delirio durante el ingreso en unidades de cuidados intensivos cardiacos 用机器学习方法开发心脏重症监护病房入院期间谵妄的预测模型。

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.recesp.2023.12.015

Ryoung-Eun Ko , Jihye Lee , Sungeun Kim , Joong Hyun Ahn , Soo Jin Na , Jeong Hoon Yang

Introduction and objectives

Delirium, recognized as a crucial prognostic factor in the cardiac intensive care unit (CICU), has evolved in response to the changing demographics among critically ill cardiac patients. This study aimed to create a predictive model for delirium for patients in the CICU.

Methods

This study included consecutive patients admitted to the CICU of the Samsung Medical Center. To assess the candidate variables for the model: we applied the following machine learning methods: random forest, extreme gradient boosting, partial least squares, and Plmnet-elastic.net. After selecting relevant variables, we performed a logistic regression analysis to derive the model formula. Internal validation was conducted using 100-repeated hold-out validation.

Results

We analyzed 2774 patients, 677 (24.4%) of whom developed delirium in the CICU. Machine learning-based models showed good predictive performance. Clinically significant and frequently important predictors were selected to construct a delirium prediction scoring model for CICU patients. The model included albumin level, international normalized ratio, blood urea nitrogen, white blood cell count, C-reactive protein level, age, heart rate, and mechanical ventilation. The model had an area under the receiver operating characteristics curve (AUROC) of 0.861 (95%CI, 0.843-0.879). Similar results were obtained in internal validation with 100-repeated cross-validation (AUROC, 0.854; 95%CI, 0.826-0.883).

Conclusions

Using variables frequently ranked as highly important in four machine learning methods, we created a novel delirium prediction model. This model could serve as a useful and simple tool for risk stratification for the occurrence of delirium at the patient's bedside in the CICU.

导言和目的谵妄被认为是心脏重症监护病房（CICU）的一个重要预后因素，随着重症心脏病患者人口统计学的变化而不断发展。本研究旨在为 CICU 患者建立一个谵妄预测模型。为了评估模型的候选变量，我们采用了以下机器学习方法：随机森林、极梯度提升、偏最小二乘法和 Plmnet-elastic.net。选定相关变量后，我们进行了逻辑回归分析，得出了模型公式。结果我们分析了2774名患者，其中677人（24.4%）在CICU中出现了谵妄。基于机器学习的模型显示出良好的预测性能。我们选择了具有临床意义且经常出现的重要预测因子，构建了CICU患者谵妄预测评分模型。该模型包括白蛋白水平、国际标准化比率、血尿素氮、白细胞计数、C反应蛋白水平、年龄、心率和机械通气。该模型的接收者操作特征曲线下面积 (AUROC) 为 0.861（95%CI，0.843-0.879）。结论利用四种机器学习方法中经常被列为高度重要的变量，我们创建了一种新型谵妄预测模型。该模型可作为一种有用且简单的工具，用于对 CICU 患者床旁发生谵妄的风险进行分层。

{"title":"Métodos de aprendizaje automático para el desarrollo de un modelo predictivo de delirio durante el ingreso en unidades de cuidados intensivos cardiacos","authors":"Ryoung-Eun Ko , Jihye Lee , Sungeun Kim , Joong Hyun Ahn , Soo Jin Na , Jeong Hoon Yang","doi":"10.1016/j.recesp.2023.12.015","DOIUrl":"10.1016/j.recesp.2023.12.015","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Delirium, recognized as a crucial prognostic factor in the cardiac intensive care unit (CICU), has evolved in response to the changing demographics among critically ill cardiac patients. This study aimed to create a predictive model for delirium for patients in the CICU.</p></div><div><h3>Methods</h3><p>This study included consecutive patients admitted to the CICU of the Samsung Medical Center. To assess the candidate variables for the model: we applied the following machine learning methods: random forest, extreme gradient boosting, partial least squares, and Plmnet-elastic.net. After selecting relevant variables, we performed a logistic regression analysis to derive the model formula. Internal validation was conducted using 100-repeated hold-out validation.</p></div><div><h3>Results</h3><p>We analyzed 2774 patients, 677 (24.4%) of whom developed delirium in the CICU. Machine learning-based models showed good predictive performance. Clinically significant and frequently important predictors were selected to construct a delirium prediction scoring model for CICU patients. The model included albumin level, international normalized ratio, blood urea nitrogen, white blood cell count, C-reactive protein level, age, heart rate, and mechanical ventilation. The model had an area under the receiver operating characteristics curve (AUROC) of 0.861 (95%CI, 0.843-0.879). Similar results were obtained in internal validation with 100-repeated cross-validation (AUROC, 0.854; 95%CI, 0.826-0.883).</p></div><div><h3>Conclusions</h3><p>Using variables frequently ranked as highly important in four machine learning methods, we created a novel delirium prediction model. This model could serve as a useful and simple tool for risk stratification for the occurrence of delirium at the patient's bedside in the CICU.</p></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"77 7","pages":"Pages 547-555"},"PeriodicalIF":5.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140088056","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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