首页 > 最新文献

Revista espanola de cardiologia最新文献

英文 中文
Diferencias de sexo en pacientes sometidos a recambio valvular aórtico: una historia de dos corazones 主动脉瓣置换术患者的性别差异:两颗心脏的故事
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-28 DOI: 10.1016/j.recesp.2025.01.014
Giovanni Occhipinti , Andrea Alberto Ruberti , Jorge Alcocer , Marc Giménez-Mila , Bárbara Vidal , Ander Regueiro
{"title":"Diferencias de sexo en pacientes sometidos a recambio valvular aórtico: una historia de dos corazones","authors":"Giovanni Occhipinti , Andrea Alberto Ruberti , Jorge Alcocer , Marc Giménez-Mila , Bárbara Vidal , Ander Regueiro","doi":"10.1016/j.recesp.2025.01.014","DOIUrl":"10.1016/j.recesp.2025.01.014","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 916-918"},"PeriodicalIF":5.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181350","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}
引用次数: 0
La continuidad asistencial en atención primaria se asocia a un mejor pronóstico de los pacientes remitidos a un servicio de cardiología 初级保健的连续性与转诊到心脏病科的患者的预后改善有关
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-28 DOI: 10.1016/j.recesp.2025.03.009
Sergio Cinza-Sanjurjo , Pilar Mazón-Ramos , Daniel Rey-Aldana , Alfonso Varela-Román , Manuel Portela-Romero , José R. González-Juanatey

Introduction and objectives

To analyze the relationship between continuity of care in primary care and hospitalizations and mortality among patients referred from primary care to a cardiology service.

Methods

Continuity of care was assessed using 3 measures: a) whether the referral was made by the patient's regular family medicine physician (FMP) or a different FMP, b) FMP turnover within a patient panel, and c) turnover of the referring FMP among different patient panels. The association between continuity of care and hospitalizations and mortality was assessed using a multivariate analysis, with adjustment for potential confounding variables. The results are expressed as odds ratios (OR) with 95% confidence intervals (95%CI).

Results

A total of 67 889 patients, referred from 2010 to 2023, were included, of whom 80.5% were referred by their FMP. Patients referred by an FMP other than their own had a higher annual referral rate (2.3 [2.9]) vs 1.5 [0.6]); P < .001) and were assigned to panels with a higher referral rate (10.5 [12.7] vs 1.6 (1.1]; P < .001). Patients referred by their FMP had a lower risk of overall hospitalizations (OR, 0.90; 95%CI, 0.86-0.94), hospitalizations for cardiovascular causes (OR, 0.88; 95%IC, 0.82-0.95), all-cause mortality (OR, 0.84; 95%CI, 0.80-0.89), cardiovascular-related mortality (OR, 0.86; 95%CI, 0.78-0.96), and heart failure-related mortality (OR, 0.77; 95%CI, 0.66-0.89).

Conclusions

Continuity of care, measured by the persistence of the FMP within the same patient panel, improves health outcomes by reducing hospitalizations and mortality, as well as the number of cardiology service referrals.
前言和目的分析初级保健护理连续性与从初级保健转到心脏病科服务的患者住院和死亡率之间的关系。方法采用3个指标评估护理的连续性:a)是否由患者的常规家庭医学医生(FMP)或不同的FMP进行转诊,b) FMP在患者小组内的更替,c)转诊FMP在不同患者小组之间的更替。使用多变量分析评估护理连续性与住院和死亡率之间的关系,并对潜在的混杂变量进行调整。结果以95%置信区间(95% ci)的优势比(OR)表示。结果2010 - 2023年共纳入67 889例患者,其中80.5%是通过FMP转诊的。由非自己的FMP转诊的患者有更高的年转诊率(2.3 [2.9]vs 1.5 [0.6]);P < .001),并被分配到转诊率较高的小组(10.5 [12.7]vs 1.6 (1.1]; P < .001)。通过FMP转诊的患者总体住院(OR, 0.90; 95%CI, 0.86-0.94)、心血管原因住院(OR, 0.88; 95%CI, 0.82-0.95)、全因死亡率(OR, 0.84; 95%CI, 0.80-0.89)、心血管相关死亡率(OR, 0.86; 95%CI, 0.78-0.96)和心力衰竭相关死亡率(OR, 0.77; 95%CI, 0.66-0.89)的风险较低。结论:通过FMP在同一组患者中的持续性来衡量的护理连续性,通过减少住院和死亡率以及心脏病服务转诊的数量来改善健康结果。
{"title":"La continuidad asistencial en atención primaria se asocia a un mejor pronóstico de los pacientes remitidos a un servicio de cardiología","authors":"Sergio Cinza-Sanjurjo ,&nbsp;Pilar Mazón-Ramos ,&nbsp;Daniel Rey-Aldana ,&nbsp;Alfonso Varela-Román ,&nbsp;Manuel Portela-Romero ,&nbsp;José R. González-Juanatey","doi":"10.1016/j.recesp.2025.03.009","DOIUrl":"10.1016/j.recesp.2025.03.009","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To analyze the relationship between continuity of care in primary care and hospitalizations and mortality among patients referred from primary care to a cardiology service.</div></div><div><h3>Methods</h3><div>Continuity of care was assessed using 3 measures: <em>a)</em> whether the referral was made by the patient's regular family medicine physician (FMP) or a different FMP, <em>b)</em> FMP turnover within a patient panel, and <em>c)</em> turnover of the referring FMP among different patient panels. The association between continuity of care and hospitalizations and mortality was assessed using a multivariate analysis, with adjustment for potential confounding variables. The results are expressed as odds ratios (OR) with 95% confidence intervals (95%<span>C</span>I).</div></div><div><h3>Results</h3><div>A total of 67 889 patients, referred from 2010 to 2023, were included, of whom 80.5% were referred by their FMP. Patients referred by an FMP other than their own had a higher annual referral rate (2.3 [2.9]) vs 1.5 [0.6]); <em>P</em> <!-->&lt;<!--> <!-->.001) and were assigned to panels with a higher referral rate (10.5 [12.7] vs 1.6 (1.1]; <em>P</em> <!-->&lt;<!--> <!-->.001). Patients referred by their FMP had a lower risk of overall hospitalizations (OR, 0.90; 95%CI, 0.86-0.94), hospitalizations for cardiovascular causes (OR, 0.88; 95%IC, 0.82-0.95), all-cause mortality (OR, 0.84; 95%CI, 0.80-0.89), cardiovascular-related mortality (OR, 0.86; 95%CI, 0.78-0.96), and heart failure-related mortality (OR, 0.77; 95%CI, 0.66-0.89).</div></div><div><h3>Conclusions</h3><div>Continuity of care, measured by the persistence of the FMP within the same patient panel, improves health outcomes by reducing hospitalizations and mortality, as well as the number of cardiology service referrals.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1033-1040"},"PeriodicalIF":5.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579123","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}
引用次数: 0
Prevención cardiovascular primaria y secundaria en los ciclos vitales de la mujer. Documento de consenso de la SEC-GT ECV en la Mujer, ACP-SEC, SEGO, AEEM, SEEN, semFYC, SEMERGEN, AEP y AEM 妇女生命周期的一级和二级心血管预防。SEC-GT - ECV关于妇女、ACP-SEC、SEGO、EEM、SEEN、SEMERGEN、AEP和AEM的共识文件
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-21 DOI: 10.1016/j.recesp.2025.01.015
Antonia Sambola , Raquel Campuzano , Almudena Castro , María Goya , Pluvio Coronado , Rosa Fernández-Olmo , Miguel Ángel María-Tablado , Carolina Ortiz-Cortés , Xènia Ortolà , Vicente Pallarés-Carratalá , Antonia Pijuan-Domenech , Rosa M. Plata , Rosa María Sánchez-Hernández , José Manuel Siurana , Càtia Timoteo , Begoña Viejo-Hernández
This consensus document on cardiovascular disease in women summarizes the views of a panel of experts organized by the Working Group on Women and Cardiovascular Disease of the Spanish Society of Cardiology (SEC-GT CVD in Women), and the Association of Preventive Cardiology of the SEC (ACP-SEC). The document was developed in collaboration with experts from various Spanish societies and associations: the Spanish Society of Gynecology and Obstetrics (SEGO), the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Association for the Study of Menopause (AEEM), the Spanish Association of Pediatrics (AEP), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC), and the Spanish Association of Midwives (AEM). The document received formal approval from the SEC. This consensus serves as a guide for the clinical community on the diagnostic approach and management of cardiovascular health during the stages or life cycles of women: adolescence, the menopausal transition, postpartum disorders, and other gynecologic conditions. It is based on current evidence and best available practices.
这份关于妇女心血管疾病的共识文件总结了由西班牙心脏病学会妇女和心血管疾病工作组(SEC- gt CVD in women)和美国预防心脏病学会(ACP-SEC)组织的一个专家小组的观点。该文件是与来自西班牙各学会和协会的专家合作制定的:西班牙妇产科学会(SEGO)、西班牙内分泌与营养学会(SEEN)、西班牙更年期研究协会(AEEM)、西班牙儿科协会(AEP)、西班牙初级保健医师协会(SEMERGEN)、西班牙家庭和社区医学学会(semFYC)和西班牙助产士协会(AEM)。该文件已获得美国证券交易委员会的正式批准。该共识可作为临床社区在女性各阶段或生命周期(青春期、绝经期过渡、产后疾病和其他妇科疾病)心血管健康诊断方法和管理的指南。它以现有证据和最佳可得做法为基础。
{"title":"Prevención cardiovascular primaria y secundaria en los ciclos vitales de la mujer. Documento de consenso de la SEC-GT ECV en la Mujer, ACP-SEC, SEGO, AEEM, SEEN, semFYC, SEMERGEN, AEP y AEM","authors":"Antonia Sambola ,&nbsp;Raquel Campuzano ,&nbsp;Almudena Castro ,&nbsp;María Goya ,&nbsp;Pluvio Coronado ,&nbsp;Rosa Fernández-Olmo ,&nbsp;Miguel Ángel María-Tablado ,&nbsp;Carolina Ortiz-Cortés ,&nbsp;Xènia Ortolà ,&nbsp;Vicente Pallarés-Carratalá ,&nbsp;Antonia Pijuan-Domenech ,&nbsp;Rosa M. Plata ,&nbsp;Rosa María Sánchez-Hernández ,&nbsp;José Manuel Siurana ,&nbsp;Càtia Timoteo ,&nbsp;Begoña Viejo-Hernández","doi":"10.1016/j.recesp.2025.01.015","DOIUrl":"10.1016/j.recesp.2025.01.015","url":null,"abstract":"<div><div>This consensus document on cardiovascular disease in women summarizes the views of a panel of experts organized by the Working Group on Women and Cardiovascular Disease of the Spanish Society of Cardiology (SEC-GT CVD in Women), and the Association of Preventive Cardiology of the SEC (ACP-SEC). The document was developed in collaboration with experts from various Spanish societies and associations: the Spanish Society of Gynecology and Obstetrics (SEGO), the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Association for the Study of Menopause (AEEM), the Spanish Association of Pediatrics (AEP), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC), and the Spanish Association of Midwives (AEM). The document received formal approval from the SEC. This consensus serves as a guide for the clinical community on the diagnostic approach and management of cardiovascular health during the stages or life cycles of women: adolescence, the menopausal transition, postpartum disorders, and other gynecologic conditions. It is based on current evidence and best available practices.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 7","pages":"Pages 639-651"},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481502","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}
引用次数: 0
Juan José Rufilanchas Sánchez 胡安·何塞·鲁菲兰查斯·桑切斯
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-21 DOI: 10.1016/j.recesp.2025.03.007
José Luis Pomar
{"title":"Juan José Rufilanchas Sánchez","authors":"José Luis Pomar","doi":"10.1016/j.recesp.2025.03.007","DOIUrl":"10.1016/j.recesp.2025.03.007","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 8","pages":"Page 751"},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714363","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}
引用次数: 0
Fibrilación auricular e infarto de miocardio: una relación bidireccional con más preguntas que respuestas 心房颤动与心肌梗死:双向关系,问题多于答案
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-21 DOI: 10.1016/j.recesp.2025.02.025
Alfredo Bardají, Gabriel Martín, Sandra Cabrera
{"title":"Fibrilación auricular e infarto de miocardio: una relación bidireccional con más preguntas que respuestas","authors":"Alfredo Bardají,&nbsp;Gabriel Martín,&nbsp;Sandra Cabrera","doi":"10.1016/j.recesp.2025.02.025","DOIUrl":"10.1016/j.recesp.2025.02.025","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 9","pages":"Pages 765-767"},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895392","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}
引用次数: 0
Arteriolovenular anastomosis Arteriolovenular融合
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-21 DOI: 10.1016/j.recesp.2025.03.005
{"title":"Arteriolovenular anastomosis","authors":"","doi":"10.1016/j.recesp.2025.03.005","DOIUrl":"10.1016/j.recesp.2025.03.005","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 9","pages":"Page 753"},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895376","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}
引用次数: 0
Preservación apical en el ecocardiograma de esfuerzo por sospecha de amiloidosis cardiaca 怀疑有心脏淀粉样变的力量超声心动图的顶端保存
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-21 DOI: 10.1016/j.recesp.2025.01.017
Jesús Peteiro , Marina Combarro , Gonzalo Barge-Caballero , Alberto Bouzas-Mosquera , José Larrañaga-Moreira , José M. Vázquez-Rodríguez
{"title":"Preservación apical en el ecocardiograma de esfuerzo por sospecha de amiloidosis cardiaca","authors":"Jesús Peteiro ,&nbsp;Marina Combarro ,&nbsp;Gonzalo Barge-Caballero ,&nbsp;Alberto Bouzas-Mosquera ,&nbsp;José Larrañaga-Moreira ,&nbsp;José M. Vázquez-Rodríguez","doi":"10.1016/j.recesp.2025.01.017","DOIUrl":"10.1016/j.recesp.2025.01.017","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 918-922"},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181398","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}
引用次数: 0
Predicción de la mortalidad intrahospitalaria mediante aprendizaje automático y validación externa en pacientes con shock cardiogénico: la escala RESCUE 通过自动学习和外部验证预测心源性休克患者的医院内死亡率:RESCUE量表
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-21 DOI: 10.1016/j.recesp.2025.01.003
Ji Hyun Cha , Ki Hong Choi , Chul-Min Ahn , Cheol Woong Yu , Ik Hyun Park , Woo Jin Jang , Hyun-Joong Kim , Jang-Whan Bae , Sung Uk Kwon , Hyun-Jong Lee , Wang Soo Lee , Jin-Ok Jeong , Sang-Don Park , Taek Kyu Park , Joo Myung Lee , Young Bin Song , Joo-Yong Hahn , Seung-Hyuk Choi , Hyeon-Cheol Gwon , Jeong Hoon Yang

Introduction and objectives

Despite advances in mechanical circulatory support, mortality rates in cardiogenic shock (CS) remain high. A reliable risk stratification system could serve as a valuable guide in the clinical management of patients with CS. This study aimed to develop and externally validate a risk prediction model for in-hospital mortality in CS patients using machine learning (ML) algorithms.

Methods

Data from 1247 patients with all-cause CS in the RESCUE registry (January 2014-December 2018) were analyzed. Key predictive variables were identified using 4 ML algorithms. A risk prediction model, the RESCUE score, was developed using logistic regression based on the selected variables. Internal validation was conducted within the RESCUE registry, and external validation was performed using an independent CS registry of 750 patients.

Results

The 4 ML models identified 7 predictors: age, vasoactive inotropic score, left ventricular ejection fraction, lactic acid level, in-hospital cardiac arrest at presentation, need for continuous renal replacement therapy, and mechanical ventilation. The RESCUE score demonstrated strong predictive performance, with an AUC of 0.86 (95%CI, 0.83-0.88) for in-hospital mortality. Ten-fold internal cross-validation yielded an AUC of 0.86 (95%CI, 0.77-0.95). External validation showed an AUC of 0.80 (95%CI, 0.76-0.84).

Conclusions

Our ML-based risk-scoring system, the RESCUE score, demonstrated excellent predictive performance for in-hospital mortality in all patients with CS, regardless of cause. The system could be a useful and reliable tool to estimate risk stratification of CS in everyday clinical practice. Clinical trial registration: NCT02985008.
尽管机械循环支持技术有所进步,但心源性休克(CS)的死亡率仍然很高。一个可靠的风险分层系统可以为CS患者的临床管理提供有价值的指导。本研究旨在利用机器学习(ML)算法开发并外部验证CS患者住院死亡率的风险预测模型。方法分析2014年1月至2018年12月RESCUE登记的1247例全因CS患者的数据。使用4ml算法确定关键预测变量。基于所选变量,采用logistic回归建立了风险预测模型,即RESCUE评分。内部验证在RESCUE注册中心进行,外部验证使用750名患者的独立CS注册中心进行。结果4 ML模型确定了7个预测因素:年龄、血管活性肌力评分、左心室射血分数、乳酸水平、住院时心脏骤停、是否需要持续肾脏替代治疗和机械通气。RESCUE评分显示出很强的预测性能,对院内死亡率的AUC为0.86 (95%CI, 0.83-0.88)。10倍内部交叉验证的AUC为0.86 (95%CI, 0.77-0.95)。外部验证显示AUC为0.80 (95%CI, 0.76-0.84)。结论基于ml的风险评分系统RESCUE评分对所有CS患者的院内死亡率均具有出色的预测效果,无论其原因如何。该系统可作为日常临床实践中评估CS风险分层的有效、可靠的工具。临床试验注册:NCT02985008。
{"title":"Predicción de la mortalidad intrahospitalaria mediante aprendizaje automático y validación externa en pacientes con shock cardiogénico: la escala RESCUE","authors":"Ji Hyun Cha ,&nbsp;Ki Hong Choi ,&nbsp;Chul-Min Ahn ,&nbsp;Cheol Woong Yu ,&nbsp;Ik Hyun Park ,&nbsp;Woo Jin Jang ,&nbsp;Hyun-Joong Kim ,&nbsp;Jang-Whan Bae ,&nbsp;Sung Uk Kwon ,&nbsp;Hyun-Jong Lee ,&nbsp;Wang Soo Lee ,&nbsp;Jin-Ok Jeong ,&nbsp;Sang-Don Park ,&nbsp;Taek Kyu Park ,&nbsp;Joo Myung Lee ,&nbsp;Young Bin Song ,&nbsp;Joo-Yong Hahn ,&nbsp;Seung-Hyuk Choi ,&nbsp;Hyeon-Cheol Gwon ,&nbsp;Jeong Hoon Yang","doi":"10.1016/j.recesp.2025.01.003","DOIUrl":"10.1016/j.recesp.2025.01.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Despite advances in mechanical circulatory support, mortality rates in cardiogenic shock (CS) remain high. A reliable risk stratification system could serve as a valuable guide in the clinical management of patients with CS. This study aimed to develop and externally validate a risk prediction model for in-hospital mortality in CS patients using machine learning (ML) algorithms.</div></div><div><h3>Methods</h3><div>Data from 1247 patients with all-cause CS in the RESCUE registry (January 2014-December 2018) were analyzed. Key predictive variables were identified using 4 ML algorithms. A risk prediction model, the RESCUE score, was developed using logistic regression based on the selected variables. Internal validation was conducted within the RESCUE registry, and external validation was performed using an independent CS registry of 750 patients.</div></div><div><h3>Results</h3><div>The 4 ML models identified 7 predictors: age, vasoactive inotropic score, left ventricular ejection fraction, lactic acid level, in-hospital cardiac arrest at presentation, need for continuous renal replacement therapy, and mechanical ventilation. The RESCUE score demonstrated strong predictive performance, with an AUC of 0.86 (95%<span>C</span>I, 0.83-0.88) for in-hospital mortality. Ten-fold internal cross-validation yielded an AUC of 0.86 (95%CI, 0.77-0.95). External validation showed an AUC of 0.80 (95%CI, 0.76-0.84).</div></div><div><h3>Conclusions</h3><div>Our ML-based risk-scoring system, the RESCUE score, demonstrated excellent predictive performance for in-hospital mortality in all patients with CS, regardless of cause. The system could be a useful and reliable tool to estimate risk stratification of CS in everyday clinical practice. Clinical trial registration: <span><span>NCT02985008</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 8","pages":"Pages 707-716"},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714368","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}
引用次数: 0
Resultados clínicos a 10 años tras el implante de SLF de primera o nueva generación en el tronco coronario izquierdo 第一代或新一代SLF植入左冠状动脉主干10年后的临床结果
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-21 DOI: 10.1016/j.recesp.2025.02.003
Jens Wiebe , Constantin Kuna , Tareq Ibrahim , Sebastian Kufner , Isabella Hintz , Paul Justenhoven , Thorsten Kessler , Heribert Schunkert , Marco Valgimigli , Gert Richardt , Jola Bresha , Karl-Ludwig Laugwitz , Adnan Kastrati , Salvatore Cassese

Introduction and objectives

Long-term data after stenting of the left main coronary artery (LMCA) are scarce, especially regarding new-generation drug-eluting stents (DES). This analysis aimed to describe the 10-year clinical outcomes of patients who underwent percutaneous coronary intervention with different DES generations for LMCA disease.

Methods

Individual patient data from the randomized controlled ISAR-LEFT MAIN and ISAR-LEFT MAIN 2 trials were pooled and 10-year clinical follow-up was obtained. The Kaplan-Meier method was used to calculate event rates. The main endpoints of interest for this analysis were all-cause mortality, myocardial infarction, target lesion revascularization and definite stent thrombosis.

Results

A total of 1257 patients were included in this analysis, of which 650 patients were treated with new-generation DES and 607 with early-generation DES. At 10 years, the mortality rate was more than 40% in both groups. After statistical adjustment, 10-year mortality was significantly reduced in patients treated with new-generation DES compared with those treated with early-generation DES (HRadj, 0.78; 95%CI, 0.62-0.97). After 10 years, the risk of myocardial infarction (HRadj, 0.43; 95%CI, 0.23-0.80), target lesion revascularization (HRadj, 0.66; 95%CI, 0.49-0.89), and definite stent thrombosis (HRadj, 0.13, 95%CI, 0.04-0.49) was significantly reduced by new-generation DES compared with early-generation DES.

Conclusions

Patients undergoing percutaneous coronary intervention for LMCA disease have high 10-year mortality regardless of DES generation. The use of new-generation DES in patients with LMCA disease is associated with improved long-term clinical outcomes compared with early-generation DES.
前言与目的:左冠状动脉主干(LMCA)支架置入术后的长期数据很少,特别是新一代药物洗脱支架(DES)。本分析旨在描述不同DES代LMCA疾病患者经皮冠状动脉介入治疗的10年临床结果。方法收集随机对照ISAR-LEFT MAIN和ISAR-LEFT MAIN 2试验的个体患者资料,进行10年临床随访。使用Kaplan-Meier方法计算事件率。该分析的主要终点是全因死亡率、心肌梗死、靶病变血运重建和明确的支架血栓形成。结果共纳入1257例患者,其中新一代DES治疗650例,早期DES治疗607例,10年时两组患者死亡率均大于40%。经统计校正后,新一代DES患者的10年死亡率明显低于早期DES患者(HRadj, 0.78; 95%CI, 0.62-0.97)。10年后,新一代DES与早期DES相比,心肌梗死(HRadj, 0.43; 95%CI, 0.23-0.80)、靶区血管重建(HRadj, 0.66; 95%CI, 0.49-0.89)、明确支架血栓形成(HRadj, 0.13, 95%CI, 0.04-0.49)的风险均显著降低。结论无论DES代如何,接受经皮冠状动脉介入治疗LMCA疾病的患者10年死亡率均较高。与早期DES相比,新一代DES在LMCA患者中的使用与改善的长期临床结果相关。
{"title":"Resultados clínicos a 10 años tras el implante de SLF de primera o nueva generación en el tronco coronario izquierdo","authors":"Jens Wiebe ,&nbsp;Constantin Kuna ,&nbsp;Tareq Ibrahim ,&nbsp;Sebastian Kufner ,&nbsp;Isabella Hintz ,&nbsp;Paul Justenhoven ,&nbsp;Thorsten Kessler ,&nbsp;Heribert Schunkert ,&nbsp;Marco Valgimigli ,&nbsp;Gert Richardt ,&nbsp;Jola Bresha ,&nbsp;Karl-Ludwig Laugwitz ,&nbsp;Adnan Kastrati ,&nbsp;Salvatore Cassese","doi":"10.1016/j.recesp.2025.02.003","DOIUrl":"10.1016/j.recesp.2025.02.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Long-term data after stenting of the left main coronary artery (LMCA) are scarce, especially regarding new-generation drug-eluting stents (DES). This analysis aimed to describe the 10-year clinical outcomes of patients who underwent percutaneous coronary intervention with different DES generations for LMCA disease.</div></div><div><h3>Methods</h3><div>Individual patient data from the randomized controlled ISAR-LEFT MAIN and ISAR-LEFT MAIN 2 trials were pooled and 10-year clinical follow-up was obtained. The Kaplan-Meier method was used to calculate event rates. The main endpoints of interest for this analysis were all-cause mortality, myocardial infarction, target lesion revascularization and definite stent thrombosis.</div></div><div><h3>Results</h3><div>A total of 1257 patients were included in this analysis, of which 650 patients were treated with new-generation DES and 607 with early-generation DES. At 10 years, the mortality rate was more than 40% in both groups. After statistical adjustment, 10-year mortality was significantly reduced in patients treated with new-generation DES compared with those treated with early-generation DES (HR<sub>adj</sub>, 0.78; 95%<span>C</span>I, 0.62-0.97). After 10 years, the risk of myocardial infarction (HR<sub>adj</sub>, 0.43; 95%CI, 0.23-0.80), target lesion revascularization (HR<sub>adj</sub>, 0.66; 95%CI, 0.49-0.89), and definite stent thrombosis (HR<sub>adj</sub>, 0.13, 95%CI, 0.04-0.49) was significantly reduced by new-generation DES compared with early-generation DES.</div></div><div><h3>Conclusions</h3><div>Patients undergoing percutaneous coronary intervention for LMCA disease have high 10-year mortality regardless of DES generation. The use of new-generation DES in patients with LMCA disease is associated with improved long-term clinical outcomes compared with early-generation DES.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 9","pages":"Pages 811-819"},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895211","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}
引用次数: 0
Factores de riesgo para progresión de la insuficiencia aórtica tras la reparación quirúrgica del aneurisma del seno de Valsalva. Análisis de 317 casos 瓦尔萨尔瓦胸动脉瘤手术修复后主动脉功能不全进展的危险因素。对317例进行分析
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2025-03-21 DOI: 10.1016/j.recesp.2025.01.006
Tianyu Chen , Jianzheng Cen , Shusheng Wen , Jimei Chen , Jian Zhuang , Xiaobing Liu
{"title":"Factores de riesgo para progresión de la insuficiencia aórtica tras la reparación quirúrgica del aneurisma del seno de Valsalva. Análisis de 317 casos","authors":"Tianyu Chen ,&nbsp;Jianzheng Cen ,&nbsp;Shusheng Wen ,&nbsp;Jimei Chen ,&nbsp;Jian Zhuang ,&nbsp;Xiaobing Liu","doi":"10.1016/j.recesp.2025.01.006","DOIUrl":"10.1016/j.recesp.2025.01.006","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 8","pages":"Pages 741-744"},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713857","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}
引用次数: 0
期刊
Revista espanola de cardiologia
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1