Pub Date : 2025-10-01DOI: 10.1016/j.rccl.2025.03.003
Ester Forcano Queralt , José Antonio Quesada , Domingo Orozco Beltrán
Introduction and objectives
Sedentary lifestyles and physical activity are key areas of scientific focus owing to their impact on the main causes of morbidity and mortality worldwide, especially in vulnerable populations. The objectives of this study were to estimate the prevalence of sedentary behaviour in people over 64 years of age living in Spain with cardiovascular disease or cardiovascular risk factors, and to analyse the associated chronic diseases.
Methods
We conducted a population-based cross-sectional study using data from the 2017 Spanish National Health Survey. The sample comprised people aged over 64 years who had at least 1 of the following: hypertension, diabetes, high cholesterol, history of acute myocardial infarction, or history of stroke. We used Poisson models with robust variance to estimate prevalence ratios.
Results
Among a representative sample of 5314 people, the prevalence of sedentary behaviour was 32.2%. Sedentary behaviour was more common in women, older people, and people with urinary incontinence or mental disorders.
Conclusions
We found a moderate-to-high level of sedentary behaviour in a Spanish population aged over 64 years with cardiovascular risk factors or a history of myocardial infarction or stroke. Factors associated with higher levels of sedentary behaviour were female sex, older age, urinary incontinence, and mental health disorders. Longitudinal studies with greater precision are needed to delve deeper into these associations.
{"title":"Physical inactivity and chronic diseases in people aged 65 years and older: A population-based cross-sectional study in Spain","authors":"Ester Forcano Queralt , José Antonio Quesada , Domingo Orozco Beltrán","doi":"10.1016/j.rccl.2025.03.003","DOIUrl":"10.1016/j.rccl.2025.03.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Sedentary lifestyles and physical activity are key areas of scientific focus owing to their impact on the main causes of morbidity and mortality worldwide, especially in vulnerable populations. The objectives of this study were to estimate the prevalence of sedentary behaviour in people over 64 years of age living in Spain with cardiovascular disease or cardiovascular risk factors, and to analyse the associated chronic diseases.</div></div><div><h3>Methods</h3><div>We conducted a population-based cross-sectional study using data from the 2017 Spanish National Health Survey. The sample comprised people aged over 64 years who had at least 1 of the following: hypertension, diabetes, high cholesterol, history of acute myocardial infarction, or history of stroke. We used Poisson models with robust variance to estimate prevalence ratios.</div></div><div><h3>Results</h3><div>Among a representative sample of 5314 people, the prevalence of sedentary behaviour was 32.2%. Sedentary behaviour was more common in women, older people, and people with urinary incontinence or mental disorders.</div></div><div><h3>Conclusions</h3><div>We found a moderate-to-high level of sedentary behaviour in a Spanish population aged over 64 years with cardiovascular risk factors or a history of myocardial infarction or stroke. Factors associated with higher levels of sedentary behaviour were female sex, older age, urinary incontinence, and mental health disorders. Longitudinal studies with greater precision are needed to delve deeper into these associations.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 4","pages":"Pages 244-252"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impacto pronóstico de los factores psicosociales en la cardiopatía isquémica crónica: aspectos que recordar","authors":"Marisol Bravo-Amaro , Dámaris Carballeira-Puentes , Cristina Prieto-Fernández","doi":"10.1016/j.rccl.2025.07.002","DOIUrl":"10.1016/j.rccl.2025.07.002","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 4","pages":"Pages 241-243"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.rccl.2025.04.001
María Oslaida Agüero Martínez , Luis Carlos Alarcón Gómez
Introduction and objectives
The anesthesia for cardiovascular surgical procedures has evolved along with the surgical specialty. Enhanced recovery programs are a typical example of this advance, and within them are actions aimed at achieving immediate orotracheal extubation in the operating room. The objective was to estimate the effectiveness of the implementation immediate orotracheal extubation in the perioperative evolution of patients scheduled for cardiac surgical procedures.
Methods
A systematic review with meta-analysis was carried out according to the recommendations of the manual 5.1.0 and 6.2.0 for reviewers of the Cochrane library.
Results
Eight studies were evaluated, for a total of 786 patients. Their quality is not ideal. Meta-analyses suggest that this procedure is associated with a decrease in intensive care unit stay (mean difference: −10.46; 95%CI, −17.15 to −3.77), hospital stay (mean difference: −1.88; 95%CI, −3.73 to −0.03), and the incidence of reintubation (RR, 0.85; 95%CI, 0.32-2.23). However, the influence of orotracheal extubation time on postoperative complications (RR, 1.08; 95%CI, 0.52-2.26) could not be demonstrated.
Conclusions
It is necessary to carry out and publish controlled and randomized clinical trials, as the first level of evidence, to safely endorse the implementation of this technique in cardiovascular surgical procedures.
{"title":"Extubación orotraqueal inmediata en procedimientos quirúrgicos cardiacos. Revisión sistemática y metanálisis","authors":"María Oslaida Agüero Martínez , Luis Carlos Alarcón Gómez","doi":"10.1016/j.rccl.2025.04.001","DOIUrl":"10.1016/j.rccl.2025.04.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The anesthesia for cardiovascular surgical procedures has evolved along with the surgical specialty. Enhanced recovery programs are a typical example of this advance, and within them are actions aimed at achieving immediate orotracheal extubation in the operating room. The objective was to estimate the effectiveness of the implementation immediate orotracheal extubation in the perioperative evolution of patients scheduled for cardiac surgical procedures.</div></div><div><h3>Methods</h3><div>A systematic review with meta-analysis was carried out according to the recommendations of the manual 5.1.0 and 6.2.0 for reviewers of the Cochrane library.</div></div><div><h3>Results</h3><div>Eight studies were evaluated, for a total of 786 patients. Their quality is not ideal. Meta-analyses suggest that this procedure is associated with a decrease in intensive care unit stay (mean difference: −10.46; 95%CI, −17.15 to −3.77), hospital stay (mean difference: −1.88; 95%CI, −3.73 to −0.03), and the incidence of reintubation (RR, 0.85; 95%CI, 0.32-2.23). However, the influence of orotracheal extubation time on postoperative complications (RR, 1.08; 95%CI, 0.52-2.26) could not be demonstrated.</div></div><div><h3>Conclusions</h3><div>It is necessary to carry out and publish controlled and randomized clinical trials, as the first level of evidence, to safely endorse the implementation of this technique in cardiovascular surgical procedures.</div><div>Registered at PROSPERO: CRD42021281286.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 4","pages":"Pages 288-296"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.rccl.2024.11.001
Bárbara Soler Bonafont , Andrea Falcón Hernández , Miguel Lorenzo Hernández , Gonzalo Núñez Marín , Rafael de la Espriella , Julio Núñez
{"title":"La hipocloremia en la insuficiencia cardiaca descompensada. A propósito de 3 casos","authors":"Bárbara Soler Bonafont , Andrea Falcón Hernández , Miguel Lorenzo Hernández , Gonzalo Núñez Marín , Rafael de la Espriella , Julio Núñez","doi":"10.1016/j.rccl.2024.11.001","DOIUrl":"10.1016/j.rccl.2024.11.001","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 4","pages":"Pages 305-308"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.rccl.2025.06.003
Guillermo A. Suárez , María Soledad Palacio , Patricia Blanco , Pablo Schygiel , María Laura Flor
Population aging continues to increase worldwide. Geriatric syndromes, prevalent in older adults and described for several years by geriatrics, refer to different health conditions. Many of them have been incorporated and evaluated in cardiology studies, increasing the possibility of adverse cardiovascular events, a term we coined as cardiogeriatric syndromes. Among them, we highlight frailty, multimorbidity, polypharmacy, sarcopenia and malnutrition. Others can determine and predispose to poor outcomes of cardiovascular diseases. This review focuses on those geriatric syndromes that enhance and determine risk and their impact on cardiovascular disease.
{"title":"Síndromes cardiogeriátricos: potenciadores y determinantes del riesgo cardiovascular","authors":"Guillermo A. Suárez , María Soledad Palacio , Patricia Blanco , Pablo Schygiel , María Laura Flor","doi":"10.1016/j.rccl.2025.06.003","DOIUrl":"10.1016/j.rccl.2025.06.003","url":null,"abstract":"<div><div>Population aging continues to increase worldwide. Geriatric syndromes, prevalent in older adults and described for several years by geriatrics, refer to different health conditions. Many of them have been incorporated and evaluated in cardiology studies, increasing the possibility of adverse cardiovascular events, a term we coined as cardiogeriatric syndromes. Among them, we highlight frailty, multimorbidity, polypharmacy, sarcopenia and malnutrition. Others can determine and predispose to poor outcomes of cardiovascular diseases. This review focuses on those geriatric syndromes that enhance and determine risk and their impact on cardiovascular disease.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 4","pages":"Pages 297-304"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.rccl.2025.07.001
Lorenzo Fácila Rubio , Rafael Vidal Pérez , Miguel Benedito , Maria Lourdes Sempere Andreu , Carlos Escobar Cervantes , Alberto Cordero Fort
Introduction and objectives
Artificial intelligence (AI) applied to electrocardiogram (ECG) analysis has shown promise for predicting cardiovascular morbidity and mortality. This meta-analysis evaluates the diagnostic and prognostic accuracy of deep learning (DL) and machine learning (ML) algorithms in predicting adverse events and cardiovascular mortality.
Methods
A systematic search was conducted in PubMed, Embase, Cochrane, and Web of Science (2010-2024). Studies evaluating AI applied to ECG for predicting morbidity and mortality were included, and diagnostic accuracy measures were calculated through meta-analysis. The protocol was previously registered at PROSPERO (CRD420251017753).
Results
A total of 28 studies with 3 569 731 patients were included. DL algorithms showed higher accuracy than ML algorithms (combined AUC: 0.85 vs 0.78; P < .001). For predicting mortality and major cardiovascular adverse events, sensitivity and specificity were high. Heterogeneity between studies was moderate to high (I2 = 68%, P < .001).
Conclusions
AI algorithms applied to ECG are effective for predicting cardiovascular morbidity and mortality, with DL models demonstrating higher accuracy than ML models. External validation in diverse populations is required before widespread clinical implementation.
人工智能（AI）应用于心电图（ECG）分析已显示出预测心血管发病率和死亡率的希望。本荟萃分析评估了深度学习（DL）和机器学习（ML）算法在预测不良事件和心血管死亡率方面的诊断和预后准确性。方法系统检索PubMed、Embase、Cochrane、Web of Science（2010-2024）数据库。纳入评估人工智能应用于心电图预测发病率和死亡率的研究，并通过meta分析计算诊断准确性指标。该协议先前已在PROSPERO注册（CRD420251017753）。结果共纳入28项研究，3 569 731例患者。DL算法的准确率高于ML算法（综合AUC: 0.85 vs 0.78; P < .001）。对于预测死亡率和主要心血管不良事件，灵敏度和特异性都很高。研究间异质性为中高（I2 = 68%, P < .001）。结论应用于ECG的ai算法可有效预测心血管疾病的发病率和死亡率，DL模型的准确率高于ML模型。在广泛的临床应用之前，需要在不同人群中进行外部验证。
{"title":"Predicción de morbimortalidad mediante inteligencia artificial aplicada al electrocardiograma: un metanálisis","authors":"Lorenzo Fácila Rubio , Rafael Vidal Pérez , Miguel Benedito , Maria Lourdes Sempere Andreu , Carlos Escobar Cervantes , Alberto Cordero Fort","doi":"10.1016/j.rccl.2025.07.001","DOIUrl":"10.1016/j.rccl.2025.07.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Artificial intelligence (AI) applied to electrocardiogram (ECG) analysis has shown promise for predicting cardiovascular morbidity and mortality. This meta-analysis evaluates the diagnostic and prognostic accuracy of deep learning (DL) and machine learning (ML) algorithms in predicting adverse events and cardiovascular mortality.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Embase, Cochrane, and Web of Science (2010-2024). Studies evaluating AI applied to ECG for predicting morbidity and mortality were included, and diagnostic accuracy measures were calculated through meta-analysis. The protocol was previously registered at PROSPERO (CRD420251017753).</div></div><div><h3>Results</h3><div>A total of 28 studies with 3 569 731 patients were included. DL algorithms showed higher accuracy than ML algorithms (combined AUC: 0.85 vs 0.78; <em>P</em> <<!--> <!-->.001). For predicting mortality and major cardiovascular adverse events, sensitivity and specificity were high. Heterogeneity between studies was moderate to high (I<sup>2</sup> <!-->=<!--> <!-->68%, <em>P</em> <<!--> <!-->.001).</div></div><div><h3>Conclusions</h3><div>AI algorithms applied to ECG are effective for predicting cardiovascular morbidity and mortality, with DL models demonstrating higher accuracy than ML models. External validation in diverse populations is required before widespread clinical implementation.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 4","pages":"Pages 263-274"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.rccl.2025.05.002
Jon Zubiaur , Raquel Pérez Barquín , Adrián Margarida de Castro , Andrea Teira Calderón , Fermín Sáinz Laso , Dae-Hyun Lee Hwang , Tamara García-Camarero , Gabriela Veiga , Aritz Gil Ongay , Celia Garilleti , Rigoberto Hernández , Sergio Barrera , Víctor Fradejas , Cristina Obregón , José M. de la Torre Hernández
Introduction and objectives
Cardiovascular disease accounts for a considerable proportion of both morbidity and mortality. In addition to well-established risk factors, some studies have identified a correlation between social determinants such as social support, income, and psychosocial factors and worse outcomes.
Methods
A prospective, single-centre observational study was conducted on patients diagnosed with coronary disease following coronary angiography. In addition to traditional risk factors, social determinants were collected via a researcher-administered questionnaire. Clinical events were prospectively recorded. A composite endpoint was defined as cardiovascular death, myocardial infarction (MI), or coronary revascularization. A multivariate Cox proportional hazards regression analysis was conducted using variables selected from the univariate analysis.
Results
A total of 2213 patients were followed for a median duration of 1461 days. The mean age of the cohort was 66.3 years; 23.5% were women, 27.8% had diabetes mellitus, and 10.4% had chronic kidney disease. During the follow-up period, there were 343 (15.5%) composite endpoint events, including 109 (4.9%) deaths, 85 (4%) cardiovascular deaths, 182 (8.2%) MI, 229 (10.3%) revascularizations, 70 (3.2%) strokes, and 129 (5.8%) clinically significant haemorrhages. The multivariate analysis revealed that 2 social variables were significantly associated with the composite endpoint: self-management of treatment (aHR, 0.61; 95%CI, 0.44–0.85; P < .01) and home Internet access (aHR, 0.73; 95%CI, 0.56–0.97; P = .013).
Conclusions
Certain social factors, such as self-management of treatment and internet access, are associated with a better prognosis in patients with ischemic heart disease. Identification of these patients would enable healthcare professionals to potentially improve prognosis.
前言和目的心血管疾病在发病率和死亡率中都占相当大的比例。除了公认的风险因素外，一些研究还确定了社会决定因素（如社会支持、收入和心理社会因素）与更糟糕的结果之间的相关性。方法对经冠状动脉造影诊断为冠心病的患者进行前瞻性、单中心观察性研究。除了传统的风险因素外，社会决定因素还通过研究人员管理的问卷收集。前瞻性地记录临床事件。复合终点定义为心血管死亡、心肌梗死（MI）或冠状动脉血运重建术。采用单因素分析中选取的变量进行多因素Cox比例风险回归分析。结果共随访2213例患者，中位随访时间为1461天。该队列的平均年龄为66.3岁；23.5%为女性，27.8%为糖尿病患者，10.4%为慢性肾病患者。在随访期间，共发生343例（15.5%）复合终点事件，包括109例（4.9%）死亡、85例（4%）心血管死亡、182例（8.2%）心肌梗死、229例（10.3%）血运重建、70例（3.2%）中风和129例（5.8%）临床显著出血。多因素分析显示，2个社会变量与复合终点显著相关：治疗自我管理（aHR, 0.61; 95%CI, 0.44-0.85; P < 0.01）和家庭上网（aHR, 0.73; 95%CI, 0.56-0.97; P = 0.013）。结论一些社会因素，如自我治疗管理和网络访问与缺血性心脏病患者较好的预后有关。识别这些患者将使医疗保健专业人员能够潜在地改善预后。
{"title":"Influence of social factors in a cohort of ischemic heart disease: Insights from the RECORVAL registry","authors":"Jon Zubiaur , Raquel Pérez Barquín , Adrián Margarida de Castro , Andrea Teira Calderón , Fermín Sáinz Laso , Dae-Hyun Lee Hwang , Tamara García-Camarero , Gabriela Veiga , Aritz Gil Ongay , Celia Garilleti , Rigoberto Hernández , Sergio Barrera , Víctor Fradejas , Cristina Obregón , José M. de la Torre Hernández","doi":"10.1016/j.rccl.2025.05.002","DOIUrl":"10.1016/j.rccl.2025.05.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Cardiovascular disease accounts for a considerable proportion of both morbidity and mortality. In addition to well-established risk factors, some studies have identified a correlation between social determinants such as social support, income, and psychosocial factors and worse outcomes.</div></div><div><h3>Methods</h3><div>A prospective, single-centre observational study was conducted on patients diagnosed with coronary disease following coronary angiography. In addition to traditional risk factors, social determinants were collected via a researcher-administered questionnaire. Clinical events were prospectively recorded. A composite endpoint was defined as cardiovascular death, myocardial infarction (MI), or coronary revascularization. A multivariate Cox proportional hazards regression analysis was conducted using variables selected from the univariate analysis.</div></div><div><h3>Results</h3><div>A total of 2213 patients were followed for a median duration of 1461 days. The mean age of the cohort was 66.3 years; 23.5% were women, 27.8% had diabetes mellitus, and 10.4% had chronic kidney disease. During the follow-up period, there were 343 (15.5%) composite endpoint events, including 109 (4.9%) deaths, 85 (4%) cardiovascular deaths, 182 (8.2%) MI, 229 (10.3%) revascularizations, 70 (3.2%) strokes, and 129 (5.8%) clinically significant haemorrhages. The multivariate analysis revealed that 2 social variables were significantly associated with the composite endpoint: self-management of treatment (aHR, 0.61; 95%CI, 0.44–0.85; <em>P</em> <!--><<!--> <!-->.01) and home Internet access (aHR, 0.73; 95%CI, 0.56–0.97; <em>P</em> <!-->=<!--> <!-->.013).</div></div><div><h3>Conclusions</h3><div>Certain social factors, such as self-management of treatment and internet access, are associated with a better prognosis in patients with ischemic heart disease. Identification of these patients would enable healthcare professionals to potentially improve prognosis.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 4","pages":"Pages 275-287"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.rccl.2025.03.002
Carla Iglesias Otero , David Dobarro Pérez , Carlos Rodríguez Pascual , Javier de Juan Bagudá , Fernando de Frutos Seminario , José González Costello , en representación de los miembros del registro español LEVO-D
Introduction and objectives
Elderly patients with advanced heart failure (AHF) who are not candidates for advanced treatments have a poor prognosis. The objective of this study is to describe patterns of use and safety of intermittent ambulatory infusion of levosimendan in patients older than 75 years with AHF as a treatment option, compared to patients younger than 75 years.
Methods
A multicenter retrospective analysis was performed involving 23 tertiary hospitals (January 2015-September 2020). A total of 404 patients were enrolled (37% older than 75 years and 63% younger than 75 years). Patients had to be on optimal medical treatment. Patients with onset heart failure (HF) or patients undergoing any procedure that would improve prognosis after starting levosimendan were excluded.
Results
A Cox regression model showed that 1-year response (defined as absence of death, HF admission, or unplanned HF visit) did not differ between patients. Levosimendan administration had to be discontinued more frequently in patients older than 75 years due to lack of efficacy and side effects (40.7% discontinued), but this was not associated with an increase in implantable cardioverter-defibrillator therapy 1 year before and 1 year after drug administration.
Conclusions
The LEVO-D registry adds information to the current limited scientific evidence on the prognosis of elderly patients with AHF and suggests that levosimendan is a safe option that can reduce readmissions and emergency visits for HF.
{"title":"Levosimendán ambulatorio intermitente en pacientes ancianos con insuficiencia cardiaca avanzada: registro LEVO-D","authors":"Carla Iglesias Otero , David Dobarro Pérez , Carlos Rodríguez Pascual , Javier de Juan Bagudá , Fernando de Frutos Seminario , José González Costello , en representación de los miembros del registro español LEVO-D","doi":"10.1016/j.rccl.2025.03.002","DOIUrl":"10.1016/j.rccl.2025.03.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Elderly patients with advanced heart failure (AHF) who are not candidates for advanced treatments have a poor prognosis. The objective of this study is to describe patterns of use and safety of intermittent ambulatory infusion of levosimendan in patients older than 75<!--> <!-->years with AHF as a treatment option, compared to patients younger than 75<!--> <!-->years.</div></div><div><h3>Methods</h3><div>A multicenter retrospective analysis was performed involving 23 tertiary hospitals (January 2015-September 2020). A total of 404 patients were enrolled (37% older than 75<!--> <!-->years and 63% younger than 75<!--> <!-->years). Patients had to be on optimal medical treatment. Patients with onset heart failure (HF) or patients undergoing any procedure that would improve prognosis after starting levosimendan were excluded.</div></div><div><h3>Results</h3><div>A Cox regression model showed that 1-year response (defined as absence of death, HF admission, or unplanned HF visit) did not differ between patients. Levosimendan administration had to be discontinued more frequently in patients older than 75<!--> <!-->years due to lack of efficacy and side effects (40.7% discontinued), but this was not associated with an increase in implantable cardioverter-defibrillator therapy 1<!--> <!-->year before and 1<!--> <!-->year after drug administration.</div></div><div><h3>Conclusions</h3><div>The LEVO-D registry adds information to the current limited scientific evidence on the prognosis of elderly patients with AHF and suggests that levosimendan is a safe option that can reduce readmissions and emergency visits for HF.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 3","pages":"Pages 204-212"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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