Pub Date : 2024-07-26DOI: 10.1016/j.rec.2024.07.004
Eva Gutiérrez-Ortiz, Javier Cobiella, Christian Muñoz-Guijosa, Rui C Teles, Rodrigo Estévez-Loureiro, Vanessa Moñivas, Ander Regueiro, Sara Blasco-Turrión, Patricia Mahía, Danela Figuereo Beltre, Pedro Freitas, Miguel Piñón, Ignacio J Amat-Santos, Ignasi Julià Amill, Tiago Nolasco, Daniel Pereda, Carlos Martín López, Luis Nombela-Franco
Introduction and objectives: Transcatheter mitral valve replacement (TMVR) is an emerging treatment alternative for mitral valve (MV) disease in patients who were ineligible for surgical intervention or edge-to-edge repair. This study aimed to assess the short- and mid-term outcomes of this procedure.
Methods: We conducted a prospective registry to include the initial experience with symptomatic, consecutive patients who underwent TMVR using the transapical Tendyne system at 7 centers in the Iberian Peninsula. Baseline clinical and imaging data, periprocedural information, and follow-up assessments were collected at 1 month and 1 year.
Results: A total of 40 patients (mean age 78.5 years [76-82], 47,5% males) underwent TMVR. The majority had significant surgical risk, comorbidities, and advanced functional class. All patients had significant mitral regurgitation (MR), except for 2 with severe stenosis. Previous MV intervention and off-label indication for the procedure were present in 4 (10.0%) and 8 (20.0%) patients, respectively. Technical success was recorded in 100%, device success in 95.0%, and procedural success in 85.0% at 30-day. All-cause mortality was 2.5% and 17.5% at the 1-month and 1-year follow-up, respectively. MR reduction (≤ 1) and functional class improvement (NYHA I-II) were observed at 1 year in 93.9% and 87.9% of survivors, respectively.
Conclusions: Treatment with TMVR produced enduring resolution of MV disease and notable functional enhancement at 1 year of follow-up. The procedure demonstrated a satisfactory early safety profile, although 1-year mortality remained relatively high in this high-risk population.
{"title":"Transapical transcatheter mitral valve replacement for mitral valve disease: an Iberian experience.","authors":"Eva Gutiérrez-Ortiz, Javier Cobiella, Christian Muñoz-Guijosa, Rui C Teles, Rodrigo Estévez-Loureiro, Vanessa Moñivas, Ander Regueiro, Sara Blasco-Turrión, Patricia Mahía, Danela Figuereo Beltre, Pedro Freitas, Miguel Piñón, Ignacio J Amat-Santos, Ignasi Julià Amill, Tiago Nolasco, Daniel Pereda, Carlos Martín López, Luis Nombela-Franco","doi":"10.1016/j.rec.2024.07.004","DOIUrl":"https://doi.org/10.1016/j.rec.2024.07.004","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Transcatheter mitral valve replacement (TMVR) is an emerging treatment alternative for mitral valve (MV) disease in patients who were ineligible for surgical intervention or edge-to-edge repair. This study aimed to assess the short- and mid-term outcomes of this procedure.</p><p><strong>Methods: </strong>We conducted a prospective registry to include the initial experience with symptomatic, consecutive patients who underwent TMVR using the transapical Tendyne system at 7 centers in the Iberian Peninsula. Baseline clinical and imaging data, periprocedural information, and follow-up assessments were collected at 1 month and 1 year.</p><p><strong>Results: </strong>A total of 40 patients (mean age 78.5 years [76-82], 47,5% males) underwent TMVR. The majority had significant surgical risk, comorbidities, and advanced functional class. All patients had significant mitral regurgitation (MR), except for 2 with severe stenosis. Previous MV intervention and off-label indication for the procedure were present in 4 (10.0%) and 8 (20.0%) patients, respectively. Technical success was recorded in 100%, device success in 95.0%, and procedural success in 85.0% at 30-day. All-cause mortality was 2.5% and 17.5% at the 1-month and 1-year follow-up, respectively. MR reduction (≤ 1) and functional class improvement (NYHA I-II) were observed at 1 year in 93.9% and 87.9% of survivors, respectively.</p><p><strong>Conclusions: </strong>Treatment with TMVR produced enduring resolution of MV disease and notable functional enhancement at 1 year of follow-up. The procedure demonstrated a satisfactory early safety profile, although 1-year mortality remained relatively high in this high-risk population.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789352","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 : 2024-07-26DOI: 10.1016/j.rec.2024.05.018
Carlos Real, Carlos Nicolás Pérez-García, Carlos Galán-Arriola, Inés García-Lunar, Ana García-Álvarez
Interest in the right ventricle has substantially increased due to advances in knowledge of its pathophysiology and prognostic implications across a wide spectrum of diseases. However, we are still far from understanding the multiple mechanisms that influence right ventricular dysfunction, its evaluation continues to be challenging, and there is a shortage of specific treatments in most scenarios. This review article aims to update knowledge about the physiology of the right ventricle, its transition to dysfunction, diagnostic tools, and available treatments from a translational perspective.
{"title":"Right ventricular dysfunction: pathophysiology, experimental models, evaluation, and treatment.","authors":"Carlos Real, Carlos Nicolás Pérez-García, Carlos Galán-Arriola, Inés García-Lunar, Ana García-Álvarez","doi":"10.1016/j.rec.2024.05.018","DOIUrl":"10.1016/j.rec.2024.05.018","url":null,"abstract":"<p><p>Interest in the right ventricle has substantially increased due to advances in knowledge of its pathophysiology and prognostic implications across a wide spectrum of diseases. However, we are still far from understanding the multiple mechanisms that influence right ventricular dysfunction, its evaluation continues to be challenging, and there is a shortage of specific treatments in most scenarios. This review article aims to update knowledge about the physiology of the right ventricle, its transition to dysfunction, diagnostic tools, and available treatments from a translational perspective.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789351","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 : 2024-07-26DOI: 10.1016/j.rec.2024.06.007
Luis Ruiz-Guerrero, Francisco González-Vílchez
{"title":"Pregnancy in women with genetic variants of dilated cardiomyopathy.","authors":"Luis Ruiz-Guerrero, Francisco González-Vílchez","doi":"10.1016/j.rec.2024.06.007","DOIUrl":"10.1016/j.rec.2024.06.007","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789350","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 : 2024-07-25DOI: 10.1016/j.rec.2024.07.001
Juan Esteban de Villarreal-Soto, Francisco José Hernández Pérez, Jessica García Suárez, Jorge Rodríguez-Roda Stuart, Sergio J Cánovas López, Alberto Forteza Gil
{"title":"Postcardiotomy cardiogenic shock: current status in Spain.","authors":"Juan Esteban de Villarreal-Soto, Francisco José Hernández Pérez, Jessica García Suárez, Jorge Rodríguez-Roda Stuart, Sergio J Cánovas López, Alberto Forteza Gil","doi":"10.1016/j.rec.2024.07.001","DOIUrl":"10.1016/j.rec.2024.07.001","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724654","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 : 2024-07-24DOI: 10.1016/j.rec.2024.05.013
Víctor Castro-Urda
{"title":"Charting the path: from the defibrillator vest to a reborn heart.","authors":"Víctor Castro-Urda","doi":"10.1016/j.rec.2024.05.013","DOIUrl":"10.1016/j.rec.2024.05.013","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724653","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 : 2024-07-24DOI: 10.1016/j.rec.2024.05.017
Sergio Raposeiras-Roubín, Emad Abu-Assi, José Ángel Pérez Rivera, Pablo Jorge Pérez, Ana Ayesta López, Ana Viana Tejedor, Miguel José Corbí Pascual, Anna Carrasquer, César Jiménez Méndez, Cristina González Cambeiro, Aitor Uribarri González, Clara Bonanad Lozano, Marta Marcos Mangas, Ana Merino-Merino, Ester Sánchez-Corral, Isabel Santos-Sánchez, Lara Aguilar-Iglesias, Alberto Alen, José Rozado Castaño, Ester Mínguez de la Guía, Macarena López Vázquez, Francisco Manuel Salmerón Martínez, Ylènia Avivar Sáez, Alberto Villar Ruiz, José Antonio Panera de la Mano, Marina Teresa García García, Ana Pérez-Asensio, Daznia Bompart, Georgiana Zaharia, Albert Ariza-Solé
Introduction and objectives: Only about 1 out of every 3 patients with acute myocardial infarction (AMI) achieve low-density lipoprotein cholesterol (LDL-C) values <55mg/dL in the first year. The present study aims to evaluate the impact of early intensive therapy on lipid control after an AMI.
Methods: An independent, prospective, pragmatic, controlled, randomized, open-label, evaluator-blinded clinical trial (PROBE design) will analyze the efficacy and safety of an oral lipid-lowering triple therapy: high-potency statin+bempedoic acid (BA) 180mg+ezetimibe (EZ) 10mg versus current European-based guidelines (high-potency statin±EZ 10mg), in AMI patients. LDL-C will be determined within the first 48hours. Patients with LDL-C ≥ 115mg/dL (without previous statin therapy), ≥ 100mg/dL (with previous low-potency or high-potency statin therapy at submaximal dose), or ≥ 70mg/dL (with previous high-potency statin therapy at high dose) will be randomly assigned 1:1 between 24 and 72hours post-AMI to the BA/EZ combination or to statin±EZ, without BA. The primary endpoint is the proportion of patients reaching LDL-C <55mg/dL at 8 weeks after treatment.
Results: The results of this study will provide novel information for post-AMI LDL-C control by evaluating the usefulness of an early intensive lipid-lowering strategy based on triple oral therapy.
Conclusions: Early intensive lipid-lowering triple oral therapy vs the treatment recommended by current clinical practice guidelines could facilitate the achievement of optimal LDL-C levels in the first 2 months after AMI (a high-risk period).
{"title":"Efficacy and safety of bempedoic acid in acute coronary syndrome. Design of the clinical trial ES-BempeDACS.","authors":"Sergio Raposeiras-Roubín, Emad Abu-Assi, José Ángel Pérez Rivera, Pablo Jorge Pérez, Ana Ayesta López, Ana Viana Tejedor, Miguel José Corbí Pascual, Anna Carrasquer, César Jiménez Méndez, Cristina González Cambeiro, Aitor Uribarri González, Clara Bonanad Lozano, Marta Marcos Mangas, Ana Merino-Merino, Ester Sánchez-Corral, Isabel Santos-Sánchez, Lara Aguilar-Iglesias, Alberto Alen, José Rozado Castaño, Ester Mínguez de la Guía, Macarena López Vázquez, Francisco Manuel Salmerón Martínez, Ylènia Avivar Sáez, Alberto Villar Ruiz, José Antonio Panera de la Mano, Marina Teresa García García, Ana Pérez-Asensio, Daznia Bompart, Georgiana Zaharia, Albert Ariza-Solé","doi":"10.1016/j.rec.2024.05.017","DOIUrl":"10.1016/j.rec.2024.05.017","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Only about 1 out of every 3 patients with acute myocardial infarction (AMI) achieve low-density lipoprotein cholesterol (LDL-C) values <55mg/dL in the first year. The present study aims to evaluate the impact of early intensive therapy on lipid control after an AMI.</p><p><strong>Methods: </strong>An independent, prospective, pragmatic, controlled, randomized, open-label, evaluator-blinded clinical trial (PROBE design) will analyze the efficacy and safety of an oral lipid-lowering triple therapy: high-potency statin+bempedoic acid (BA) 180mg+ezetimibe (EZ) 10mg versus current European-based guidelines (high-potency statin±EZ 10mg), in AMI patients. LDL-C will be determined within the first 48hours. Patients with LDL-C ≥ 115mg/dL (without previous statin therapy), ≥ 100mg/dL (with previous low-potency or high-potency statin therapy at submaximal dose), or ≥ 70mg/dL (with previous high-potency statin therapy at high dose) will be randomly assigned 1:1 between 24 and 72hours post-AMI to the BA/EZ combination or to statin±EZ, without BA. The primary endpoint is the proportion of patients reaching LDL-C <55mg/dL at 8 weeks after treatment.</p><p><strong>Results: </strong>The results of this study will provide novel information for post-AMI LDL-C control by evaluating the usefulness of an early intensive lipid-lowering strategy based on triple oral therapy.</p><p><strong>Conclusions: </strong>Early intensive lipid-lowering triple oral therapy vs the treatment recommended by current clinical practice guidelines could facilitate the achievement of optimal LDL-C levels in the first 2 months after AMI (a high-risk period).</p><p><strong>Identification number: </strong>EudraCT 2021-006550-31.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767544","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 : 2024-07-20DOI: 10.1016/j.rec.2024.07.002
Miguel Lorenzo, Rafael de la Espriella, Gema Miñana, Gonzalo Núñez, Arturo Carratalá, Enrique Rodríguez, Enrique Santas, Neus Valls, Sandra Villar, Víctor Donoso, Antoni Bayés-Genís, Juan Sanchis, Julio Núñez
Introduction and objectives: Spot determination of urinary sodium (UNa+) has emerged as a useful tool for monitoring diuretic response in patients with acute heart failure (AHF). However, the evidence in outpatients is scarce. We aimed to examine the relationship between spot UNa+ levels and the risk of mortality and worsening heart failure (WHF) events in individuals with chronic HF.
Methods: This observational and ambispective study included 1145 outpatients with chronic HF followed in a single center specialized HF clinic. UNa+ assessment was carried out 1-5 days before each visit. The endpoints of the study were the association between UNa+ and risk of a) long-term death and b) AHF-hospitalization and total WHF events (including AHF-hospitalization, emergency department visits or parenteral loop-diuretic administration in HF clinic), assessed by multivariate Cox and negative binomial regressions.
Results: The mean±standard deviation of age was 73±11 years, 670 (58.5%) were men, 902 (78.8%) were on stable NYHA class II, and 595 (52%) had LFEF ≥50%. The median (interquartile range) UNa+ was 72 (51-94) mmol/L. Over a median follow-up of 2.63 (1.70-3.36) years, there were 293 (25.6%) deaths and 382 WHF events (244 AHF-admissions) in 233 (20.3%) patients. After multivariate adjustment, baseline UNa+ was inverse and linearly associated with the risk of total WHF (IRR, 1.07; 95%CI, 1.02-1.12; P=.007) and AHF-admissions (IRR, 1.08; 95%CI, 1.02-1.14; P=.012) and borderline associated with all-cause mortality (HR, 1.04; 95%CI, 0.99-1.09; P=.068).
Conclusions: In outpatients with chronic HF, lower UNa+ was associated with a higher risk of recurrent WHF events.
{"title":"Role of spot urinary sodium in outpatients with heart failure.","authors":"Miguel Lorenzo, Rafael de la Espriella, Gema Miñana, Gonzalo Núñez, Arturo Carratalá, Enrique Rodríguez, Enrique Santas, Neus Valls, Sandra Villar, Víctor Donoso, Antoni Bayés-Genís, Juan Sanchis, Julio Núñez","doi":"10.1016/j.rec.2024.07.002","DOIUrl":"10.1016/j.rec.2024.07.002","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Spot determination of urinary sodium (UNa+) has emerged as a useful tool for monitoring diuretic response in patients with acute heart failure (AHF). However, the evidence in outpatients is scarce. We aimed to examine the relationship between spot UNa+ levels and the risk of mortality and worsening heart failure (WHF) events in individuals with chronic HF.</p><p><strong>Methods: </strong>This observational and ambispective study included 1145 outpatients with chronic HF followed in a single center specialized HF clinic. UNa+ assessment was carried out 1-5 days before each visit. The endpoints of the study were the association between UNa+ and risk of a) long-term death and b) AHF-hospitalization and total WHF events (including AHF-hospitalization, emergency department visits or parenteral loop-diuretic administration in HF clinic), assessed by multivariate Cox and negative binomial regressions.</p><p><strong>Results: </strong>The mean±standard deviation of age was 73±11 years, 670 (58.5%) were men, 902 (78.8%) were on stable NYHA class II, and 595 (52%) had LFEF ≥50%. The median (interquartile range) UNa+ was 72 (51-94) mmol/L. Over a median follow-up of 2.63 (1.70-3.36) years, there were 293 (25.6%) deaths and 382 WHF events (244 AHF-admissions) in 233 (20.3%) patients. After multivariate adjustment, baseline UNa+ was inverse and linearly associated with the risk of total WHF (IRR, 1.07; 95%CI, 1.02-1.12; P=.007) and AHF-admissions (IRR, 1.08; 95%CI, 1.02-1.14; P=.012) and borderline associated with all-cause mortality (HR, 1.04; 95%CI, 0.99-1.09; P=.068).</p><p><strong>Conclusions: </strong>In outpatients with chronic HF, lower UNa+ was associated with a higher risk of recurrent WHF events.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749247","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 : 2024-07-19DOI: 10.1016/j.rec.2024.07.003
David García-Vega, Sergio Cinza-Sanjurjo, Carlos Tilves-Bellas, Sonia Eiras, José R González-Juanatey
Introduction and objectives: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1ra) reduce cardiovascular events through different mechanisms, but their association with cancer remains unclear. The aim of this study was to compare the effect of combined treatment (SGLT2i and GLP1ra) and monotherapy (SGLT2i or GLP1ra) on hospitalization and/or death from cancer in a general population and a subgroup of patients with cardiovascular disease (CVD).
Methods: We conducted a nonconcurrent observational prospective study of patients prescribed SGLT2i, GLP1ra, or both. Multinomial propensity scores were performed in the entire population and in a subgroup of patients with CVD. A multivariate Cox regression analysis was used to determine the hazard ratio (HR) for age, sex, risk factors, and treatment for each outcome.
Results: We included 14 709 patients (11366 with SGLT2i, 1016 with GLP1ra, and 2327 with both treatments) from treatment initiation. Diabetes was present in 97% of the patients. The subgroup with CVD included 4957 (33.7%) patients. After a median of 33 months of follow-up, the risk of adverse cancer events was similar between patients with and without CVD (3.4% or 3.7%, respectively). The main risk factors for cancer mortality were male sex and age. Combined treatment and its duration reduced the risk of cancer mortality compared with monotherapy with SGLT2i or GLP1ra in the overall population (HR, 0.2216; 95%CI, 0.1106-0.4659; P<.001; and HR, 0.1928; 95%CI, 0.071-0.5219; P=.001, respectively) and in the subgroup of patients with CVD (HR, 0.2879; 95%CI, 0.0878-0.994; P<.049; and HR, 0.1329; 95%CI, 0.024-0.6768; P=.014, respectively).
Conclusions: Initiation of combined therapy (SGLT2i and GLP1ra) vs monotherapy with SGLT2i or GLP1ra was associated with a lower risk of cancer mortality, mostly in diabetic patients with or without CVD. Although clinical trials are needed, these results might be explained by the complementary mechanisms of these drugs, including their antiproliferative, anti-inflammatory, and metabolic effects. Future clinical trials and mechanistic studies will clarify the possible role of these drugs in carcinogenesis.
{"title":"Sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists and cancer mortality. A real-world registry.","authors":"David García-Vega, Sergio Cinza-Sanjurjo, Carlos Tilves-Bellas, Sonia Eiras, José R González-Juanatey","doi":"10.1016/j.rec.2024.07.003","DOIUrl":"10.1016/j.rec.2024.07.003","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1ra) reduce cardiovascular events through different mechanisms, but their association with cancer remains unclear. The aim of this study was to compare the effect of combined treatment (SGLT2i and GLP1ra) and monotherapy (SGLT2i or GLP1ra) on hospitalization and/or death from cancer in a general population and a subgroup of patients with cardiovascular disease (CVD).</p><p><strong>Methods: </strong>We conducted a nonconcurrent observational prospective study of patients prescribed SGLT2i, GLP1ra, or both. Multinomial propensity scores were performed in the entire population and in a subgroup of patients with CVD. A multivariate Cox regression analysis was used to determine the hazard ratio (HR) for age, sex, risk factors, and treatment for each outcome.</p><p><strong>Results: </strong>We included 14 709 patients (11366 with SGLT2i, 1016 with GLP1ra, and 2327 with both treatments) from treatment initiation. Diabetes was present in 97% of the patients. The subgroup with CVD included 4957 (33.7%) patients. After a median of 33 months of follow-up, the risk of adverse cancer events was similar between patients with and without CVD (3.4% or 3.7%, respectively). The main risk factors for cancer mortality were male sex and age. Combined treatment and its duration reduced the risk of cancer mortality compared with monotherapy with SGLT2i or GLP1ra in the overall population (HR, 0.2216; 95%CI, 0.1106-0.4659; P<.001; and HR, 0.1928; 95%CI, 0.071-0.5219; P=.001, respectively) and in the subgroup of patients with CVD (HR, 0.2879; 95%CI, 0.0878-0.994; P<.049; and HR, 0.1329; 95%CI, 0.024-0.6768; P=.014, respectively).</p><p><strong>Conclusions: </strong>Initiation of combined therapy (SGLT2i and GLP1ra) vs monotherapy with SGLT2i or GLP1ra was associated with a lower risk of cancer mortality, mostly in diabetic patients with or without CVD. Although clinical trials are needed, these results might be explained by the complementary mechanisms of these drugs, including their antiproliferative, anti-inflammatory, and metabolic effects. Future clinical trials and mechanistic studies will clarify the possible role of these drugs in carcinogenesis.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735252","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 : 2024-07-19DOI: 10.1016/j.rec.2024.05.016
José Rozado
{"title":"Acute pericarditis: when is an exhaustive search of causes needed?","authors":"José Rozado","doi":"10.1016/j.rec.2024.05.016","DOIUrl":"10.1016/j.rec.2024.05.016","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735251","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 : 2024-07-18DOI: 10.1016/j.rec.2024.05.014
Ana Belén Merón Pino, Andrea Alonso Campana, Eugenio Picazo Feu, Miguel Ángel Vallejo Ruiz, Alejandra Vaello Paños
{"title":"Acute pericarditis due to Q fever: a rare manifestation.","authors":"Ana Belén Merón Pino, Andrea Alonso Campana, Eugenio Picazo Feu, Miguel Ángel Vallejo Ruiz, Alejandra Vaello Paños","doi":"10.1016/j.rec.2024.05.014","DOIUrl":"10.1016/j.rec.2024.05.014","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735250","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}