Pub Date : 2025-02-13DOI: 10.1016/j.rec.2025.02.002
Martín Negreira-Caamaño, Felipe Díez-Delhoyo, Pedro Cepas-Guillén, María Thiscal López-Lluva, Alfonso Jurado-Román, Pablo Bazal-Chacón, Iván Olavarri-Miguel, Ane Elorriaga, Ricardo Rivera-López, Emilio Blanco-López, Pablo Díez-Villanueva
Introduction and objectives: Arrhythmias such as atrial fibrillation and atrial flutter (AF/AFl) complicate the management of patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). The aim of this study was to analyze the prognostic impact of AF/AFl in this clinical setting.
Methods: The IMPACT-TIMING-GO is a prospective, multicenter registry that enrolled patients with NSTEACS undergoing invasive management. In this subanalysis, patients were categorized based on the presence of AF/AFl (either pre-existing or occurring during admission). Clinical management and complications were assessed both during hospitalization (using a composite endpoint of death, renal failure, ventricular arrhythmias, delirium, new infarction, mechanical complications, and major bleeding) and after 1 year of follow-up (using a composite endpoint of death, cardiovascular admissions, and major bleeding).
Results: A total of 1020 patients (mean age, 66.8±12.7 years; 23.5% women) were included. Of these, 79 (7.7%) had prior AF/AFl, and 37 (3.6%) developed de novo AF/AFl during admission. Patients with AF/AFl were older and had a higher comorbidity burden, with de novo AF/AFl being associated with greater clinical severity. After multivariate adjustment, only de novo AF/AFl, and not previous AF/AFl, was independently associated with the composite endpoint of in-hospital complications (OR, 5.12; 95%CI, 2.30-11.43; P <.001 vs OR, 1.70, 95%CI, 0.91-3.58; P=.166) and adverse events at 1 year (HR, 1.95; 95%CI, 1.02-3.76; P=.045 vs HR, 1.02, 95%CI, 0.55-5.86; P=.957).
Conclusions: In patients with NSTEACS, de novo AF/AFl is independently associated with higher rates of both in-hospital and follow-up complications.
{"title":"Prognostic impact of atrial fibrillation and atrial flutter in patients with non-ST-segment elevation acute coronary syndrome.","authors":"Martín Negreira-Caamaño, Felipe Díez-Delhoyo, Pedro Cepas-Guillén, María Thiscal López-Lluva, Alfonso Jurado-Román, Pablo Bazal-Chacón, Iván Olavarri-Miguel, Ane Elorriaga, Ricardo Rivera-López, Emilio Blanco-López, Pablo Díez-Villanueva","doi":"10.1016/j.rec.2025.02.002","DOIUrl":"10.1016/j.rec.2025.02.002","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Arrhythmias such as atrial fibrillation and atrial flutter (AF/AFl) complicate the management of patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). The aim of this study was to analyze the prognostic impact of AF/AFl in this clinical setting.</p><p><strong>Methods: </strong>The IMPACT-TIMING-GO is a prospective, multicenter registry that enrolled patients with NSTEACS undergoing invasive management. In this subanalysis, patients were categorized based on the presence of AF/AFl (either pre-existing or occurring during admission). Clinical management and complications were assessed both during hospitalization (using a composite endpoint of death, renal failure, ventricular arrhythmias, delirium, new infarction, mechanical complications, and major bleeding) and after 1 year of follow-up (using a composite endpoint of death, cardiovascular admissions, and major bleeding).</p><p><strong>Results: </strong>A total of 1020 patients (mean age, 66.8±12.7 years; 23.5% women) were included. Of these, 79 (7.7%) had prior AF/AFl, and 37 (3.6%) developed de novo AF/AFl during admission. Patients with AF/AFl were older and had a higher comorbidity burden, with de novo AF/AFl being associated with greater clinical severity. After multivariate adjustment, only de novo AF/AFl, and not previous AF/AFl, was independently associated with the composite endpoint of in-hospital complications (OR, 5.12; 95%CI, 2.30-11.43; P <.001 vs OR, 1.70, 95%CI, 0.91-3.58; P=.166) and adverse events at 1 year (HR, 1.95; 95%CI, 1.02-3.76; P=.045 vs HR, 1.02, 95%CI, 0.55-5.86; P=.957).</p><p><strong>Conclusions: </strong>In patients with NSTEACS, de novo AF/AFl is independently associated with higher rates of both in-hospital and follow-up complications.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426000","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 : 2025-02-10DOI: 10.1016/j.rec.2025.01.017
Chi-Hion Pedro Li, Lluís Asmarats, Albert Massó van Roessel, Helena Capellades, Xavier Millán, Dabit Arzamendi
{"title":"Predictability and device tilting in edge-to-edge mitral valve repair.","authors":"Chi-Hion Pedro Li, Lluís Asmarats, Albert Massó van Roessel, Helena Capellades, Xavier Millán, Dabit Arzamendi","doi":"10.1016/j.rec.2025.01.017","DOIUrl":"10.1016/j.rec.2025.01.017","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410762","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 : 2025-02-10DOI: 10.1016/j.rec.2025.01.018
Chi-Hion Pedro Li, Lluís Asmarats, Albert Massó van Roessel, Helena Capellades, Estefanía Fernández-Peregrina, Dabit Arzamendi
{"title":"Sex differences in mitral regurgitation anatomy and outcomes of transcatheter edge-to-edge repair.","authors":"Chi-Hion Pedro Li, Lluís Asmarats, Albert Massó van Roessel, Helena Capellades, Estefanía Fernández-Peregrina, Dabit Arzamendi","doi":"10.1016/j.rec.2025.01.018","DOIUrl":"10.1016/j.rec.2025.01.018","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410711","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 : 2025-02-08DOI: 10.1016/j.rec.2025.01.015
Woochan Kwon, Taek Kyu Park, Ki Hong Choi, Joo Myung Lee, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Hyeon-Cheol Gwon, Seung-Hyuk Choi
Introduction and objectives: The clinical benefits of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remain controversial. This study aimed to investigate whether PCI for CTO located in the left anterior descending artery (LAD) could have beneficial effects on clinical outcomes.
Methods: Patients were retrospectively selected from a single-center CTO registry and followed up for approximately 10 years. The patients were grouped based on the presence of LAD CTO and whether the CTO was revascularized. Inverse probability weighting adjustment was also performed. The primary outcome was the composite of cardiac death or myocardial infarction at 10 years.
Results: Among 1323 patients with CTO, 1034 were male, and 417 had LAD CTO. PCI was attempted in 72.2% of participants in the LAD CTO group and in 49.9% of those in the non-LAD CTO group. In the non-LAD CTO group, PCI did not significantly affect the primary outcome (medical therapy vs PCI, 20.7% vs 13.4%, adjusted HR: 0.72, 95%CI, 0.47-1.10; P = .13). However, a significant difference in the incidence of the primary outcome between the treatment methods was observed in the LAD CTO group (30.8% vs 15.4%; adjusted HR: 0.44; 95%CI, 0.25-0.81; P = .007). A significant interaction was observed between LAD CTO and treatment method (P for interaction = .011).
Conclusions: The benefits of PCI compared with medical therapy for CTO might be more apparent when the CTO is located in the LAD.
{"title":"Chronic total occlusion location and outcomes after percutaneous coronary intervention or medical therapy: ten-year follow-up of a single-center registry.","authors":"Woochan Kwon, Taek Kyu Park, Ki Hong Choi, Joo Myung Lee, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Hyeon-Cheol Gwon, Seung-Hyuk Choi","doi":"10.1016/j.rec.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.rec.2025.01.015","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The clinical benefits of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remain controversial. This study aimed to investigate whether PCI for CTO located in the left anterior descending artery (LAD) could have beneficial effects on clinical outcomes.</p><p><strong>Methods: </strong>Patients were retrospectively selected from a single-center CTO registry and followed up for approximately 10 years. The patients were grouped based on the presence of LAD CTO and whether the CTO was revascularized. Inverse probability weighting adjustment was also performed. The primary outcome was the composite of cardiac death or myocardial infarction at 10 years.</p><p><strong>Results: </strong>Among 1323 patients with CTO, 1034 were male, and 417 had LAD CTO. PCI was attempted in 72.2% of participants in the LAD CTO group and in 49.9% of those in the non-LAD CTO group. In the non-LAD CTO group, PCI did not significantly affect the primary outcome (medical therapy vs PCI, 20.7% vs 13.4%, adjusted HR: 0.72, 95%CI, 0.47-1.10; P = .13). However, a significant difference in the incidence of the primary outcome between the treatment methods was observed in the LAD CTO group (30.8% vs 15.4%; adjusted HR: 0.44; 95%CI, 0.25-0.81; P = .007). A significant interaction was observed between LAD CTO and treatment method (P for interaction = .011).</p><p><strong>Conclusions: </strong>The benefits of PCI compared with medical therapy for CTO might be more apparent when the CTO is located in the LAD.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391963","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 : 2025-02-08DOI: 10.1016/j.rec.2025.01.016
Daiana Ibarretxe-Guerediaga, Cristina Marimón, Albert Feliu, Cèlia Rodriguez-Borjabad, Núria Plana, Lluís Masana
{"title":"Sudden death in a homozygous familial hypercholesterolemic child with noncompaction cardiomyopathy. Just a coincidence?","authors":"Daiana Ibarretxe-Guerediaga, Cristina Marimón, Albert Feliu, Cèlia Rodriguez-Borjabad, Núria Plana, Lluís Masana","doi":"10.1016/j.rec.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.rec.2025.01.016","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391964","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 : 2025-02-06DOI: 10.1016/j.rec.2025.01.013
Marta Herrero-Brocal, Almudena Ureña, Juan M Ruiz-Nodar
{"title":"Detachment of a severely calcified atheroma during TAVI.","authors":"Marta Herrero-Brocal, Almudena Ureña, Juan M Ruiz-Nodar","doi":"10.1016/j.rec.2025.01.013","DOIUrl":"10.1016/j.rec.2025.01.013","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374392","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 : 2025-02-06DOI: 10.1016/j.rec.2025.01.014
Giovanni Occhipinti, Andrea Alberto Ruberti, Jorge Alcocer, Marc Giménez-Mila, Bárbara Vidal, Ander Regueiro
{"title":"Sex differences in patients undergoing aortic valve replacement: a tale of 2 hearts.","authors":"Giovanni Occhipinti, Andrea Alberto Ruberti, Jorge Alcocer, Marc Giménez-Mila, Bárbara Vidal, Ander Regueiro","doi":"10.1016/j.rec.2025.01.014","DOIUrl":"10.1016/j.rec.2025.01.014","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374525","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 : 2025-02-06DOI: 10.1016/j.rec.2025.01.012
Luigi Gerra, Tommaso Bucci, Ho Man Lam, Marta Mantovani, Antonios A Argyris, Muath Alobaida, Kully Sandhu, Joseph Mills, Giuseppe Boriani, Gregory Y H Lip
Introduction and objectives: Data on the impact of amyloidosis on outcomes after transcatheter aortic valve implantation (TAVI) are limited. The objective of this study was to evaluate the 1-year risk of adverse events post-TAVI in patients with amyloidosis.
Methods: Patients undergoing TAVI (between 2005 and 2023) were categorized into 2 groups based on the presence of amyloidosis. The primary outcome was the 1-year risk of a composite endpoint: heart failure (HF), ischemic stroke, pacemaker implantation, acute kidney injury, and all-cause death. Secondary outcomes assessed the individual components of the composite. Propensity score matching was used to balance the groups, and Cox regression was used to assess the risk of adverse outcomes associated with amyloidosis. Composite outcomes were analyzed for early (30-days) and long-term (30-days to 1 year) follow-up.
Results: Data from 589 TAVI patients with amyloidosis (mean age 78.9±8.2 years, 31.9% female) were compared with 52 296 individuals without amyloidosis (mean age 78.1±8.8 years, 40.3% female). After propensity score matching, patients with amyloidosis had a significantly higher 1-year risk of adverse events (HR, 1.27; 95%CI, 1.08-1.49). Specifically, patients with amyloidosis showed an increased risk of HF (HR, 1.37; 95%CI, 1.10-1.70). Stroke risk (HR, 1.67; 95%CI, 1.16-2.40) and pacemaker implantation (HR, 2.25; 95%CI, 1.15-4.41) were higher during long-term follow-up, while no differences were found for acute kidney injury or all-cause mortality between the 2 groups.
Conclusions: Among patients undergoing TAVI, those with amyloidosis are at a higher risk of adverse events, particularly HF, and have an increased risk of pacemaker implantation and stroke in the long-term.
{"title":"Impact of amyloidosis on outcomes after transcatheter aortic valve implantation.","authors":"Luigi Gerra, Tommaso Bucci, Ho Man Lam, Marta Mantovani, Antonios A Argyris, Muath Alobaida, Kully Sandhu, Joseph Mills, Giuseppe Boriani, Gregory Y H Lip","doi":"10.1016/j.rec.2025.01.012","DOIUrl":"10.1016/j.rec.2025.01.012","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Data on the impact of amyloidosis on outcomes after transcatheter aortic valve implantation (TAVI) are limited. The objective of this study was to evaluate the 1-year risk of adverse events post-TAVI in patients with amyloidosis.</p><p><strong>Methods: </strong>Patients undergoing TAVI (between 2005 and 2023) were categorized into 2 groups based on the presence of amyloidosis. The primary outcome was the 1-year risk of a composite endpoint: heart failure (HF), ischemic stroke, pacemaker implantation, acute kidney injury, and all-cause death. Secondary outcomes assessed the individual components of the composite. Propensity score matching was used to balance the groups, and Cox regression was used to assess the risk of adverse outcomes associated with amyloidosis. Composite outcomes were analyzed for early (30-days) and long-term (30-days to 1 year) follow-up.</p><p><strong>Results: </strong>Data from 589 TAVI patients with amyloidosis (mean age 78.9±8.2 years, 31.9% female) were compared with 52 296 individuals without amyloidosis (mean age 78.1±8.8 years, 40.3% female). After propensity score matching, patients with amyloidosis had a significantly higher 1-year risk of adverse events (HR, 1.27; 95%CI, 1.08-1.49). Specifically, patients with amyloidosis showed an increased risk of HF (HR, 1.37; 95%CI, 1.10-1.70). Stroke risk (HR, 1.67; 95%CI, 1.16-2.40) and pacemaker implantation (HR, 2.25; 95%CI, 1.15-4.41) were higher during long-term follow-up, while no differences were found for acute kidney injury or all-cause mortality between the 2 groups.</p><p><strong>Conclusions: </strong>Among patients undergoing TAVI, those with amyloidosis are at a higher risk of adverse events, particularly HF, and have an increased risk of pacemaker implantation and stroke in the long-term.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374518","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 : 2025-02-06DOI: 10.1016/j.rec.2024.11.018
{"title":"Comments on the 2024 ESC guidelines for the management of elevated blood pressure and hypertension.","authors":"","doi":"10.1016/j.rec.2024.11.018","DOIUrl":"10.1016/j.rec.2024.11.018","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374197","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}