Revista española de cardiología (English ed.)最新文献

Introduction and objectives: This study aimed to assess the effectiveness and clinical outcomes of tricuspid transcatheter edge-to-edge repair (T-TEER) in patients with cardiac implantable electronic devices (CIEDs).

Methods: This subanalysis of the Transcatheter Tricuspid Valve Repair in Spain (TRI-SPA) registry included patients with at least severe tricuspid regurgitation (TR) who were treated with T-TEER between June 2020 and May 2023 in Spain. Patients with CIEDs and no or mild tricuspid lead-leaflet interaction were compared with those without CIEDs. The primary composite endpoint was all-cause mortality, heart failure-related hospitalization, and tricuspid valve reintervention at 12 months.

Results: Among 310 patients (mean age 75.5 ± 9.1 years, 70% female) with significant TR treated with T-TEER, 35 (11%) had CIEDs. Device implantation success was high in both groups (97.1% in the CIED group vs 96.4% in the non-CIED group, P = .81), with a similar rate of ≤ 2+ residual TR (84.9% in the CIED group vs 91.0% in the non-CIED group, P = .26). Patients with CIEDs experienced comparable rates of the primary composite endpoint to the non-CIED group (23.8% vs 19.1%, respectively, HR, 1.40; 95%CI, 0.60-3.31; P = .44), sustained successful TR reduction (≤ 2+ in 55.0% vs 73.8%, P = .07), and functional improvement (NYHA class I/II 81.8% vs 79.9%, P = .79).

Conclusions: In a real-world setting, T-TEER seems to be an effective therapeutic option for selected patients with more than moderate TR and CIEDs with no or mild lead-leaflet interaction, offering comparable cardiovascular outcomes and clinical improvement to those without leads. However, the presence of CIEDs may represent an independent risk factor for TR recurrence.

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.

Introduction and objectives: Infective endocarditis (IE) is a serious public health problem both in Spain and worldwide. This study aimed to analyze the trends in the incidence of IE in Spain from 1992 to 2021.

Methods: We used IE incidence data from the Global Health Data Exchange and population data from the Spanish National Statistics Institute to analyze changes in age-standardized incidence rates. Joinpoint and Age-Period-Cohort (A-P-C) models were applied to identify significant trend changes and the effects of age, period, and birth cohort.

Results: The age-standardized incidence rates of IE increased from 17.5 cases per 100 000 population in 1992 to 30.8 per 100,000 in 2021 among men and from 16.8 per 100 000 in 1992 to 22.9 per 100 000 in 2021 among women. Joinpoint analysis revealed distinct trend changes, with men having a faster rate of increase (1.9%) compared with women (1.1%). The male-to-female incidence rate ratio peaked at 1.4, indicating a higher risk of IE among men. The incidence of IE was significantly influenced by age, period, and cohort. Both sexes showed increasing risk with age. Risk increased in women born in the late 20th and early 21st centuries compared with earlier cohorts. Men in these later cohorts showed a decreasing risk. Period effects increased from the 1990s to the mid-2000s and then declined, especially among men.

Conclusions: This study reveals a significant increase in the incidence of IE in Spain, especially among older adults and men. These trends reflect demographic changes, medical advances, and changing risk factors.