Arturo Carratalá - Academia.edu (original) (raw)

Papers by Arturo Carratalá

European Journal of Internal Medicine, Jun 1, 2023

PubMed, 1983

A total of 200 cases of thalassaemia trait, 102 of F thalassaemia and 98 of A2 thalassaemia were ... more A total of 200 cases of thalassaemia trait, 102 of F thalassaemia and 98 of A2 thalassaemia were studied, evaluating haematometric, and morphological aspects of both groups. Significantly higher values were found in F thalassaemia for PCV, MCV and MCH, with 33.5% of women and 52% of men being found anaemic in F thalassaemia and 45% of women and 62% of men in A2 thalassaemia. Asthenia was usually present in A2 thalassaemia more so in women 50.9% as compared to 25% in man. Only 4% of F thalassaemia carriers were affected by asthenia. Cholecystectomy had been performed on 10% of the A2 thalassaemia group and on 5% of the F thalassaemia thamia group. Both groups show a high proportion of red cells with basophilic stippling (80%), the groups being morphologically indistinguishable. Intrafamilial segregation of Hb F values affected 22% of families carriers of F thalassaemia, whereas only 8% of families carriers of A2 thalassaemia showed segregation of HbA2 values. The values obtained in this study were compared with those of other authors.

medRxiv (Cold Spring Harbor Laboratory), Jun 23, 2020

doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by pee... more doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.

Journal of Clinical and Experimental Cardiology, 2012

Background: Homeostasis Model Assessment (HOMA) is a widely used index to study the role of insul... more Background: Homeostasis Model Assessment (HOMA) is a widely used index to study the role of insulin resistance (IR).Our objective has been to clarify if IR would predict short-term mortality in patients with acute myocardial infarction (AMI). Methods: Observational prospective study in 518 consecutive patients with a clinical diagnosis of AMI with or without diabetes mellitus. We evaluated glucose and insulin levels at baseline in order to estimate IR and mortality. Association between IR and mortality was assessed by means of the Cox regression analysis, and discriminative accuracy of the multivariate model with the Harrell's C statistic. Results: In-hospital mortality was 6% (32/518 of patients). Using ROC curve, in non-diabetic patients, IR index >2.2 was the best cutoff for predicting in-hospital mortality with a sensitivity of 71% and specificity of 80% (AUC=0,710) (p=0,008). An IR>2.2 was present in 27% (140 patients) and this group had higher rates of NYHA>2, Body Mass Index ≥30, hypertension and diabetes mellitus. Harrell's C statistic of 0.967 was obtained when an IR>2.2 was used in the model to predict mortality. Furthermore, mortality rose as IR values increased, from 3% IR<2 to 18% when IR>3.5. In multivariate adjusted hazard ratio analysis IR>2.2 was an independent factor for in-hospital mortality (HR=3.4; 1.2-9) (p=0.017) in addition to age >70 years (HR=3.2; 1.04-10) (p=0.04) and Killip class >1 (HR=4; 1.4-14) (p=0.012). Conclusions: Beyond traditional cardiovascular risk factors, insulin resistance as assessed by HOMA index, seems to strongly influence prognosis and could be included in the routine clinical work up of patients with acute myocardial infarction.

Expert Review of Molecular Diagnostics, May 27, 2023

44 Congreso de la Sociedad Española de Endoscopia Digestiva Abstracts Publication

Journal of Clinical Pathology, 2014

Traditionally, laboratories&amp;amp;amp;amp;amp;amp;amp;amp;#39; turnaround times (TAT) h... more Traditionally, laboratories&amp;amp;amp;amp;amp;amp;amp;amp;#39; turnaround times (TAT) have been calculated by only considering analytical or intralaboratory steps. The measure of the postanalytical impact in TAT has barely been studied and, more specifically, the running time from when finalised results are available to when clinicians make their first enquiry with an electronic medical record. During May-June of 2013, two &amp;amp;amp;amp;amp;amp;amp;amp;#39;Times&amp;amp;amp;amp;amp;amp;amp;amp;#39; were collected from our laboratory information system for all the priority requests coming from our day hospitals: &amp;amp;amp;amp;amp;amp;amp;amp;#39;Validation time&amp;amp;amp;amp;amp;amp;amp;amp;#39; (TV), as the request report time with full verified results and &amp;amp;amp;amp;amp;amp;amp;amp;#39;Enquiry time&amp;amp;amp;amp;amp;amp;amp;amp;#39; (TQ), as the time when the first consult was made via electronic medical record. We classified requests in groups depending on time results, and TQ-TV (percentiles) were calculated for each group. 654 (69%) requests were consulted by clinicians before 15 : 00 on the same day with available results. 191 (20%) were consulted after 15 : 00 and had complete results as well (p50 (TQ-TV): 5 days) while 61 (7%) were never consulted (up to 31/12/2013). 39 (4%) requests were finally consulted before 15 : 00 h with no available results, but the average time difference between validation and enquiry was 31 min. The results obtained lead us to reconsider the TAT established with our day hospitals in order to know if priority has to be reviewed or if there are failures in follow-up results. &amp;amp;amp;amp;amp;amp;amp;amp;#39;Enquiry time&amp;amp;amp;amp;amp;amp;amp;amp;#39; appears to be a powerful tool in detecting these issues and shows that TATs are no longer just a &amp;amp;amp;amp;amp;amp;amp;amp;#39;laboratory problem&amp;amp;amp;amp;amp;amp;amp;amp;#39;.

Journal of the American College of Cardiology, 2012

The aim of this study was to investigate the metabolomic profile of acute myocardial ischemia (MI... more The aim of this study was to investigate the metabolomic profile of acute myocardial ischemia (MIS) using nuclear magnetic resonance spectroscopy of peripheral blood serum of swine and patients undergoing angioplasty balloon-induced transient coronary occlusion. Background Biochemical detection of MIS is a major challenge. The validation of novel biosignatures is of utmost importance. Methods High-resolution nuclear magnetic resonance spectroscopy was used to profile 32 blood serum metabolites obtained (before and after controlled ischemia) from swine (n ϭ 9) and patients (n ϭ 20) undergoing transitory MIS in the setting of planned coronary angioplasty. Additionally, blood serum of control patients (n ϭ 10) was sequentially profiled. Preliminary clinical validation of the developed metabolomic biosignature was undertaken in patients with spontaneous acute chest pain (n ϭ 30). Results Striking differences were detected in the blood profiles of swine and patients immediately after MIS. MIS induced early increases (10 min) of circulating glucose, lactate, glutamine, glycine, glycerol, phenylalanine, tyrosine, and phosphoethanolamine; decreases in choline-containing compounds and triacylglycerols; and a change in the pattern of total, esterified, and nonesterified fatty acids. Creatine increased 2 h after ischemia. Using multivariate analyses, a biosignature was developed that accurately detected patients with MIS both in the setting of angioplasty-related MIS (area under the curve 0.94) and in patients with acute chest pain (negative predictive value 95%). Conclusions This study reports, to the authors' knowledge, the first metabolic biosignature of acute MIS developed under highly controlled coronary flow restriction. Metabolic profiling of blood plasma appears to be a promising approach for the early detection of MIS in patients. (

Journal of the American Heart Association, 2016

Background Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid ( ALA ),... more Background Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid ( ALA ), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results We longitudinally evaluated 7202 participants in the PRE vención con DI eta MED iterránea ( PREDIMED ) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption ...

European Heart Journal: Acute Cardiovascular Care, 2014

Background: Acute glycometabolic derangement in non-diabetic patients with acute myocardial infar... more Background: Acute glycometabolic derangement in non-diabetic patients with acute myocardial infarction (AMI) has been reported with discrepant prognostic results. The aim of the present study was to assess the prognostic impact of glycated haemoglobin (HbA1c) levels, reflecting long-term glycometabolic disturbance, in a population of patients without known diabetes mellitus. Methods: We examined 601 consecutive prospective patients diagnosed with AMI and unknown diabetes mellitus. We analysed metabolic function as a stratified variable using three groups of patients according to HbA1c: Group 1 (< 5.5%): 222 patients (37%); Group 2 (5.5 to 6.4%): 337 patients (56%); Group 3 (>6.4%): 42 patients (7%). Association between HbA1c groups and classic cardiovascular risk factor and in-hospital outcomes were assessed through univariate and multivariate analysis. Results: In-hospital mortality was 5% (32/601 patients). Higher HbA1c was associated with poor glycometabolic control, older patients, obesity, hypertension, Killip's class>1, increased heart rate, initial bundle branch block, atrial fibrillation and higher mortality during follow-up. In a multivariate adjusted risk, in-hospital mortality was associated with age (odds ratio (OR)= 1.056; 1-1.1; p=0.006), Killip's class>1 (OR=2.4; 1-6.1; p=0.05) and HbA1c (OR=1.5; 1.15-1.9; p=0.002). Hypertension (OR=0.39; 0.18-0.87; p=0.022) and angiotensin-converting enzyme inhibitors (OR=0.28; 0.12-0.69; p=0.005) were protective factors. Conclusions: HbA1c is an important risk marker in the absence of a history of diabetes mellitus in patients with AMI. The optimal management strategy in these patients may contribute to decreased in-hospital mortality.

Journal of Investigative Medicine, 2017

Familial combined hyperlipidemia (FCH) is a primary atherogenic dyslipidemia with insulin resista... more Familial combined hyperlipidemia (FCH) is a primary atherogenic dyslipidemia with insulin resistance and increased cardiovascular risk. Plasminogen activator inhibitor type 1 (PAI-1) and myeloperoxidase (MPO) activity are associated with proinflammatory and atherothrombotic risk. Our aim was to study the role played by PAI-1 and MPO activity in the carotid atherosclerosis prevalence in FCH subjects. 36 FCH unrelated subjects (17 women) were matched by age and body weight with 36 healthy normolipidemic subjects (19 female). Blood lipids, glucose, insulin, insulin resistance (homeostasis model assessment (HOMA)), MPO, and PAI-1 were determined in both groups. Carotid intima media thickness (IMT) was measured by the same investigator by standardized protocol. No differences in age, body mass index (BMI) or waist circumference were observed between the two groups. HOMA and PAI-1 values were higher in the FCH group, reaching statistical significance in those subjects with insulin resista...

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Archivos espanoles de urologia, 2015

OBJECTIVES PSA is a frequently used marker in the daily clinical practice for the diagnosis and m... more OBJECTIVES PSA is a frequently used marker in the daily clinical practice for the diagnosis and management of prostate cancer. We analysed the use of PSA in our health department in patients with and without prostate cancer diagnosis. METHODS The registry of all PSA petitions in our health department during 2011 and 2012 was used. Demographic data were used to establish each year's population and the data corresponding to the prevalence of prostate cancer patients, performing a descriptive study. Thus, the use of PSA in patients with or without prostate cancer was studied. RESULTS 25.700 PSA petitions are issued annually in our department over a total of 67.000 males older than 45. This entails a cost of 332.815 Euros annually. Within the group of patients with no prostate cancer diagnosis, it was noticed that the percentage of individuals with at least one annual PSA petition per decade of age is of 23% in males in their fifties, 40% in their sixties, 46% in their seventies, an...

European Heart Journal, Aug 1, 2017

Methods: We prospectively enrolled unselected patients presenting with syncope to the emergency d... more Methods: We prospectively enrolled unselected patients presenting with syncope to the emergency department (ED) in a diagnostic multicenter study. EDprobability of cardiac syncope was quantified by the treating ED-physician using a visual analogue scale (VAS). Pro-hormones were measured in a blinded fashion. Two independent cardiologists adjudicated the final diagnosis based on all information becoming available during clinical work-up including 1-year followup. Results: Among 769 patients, cardiac syncope was the adjudicated final diagnosis in 125 patients (16%). Plasma concentrations of MRproANP, CTproET1, copeptin, and MR-proADM were all significantly higher in patients with cardiac syncope compared to patients with other causes (p<0.001, Figure 1). The diagnostic accuracy for cardiac syncope as quantified by the area under the receiveroperator characteristics curve (AUC) were 0.80 (95% CI 0.76-0.84), 0.69 (95% CI 0.64-0.74), 0.58 (95% CI 0.52-0.63) and 0.68 (95% CI 0.63-0.73), respectively. In conjunction with the ED probability MRproANP, but not the other pro-hormone, improved the AUC to 0.90 (95% CI 0.87-0.93), which was significantly higher than for the ED probability alone (p=0.003). MR-proANP also proved an independent predictor in multivariate analysis (p<0.01). Conclusion: The use of MRproANP significantly improves the early detection of cardiac syncope among unselected patients presenting to the ED with syncope.

International Journal of Cardiology, 2014

Revista Española de Cardiología, 2021

Resumen Introduccion y objetivos El antigeno carbohidrato 125 (CA125) se ha mostrado util para la... more Resumen Introduccion y objetivos El antigeno carbohidrato 125 (CA125) se ha mostrado util para la estratificacion del riesgo de los pacientes ingresados por insuficiencia cardiaca aguda (ICA). Se intenta determinar un punto de corte para identificar a los pacientes con bajo riesgo de muerte y muerte/reingreso por insuficiencia cardiaca 1 mes tras el ingreso por ICA. Metodos La cohorte de derivacion incluyo a 3.231 pacientes con ICA consecutivos. Se identificaron valores de corte de CA125 con un valor predictivo negativo (VPN) del 90% y una sensibilidad de hasta el 85%. La idoneidad de estos puntos de corte y el riesgo de muerte/reingreso al mes se evaluaron mediante el metodo de Royston-Parmar. Se selecciono el mejor punto de corte y se valido en una cohorte del BIOSTAT-CHF (n = 1.583). Resultados En la cohorte de derivacion, la mediana [intervalo intercuartilico] de CA125 fue 57 [25,3-157] U/ml. El punto de corte optimo fue Conclusiones En pacientes ingresados por ICA, el CA125

Journal of Clinical Medicine, 2020

This study aimed to assess the time course of circulating neutrophil and lymphocyte counts and th... more This study aimed to assess the time course of circulating neutrophil and lymphocyte counts and their ratio (NLR) in ST-segment elevation myocardial infarction (STEMI) and coronavirus disease (COVID)-19 and explore their associations with clinical events and structural damage. Circulating neutrophil, lymphocyte and NLR were sequentially measured in 659 patients admitted for STEMI and in 103 COVID-19 patients. The dynamics detected in STEMI (within a few hours) were replicated in COVID-19 (within a few days). In both entities patients with events and with severe structural damage displayed higher neutrophil and lower lymphocyte counts. In both scenarios, higher maximum neutrophil and lower minimum lymphocyte counts were associated with more events and more severe organ damage. NLR was higher in STEMI and COVID-19 patients with the worst clinical and structural outcomes. A canonical deregulation of the immune response occurs in STEMI and COVID-19 patients. Boosted circulating innate (n...