Vivencio Barrios - Academia.edu (original) (raw)
Papers by Vivencio Barrios
American Journal of Hypertension, Nov 1, 2001
groups (subgroup ["A"]-patients with development of SCD and subgroup ["B"]-patients without devel... more groups (subgroup ["A"]-patients with development of SCD and subgroup ["B"]-patients without development of SCD). All patient were evalueted after clinical stabilization by daily monitoring of arterial hypertension. Arterial hypertension was compared to other SCD risk factors by multivariate regression analysis of Cox. Results: during 2 years observations, SCD occured at 22 patients (33,3 %) in group I. At comparison of parameters of daily average systolic arterial, diastolic arterial and pulse hypertension between subgroups IA and IB of authentic differences was not observed. In group II SCD was developed at 20 patients (15,0 %). The patients of subgroup IIA, at which was developed SCD had authentically more high level daily average sistolic hypertension (145,0Ϯ9,6 mmhg), than patients without development of SCD (122Ϯ7,5 mmhg, p Ͻ 0,05, ORϭ2,3(1,5-2,7)). Conclusion: the increased level of systolic arterial hypertension is an independent risk factor of development of SCD at the patients of elderly age, who had unstable angina.
Journal of hypertension, 2012
Current Medical Research and Opinion, Oct 12, 2021
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Oct 1, 2018
Metabolic syndrome (MetS), a disorder with a high and growing prevalence, is a recognized risk fa... more Metabolic syndrome (MetS), a disorder with a high and growing prevalence, is a recognized risk factor for cardiovascular disease (CVD) and type 2 diabetes. It is a constellation of clinical and metabolic risk factors that include abdominal obesity, dyslipidemia, glucose intolerance, and hypertension. Unfortunately, MetS is typically underrecognized, and there is great heterogeneity in its management, which can hamper clinical decision-making and be a barrier to achieving the therapeutic goals of CVD and diabetes prevention. Although no single treatment for MetS as a whole currently exists, management should be targeted at treating the conditions contributing to it and possibly reversing the risk factors. All this justifies the need to develop recommendations that adapt existing knowledge to clinical practice in our healthcare system. In this regard, professionals from different scientific societies who are involved in the management of the different MetS components reviewed the available scientific evidence focused basically on therapeutic aspects of MetS and developed a consensus document to establish recommendations on therapeutic goals that facilitate their homogenization in clinical decision-making.
European Heart Journal, Aug 1, 2017
density lipoprotein cholesterol (LDL-C) levels (p=0,001). Such duplex scanning indicators as inti... more density lipoprotein cholesterol (LDL-C) levels (p=0,001). Such duplex scanning indicators as intima-media thickness in systole, intima-media thickness increasing, carotid stenosis degree, significantly different between groups with and without atherosclerotic plaques in carotid arteries (p=0,001, p=0,025 and p=0,001, respectively). Correlation analysis detect statistically significant positive correlations between Lp-PLA2 levels and total cholesterol (p=0,000, p=0,01, p=0,001, respectively); between Lp-PLA2 levels and LDL-C (p=0,000, p=0,03, p=0,000, respectively) in all 3 groups. Besides, it was determined that Lp-PLA2 levels positively correlates with intima-media thickness of carotid arteries increasing in patients of 2 and 3 groups (p=0,03 and p=0,000, respectively), which is not found in 1 group, where patients were without carotid atherosclerosis. Conclusion: A significant relationship between elevated Lp-PLA2 and the degree of carotid stenosis, and increased levels of total cholesterol, LDL-C. Elevated levels of Lp-PLA2 in serum, combined with the presence of increasing the degree of carotid stenosis, levels of total cholesterol, LDL-C, can be considered as probable risk factor for cardiovascular events.
European Heart Journal, Aug 1, 2017
Latest on STEMI 1203 (p=0.13 and p=0.05, respectively) and female gender was not significantly as... more Latest on STEMI 1203 (p=0.13 and p=0.05, respectively) and female gender was not significantly associated with mortality (HR 1.0 p=0.9 for female gender, HR 2.00 p<0.01 for age) Conclusions: Data from nationwide registry of acute MI patients does not support existence of a significant gender difference in time to intervention. Apparent higher mortality of women in non-balanced sample may be explained by different age and clinical risk profile of female cases.
Future Cardiology, May 1, 2021
Patients with Type 2 Diabetes (T2D) are at risk of developing macrovascular (cardiac, cerebrovasc... more Patients with Type 2 Diabetes (T2D) are at risk of developing macrovascular (cardiac, cerebrovascular, peripheral arterial disease) and microvascular (nephropathy, neuropathy, retinopathy) complications. Glycemic control improves only microvascular outcomes. However, some SGLT-2 inhibitors and GLP1-R agonists have proven beneficial in macrovascular conditions. Canagliflozin is an SGLT2 inhibitor that provides sustained reductions in HbA1c, blood pressure and weight. Remarkably, as CANVAS program and CREDENCE trial demonstrated, canagliflozin promotes significant reductions in the frequency of atherosclerotic cardiovascular events, hospitalizations for heart failure and renal outcomes. In addition, real-world studies have confirmed the results of clinical trials in clinical practice. Therefore, canagliflozin should be considered a first-line therapy in the management of T2D patients in order to reduce both micro- and macrovascular complications.
Journal of Clinical Medicine
Patients with Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are at high risk ... more Patients with Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are at high risk of developing major adverse cardiovascular events (MACE). This is a multicenter, retrospective, and observational study performed in Spain aimed to characterize these patients in a real-world setting. Unstructured data from the Electronic Health Records were extracted by EHRead®, a technology based on Natural Language Processing and machine learning. The association between new MACE and the variables of interest were investigated by univariable and multivariable analyses. From a source population of 2,184,662 patients, we identified 4072 adults diagnosed with T2DM and CAD (62.2% male, mean age 70 ± 11). The main comorbidities observed included arterial hypertension, hyperlipidemia, and obesity, with metformin and statins being the treatments most frequently prescribed. MACE development was associated with multivessel (Hazard Ratio (HR) = 2.49) and single coronary vessel disease (HR = 1.7...
Medicina General y de Familia, May 20, 2022
European Heart Journal: Acute Cardiovascular Care, 2021
Aims Temporary cardiac pacing with active-fixation leads (TPAFL) using a reusable permanent pacem... more Aims Temporary cardiac pacing with active-fixation leads (TPAFL) using a reusable permanent pacemaker generator has been shown to be safer than lead systems without fixation. However, TPAFL requires the off-label use of pacemaker leads and generators. We designed a fastening system to ensure the safety and efficacy of the procedure: the KronoSafe System®. To demonstrate the safety and effectiveness of the KronoSafe System® for temporary pacing in a series of patients receiving TPAFL. Methods and results A prospective cohort of 20 patients undergoing TPAFL between August 2019 and June 2020 was recruited in a Spanish region. The temporary pacemaker was implanted through jugular access and secured with the KronoSafe System®. R-wave detection, lead impedance, and capture threshold were assessed every 48 h. Complications associated with the procedure or occurring during TPAFL were recorded. There were no complications associated with temporary pacing, and the therapy was effective in all...
Diabetic Medicine, 2021
To assess the efficacy of glucagon‐like peptide‐1 receptor agonists (GLP1‐RAs) and sodium‐glucose... more To assess the efficacy of glucagon‐like peptide‐1 receptor agonists (GLP1‐RAs) and sodium‐glucose co‐transporter 2 (SGLT2) inhibitors, administered without metformin on cardiovascular outcomes in type 2 diabetes patients.
Revista Española de Cardiología, 2021
Revista Española de Cardiología, 2020
Resumen Introduccion y objetivos El objetivo del analisis es evaluar la carga y el coste de las c... more Resumen Introduccion y objetivos El objetivo del analisis es evaluar la carga y el coste de las complicaciones del mal control de la anticoagulacion en pacientes con fibrilacion auricular no valvular (FANV) tratados con antagonistas de la vitamina K (AVK) en Espana. Metodos Un modelo analitico estimo las diferencias anuales en ictus isquemico, hemorragia grave, muertes, costes y anos potenciales de vida perdidos en pacientes con mal control (tiempo en rango terapeutico Resultados Se analizo una cohorte hipotetica de 594.855 pacientes, el 48,3% de ellos con mal control de la anticoagulacion, con un aumento de 2.321 ictus isquemicos, 2.236 hemorragias graves y 14.463 muertes, y un coste incremental anual de 29.578.306 euros desde la perspectiva del SNS y 75.737.451 euros desde la perspectiva social. El impacto anual de la mortalidad fue de 170.502 anos potenciales de vida perdidos. Los resultados del analisis de sensibilidad muestran que el coste anual alcanzaria los 97.787.873 euros desde la perspectiva social. Conclusiones El mal control de la anticoagulacion con AVK conlleva un gran impacto en perdida de salud y aumento del gasto del SNS.
Journal of Comparative Effectiveness Research, 2020
Aim: To analyze the perception of anticoagulation with dabigatran in patients with nonvalvular at... more Aim: To analyze the perception of anticoagulation with dabigatran in patients with nonvalvular atrial fibrillation previously treated with vitamin K antagonists over a 6-month period. Materials & methods: This is a prospective, noninterventional, noncontrolled, multicenter study. To assess patients’ perceptions, PACT-Q2 questionnaire was completed. Results: Six hundred and fifty nine patients (73.1 ± 9.4 years, CHA 2 DS 2 -VASc 3.6 ± 1.6) were included. At baseline, the convenience and satisfaction scores were 60.9 ± 24.9 and 49.9 ± 17.7, respectively. The scores significantly increased along the study. Convenience score was higher in males and in patients with low–moderate thromboembolic risk. Satisfaction score was higher in females. Only 8.0% of patients discontinued dabigatran (3.7% due to side effects). Conclusion: Convenience and satisfaction scores for nonvalvular atrial fibrillation patients treated with dabigatran at 6 months were significantly better than with previous v...
European Heart Journal, 2018
CS (56.8% vs 72.0%; p=0.061), minimal (8.2% and 7.9%) and mean (11.7% and 11.2%; p=0.856) values ... more CS (56.8% vs 72.0%; p=0.061), minimal (8.2% and 7.9%) and mean (11.7% and 11.2%; p=0.856) values of CS were comparable in the groups. The values of moderate and severe CS were higher in the group with type D (10.3% and 12.5% vs 5.8% and 2.9%, respectively; p=0.043 and p=0.011). The greatest differences in CS were revealed in the system of left coronary artery, namely in anterior interventricular branch (189.1±12.5 with type D vs 155.6±16.7 without type D; p=0.011) and circumflex branch (121.7±30.6 vs 63.8±21.7; p=0.032). According to the results of multivariate analysis the independent predictors of moderate and severe CS detection remained such indicators as the presence of CAD (OR 1.24 95% CI 1.01-1.53; p=0.04), diabetes mellitus (DM) (OR 1.28; 95% CI 1.80-3.24 p=0.02) and type D personality (OR 1.49; 95% CI 2.01-2.29 p=0.01). Conclusion: The independent factors associated with moderate and severe coronary arteries calcification besides the present of CAD were DM and type D personality. The data of the present study show that even just the presence of type D personality is associated with an increase in coronary arteries calcification level and that the interventions for the correction of negative manifestations of this psychological type are relevant from this point of view either.
JACC: Heart Failure, 2019
Objective: Our objective is to describe the short-term, health status benefits of ARNI initiation... more Objective: Our objective is to describe the short-term, health status benefits of ARNI initiation in patients with heart failure and reduced ejection fraction (HFrEF). Background: While sacubitril/valsartan, a neprilysin inhibitor (ARNI), improved patients' health status (compared with enalapril) at 8 months in PARADIGM-HF, the early impact of ARNI on patients' symptoms, function and quality of life is unknown. Methods: Health status was assessed with the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12) in 3,918 outpatients with HFrEF (LVEF ≤ 40%) across 140 US centers in the CHAMP-HF registry. ARNI was initiated in 508 patients, who were matched 1:2 to 1,016 patients not started on ARNI (no-ARNI) using a non-parsimonious time-dependent propensity
Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia, 2017
Invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP) represent an important health... more Invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP) represent an important health problem among aging adults and those with certain underlying pathologies and some diseases, especially immunosuppressed and some immunocompetent subjects, who are more susceptible to infections and present greater severity and worse evolution. Among the strategies to prevent IPD and PP, vaccination has its place, although vaccination coverage in this group is lower than desirable. Nowadays, there are 2 vaccines available for adults. Polysacharide vaccine (PPV23), used in patients aged 2 and older since decades ago, includes a greater number of serotypes (23), but it does not generate immune memory, antibody levels decrease with time, causes an immune tolerance phenomenon, and have no effect on nasopharyngeal colonization. PCV13 can be used from children 6 weeks of age to elderly and generates an immune response more powerful than PPV23 against most of the 13 serotypes included in it. In...
Revista clinica espanola, Jan 5, 2015
Cardiovascular diseases are the leading cause of death for women, especially ischaemic heart dise... more Cardiovascular diseases are the leading cause of death for women, especially ischaemic heart disease, which is still considered a man's disease. In Spain, there are various registries on ischaemic heart disease, although none are exclusively for women. The objectives of the SIRENA study were to describe the clinical profile of women with ischaemic heart disease treated in cardiology consultations, to estimate its prevalence of cardiovascular risk factors and understand its clinical management. A multicentre observational study was conducted with a sample of 631 women with stable ischaemic heart disease, consecutively included during cardiology consultations. Forty-one researchers from all over Spain participated in the study. The mean age was 68.5 years. The clinical presentation was in the form of acute coronary syndrome in up to 67.2% of the patients. The prevalence of cardiovascular risk factors was high (77.7% of the patients had hypertension, 40.7% had diabetes and 68% had ...
Journal of Hypertension, 2004
Expert Review of Cardiovascular Therapy, 2013
Dihydropyridinic calcium channel blockers are a subclass of antihypertensive drugs with growing s... more Dihydropyridinic calcium channel blockers are a subclass of antihypertensive drugs with growing significance in the therapeutic armamentarium. Early studies in the 1990s had aroused certain fears with regard to the safety of the first drugs from this class, since they had a fast onset of action and a short half-life, and thus they were associated with reflex adrenergic activation. New molecules with long half-lives and high lipophilia have shown safety and efficacy in the control of blood pressure, as well as in the reduction of several end points related to hypertension. Moreover, these new molecules, which block special subtypes of calcium channel receptors, provide drugs not only with an action profile that goes beyond the antihypertensive effect, but also with a lower rate of side effects. Therefore, in the light of new studies that include calcium channel blockers alone or in combination, these agents will probably be used even more extensively for the management of hypertension in the following years.
American Journal of Hypertension, Nov 1, 2001
groups (subgroup ["A"]-patients with development of SCD and subgroup ["B"]-patients without devel... more groups (subgroup ["A"]-patients with development of SCD and subgroup ["B"]-patients without development of SCD). All patient were evalueted after clinical stabilization by daily monitoring of arterial hypertension. Arterial hypertension was compared to other SCD risk factors by multivariate regression analysis of Cox. Results: during 2 years observations, SCD occured at 22 patients (33,3 %) in group I. At comparison of parameters of daily average systolic arterial, diastolic arterial and pulse hypertension between subgroups IA and IB of authentic differences was not observed. In group II SCD was developed at 20 patients (15,0 %). The patients of subgroup IIA, at which was developed SCD had authentically more high level daily average sistolic hypertension (145,0Ϯ9,6 mmhg), than patients without development of SCD (122Ϯ7,5 mmhg, p Ͻ 0,05, ORϭ2,3(1,5-2,7)). Conclusion: the increased level of systolic arterial hypertension is an independent risk factor of development of SCD at the patients of elderly age, who had unstable angina.
Journal of hypertension, 2012
Current Medical Research and Opinion, Oct 12, 2021
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Oct 1, 2018
Metabolic syndrome (MetS), a disorder with a high and growing prevalence, is a recognized risk fa... more Metabolic syndrome (MetS), a disorder with a high and growing prevalence, is a recognized risk factor for cardiovascular disease (CVD) and type 2 diabetes. It is a constellation of clinical and metabolic risk factors that include abdominal obesity, dyslipidemia, glucose intolerance, and hypertension. Unfortunately, MetS is typically underrecognized, and there is great heterogeneity in its management, which can hamper clinical decision-making and be a barrier to achieving the therapeutic goals of CVD and diabetes prevention. Although no single treatment for MetS as a whole currently exists, management should be targeted at treating the conditions contributing to it and possibly reversing the risk factors. All this justifies the need to develop recommendations that adapt existing knowledge to clinical practice in our healthcare system. In this regard, professionals from different scientific societies who are involved in the management of the different MetS components reviewed the available scientific evidence focused basically on therapeutic aspects of MetS and developed a consensus document to establish recommendations on therapeutic goals that facilitate their homogenization in clinical decision-making.
European Heart Journal, Aug 1, 2017
density lipoprotein cholesterol (LDL-C) levels (p=0,001). Such duplex scanning indicators as inti... more density lipoprotein cholesterol (LDL-C) levels (p=0,001). Such duplex scanning indicators as intima-media thickness in systole, intima-media thickness increasing, carotid stenosis degree, significantly different between groups with and without atherosclerotic plaques in carotid arteries (p=0,001, p=0,025 and p=0,001, respectively). Correlation analysis detect statistically significant positive correlations between Lp-PLA2 levels and total cholesterol (p=0,000, p=0,01, p=0,001, respectively); between Lp-PLA2 levels and LDL-C (p=0,000, p=0,03, p=0,000, respectively) in all 3 groups. Besides, it was determined that Lp-PLA2 levels positively correlates with intima-media thickness of carotid arteries increasing in patients of 2 and 3 groups (p=0,03 and p=0,000, respectively), which is not found in 1 group, where patients were without carotid atherosclerosis. Conclusion: A significant relationship between elevated Lp-PLA2 and the degree of carotid stenosis, and increased levels of total cholesterol, LDL-C. Elevated levels of Lp-PLA2 in serum, combined with the presence of increasing the degree of carotid stenosis, levels of total cholesterol, LDL-C, can be considered as probable risk factor for cardiovascular events.
European Heart Journal, Aug 1, 2017
Latest on STEMI 1203 (p=0.13 and p=0.05, respectively) and female gender was not significantly as... more Latest on STEMI 1203 (p=0.13 and p=0.05, respectively) and female gender was not significantly associated with mortality (HR 1.0 p=0.9 for female gender, HR 2.00 p<0.01 for age) Conclusions: Data from nationwide registry of acute MI patients does not support existence of a significant gender difference in time to intervention. Apparent higher mortality of women in non-balanced sample may be explained by different age and clinical risk profile of female cases.
Future Cardiology, May 1, 2021
Patients with Type 2 Diabetes (T2D) are at risk of developing macrovascular (cardiac, cerebrovasc... more Patients with Type 2 Diabetes (T2D) are at risk of developing macrovascular (cardiac, cerebrovascular, peripheral arterial disease) and microvascular (nephropathy, neuropathy, retinopathy) complications. Glycemic control improves only microvascular outcomes. However, some SGLT-2 inhibitors and GLP1-R agonists have proven beneficial in macrovascular conditions. Canagliflozin is an SGLT2 inhibitor that provides sustained reductions in HbA1c, blood pressure and weight. Remarkably, as CANVAS program and CREDENCE trial demonstrated, canagliflozin promotes significant reductions in the frequency of atherosclerotic cardiovascular events, hospitalizations for heart failure and renal outcomes. In addition, real-world studies have confirmed the results of clinical trials in clinical practice. Therefore, canagliflozin should be considered a first-line therapy in the management of T2D patients in order to reduce both micro- and macrovascular complications.
Journal of Clinical Medicine
Patients with Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are at high risk ... more Patients with Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are at high risk of developing major adverse cardiovascular events (MACE). This is a multicenter, retrospective, and observational study performed in Spain aimed to characterize these patients in a real-world setting. Unstructured data from the Electronic Health Records were extracted by EHRead®, a technology based on Natural Language Processing and machine learning. The association between new MACE and the variables of interest were investigated by univariable and multivariable analyses. From a source population of 2,184,662 patients, we identified 4072 adults diagnosed with T2DM and CAD (62.2% male, mean age 70 ± 11). The main comorbidities observed included arterial hypertension, hyperlipidemia, and obesity, with metformin and statins being the treatments most frequently prescribed. MACE development was associated with multivessel (Hazard Ratio (HR) = 2.49) and single coronary vessel disease (HR = 1.7...
Medicina General y de Familia, May 20, 2022
European Heart Journal: Acute Cardiovascular Care, 2021
Aims Temporary cardiac pacing with active-fixation leads (TPAFL) using a reusable permanent pacem... more Aims Temporary cardiac pacing with active-fixation leads (TPAFL) using a reusable permanent pacemaker generator has been shown to be safer than lead systems without fixation. However, TPAFL requires the off-label use of pacemaker leads and generators. We designed a fastening system to ensure the safety and efficacy of the procedure: the KronoSafe System®. To demonstrate the safety and effectiveness of the KronoSafe System® for temporary pacing in a series of patients receiving TPAFL. Methods and results A prospective cohort of 20 patients undergoing TPAFL between August 2019 and June 2020 was recruited in a Spanish region. The temporary pacemaker was implanted through jugular access and secured with the KronoSafe System®. R-wave detection, lead impedance, and capture threshold were assessed every 48 h. Complications associated with the procedure or occurring during TPAFL were recorded. There were no complications associated with temporary pacing, and the therapy was effective in all...
Diabetic Medicine, 2021
To assess the efficacy of glucagon‐like peptide‐1 receptor agonists (GLP1‐RAs) and sodium‐glucose... more To assess the efficacy of glucagon‐like peptide‐1 receptor agonists (GLP1‐RAs) and sodium‐glucose co‐transporter 2 (SGLT2) inhibitors, administered without metformin on cardiovascular outcomes in type 2 diabetes patients.
Revista Española de Cardiología, 2021
Revista Española de Cardiología, 2020
Resumen Introduccion y objetivos El objetivo del analisis es evaluar la carga y el coste de las c... more Resumen Introduccion y objetivos El objetivo del analisis es evaluar la carga y el coste de las complicaciones del mal control de la anticoagulacion en pacientes con fibrilacion auricular no valvular (FANV) tratados con antagonistas de la vitamina K (AVK) en Espana. Metodos Un modelo analitico estimo las diferencias anuales en ictus isquemico, hemorragia grave, muertes, costes y anos potenciales de vida perdidos en pacientes con mal control (tiempo en rango terapeutico Resultados Se analizo una cohorte hipotetica de 594.855 pacientes, el 48,3% de ellos con mal control de la anticoagulacion, con un aumento de 2.321 ictus isquemicos, 2.236 hemorragias graves y 14.463 muertes, y un coste incremental anual de 29.578.306 euros desde la perspectiva del SNS y 75.737.451 euros desde la perspectiva social. El impacto anual de la mortalidad fue de 170.502 anos potenciales de vida perdidos. Los resultados del analisis de sensibilidad muestran que el coste anual alcanzaria los 97.787.873 euros desde la perspectiva social. Conclusiones El mal control de la anticoagulacion con AVK conlleva un gran impacto en perdida de salud y aumento del gasto del SNS.
Journal of Comparative Effectiveness Research, 2020
Aim: To analyze the perception of anticoagulation with dabigatran in patients with nonvalvular at... more Aim: To analyze the perception of anticoagulation with dabigatran in patients with nonvalvular atrial fibrillation previously treated with vitamin K antagonists over a 6-month period. Materials & methods: This is a prospective, noninterventional, noncontrolled, multicenter study. To assess patients’ perceptions, PACT-Q2 questionnaire was completed. Results: Six hundred and fifty nine patients (73.1 ± 9.4 years, CHA 2 DS 2 -VASc 3.6 ± 1.6) were included. At baseline, the convenience and satisfaction scores were 60.9 ± 24.9 and 49.9 ± 17.7, respectively. The scores significantly increased along the study. Convenience score was higher in males and in patients with low–moderate thromboembolic risk. Satisfaction score was higher in females. Only 8.0% of patients discontinued dabigatran (3.7% due to side effects). Conclusion: Convenience and satisfaction scores for nonvalvular atrial fibrillation patients treated with dabigatran at 6 months were significantly better than with previous v...
European Heart Journal, 2018
CS (56.8% vs 72.0%; p=0.061), minimal (8.2% and 7.9%) and mean (11.7% and 11.2%; p=0.856) values ... more CS (56.8% vs 72.0%; p=0.061), minimal (8.2% and 7.9%) and mean (11.7% and 11.2%; p=0.856) values of CS were comparable in the groups. The values of moderate and severe CS were higher in the group with type D (10.3% and 12.5% vs 5.8% and 2.9%, respectively; p=0.043 and p=0.011). The greatest differences in CS were revealed in the system of left coronary artery, namely in anterior interventricular branch (189.1±12.5 with type D vs 155.6±16.7 without type D; p=0.011) and circumflex branch (121.7±30.6 vs 63.8±21.7; p=0.032). According to the results of multivariate analysis the independent predictors of moderate and severe CS detection remained such indicators as the presence of CAD (OR 1.24 95% CI 1.01-1.53; p=0.04), diabetes mellitus (DM) (OR 1.28; 95% CI 1.80-3.24 p=0.02) and type D personality (OR 1.49; 95% CI 2.01-2.29 p=0.01). Conclusion: The independent factors associated with moderate and severe coronary arteries calcification besides the present of CAD were DM and type D personality. The data of the present study show that even just the presence of type D personality is associated with an increase in coronary arteries calcification level and that the interventions for the correction of negative manifestations of this psychological type are relevant from this point of view either.
JACC: Heart Failure, 2019
Objective: Our objective is to describe the short-term, health status benefits of ARNI initiation... more Objective: Our objective is to describe the short-term, health status benefits of ARNI initiation in patients with heart failure and reduced ejection fraction (HFrEF). Background: While sacubitril/valsartan, a neprilysin inhibitor (ARNI), improved patients' health status (compared with enalapril) at 8 months in PARADIGM-HF, the early impact of ARNI on patients' symptoms, function and quality of life is unknown. Methods: Health status was assessed with the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12) in 3,918 outpatients with HFrEF (LVEF ≤ 40%) across 140 US centers in the CHAMP-HF registry. ARNI was initiated in 508 patients, who were matched 1:2 to 1,016 patients not started on ARNI (no-ARNI) using a non-parsimonious time-dependent propensity
Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia, 2017
Invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP) represent an important health... more Invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP) represent an important health problem among aging adults and those with certain underlying pathologies and some diseases, especially immunosuppressed and some immunocompetent subjects, who are more susceptible to infections and present greater severity and worse evolution. Among the strategies to prevent IPD and PP, vaccination has its place, although vaccination coverage in this group is lower than desirable. Nowadays, there are 2 vaccines available for adults. Polysacharide vaccine (PPV23), used in patients aged 2 and older since decades ago, includes a greater number of serotypes (23), but it does not generate immune memory, antibody levels decrease with time, causes an immune tolerance phenomenon, and have no effect on nasopharyngeal colonization. PCV13 can be used from children 6 weeks of age to elderly and generates an immune response more powerful than PPV23 against most of the 13 serotypes included in it. In...
Revista clinica espanola, Jan 5, 2015
Cardiovascular diseases are the leading cause of death for women, especially ischaemic heart dise... more Cardiovascular diseases are the leading cause of death for women, especially ischaemic heart disease, which is still considered a man's disease. In Spain, there are various registries on ischaemic heart disease, although none are exclusively for women. The objectives of the SIRENA study were to describe the clinical profile of women with ischaemic heart disease treated in cardiology consultations, to estimate its prevalence of cardiovascular risk factors and understand its clinical management. A multicentre observational study was conducted with a sample of 631 women with stable ischaemic heart disease, consecutively included during cardiology consultations. Forty-one researchers from all over Spain participated in the study. The mean age was 68.5 years. The clinical presentation was in the form of acute coronary syndrome in up to 67.2% of the patients. The prevalence of cardiovascular risk factors was high (77.7% of the patients had hypertension, 40.7% had diabetes and 68% had ...
Journal of Hypertension, 2004
Expert Review of Cardiovascular Therapy, 2013
Dihydropyridinic calcium channel blockers are a subclass of antihypertensive drugs with growing s... more Dihydropyridinic calcium channel blockers are a subclass of antihypertensive drugs with growing significance in the therapeutic armamentarium. Early studies in the 1990s had aroused certain fears with regard to the safety of the first drugs from this class, since they had a fast onset of action and a short half-life, and thus they were associated with reflex adrenergic activation. New molecules with long half-lives and high lipophilia have shown safety and efficacy in the control of blood pressure, as well as in the reduction of several end points related to hypertension. Moreover, these new molecules, which block special subtypes of calcium channel receptors, provide drugs not only with an action profile that goes beyond the antihypertensive effect, but also with a lower rate of side effects. Therefore, in the light of new studies that include calcium channel blockers alone or in combination, these agents will probably be used even more extensively for the management of hypertension in the following years.