Risks and benefits of sharing patient information on social media: a digital dilemma.

Social media (SoMe) has witnessed remarkable growth and emerged as a dominant method of communication worldwide. Platforms such as Facebook, X (formerly Twitter), LinkedIn, Instagram, TikTok, and YouTube have become important tools of the digital native generation. In the field of medicine, particularly, cardiology, attitudes towards SoMe have shifted, and professionals increasingly utilize it to share scientific findings, network with experts, and enhance teaching and learning. Notably, SoMe is being leveraged for teaching purposes, including the sharing of challenging and intriguing cases. However, sharing patient data, including photos or images, online carries significant implications and risks, potentially compromising individual privacy both online and offline. Privacy and data protection are fundamental rights within European Union treaties, and the General Data Protection Regulation (GDPR) serves as the cornerstone of data protection legislation. The GDPR outlines crucial requirements, such as obtaining 'consent' and implementing 'anonymization', that must be met before sharing sensitive and patient-identifiable information. Additionally, it is vital to consider the patient's perspective and prioritize ethical and social considerations when addressing challenges associated with sharing patient information on SoMe platforms. Given the absence of a peer-review process and clear guidelines, we present an initial approach, a code of conduct, and recommendations for the ethical use of SoMe. In conclusion, this comprehensive review underscores the importance of a balanced approach that ensures patient privacy and upholds ethical standards while harnessing the immense potential of SoMe to advance cardiology practice and facilitate knowledge dissemination.

Prevalencia de obesidad y comorbilidad cardiovascular asociada en los pacientes incluidos en el estudio IBERICAN (Identificación de la poBlación Española de RIesgo CArdiovascular y reNal) / Prevalence of obesity and cardiovascular comorbidity associated in patients included in the IBERICAN study

OBJETIVOS: Analizar la prevalencia de obesidad y su asociación con otros factores de riesgo cardiovascular y la enfermedad cardiovascular en una muestra de pacientes del estudio IBERICAN. MATERIAL Y MÉTODOS: Análisis de la visita de inclusión de los primeros 5.013 individuos reclutados del estudio IBERICAN, estudio longitudinal, observacional y multicéntrico en el que se están incluyendo individuos de 18 a 85 años en las consultas de Atención Primaria en las diferentes comunidades autónomas de España. En este trabajo se definió la obesidad como índice de masa corporal ≥ 30 kg/m2. RESULTADOS: La prevalencia de obesidad fue del 35,7% (IC 95%: 35,0-36,4%), 36,6% en varones y 34,9% en mujeres (p = 0,214), que se incrementa con la edad de manera significativa (p < 0,001). Los obesos presentaron, respecto a los no obesos, mayor prevalencia de hipertensión arterial (62,8 vs. 39,4%; p < 0,001), dislipidemia (56,9 vs. 47,1%; p < 0,001), sedentarismo (40,6 vs. 24,6%; p < 0,001), diabetes mellitus (27,5 vs. 14,8%; p < 0,001), hiperuricemia (23,6 vs. 12,7%; p < 0,001), lesión subclínica de órgano (33,7 vs. 26,5%; p <0,001) y enfermedad cardiovascular (21,2 vs. 15,3%; p < 0,001). El análisis multivariante mostró que las variables asociadas con la obesidad fueron: hipertensión arterial (p < 0,001), hiperuricemia (p < 0,001), sedentarismo (p < 0,001), diabetes mellitus (p < 0,001), edad (p <0,001), bajo nivel educativo (p < 0,001) y menor consumo de tabaco (p < 0,001). CONCLUSIONES: El análisis del estudio IBERICAN muestra que aproximadamente una tercera parte de la población analizada cumple criterios de obesidad y que los factores de riesgo cardiovascular, lesión en órganos diana y enfermedad cardiovascular eran más frecuentes en los obesos

OBJECTIVES: To analyse the prevalence of obesity and its association with other cardiovascular risk factors and cardiovascular disease in a sample of patients from the (Identification of the Spanish population at cardiovascular and renal risk) IBERICAN study. MATERIAL AND METHODS: Analysis of the inclusion visit of the first 5,013 patients of the IBERICAN longitudinal, observational, and multicentre study in which individuals aged 18 to 85 years were included in Primary Care Clinics in the different regions of Spain. In this work obesity was defined as a body mass index ≥ 30 kg/m2. RESULTS: The prevalence of obesity was 35.7% (95% CI: 35.0-36.4%), of which 36.6% were men and 34.9% were women (P = 0.214), and significantly increasing with age (0.001). The obesity had the associated higher prevalence of hypertension (62.8% vs. 39.4%, P < 001), dyslipidaemia (56.9% vs. 47.1%, P <0.001), sedentary lifestyle (40.6% vs. 24.6%, P <.001), diabetes (27.5% vs. 14.8%, P <.001), hyperuricaemia (23.6% vs. 12.7%, P <.001), subclinical organ injury (33.7% vs. 26.5%, P < .001) and cardiovascular disease (21.2% vs. 15.3%, P <.001). The multivariate analysis showed that the variables associated with obesity were: arterial hypertension (P <.001), hyperuricemia (P < .001), sedentary lifestyle (P < .001), diabetes mellitus (P < 0.001), age (P < 0.001), low educational level (P < 0.001) and lower consumption of tobacco (P < 0.001). CONCLUSIONS: The analysis of the IBERICAN study shows that approximately one third of the analysed population meets criteria of obesity and cardiovascular risk factors. Target organ damage and cardiovascular disease were more frequent in obese patients

[Prevalence of obesity and cardiovascular comorbidity associated in patients included in the IBERICAN study]. / Prevalencia de obesidad y comorbilidad cardiovascular asociada en los pacientes incluidos en el estudio IBERICAN (Identificación de la poBlación Española de RIesgo CArdiovascular y reNal).

OBJECTIVES: To analyse the prevalence of obesity and its association with other cardiovascular risk factors and cardiovascular disease in a sample of patients from the (Identification of the Spanish population at cardiovascular and renal risk) IBERICAN study. MATERIAL AND METHODS: Analysis of the inclusion visit of the first 5,013 patients of the IBERICAN longitudinal, observational, and multicentre study in which individuals aged 18 to 85 years were included in Primary Care Clinics in the different regions of Spain. In this work obesity was defined as a body mass index ≥ 30kg/m2. RESULTS: The prevalence of obesity was 35.7% (95% CI: 35.0-36.4%), of which 36.6% were men and 34.9% were women (P=0.214), and significantly increasing with age (0.001). The obesity had the associated higher prevalence of hypertension (62.8% vs. 39.4%, P<001), dyslipidaemia (56.9% vs. 47.1%, P<0.001), sedentary lifestyle (40.6% vs. 24.6%, P<.001), diabetes (27.5% vs. 14.8%, P<.001), hyperuricaemia (23.6% vs. 12.7%, P<.001), subclinical organ injury (33.7% vs. 26.5%, P<.001) and cardiovascular disease (21.2% vs. 15.3%, P<.001). The multivariate analysis showed that the variables associated with obesity were: arterial hypertension (P<.001), hyperuricemia (P<.001), sedentary lifestyle (P<.001), diabetes mellitus (P<0.001), age (P<0.001), low educational level (P<0.001) and lower consumption of tobacco (P<0.001). CONCLUSIONS: The analysis of the IBERICAN study shows that approximately one third of the analysed population meets criteria of obesity and cardiovascular risk factors. Target organ damage and cardiovascular disease were more frequent in obese patients.

Utilidad del calcio arterial coronario para detectar enfermedad arterial coronaria significativa en sujetos asintomáticos / Usefulness of coronary artery calcium for detecting significant coronary artery disease in asymptomatic individuals

Objetivos: Confirmar el valor de la puntuación o score del calcio arterial coronario (CAC) como indicador de enfermedad arterial coronaria (EAC) significativa en población española asintomática, mediante coronariografía no invasiva por tomografía computarizada multidetector (TCMD). Métodos: Estudio retrospectivo de 232 individuos asintomáticos, remitidos para un chequeo de salud cardiovascular que incluyó CAC y TCMD. Resultados: La edad media de los sujetos estudiados fue de 54,6 años (DE: 12,8; 73,3% varones). El valor medio del CAC fue de 117,8 (DE: 277). Los individuos con hipertensión arterial, diabetes mellitus, tabaquismo y con ≥3 factores de riesgo mostraron un CAC significativamente mayor. Un 16,4% de los sujetos se encontraban en el percentil poblacional ≥75 de CAC. La TCMD identificó a 148 individuos (63,8%) con EAC, siendo las lesiones coronarias no significativas en 116 individuos (50%) y significativas (estenosis>50%) en 32 (13,8%). Los sujetos con diabetes, tabaquismo y ≥3 factores de riesgo vascular mostraron una mayor prevalencia de estenosis significativa. Los individuos con estenosis>50% presentaron valores de CAC superiores (352,5 vs. 1; p<0,0001) y los de percentil ≥75 presentaron un alto porcentaje de lesiones (57,9 vs. 5,2%; p<0,0001). Como variables predictoras de EAC significativa destacaron el CAC >300 (OR=10,9; IC95%: 3,35-35,8; p=0,0001), ocupar un percentil ≥75 (OR=5,65; IC95%: 1,78-17,93; p=0,03) y la agrupación de ≥3 factores de riesgo vascular (OR=4,19; IC95%: 1,44-12,14; p=0,008). Conclusión: La cuantificación del CAC es un método eficaz para determinar la extensión y magnitud de la EAC y delimitar la capacidad predictiva de los factores de riesgo tradicionales (AU)

Objectives: To confirm the value of the coronary artery calcium (CAC) score as an indicator of significant coronary artery disease (CAD) in the asymptomatic Spanish population, using noninvasive coronary angiography by multidetector computed tomography (MDCT). Methods: This was a retrospective study of 232 asymptomatic individuals, referred for a cardiovascular health checkup that included CAC and MDCT. Results: Participants’ mean age was 54.6 years (SD±12.8); 73.3% of them were men. The mean CAC value was 117.8 (SD±277). The individuals with arterial hypertension, diabetes mellitus, smoking and 3 or more risk factors had significantly greater CAC scores. Some 16.4% of the participants were in the ≥75 percentile population for CAC. The MDCT identified 148 individuals (63.8%) with CAD; the coronary lesions were not significant in 116 individuals (50%) and were significant (>50% stenosis) in 32 (13.8%). The participants with diabetes, smoking and ≥3 risk vascular factors had a greater prevalence of significant stenosis. The individuals with >50% stenosis had higher CAC values (352.5 vs. 1; P<.0001), and those in the ≥75 percentile had a high percentage of significant lesions (57.9% vs. 5.2%; P<.0001). The predictors of significant CAD were a CAC score >300 (OR=10.9; 95% CI 3.35-35.8; P=.0001), belonging to the ≥75 percentile (OR=5.65; 95% CI 1.78-17.93; P=.03) and having 3 or more vascular risk factors (OR=4.19; 95% CI 1.44-12.14; P=.008). Conclusion: CAC quantification is an effective method for determining the extent and magnitude of CAD and delimiting the predictive capacity of traditional risk factor (AU)

Usefulness of coronary artery calcium for detecting significant coronary artery disease in asymptomatic individuals.

OBJECTIVES: To confirm the value of the coronary artery calcium (CAC) score as an indicator of significant coronary artery disease (CAD) in the asymptomatic Spanish population, using noninvasive coronary angiography by multidetector computed tomography (MDCT). METHODS: This was a retrospective study of 232 asymptomatic individuals, referred for a cardiovascular health checkup that included CAC and MDCT. RESULTS: Participants' mean age was 54.6 years (SD ± 12.8); 73.3% of them were men. The mean CAC value was 117.8 (SD ± 277). The individuals with arterial hypertension, diabetes mellitus, smoking and 3 or more risk factors had significantly greater CAC scores. Some 16.4% of the participants were in the ≥75 percentile population for CAC. The MDCT identified 148 individuals (63.8%) with CAD; the coronary lesions were not significant in 116 individuals (50%) and were significant (>50% stenosis) in 32 (13.8%). The participants with diabetes, smoking and ≥3 risk vascular factors had a greater prevalence of significant stenosis. The individuals with >50% stenosis had higher CAC values (352.5 vs. 1; P<.0001), and those in the ≥75 percentile had a high percentage of significant lesions (57.9% vs. 5.2%; P<.0001). The predictors of significant CAD were a CAC score >300 (OR=10.9; 95% CI 3.35-35.8; P=.0001), belonging to the ≥75 percentile (OR=5.65; 95% CI 1.78-17.93; P=.03) and having 3 or more vascular risk factors (OR=4.19; 95% CI 1.44-12.14; P=.008). CONCLUSION: CAC quantification is an effective method for determining the extent and magnitude of CAD and delimiting the predictive capacity of traditional risk factors.

Características clínicas y pronóstico de pacientes con enfermedad cerebrovascular crónica (estudio ICBAR) / Clinical features and prognosis of patients with chronic cerebrovascular disease (ICBAR study)

Introducción. Los pacientes con enfermedad cerebrovascular (ECV) son un grupo de muy alto riesgo cardiovascular, ademásde por su propia patología vascular, probablemente por un inadecuado control de factores de riesgo y por la presencia de comorbilidades.Pacientes y métodos. Estudio multicéntrico, con participación de 34 médicos de atención primaria y registro de característicasde 473 pacientes con historia de episodio de ECV que precisó hospitalización. Tras seguimiento clínico de la cohorte, se analizaron reingresos hospitalarios, mortalidad y causas. Resultados. La edad media de los pacientes (el 52% varones) fue de 75 ± 10 años, y los factores de riesgo más prevalentesfueron hipertensión arterial (79%), dislipidemia (66%), obesidad (43%) y diabetes (29%). El 68% de los pacientes tenía diagnóstico de ictus y el 32%, de ataque isquémico transitorio. El tiempo medio transcurrido desde el primer episodio de ECV fue de 6,6 ± 5,5 años. Presentaban situación de dependencia el 29% y sólo un tercio mostraron buen control tensionaly lipídico. Durante un seguimiento de 8,2 ± 2,3 meses, el 7,2% de los pacientes sufrió algún episodio cardiovascular (muerte u hospitalización), del que resultaron determinantes independientes la insuficiencia cardíaca previa (hazard ratio, HR = 2,74; intervalo de confianza del 95%, IC 95% = 1,3-5,9), la miocardiopatía (HR = 3,32; IC 95% = 1,4-8,2), laanemia (HR = 3,09; IC 95% = 1,6-6,2), la insuficiencia renal (HR = 2,4; IC 95% = 1,0-5,6), la situación de dependencia (HR = 2,57; IC 95% = 1,3-5,7) y los ingresos cardiovasculares en el último año (HR = 3,05; IC 95% = 1,5-5,6).Conclusiones. Los pacientes con ECV seguidos en el ámbito de atención primaria presentan una prevalencia elevada y un escaso grado de control de hipertensión arterial. Su pronóstico está condicionado por comorbilidades cardiovasculares ysecuelas de su patología cerebrovascular (AU)

Introduction. Patients with cerebrovascular disease (CVD) are a group with a very high cardiovascular risk, in addition tothat arising from their own vascular pathology, probably due to an inadequate control of risk factors and owing to the presence of comorbidities. Patients and methods. This research consisted in a multi-centre study involving the collaboration of 34 primary carephysicians and recording of the features of 473 patients with a previous history of a CVD event that required hospitalisation.After a clinical follow-up of the cohort, hospital readmissions, mortality and causes were analysed.Results. The mean age of patients (52% males) was 75 ± 10 years and the most prevalent risk factors were arterial hypertension (79%), dyslipidaemia (66%), obesity (43%) and diabetes (29%). Sixty-eight per cent of patients had been diagnosed with stroke and 32% with transient ischaemic attack. The mean amount of time elapsed since the first CVDevent was 6.6 ± 5.5 years. Twenty-nine per cent of patients had a situation of dependence and only one third showed good blood pressure and lipid control. During a follow-up lasting 8.2 ± 2.3 months, 7.2% of patients suffered some kind of cardiovascular event (death or hospitalisation), which independent determinants were found to be previous heart failure (hazard ratio, HR = 2.74; 95% confidence interval, CI 95% = 1.3-5.9); cardiomyopathy (HR = 3.32; CI 95% = 1.4-8.2); anaemia (HR = 3.09; CI 95% = 1.6-6.2); renal failure (HR = 2.4; CI 95% = 1.0-5.6); the situation of dependence (HR = 2.57; CI 95% =1.3-5.7) and cardiovascular admissions over the past year (HR = 3.05; CI 95% = 1.5-5.6).Conclusions. Patients with CVD followed up in the area of primary care present a high prevalence of arterial hypertension and little is done to control it. Their prognosis is conditioned by cardiovascular comorbidities and sequelae of their cerebrovascular disease (AU)

Correlation between myocardial fibrosis and the occurrence of atrial fibrillation in hypertrophic cardiomyopathy: a cardiac magnetic resonance imaging study.

Cardiac magnetic resonance imaging (CMR) in hypertrophic cardiomyopathy (HCM) often shows delayed contrast enhancement (DE) representing regions of focal myocardial fibrosis. Atrial fibrillation (AF) is a commonly reported complication of HCM. We determined the relationship between the presence of left ventricular myocardial fibrosis (LVMF) detected by DE-CMR and the occurrence AF in a series of patients with HCM. 67 patients with HCM (47 males; mean age 50.1+/-18.5 years) were studied by CMR measuring mass of LVMF, left ventricular mass, volume and function, and left atrial (LA) area. AF was present in 17 (25%) patients. LVMF was observed in 57% of patients. AF was significantly more frequent in patients who also showed LVMF, compared with the group without LVMF (42.1% vs. 3.4%, respectively; p<0.0001). LA size was larger in patients showing DE (LA area: 37.4+/-11.1 vs. 25.9+/-6.8 cm(2); respectively, p=0.0001). AF in HCM is related with myocardial fibrosis detected by DE-CMR and dilatation of the LA. This fact adds to the proven adverse prognostic value of myocardial fibrosis in HCM, thus, reinforcing the usefulness of this technique in the assessment of these patients.