Angiographic and Clinical Profile of Patients With COVID-19 Referred for Coronary Angiography During SARS-CoV-2 Outbreak: Results From a Collaborative, European, Multicenter Registry.

Data regarding angiographic characteristics, clinical profile, and inhospital outcomes of patients with coronavirus disease 2019 (COVID-19) referred for coronary angiography (CAG) are scarce. This is an observational study analyzing confirmed patients with COVID-19 referred for CAG from 10 European centers. We included 57 patients (mean age: 66 ± 15 years, 82% male) , of whom 18% had previous myocardial infarction (MI) and 29% had renal insufficiency and chronic pulmonary disease. ST-segment elevation myocardial infarction (STEMI) was the most frequent indication for CAG (58%). Coronavirus disease 2019 was confirmed after CAG in 86% and classified as mild in 49%, with 21% fully asymptomatic. A culprit lesion was identified in 79% and high thrombus burden in 42%; 7% had stent thrombosis. At 40 days follow-up, 16 (28%) patients experienced a major adverse cardiovascular event (MACE): 12 deaths (92% noncardiac), 1 MI, 2 stent thrombosis, and 1 stroke. In an European multicenter registry, patients with confirmed COVID-19 infection referred for CAG during the first wave of the severe acute respiratory syndrome coronavirus 2 pandemic presented mostly with STEMI and were predominantly males with comorbidities. Severity of COVID-19 was in general noncritical and 21% were asymptomatic at the time of CAG. Culprit coronary lesions with high thrombus burden were frequently identified, with a rate of stent thrombosis of 7%. The incidence of MACE at 40 days was high (28%), mostly due to noncardiac death.

Update on smoking. Alternatives for the management of patients with cardiovascular risk / Puesta al día del tabaquismo. Alternativas para el manejo del paciente con riesgo cardiovascular

Smoking is the leading cause of morbidity and mortality worldwide and is clearly involved as a cardiovascular risk factor. Smoking has different effects on the cardiovascular system, such as a decrease in nitric oxide, increased inflammatory response, increased adhesion of pro-atherogenic molecules, lipid disturbances, generation of oxidative stress and endothelial dysfunction as can be shown in different biomarkers modifications. Despite the aids currently available for smoking cessation, many smokers are unwilling or unable to achieve this. So alternative tools with potential harm reduction, such as non-combustion tobacco products, could be an option due to the better results they had shown on cardiovascular risk factors. This has led these devices to be taken into account as a risk-modifying tobacco product according to the FDA. (AU)

El tabaquismo es la principal causa de morbimortalidad a nivel mundial y tiene una implicación clara como factor de riesgo cardiovascular. El tabaco posee distintos efectos a nivel cardiovascular, como son una disminución del óxido nítrico, aumento de la respuesta inflamatoria, aumento de la adhesión de moléculas proaterogénicas, modificaciones lipídicas, generación de estrés oxidativo y disfunción endotelial que puede verse reflejada en distintos biomarcadores. A pesar de las ayudas que se poseen actualmente para la cesación tabáquica, parte de la población consumidora no quiere o no lo puede conseguir y es por ello que herramientas alternativas como los productos de reducción del daño y el tabaco por calentamiento podrían ser una opción gracias a los mejores resultados que muestran sobre los factores de riesgo cardiovascular comparado con el cigarrillo convencional. Algo que ha llevado a estos dispositivos para ser considerados como producto de tabaco modificador del riesgo, según la FDA. (AU)

Update on smoking. Alternatives for the management of patients with cardiovascular risk.

Smoking is the leading cause of morbidity and mortality worldwide and is clearly involved as a cardiovascular risk factor. Smoking has different effects on the cardiovascular system, such as a decrease in nitric oxide, increased inflammatory response, increased adhesion of pro-atherogenic molecules, lipid disturbances, generation of oxidative stress and endothelial dysfunction as can be shown in different biomarkers modifications. Despite the aids currently available for smoking cessation, many smokers are unwilling or unable to achieve this. So alternative tools with potential harm reduction, such as non-combustion tobacco products, could be an option due to the better results they had shown on cardiovascular risk factors. This has led these devices to be taken into account as a risk-modifying tobacco product according to the FDA.

Cocaine-Associated ST-Elevation Myocardial Infarction: Different Pathophysiological Mechanisms.

There are many underlying mechanisms for cocaine-associated myocardial infarction, and the culprit must be elucidated for appropriate therapeutic management. Optical coherence tomography provides unique insights when angiography alone has limited diagnostic value; it also aids in the decision between conservative management and revascularization strategy and guides coronary interventions.

Most advisable strategy in search of asymptomatic target organ damage in hypertensive patients / Estrategia óptima de búsqueda de daño de órgano diana asintomático en el hipertenso

Objective: To evaluate the diagnostic potential of seven examinations in order to define the most suitable strategy for target organ damage (TOD) search in hypertensive patients. Methods: This is a descriptive, cross-sectional study. 153 consecutive treated and essential hypertensive patients were enrolled. Patients with established cardiovascular or chronic renal disease (stage ≥ 4) were excluded. TOD search was assessed by: glomerular filtration rate (GFR), albumin/creatinine ratio (ACR), electrocardiogram (ECG), echocardiogram (ECO), ankle-brachial index (ABI), pulse wave velocity (PWV), and carotid ultrasound (intima media thickness and presence of plaques). The rationale of our strategy ought to determine the performance of applying a set of the most widely available tests (GFR, ACR, ABI, ECG) and advise about the optimal sequence of the remaining tests. Results: The sample was 64.4 ± 7.9 years old, 45.8% males. 82.6% of the sample had any TOD at all. The resulting algorithm found a 37% TOD in relation to GFR, ACR, ABI and ECG values. Adding carotid ultrasound added up to 70% of the studied population and properly classified (TOD+/TOD−) 89% of the cohort. When performing PWV, 78% of the patients had been identified as TOD+ and 96% of the population was correctly identified. Contribution of ECO was minor. Conclusion: After running the more widely available explorations (GFR, ACR, ABI, ECG), a step-by-step strategy that included carotid ultrasound, PWV and ECO could be the best sequence for TOD search in asymptomatic hypertensive patientsien

Objetivo: Evaluar el rendimiento diagnóstico de un panel de siete pruebas de determinación de daño de órgano diana (DOD) aplicadas de forma sistemática, a fin de sugerir la estrategia óptima para la búsqueda de DOD en el hipertenso. Método: Estudio descriptivo y transversal. Se incluyeron 153 pacientes diagnosticados de hipertensión esencial bajo tratamiento farmacológico. Se excluyeron pacientes con enfermedad cardiovascular establecida o enfermedad renal crónica estadio ≥4. Se realizó una búsqueda de DOD mediante filtrado glomerular estimado (FGe), índice albúmina creatinina (IAC), hipertrofia ventricular por electrocardiograma (ECG) y ecocardiograma (ECO), índice tobillo brazo (ITB), velocidad de la onda de pulso (VOP) y ecografía carotídea (placas y grosor íntima media). Se propuso una estrategia de búsqueda de DOD en la que tras la realización de las exploraciones más accesibles (FGe, IAC, ITB y ECG) se sugiere la secuencia de exploraciones a realizar con mayor eficacia diagnóstica. Resultados: La edad media fue 64.4 ± 7.9 años, siendo el 45.8% varones. El 82.6% presentó algún tipo de DOD. Según el algoritmo propuesto, las pruebas de mayor accesibilidad diagnosticaron un 37% de DOD en la muestra. Tras añadir la ecografía carotídea, se detectó DOD en el 70%, y el 89% de la población fue apropiadamente clasificada en DOD+/DOD−. La realización de VOP incrementó la prevalencia de DOD hasta el 78%, y el 96% de la muestra fue correctamente clasificada. La contribución de la ECO fue menor. Conclusión: Tras la realización de las exploraciones más accesibles (FGe, IAC, ITB y ECG), la realización sistemática de ecografía carotídea, VOP y ECO podría ser la estrategia óptima para la búsqueda de DOD en el hipertenso

Most advisable strategy in search of asymptomatic target organ damage in hypertensive patients.

OBJECTIVE: To evaluate the diagnostic potential of seven examinations in order to define the most suitable strategy for target organ damage (TOD) search in hypertensive patients. METHODS: This is a descriptive, cross-sectional study. 153 consecutive treated and essential hypertensive patients were enrolled. Patients with established cardiovascular or chronic renal disease (stage ≥4) were excluded. TOD search was assessed by: glomerular filtration rate (GFR), albumin/creatinine ratio (ACR), electrocardiogram (ECG), echocardiogram (ECO), ankle-brachial index (ABI), pulse wave velocity (PWV), and carotid ultrasound (intima media thickness and presence of plaques). The rationale of our strategy ought to determine the performance of applying a set of the most widely available tests (GFR, ACR, ABI, ECG) and advise about the optimal sequence of the remaining tests. RESULTS: The sample was 64.4±7.9 years old, 45.8% males. 82.6% of the sample had any TOD at all. The resulting algorithm found a 37% TOD in relation to GFR, ACR, ABI and ECG values. Adding carotid ultrasound added up to 70% of the studied population and properly classified (TOD+/TOD-) 89% of the cohort. When performing PWV, 78% of the patients had been identified as TOD+ and 96% of the population was correctly identified. Contribution of ECO was minor. CONCLUSION: After running the more widely available explorations (GFR, ACR, ABI, ECG), a step-by-step strategy that included carotid ultrasound, PWV and ECO could be the best sequence for TOD search in asymptomatic hypertensive patients.

Estimación fiable del perímetro de cintura mediante la talla de pantalón / Trouser size as a reliable estimate of waist circumference

No disponible

Influencia de la balneoterapia sobre la presión arterial. Estudio Balneotens / Effect of balneotherapy on blood pressure. The Balneotens study

Objective To determine whether a stay in a treatment center with thermal and sulfur mineral water and topically applied peloids correlates with changes in blood pressure. Design Observational study of a cohort of individuals. Participants A total of 53 individuals. There was no age range and both hypertensive and non-hypertensive individuals were evaluated. Method Before and after balneotherapy, a total of 18 self blood-pressure measurements were taken, as well an isolated clinical blood pressure measurement (seated and standing). We also conducted a survey to evaluate adherence to the Mediterranean diet. Scores ranged from 0 points (non-adherence) and 10 points (complete adherence). Results Clinical measurement: systolic blood pressure (SBP) was 133.0 ± 13.9 mm Hg at baseline and 126.5 ± 12.3 mm Hg (P=.015) at the end of the study. The mean diastolic blood pressure (DBP) was 78.5 ± 7.8 mm Hg at baseline and 75.9 ± 6.5 mm Hg (ns) at the end of the study. Self-monitored blood pressure: The mean SBP after treatment was 2.3 mm Hg lower than before treatment (P=.008). The mean DBP was 1.1 mm Hg lower after treatment than before treatment (ns). Conclusions A 10-day stay in a spa with sulfur water correlates with decreased blood pressure mainly due to the decrease in SBP(AU)

Objetivo Analizar si la estancia en un centro termal y el tratamiento con aguas mineromedicinales sulfuradas y peloides aplicadas por vía tópica se correlaciona con cambios en la presión arterial. Diseño Estudio observacional de una cohorte de individuos. Participantes Un total de 53 individuos. No existe rango de edad y se valoran tanto individuos hipertensos como no hipertensos. Método Previa y posteriormente al tratamiento, balneoterápico se practican un total de 18 automedidas de la presión arterial (AMPA) y una medición clínica aislada (sentado y en bipedestación) de la presión arterial. También se realizó una encuesta para evaluar el seguimiento de la dieta mediterránea valorándose entre 0 puntos (nada de seguimiento) y 10 puntos (total seguimiento). Resultados Medición clínica: La presión arterial sistólica (PAS) al inicio del estudio fue 133,0 ± 13,9 mm Hg y al final de 126,5 ± 12,3 mm Hg (p = 0,015). La presión arterial diastólica (PAD) media al inicio del estudio fue 78,5 ± 7,8 mm Hg y al final 75,9 ± 6,5 mm Hg (ns). AMPA: Al comparar PAS media antes del tratamiento y después se puede ver que la PAS media después del tratamiento es 2,3 mm Hg más baja que antes de dicho tratamiento (p = 0,008). Al comparar PAD media antes del tratamiento y después se determina que la PAD media después del tratamiento es 1,1 mm Hg más baja (ns). Conclusiones La estancia en un balneario de aguas sulfuradas, siguiendo un tratamiento de 10 días se correlaciona con disminución de la presión arterial a expensas de la PAS(AU)