Impacto pronóstico de los factores de riesgo cardiovascular en pacientes ingresados por síndrome coronario agudo / Prognostic impact of cardiovascular risk factors in patients admitted for acute coronary syndrome

Introducción y objetivos: Las medidas de prevención cardiovascular hacen hincapié en la importancia del control de factores de riesgo cardiovascular (FRCV). Sin embargo, los estudios más recientes arrojan datos desalentadores cuyo impacto está por determinar. El objetivo de este estudio fue analizar la repercusión que los distintos FRCV y su grado de control tienen sobre el pronóstico de los pacientes tras un síndrome coronario agudo. Pacientes y métodos: Se recogieron datos epidemiológicos, farmacológicos y sobre el control de FRCV de 1.689 pacientes consecutivos que ingresaron durante 2018-2020 por síndrome coronario agudo en un hospital de tercer nivel. Finalmente, se calculó la tasa de eventos adversos cardiovasculares mayores. Resultados: Los pacientes que ingresaron por síndrome coronario agudo fueron predominantemente hombres, con índice de masa corporal>25kg/m2, fumadores (o exfumadores) y con un deficiente control de FRCV (50% para hipertensión y diabetes, y 35% en dislipidemia), especialmente aquellos pacientes con antecedentes personales de cardiopatía isquémica. Se encontró una infrautilización de fármacos útiles para dicho control. Se observó una relación directamente proporcional entre el número de FRCV (o su mal control) con la incidencia de eventos adversos cardiovasculares mayores a 2 años, siendo la hipertensión el factor con mayor repercusión cardiovascular. El confinamiento por SARS-CoV-2 empeoró el grado de control de FRCV y el pronóstico cardiovascular. Conclusión: Hay un importante margen de mejora en el control de los FRCV, que se traduciría en un beneficio pronóstico de los pacientes con cardiopatía isquémica. Es preciso intensificar las medidas de prevención y promoción de salud cardiovascular. (AU)

Introduction and objectives: Cardiovascular prevention measures place the emphasis on controlling cardiovascular risk factors (CVRF). However, the most recent studies provide disappointing data, the impact of which remains to be determined. The objective of this study was to analyse the impact that the different CVRFs, and their degree of control, have on the prognosis of patients after acute coronary syndrome. Patients and methods: Epidemiological, pharmacological, and CVRF control data were collected from 1,689 consecutive patients admitted from 2018 to 2020 for acute coronary syndrome to a tertiary hospital. Finally, the rate of major adverse cardiovascular events was calculated. Results: The patients admitted for acute coronary syndrome were predominantly men, with body mass index>25Kg/m2, smokers (or former smokers) and with poor CVRF control (50% for hypertension and diabetes and 35% for dyslipidaemia), especially those patients with a personal history of ischaemic heart disease. An underutilisation of useful drugs for CVRF control was found. A directly proportional relationship was observed between the number of CVRFs (or their poor control) and the incidence of major adverse cardiovascular events at 2 years, hypertension being the factor with the greatest cardiovascular impact. The SARS-CoV-2 lockdown worsened the degree of CVRF control and cardiovascular prognosis. Conclusion: There is still room for improvement in the control of CVRF, which would translate into a prognostic benefit for patients with ischaemic heart disease. The implementation of cardiovascular prevention campaigns seems essential. (AU)

Seasonality of coastal upwelling trends in the Mauritania-Senegalese region under RCP8.5 climate change scenario.

The Mauritania-Senegalese upwelling region (MSUR), the southernmost region of the Canary current upwelling system, is well-known for its coastal productivity and the key role it plays in enriching the oligotrophic open ocean through the offshore transport of the upwelled coastal waters. The great ecological and socio-economic importance makes it necessary to evaluate the impact of climate change on this region. Hence, our main objective is to examine the climate change signal over the MSUR with a high resolution regional climate system model (RCSM) forced by the Earth system model MPI-ESM-LR under RCP8.5 scenario. This RCSM has a regional atmosphere model (REMO) coupled to a global ocean model (MPIOM) with high-resolution in the MSUR, which allows us to evaluate the wind pattern, the ocean stratification, as well as the upwelling source water depth, while maintaining an ocean global domain. Under RCP8.5 scenario, our results show that the upwelling favourable winds of the northern MSUR are year-round intensified, while the southern MSUR presents a strengthening in winter and a weakening in March-April. Along with changes in the wind pattern, we found increased ocean stratification in the spring months. In those months southern MSUR presents a shallowing of the upwelling source water depth associated to changes in both mechanisms. However, in winter the whole MSUR shows a deepening of the upwelling source water depth due to the intensification of the upwelling favourable winds, with the increased ocean stratification playing a secondary role. Our results demonstrate the need to evaluate the future evolution of coastal upwelling systems taking into account their latitudinal and seasonal variability and the joint contribution of both mechanisms.

Prevalence, risk factors and evolution of diabetes mellitus after treatment in primary aldosteronism. Results from the SPAIN-ALDO registry.

PURPOSE: To evaluate the prevalence, risk factors and evolution of diabetes mellitus (DM) after targeted treatment in patients with primary aldosteronism (PA). METHODS: A retrospective multicenter study of PA patients in follow-up at 27 Spanish tertiary hospitals (SPAIN-ALDO Register). RESULTS: Overall, 646 patients with PA were included. At diagnosis, 21.2% (n = 137) had DM and 67% of them had HbA1c levels < 7%. In multivariate analysis, family history of DM (OR 4.00 [1.68-9.53]), the coexistence of dyslipidemia (OR 3.57 [1.51-8.43]) and advanced age (OR 1.04 per year of increase [1.00-1.09]) were identified as independent predictive factors of DM. Diabetic patients were on beta blockers (46.7% (n = 64) vs. 27.5% (n = 140), P < 0.001) and diuretics (51.1% (n = 70) vs. 33.2% (n = 169), p < 0.001) more frequently than non-diabetics. After a median follow-up of 22 months [IQR 7.5-63.0], 6.9% of patients developed DM, with no difference between those undergoing adrenalectomy and those treated medically (HR 1.07 [0.49-2.36], p = 0.866). There was also no significant difference in the evolution of glycemic control between DM patients who underwent surgery and those medically treated (p > 0.05). CONCLUSION: DM affects about one quarter of patients with PA and the risk factors for its development are common to those of the general population. Medical and surgical treatment provides similar benefit in glycemic control in patients with PA and DM.

2-years retrospective observational case-control study on survival and marginal bone loss of implants in patients with hereditary coagulopathies.

BACKGROUND: Evaluating 2-years implant loss and marginal bone loss in patients with hereditary coagulopathies, comparing with a healthy control group. MATERIAL AND METHODS: 37 implants in 13 patients (17 haemophilia A, 20 Von-Willebrand disease) versus 26 implants in 13 healthy patients. Data measured through Lagervall-Jansson index (after surgery, at prosthetic loading, at 2 years). STATISTICS: Chi-square, Haberman's, ANOVA, Mann-Whitney-U. Significance p<0.05. RESULTS: Haemorrhagic accidents in 2 coagulopathies patients (non-statistical differences). Hereditary coagulopathies patients suffered more hepatitis (p<0.05), HIV (p<0.05) and less previous periodontitis (p<0.01). Non-statistical differences in marginal bone loss among groups. 2 implants were lost in the hereditary coagulopathies and none in the control group (non-statistical differences). Hereditary coagulopathies patients had longer (p<0.001), and narrower implants (p<0.05) placed. 43.2% external prosthetic connection in hereditary coagulopathies patients (p<0.001); change of prosthetic platform more frequent in control group (p<0.05). 2 implants lost: external connection (p<0.05). Survival rate 96.8% (hereditary coagulopathies 94.6%, control group 100%). CONCLUSIONS: Implant and marginal bone loss at 2 years is similar in patients with hereditary coagulopathies and control group. Precautions should be taken on the treatment for hereditary coagulopathies patients, through prior haematological protocol. Implant loss only occurred in in a patient with Von-Willebrand´s disease.

Dihydroartemisinin-induced ferroptosis in acute myeloid leukemia: links to iron metabolism and metallothionein.

Artemisinin is an anti-malarial drug that has shown anticancer properties. Recently, ferroptosis was reported to be induced by dihydroartemisinin (DHA) and linked to iron increase. In the current study, we determined the effect of DHA in leukemic cell lines on ferroptosis induction and iron metabolism and the cytoprotective effect triggered in leukemic cells. We found that treatment of DHA induces early ferroptosis by promoting ferritinophagy and subsequent iron increase. Furthermore, our study demonstrated that DHA activated zinc metabolism signaling, especially the upregulation of metallothionein (MT). Supportingly, we showed that inhibition MT2A and MT1M isoforms enhanced DHA-induced ferroptosis. Finally, we demonstrated that DHA-induced ferroptosis alters glutathione pool, which is highly dependent on MTs-driven antioxidant response. Taken together, our study indicated that DHA activates ferritinophagy and subsequent ferroptosis in AML and that MTs are involved in glutathione regenerating and antioxidant response.

[Prognostic impact of cardiovascular risk factors in patients admitted for acute coronary syndrome]. / Impacto pronóstico de los factores de riesgo cardiovascular en pacientes ingresados por síndrome coronario agudo.

INTRODUCTION AND OBJECTIVES: Cardiovascular prevention measures place the emphasis on controlling cardiovascular risk factors (CVRF). However, the most recent studies provide disappointing data, the impact of which remains to be determined. The objective of this study was to analyse the impact that the different CVRFs, and their degree of control, have on the prognosis of patients after acute coronary syndrome. PATIENTS AND METHODS: Epidemiological, pharmacological, and CVRF control data were collected from 1,689 consecutive patients admitted from 2018 to 2020 for acute coronary syndrome to a tertiary hospital. Finally, the rate of major adverse cardiovascular events was calculated. RESULTS: The patients admitted for acute coronary syndrome were predominantly men, with body mass index>25Kg/m2, smokers (or former smokers) and with poor CVRF control (50% for hypertension and diabetes and 35% for dyslipidaemia), especially those patients with a personal history of ischaemic heart disease. An underutilisation of useful drugs for CVRF control was found. A directly proportional relationship was observed between the number of CVRFs (or their poor control) and the incidence of major adverse cardiovascular events at 2 years, hypertension being the factor with the greatest cardiovascular impact. The SARS-CoV-2 lockdown worsened the degree of CVRF control and cardiovascular prognosis. CONCLUSION: There is still room for improvement in the control of CVRF, which would translate into a prognostic benefit for patients with ischaemic heart disease. The implementation of cardiovascular prevention campaigns seems essential.

Polyunsaturated ω3 fatty acids prevent the cardiac hypertrophy in hypertensive rats.

It has been demonstrated that supplementation with the two main omega 3 polyunsaturated fatty acids (ω3 FAs), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA), leads to modifications in the cardiac physiology. ω3 FAs can affect the membrane's lipid composition, as well as proteins' location and/or function. The Na+/H+ exchanger (NHE1) is an integral membrane protein involved in the maintenance of intracellular pH and its hyperactivity has been associated with the development of various cardiovascular diseases such as cardiac hypertrophy. Our aim was to determine the effect of ω3 FAs on systolic blood pressure (SBP), lipid profiles, NHE1 activity, and cardiac function in spontaneously hypertensive rats (SHR) using Wistar rats (W) as normotensive control. After weaning, the rats received orally ω3 FAs (200 mg/kg body mass/day/ 4 months). We measured SBP, lipid profiles, and different echocardiography parameters, which were used to calculate cardiac hypertrophy index, systolic function, and ventricular geometry. The rats were sacrificed, and ventricular cardiomyocytes were obtained to measure NHE1 activity. While the treatment with ω3 FAs did not affect the SBP, lipid analysis of plasma revealed a significant decrease in omega-6/omega-3 ratio, correlated with a significant reduction in left ventricular mass index in SHR. The NHE1 activity was significantly higher in SHR compared with W. While in W the NHE1 activity was similar in both groups, a significant decrease in NHE1 activity was detected in SHRs supplemented with ω3 FAs, reaching values comparable with W. Altogether, these findings revealed that diet supplementation with ω3 FAs since early age prevents the development of cardiac hypertrophy in SHR, perhaps by decreasing NHE1 activity, without altering hemodynamic overload.

TLR4 polymorphism and haplotype are associated with obesity and lipid profile in young population: a pilot study.

BACKGROUND: The single nucleotide polymorphisms in the TLR4 gene can decrease or increase the response to lipopolysaccharide, increasing the susceptibility to inflammatory diseases, affecting the expression or receptor function by inducing a low-grade chronic inflammatory response. PURPOSE: The objective of this study was to evaluate the association of SNPs - 2570 A > G (rs2737190), - 2081 G > A (rs10983755), 896 A > G (rs 4986790), and 1196 C > T (rs4986791) of the TLR4 gene with obesity and metabolic alterations in the young population. RESULTS: In this study, it was found that the carriers of the heterozygous genotype of the SNPs - 2081 G > A, 896 A > G, and 1196 C > T confer a higher risk of developing obesity (OR = 3.73, p = 0.018; OR = 5.66, p = 0.014, and OR = 8.95, p = 0.014, respectively). Also, with the lipid profile, the SNP - 2081 G > A was associated with total cholesterol (TC) ≥ 200 mg/dL (OR = 3.91, p = 0.020) and Kannel index > 3% (OR = 4.00, p = 0.008). The SNP 896 A > G was associated with LDL-c ≥ 100 mg/dL (OR = 3.64, p = 0.040) and Kannel index > 3% (OR = 4.33, p = 0.016), and the SNP 1196 C > T was associated with TC ≥ 200 mg/dL (OR = 4.37, p = 0.048), Castelli index > 4.5/> 5% (OR = 5.33, p = 0.016), and Kannel index > 3% (OR = 16.00, p = 0.001). Finally, the AGGT haplotype was associated with Castelli index > 4.5/> 5% (OR = 5.40, p = 0.015) and Kannel index > 3% (OR = 10.46, p < 0.001), and the AAAC haplotype was associated with obesity (OR = 3.56, p = 0.020), TC ≥ 200 mg/dL (OR = 4.04, p = 0.007), LDL-c ≥ 100 mg/dL (OR = 2.98, p = 0.030) and Kannel index > 3% (OR = 4.20, p = 0.002). CONCLUSION: The heterozygous genotype of the SNPs - 2081 G > A, 896 A > G and 1196 C > T of the TLR4 gene was associated with altered lipid profile and development of obesity in young university students of Guerrero State, Mexico.

FNDC5/Irisin polymorphisms are associated with osteopenia in postmenopausal Mayan-Mestizo women.

OBJECTIVE: This study aimed to analyze the association between rs3480 and rs16835198 of FNDC5/Irisin and their haplotypes with variations in bone mineral density (BMD) and osteopenia/osteoporosis in postmenopausal Mayan-Mestizo women. METHODS: We studied 547 postmenopausal women of Maya-Mestizo origin. BMD was measured in the lumbar spine and total hip by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. rs3480 and rs16835198 of FNDC5/Irisin were studied using real-time PCR allelic discrimination. Differences between the means of BMD according to genotype were analyzed with covariance. Allele frequency differences were assessed by χ2 and logistic regression was used to test for associations. Pairwise linkage disequilibrium between polymorphisms was calculated by direct correlation r2, and haplotype analysis was conducted. RESULTS: Under a recessive model, we observed a significant association of rs3480 with the presence of osteopenia at the total hip and femoral neck (p = 0.008 and p = 0.003, respectively). For rs16835198, we found an association with osteopenia at the total hip and femoral neck in a dominant model (p = 0.043 and p = 0.009, respectively). CONCLUSIONS: We found an association of rs3480 with risk to present osteopenia at the total hip and femoral neck, while rs16835198 was associated as a protector for presence of osteopenia only at the femoral neck.

Cracking the immune fingerprint of metal-organic frameworks.

The human body is in a never-ending chess game against pathogens. When the immune system, our natural defence tool, is weakened, these organisms are able to escape, overcoming the body's contingency plan, which results in the body going into a pathological state. To overcome this checkmate status, emerging nanomedicines have been successfully employed as one of the best tactics for boosting the immune response, manipulating the body's defence tools for the specific recognition/elimination of pathological cells via the active ingredient delivery. However, the vast majority of these drug-delivery systems (DDS) are considered to be exclusively passive vehicles, with nanoscale metal-organic frameworks (nanoMOFs) attracting a great deal of attention due to their versatility and ability to carry and deliver exceptional drug payloads and to modulate their biological bypass. Nonetheless, their intrinsic immunogenicity character has been never addressed. Considering the immense possibilities that nanoMOFs offer as a treatment platform, the present study aimed to unveil the immunological fingerprint of MOFs, including an in-deep evaluation of the cellular oxidation balance, the inflammation and recruitment of immune cells and the precise Th1/Th2 cytokine profile that is triggered. This study aims to gain insights that will make more feasible the design of customized immune-active MOF nanoplatforms according to targeted diseases, as the next ace up immune system sleeve.

Physical units to report intensity of electromagnetic wave.

The aim of this work is to propose a consensus to scientific community that handles personal exposimeters, which measure intensity of an electromagnetic wave (W/m2). To express the intensity of an electromagnetic wave there is a duality in the way of expressing it. Some scientists prefer to use W/m2 while others use V/m, which is a unit of the electric field. There is also a duality in the name, sometimes it is called it power flux density and some other times, wave intensity. We believe that this second name is more appropriate from the point of view of physics. We suggest expressing intensity of an electromagnetic wave in W/m2 instead of giving the value of their electric field which is measured in V/m. There is a quadratic relation between electric field and intensity of the wave, and it is necessary to do a mathematical operation, so in our opinion, it is preferable to use W/m2 which directly gives us the value of the measured intensity. Furthermore, if the intensity is very low, it may be expressed in µW/m2 and with only three significant figures, due to sensitivity of the current exposimeters used.

Comment on: What is the radiation before 5G? A correlation study between measurements in situ and in real time and epidemiological indicators in Vallecas, Madrid, by I. López, N. Félix, M. Rivera, A. Alonso, and C. Maestú.

We have read the article recently published by Lopez et al., 2020 (Lopez et al., 2021). This study aimed to find a possible relationship, if any, between exposure to RF-EMF with some health indicators such as sleep, headache, and fatigue collected through surveys, using maximum electromagnetic radiation peak-to-peak measurements. And after a detailed analysis of the study, we want to make some comments on said publication to clarify some aspects.

Prótesis total de rodilla primaria en un paciente con ruptura no reciente del tendón rotuliano, tratado en 2 tiempos quirúrgicos / Total primary knee prosthesis in a patient with non-recent rupture of the patellar tendon, treated in 2 surgical times

Resumen: Introducción: La ruptura de tendón rotuliano en pacientes mayores se relaciona con enfermedades sistémicas como la artritis reumatoide, el lupus eritematoso y aquéllos con tratamiento prolongado con corticoides o antibioticoterapia. Es ocasionado por traumatismo con la rodilla en flexión acompañado de una contracción del cuádriceps o fuerza excéntrica, su diagnóstico puede omitirse hasta en 38% de los casos. El tratamiento en las rupturas no recientes es más complejo ya que después de 45 días de la lesión ocurre retracción del cuádriceps, fibrosis, formación de adherencias e hipotrofia muscular. Las opciones de tratamiento son variadas utilizando desde autoinjertos hasta injertos sintéticos con túneles óseos y anclas de fijación. Reporte de caso: Hombre de 71 años con ruptura del tendón rotuliano de 18 años de evolución tratado en dos tiempos, comenzando por la reparación del aparato extensor con tendones de la pata de ganso preservando la inserción de los mismos y realizando después prótesis total de rodilla en un segundo tiempo quirúrgico y mostramos su evolución.

Abstract: Introduction: Patellar tendon rupture has a higher prevalence in older patients related to systemic diseases such as rheumatoid arthritis, lupus erythematosus and those with prolonged treatment with corticosteroids or antibiotic therapy. It is caused by trauma with the knee in flexion accompanied by a contraction of the quadriceps or eccentric force, the diagnosis can be omitted in up to 38% of cases. Treatment of non-recent tendon ruptures is more difficult with end-to-end techniques are complicated and difficult to perform 45 days after injury due to quadriceps retraction, fibrosis, adhesion formation, and muscle hypotrophy. Treatment options are varied, ranging from autografts to synthetic grafts using bone tunnels and fixation anchors. Case report: Our case is a 71-year-old patient with an 18-year-old patellar tendon rupture treated in two stages, starting with repairing the extensor apparatus with pes anserinus tendons, preserving their insertion and subsequently performing total knee replacement in a second surgical time and we show its evolution.

Cáncer y riesgo cardiovascular / Cancer and cardiovascular risk

Los pacientes que sobreviven a un cáncer tienen una menor supervivencia a largo plazo, en parte debido al incremento de las enfermedades cardiovasculares (ECV). Hasta el 30% de los fallecimientos de pacientes con cáncer pueden ser de causa cardiovascular. El cáncer puede causar ateroesclerosis por diferentes mecanismos, los más frecuentes son las secuelas de los fármacos antitumorales, la radioterapia y el trasplante de células hematopoyéticas. Los factores de riesgo cardiovascular son prevalentes en los supervivientes de cáncer. Estos pacientes deberían ser considerados en alto riesgo cardiovascular. Se aconseja recomendar hábitos de vida saludables y un control estricto de los factores de riesgo. Hay una necesidad inmediata para ampliar la disponibilidad de servicios preventivos cardiovasculares de cara a reducir los efectos adversos tardíos de la quimioterapia y la radiación. La intervención precoz podría ayudar a mejorar el perfil de riesgo cardiovascular. (AU)

Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile (AU)

Mycoremediation of an agricultural salty soil contaminated with endosulfan by Penicillium crustosum: and agronomic bioassays with Phaseolus leptostachyus.

The fungus Penicillium crustosum was employed for endosulfan biodegradation, finding that sulphate endosulfan and mono alcohol endosulfan were the main compounds produced; therefore, an oxidative degradation pathway was suggested. A 93 ± 4.7% of Endosulfan degradation after one month of treatment of a highly salty agricultural soil was obtained, where ΔST was up to 17 ± 0.58 mN m-1, (related to the water value of 72 mNm-1), that was induced by the fungus during soil mycoremediation Additionally, an improvement in soil quality (reduction of clay proportion and salinity, as well as an increase of soluble phosphorus, carbon content and organic matter) was observed during the mycoremediation treatment. The phytotoxicity of the pesticide on Phaseolus leptostachyus was evaluated in the soil without the fungus addition (control), where the pesticide was translocated in the crop, presenting a negative effect in germination index, root length and weight, aerial weight, humidity, and proline content. This contrasted with the effect on the crop grown in the soil treated with P. crustosum, which had better agronomic characteristics. This is first report in which the effect of this property allows the pesticide biodegradation, due to a combined Endosulfan bioavailability and fungal biodegradation.

Feature Extraction from Distributions of Phase Synchronization Values of EEG Recordings

ABSTRACT Epilepsy is the most common neurological pathology. Despite treatments available to patients, only 58% to 73% will be free of seizures. This uncertainty in treatment outcomes can lead to other psychiatric affectations in cases where treatment success may be in doubt. Seizure prediction models (SPMs) emerged as a measure to help determine when patients may be susceptible to an imminent crisis. These models are based on the continuous monitoring of patient's EEG signals and subsequent continuous analysis to identify features that differentiate ictal from interictal states. This is an ongoing field of research whose aim is to establish a robust set of features to feed the SPM and obtain a high degree of certainty regarding when the next seizure will occur. In this work we propose the analysis of phase differences of EEG as a method to extract features capable of discriminating ictal and preictal states in patients; specifically, the numeric distance between Q1 and Q3 of the distribution of phase differences. We compared this values to other phase synchronization methods and tested our hypothesis getting a p < 0.0009 with our proposed method.

Cáncer, tratamiento onco-hematológico y toxicidad cardiovascular / Cancer, onco-haematological treatment and cardiovascular toxicity

La mayor disponibilidad de nuevos tratamientos oncológicos en los últimos años ha conllevado una mejoría del pronóstico e incremento de la expectativa de vida de los pacientes con cáncer, si bien a expensas de un incremento del riesgo cardiovascular. Por este motivo ha surgido la necesidad de la creación de equipos multidisciplinares para la valoración conjunta de estos pacientes y así lograr optimizar la salud cardiovascular y la supervivencia global de estos pacientes, minimizando las interrupciones de los tratamientos onco-hematológicos. Existe un amplio abanico de toxicidades cardiovasculares asociadas a los diferentes tratamientos del cáncer. El control estructurado del riesgo cardiovascular antes, durante y después del tratamiento oncológico permite seguir estrategias de prevención, detección temprana y tratamiento precoz de las cardiotoxicidades. (AU)

The increased availability of new cancer treatments in recent years has led to improved prognosis and increased life expectancy for cancer patients, but at the expense of increased cardiovascular risk. For this reason, multidisciplinary teams need to be formed for the joint evaluation of these patients to optimise the cardiovascular health and overall survival of these patients and minimise interruptions to onco-haematological treatments. A wide range of cardiovascular toxicities are associated with the various cancer treatments. The structured control of cardiovascular risk before, during and after oncological treatment will enable strategies for the prevention, early detection and early treatment of cardiotoxicities. (AU)