1
|
Delgado-Lista J, Mostaza JM, Arrobas-Velilla T, Blanco-Vaca F, Masana L, Pedro-Botet J, Perez-Martinez P, Civeira F, Cuende-Melero JI, Gomez-Barrado JJ, Lahoz C, Pintó X, Suarez-Tembra M, Lopez-Miranda J, Guijarro C. Consensus on lipoprotein(a) of the Spanish Society of Arteriosclerosis. Literature review and recommendations for clinical practice. Clin Investig Arterioscler 2024:S0214-9168(24)00023-8. [PMID: 38599943 DOI: 10.1016/j.arteri.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/12/2024]
Abstract
The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (iPCSK9) inhibitor drugs, the greatest novelty in the field for decades. Lp(a) concentration (especially very high levels) has an undeniable association with certain cardiovascular complications, such as atherosclerotic vascular disease (AVD) and aortic stenosis. However, there are several current limitations to both establishing epidemiological associations and specific pharmacological treatment. Firstly, the measurement of Lp(a) is highly dependent on the test used, mainly because of the characteristics of the molecule. Secondly, Lp(a) concentration is more than 80% genetically determined, so that, unlike other cardiovascular risk factors, it cannot be regulated by lifestyle changes. Finally, although there are many promising clinical trials with specific drugs to reduce Lp(a), currently only iPCSK9 (limited for use because of its cost) significantly reduces Lp(a). However, and in line with other scientific societies, the SEA considers that, with the aim of increasing knowledge about the contribution of Lp(a) to cardiovascular risk, it is relevant to produce a document containing the current status of the subject, recommendations for the control of global cardiovascular risk in people with elevated Lp(a) and recommendations on the therapeutic approach to patients with elevated Lp(a).
Collapse
Affiliation(s)
- Javier Delgado-Lista
- Unidad de Lípidos y Aterosclerosis, Servicio de Medicina Interna, Hospital Universitario Reina Sofía; Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Córdoba; IMIBIC, Córdoba; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España.
| | - Jose M Mostaza
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, España
| | - Teresa Arrobas-Velilla
- Sociedad Española de Medicina de Laboratorio (SEQCML), Laboratorio de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - Francisco Blanco-Vaca
- Departamento de Bioquímica Clínica, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona; Departamento de Bioquímica y Biología Molecular, Universitat Autònoma de Barcelona, 08193 Barcelona; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, España
| | - Luis Masana
- Unidad de Medicina Vascular y Metabolismo, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, IISPV, CIBERDEM, Reus, Tarragona, España
| | - Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España
| | - Pablo Perez-Martinez
- Unidad de Lípidos y Aterosclerosis, Servicio de Medicina Interna, Hospital Universitario Reina Sofía; Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Córdoba; IMIBIC, Córdoba; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España
| | - Fernando Civeira
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, Universidad de Zaragoza, Zaragoza; CIBER Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
| | - Jose I Cuende-Melero
- Consulta de Riesgo Vascular, Servicio de Medicina Interna, Complejo Asistencial Universitario de Palencia, Palencia; Departamento de Medicina, Dermatología y Toxicología, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
| | - Jose J Gomez-Barrado
- Unidad de Cuidados Cardiológicos Agudos y Riesgo Cardiovascular, Servicio de Cardiología, Hospital Universitario San Pedro de Alcántara, Cáceres, España
| | - Carlos Lahoz
- Unidad de Lípidos y Arteriosclerosis, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - Xavier Pintó
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario de Bellvitge-Idibell-Universidad de Barcelona-CiberObn, España
| | - Manuel Suarez-Tembra
- Unidad de Lípidos y RCV, Servicio de Medicina Interna, Hospital San Rafael, A Coruña, España
| | - Jose Lopez-Miranda
- Unidad de Lípidos y Aterosclerosis, Servicio de Medicina Interna, Hospital Universitario Reina Sofía; Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Córdoba; IMIBIC, Córdoba; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España.
| | - Carlos Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| |
Collapse
|
2
|
Mostaza JM, Pintó X, Armario P, Masana L, Real JT, Valdivielso P, Arrobas-Velilla T, Baeza-Trinidad R, Calmarza P, Cebollada J, Civera-Andrés M, Cuende Melero JI, Díaz-Díaz JL, Espíldora-Hernández J, Fernández Pardo J, Guijarro C, Jericó C, Laclaustra M, Lahoz C, López-Miranda J, Martínez-Hervás S, Muñiz-Grijalvo O, Páramo JA, Pascual V, Pedro-Botet J, Pérez-Martínez P, Puzo J. SEA 2024 Standards for Global Control of Vascular Risk. Clin Investig Arterioscler 2024:S0214-9168(24)00017-2. [PMID: 38490888 DOI: 10.1016/j.arteri.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/03/2024] [Indexed: 03/17/2024]
Abstract
One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to the knowledge, prevention and treatment of vascular diseases, which are the leading cause of death in Spain and entail a high degree of disability and health expenditure. Atherosclerosis is a multifactorial disease and its prevention requires a global approach that takes into account the associated risk factors. This document summarises the current evidence and includes recommendations for patients with established vascular disease or at high vascular risk: it reviews the symptoms and signs to evaluate, the laboratory and imaging procedures to request routinely or in special situations, and includes the estimation of vascular risk, diagnostic criteria for entities that are vascular risk factors, and general and specific recommendations for their treatment. Finally, it presents aspects that are not usually referenced in the literature, such as the organisation of a vascular risk consultation.
Collapse
Affiliation(s)
- José María Mostaza
- Servicio de Medicina Interna, Unidad de Lípidos y Arteriosclerosis, Hospital La Paz-Carlos III, Madrid, España.
| | - Xavier Pintó
- Unidad de Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario Bellvitge, Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Fundación para la Investigación y Prevención de las Enfermedades Cardiovasculares (FIPEC), Universidad de Barcelona, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España
| | - Pedro Armario
- Servicio de Medicina Interna, Área de Atención Integrada de Riesgo Vascular, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral (CSI), Sant Joan Despí, Universidad de Barcelona, Barcelona, España
| | - Luis Masana
- Unidad de Medicina Vascular y Metabolismo (UVASMET), Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universitat Rovira i Virgili, Tarragona, España
| | - José T Real
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Pedro Valdivielso
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand), Universidad de Málaga, Málaga, España
| | - Teresa Arrobas-Velilla
- Laboratorio de Nutrición y RCV, UGC de Bioquímica clínica, Hospital Virgen Macarena, Sevilla, España
| | | | - Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España; Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Investigación Sanitaria (ISS) de Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Jesús Cebollada
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Miguel Civera-Andrés
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España
| | - José I Cuende Melero
- Consulta de Riesgo Cardiovascular, Servicio de Medicina Interna, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - José L Díaz-Díaz
- Sección de Medicina Interna, Unidad de Lípidos y Riesgo Cardiovascular, Hospital Abente y Lago Complejo Hospitalario Universitario A Coruña, La Coruña, España
| | - Javier Espíldora-Hernández
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand), Universidad de Málaga, Málaga, España; Unidad de Lípidos y Unidad Asistencial de Hipertensión Arterial- Riesgo Vascular (HTA-RV), UGC Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Jacinto Fernández Pardo
- Servicio de Medicina Interna, Hospital General Universitario Reina Sofía de Murcia, Universidad de Murcia, Murcia, España
| | - Carlos Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorón, España
| | - Carles Jericó
- Servicio de Medicina Interna, Área de Atención Integrada de Riesgo Vascular, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral (CSI), Sant Joan Despí, Universidad de Barcelona, Barcelona, España
| | - Martín Laclaustra
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Investigación Sanitaria (ISS) de Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Carlos Lahoz
- Servicio de Medicina Interna, Unidad de Lípidos y Arteriosclerosis, Hospital La Paz-Carlos III, Madrid, España
| | - José López-Miranda
- Unidad de Lípidos y Arteriosclerosis, UGC de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, España; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Sergio Martínez-Hervás
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Ovidio Muñiz-Grijalvo
- Servicio de Medicina Interna, UCERV, UCAMI, Hospital Virgen del Rocío de Sevilla, Sevilla, España
| | - Juan A Páramo
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Investigación Sanitaria (ISS) de Aragón, Universidad de Zaragoza, Zaragoza, España; Servicio de Hematología, Clínica Universidad de Navarra, Navarra, España; Laboratorio Aterotrombosis, CIMA, Universidad de Navarra, Pamplona, España
| | - Vicente Pascual
- Centro de Salud Palleter, Universidad CEU-Cardenal Herrera, Castellón, España
| | - Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Nutrición, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España
| | - Pablo Pérez-Martínez
- Unidad de Lípidos y Arteriosclerosis, UGC de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, España; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - José Puzo
- Servicio de Bioquímica Clínica, Unidad de Lípidos, Hospital General Universitario San Jorge de Huesca, Huesca, España; Departamento de Medicina, Universidad de Zaragoza, Zaragoza, España
| |
Collapse
|
3
|
Fernández-de-Las-Peñas C, Guijarro C, Velasco-Arribas M, Pellicer-Valero O, Torres-Macho J. Serological biomarkers at hospital admission and hospitalization treatments are not related to the development of post-COVID dyspnea. Eur J Intern Med 2024; 119:132-135. [PMID: 37945411 DOI: 10.1016/j.ejim.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/24/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain; Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - Carlos Guijarro
- Department of Internal Medicine-Infectious Department, Research Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - María Velasco-Arribas
- Department of Internal Medicine-Infectious Department, Research Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Oscar Pellicer-Valero
- Image Processing Laboratory (IPL), Universitat de València, Parc Científic, Paterna, València, Spain
| | - Juan Torres-Macho
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid Spain; Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
4
|
Melone S, Fernández-Cebrián JM, Amores M, Pérez-Fernández E, Guijarro C, Martínez S, Pazos MR. Modified SADI-S in non-obese diabetic rats: Description of the surgical technique. Surg Open Sci 2024; 17:54-57. [PMID: 38293006 PMCID: PMC10826812 DOI: 10.1016/j.sopen.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/22/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Background Single anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) is a predominantly malabsorptive technique that has shown excellent results in morbid obese patients. The aim of this study is to establish a rodent model modifying the SADI-S technique by performing a proximal duodenojejunal anastomosis. This model can be useful for the study of glucose metabolism without malabsorption observed after the SADI-S technique. Methods Goto-Kakizaki rats, a genetic model of non-obese and non-hypertensive type 2 diabetes mellitus, that develop hyperglycemia at an early age was used. Surgery consisted in a sleeve gastrectomy, duodenojejunal anastomosis and duodenal exclusion using three different techniques: duodenal transection (DT), duodenal ligation with hem-o-lock (DLH), and duodenal ligation with suture (DLS). Surgery time, weight loss, morbidity and mortality were recorded. Results A total of 16 animals were subjected to surgical intervention and overall mortality was 25 %, with the DT group showing the highest mortality rate (42.9 %). No differences were observed among groups in terms of weight loss. Conclusion The surgical technique described in this work is feasible and reproducible. Weight loss is comparable regardless of the technique used for duodenal exclusion.
Collapse
Affiliation(s)
- Sirio Melone
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - José Mª Fernández-Cebrián
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Mario Amores
- Laboratorio de Apoyo a la Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Elia Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Carlos Guijarro
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
- Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Sagrario Martínez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
- Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Maria Ruth Pazos
- Laboratorio de Apoyo a la Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| |
Collapse
|
5
|
Fernández-de-Las-Peñas C, Guijarro C, Torres-Macho J, Pellicer-Valero OJ, Franco-Moreno A, Nijs J, Velasco-Arribas M. Serological Biomarkers at Hospital Admission and Hospitalization Treatments Are Not Related to Sensitization-Associated Symptoms in Patients with Post-COVID Pain. Pathogens 2023; 12:1235. [PMID: 37887751 PMCID: PMC10610051 DOI: 10.3390/pathogens12101235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/03/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
Current evidence suggests that a group of patients who had survived coronavirus disease, 2019 (COVID-19) and developed post-COVID pain can exhibit altered nociceptive processing. The role of serological biomarkers and hospitalization treatments in post-COVID pain is unclear. This study aimed to investigate the association of serological biomarkers and treatments received during hospitalization with sensitization-associated symptoms in COVID-19 survivors with post-COVID pain. One hundred and eighty-three (n = 183) patients who had been hospitalized due to COVID-19 in one urban hospital of Madrid (Spain) during the first wave of the pandemic were assessed in a face-to-face interview 9.4 (SD 3.4) months after hospitalization. Levels of 19 serological biomarkers, hospitalization data, and treatments during hospitalization were obtained from hospital records. Sensitization-associated symptoms (Central Sensitization Inventory, CSI), sleep quality (Pittsburgh Sleep Quality Index, PSQI), pain catastrophism (Pain Catastrophizing Scale), and anxiety/depressive level (Hospital Anxiety and Depression Scale, HADS) were assessed. The prevalence of post-COVID pain was 40.9% (n = 75). Twenty-nine (38.6%) patients had sensitization-associated symptoms. Overall, no differences in hospitalization data and serological biomarkers were identified according to the presence of sensitization-associated symptoms. The analysis revealed that patients with sensitization-associated symptoms exhibited higher lymphocyte count and lower urea levels than those without sensitization-associated symptoms, but differences were small. Pain catastrophism and depressive levels, but not fatigue, dyspnea, brain fog, anxiety levels, or poor sleep, were higher in individuals with sensitization-associated symptoms. In conclusion, this study revealed that sensitization-associated post-COVID pain symptoms are not associated with serological biomarkers at hospital admission and hospitalization treatments received.
Collapse
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), 28922 Madrid, Spain
| | - Carlos Guijarro
- Department of Internal Medicine-Infectious Department, Research Department, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain
- Department of Medicine, Universidad Rey Juan Carlos (URJC), 28922 Madrid, Spain
| | - Juan Torres-Macho
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, 28031 Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Oscar J Pellicer-Valero
- Image Processing Laboratory (IPL), Universitat de València, Parc Científic, 46980 València, Spain
| | - Ana Franco-Moreno
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, 28031 Madrid, Spain
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Ixelles, Belgium
- Chronic Pain Rehabilitation Center, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1050 Ixelles, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41390 Göterbog, Sweden
| | - María Velasco-Arribas
- Department of Internal Medicine-Infectious Department, Research Department, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain
- Department of Medicine, Universidad Rey Juan Carlos (URJC), 28922 Madrid, Spain
| |
Collapse
|
6
|
Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Carlos Obaya J, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories: What parameters should a basic lipid profile include? Rev Clin Esp 2023; 223:440-449. [PMID: 37302464 DOI: 10.1016/j.rceng.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/13/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
Collapse
Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicinade Laboratorio (SEQCML), Laboratoriode Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain. Investigador Asociado, Facultad de Cienciasdela Salud, Universidad Autónomade Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidadde Medicina Interna, Hospital Universitario Fundaciónde Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidadde Cardiología, Hospital Universitario Fundaciónde Alcorcón, Asociaciónde Riesgo vasculary Rehabilitación Cardiacadela Sociedad Española de Cardiología, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiologíay CirugíaVascular (SEACV), Unidad Intercentros Cádiz-Jerezde Angiologíay Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovasculary Endovascular (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Serviciode Endocrinologíay Nutrición, Hospital de la Santa Creui Sant Pau, Barcelona, Spain
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinologíay Nutrición (SEEN), Secciónde Endocrinología, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatologíay Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantily Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, Spain
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Sociedad Española de Medicinade Familiay Comunitaria (SEMFyC), Medicina Familiary Comunitaria, CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Sociedad Española de MedicinaInterna (SEMI), Unidad de Hipertensión, Lípidosy Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Uniónde Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Islade Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, A Coruña, Spain
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, Spain
| |
Collapse
|
7
|
Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Botana López AM, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories. ENDOCRINOL DIAB NUTR 2023; 70:501-510. [PMID: 37268528 DOI: 10.1016/j.endien.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/04/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
Collapse
Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Antonio Buño Soto
- Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
| |
Collapse
|
8
|
Velilla TA, Guijarro C, Ruiz RC, Piñero MR, Francisco Valderrama Marcos J, López AMB, López AM, Antonio García Donaire J, Obaya JC, Castilla Guerra L, Carratalá VP, Cabello IE, Lazo MS, Rodrigo MMC, María Mostaza Prieto J, Doblas JJG, Soto AB. Consensus document for lipid profile determination and reporting in Spanish clinical laboratories. What parameters should be included in a basic lipid profile? Nefrologia 2023; 43:474-483. [PMID: 37813740 DOI: 10.1016/j.nefroe.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 10/11/2023] Open
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
Collapse
Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Sevilla, Spain, Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain q Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
| | - Antonio Buño Soto
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain q Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
| |
Collapse
|
9
|
Arrobas Velilla T, Guijarro C, Ruiz RC, Piñero MR, Valderrama Marcos JF, Pérez Pérez A, Botana López AM, López AM, García Donaire JA, Obaya JC, Castilla-Guerra L, Carratalá VP, Cabello IE, Lazo MS, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories: what parameters should a basic lipid profile include? Advances in Laboratory Medicine / Avances en Medicina de Laboratorio 2023; 4:138-156. [PMID: 38075943 PMCID: PMC10701497 DOI: 10.1515/almed-2023-0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/02/2023] [Indexed: 04/05/2024]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
Collapse
Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio Pérez Pérez
- Spanish Society of Diabetes (SED), Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla-Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Seville, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Sevilla, Spain
- Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Antonio Buño Soto
- Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
| |
Collapse
|
10
|
Fernández-de-Las-Peñas C, Torres-Macho J, Guijarro C, Martín-Guerrero JD, Pellicer-Valero OJ, Plaza-Manzano G. Trajectory of Gastrointestinal Symptoms in Previously Hospitalized COVID-19 Survivors: The Long COVID Experience Multicenter Study. Viruses 2023; 15:v15051134. [PMID: 37243220 DOI: 10.3390/v15051134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
This multicenter cohort study used Sankey plots and exponential bar plots to visualize the fluctuating evolution and the trajectory of gastrointestinal symptoms in previously hospitalized COVID-19 survivors during the first 18 months after acute SARS-CoV-2 infection. A total of 1266 previously hospitalized COVID-19 survivors were assessed at four points: hospital admission (T0), at 8.4 months (T1), at 13.2 months (T2), and at 18.3 months (T3) after hospitalization. Participants were asked about their overall gastrointestinal symptoms and particularly diarrhea. Clinical and hospitalization data were collected from hospital medical records. The prevalence of overall gastrointestinal post-COVID symptomatology was 6.3% (n = 80) at T1, 3.99% (n = 50) at T2 and 2.39% (n = 32) at T3. The prevalence of diarrhea decreased from 10.69% (n = 135) at hospital admission (T0), to 2.55% (n = 32) at T1, to 1.04% (n = 14) at T2, and to 0.64% (n = 8) at T3. The Sankey plots revealed that just 20 (1.59%) and 4 (0.32%) patients exhibited overall gastrointestinal post-COVID symptoms or diarrhea, respectively, throughout the whole follow-up period. The recovery fitted exponential curves revealed a decreasing prevalence trend, showing that diarrhea and gastrointestinal symptoms recover during the first two or three years after COVID-19 in previously hospitalized COVID-19 survivors. The regression models did not reveal any symptoms to be associated with the presence of gastrointestinal post-COVID symptomatology or post-COVID diarrhea at hospital admission or at T1. The use of Sankey plots revealed the fluctuating evolution of gastrointestinal post-COVID symptoms during the first two years after infection. In addition, exponential bar plots revealed the decreased prevalence of gastrointestinal post-COVID symptomatology during the first three years after infection.
Collapse
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Madrid, Spain
| | - Juan Torres-Macho
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, 28031 Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Carlos Guijarro
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain
- Department of Medicine, Universidad Rey Juan Carlos (URJC), 28922 Madrid, Spain
| | - José D Martín-Guerrero
- Intelligent Data Analysis Laboratory, Department of Electronic Engineering, ETSE (Engineering School), Universitat de València (UV), 46010 Valencia, Spain
| | - Oscar J Pellicer-Valero
- Image Processing Laboratory (IPL), Universitat de València, Parc Científic, Paterna, 46010 València, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid (UCM), IdISSC, 28040 Madrid, Spain
| |
Collapse
|
11
|
Pérez de Isla L, Díaz-Díaz JL, Romero MJ, Muñiz-Grijalvo O, Mediavilla JD, Argüeso R, Sánchez Muñoz-Torrero JF, Rubio P, Álvarez-Baños P, Ponte P, Mañas D, Suárez Gutierrez L, Cepeda JM, Casañas M, Fuentes F, Guijarro C, Ángel Barba M, Saltijeral Cerezo A, Padró T, Mata P. Alirocumab and Coronary Atherosclerosis in Asymptomatic Patients with Familial Hypercholesterolemia: The ARCHITECT Study. Circulation 2023; 147:1436-1443. [PMID: 37009731 PMCID: PMC10158600 DOI: 10.1161/circulationaha.122.062557] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 03/01/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND The effect of alirocumab, a PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor, on coronary plaque burden in patients with familial hypercholesterolemia has not been addressed. Our aim was to assess changes in coronary plaque burden and its characteristics after treatment with alirocumab by quantification and characterization of atherosclerotic plaque throughout the coronary tree on the basis of a noninvasive analysis of coronary computed tomographic angiography in asymptomatic subjects with familial hypercholesterolemia receiving optimized and stable treatment with maximum tolerated statin dose with or without ezetimibe. METHODS This study is a phase IV, open-label, multicenter, single-arm clinical trial to assess changes in coronary plaque burden and its characteristics after 78 weeks of treatment with alirocumab in patients with familial hypercholesterolemia without clinical atherosclerotic cardiovascular disease. Participants underwent an initial coronary computed tomographic angiography at baseline and another at 78 weeks. Every patient received 150 mg of alirocumab subcutaneiously every 14 days in addition to high-intensity statin therapy. The main outcome was the change on coronary plaque burden and its characteristics by quantification and characterization of atherosclerotic plaque throughout the coronary tree on the basis of analysis of coronary computed tomographic angiography. RESULTS The study was completed by 104 patients. The median age was 53.3 (46.2-59.4) years. Of these patients, 54 were women (51.9%). Median low-density lipoprotein cholesterol was 138.9 (117.5-175.3) mg/dL at entry and 45.0 (36.0-65.0) mg/dL at follow-up (P<0.001). Coronary plaque burden changed from 34.6% (32.5%-36.8%) at entry to 30.4% (27.4%-33.4%) at follow-up (P<0.001). A significant change in the characteristics of the coronary atherosclerosis was also found: an increase in the proportion of calcified (+0.3%; P<0.001) and mainly fibrous (+6.2%; P<0.001) plaque, accompanied by a decrease in the percentage of fibro-fatty (-3.9%; P<0.001) and necrotic plaque (-0.6%; P<0.001). CONCLUSIONS Treatment with alirocumab in addition to high-intensity statin therapy resulted in significant regression of coronary plaque burden and plaque stabilization on coronary computed tomographic angiography over 78 weeks in these groups of patients with familial hypercholesterolemia without clinical atherosclerotic cardiovascular disease. ARCHITECT (Effect of Alirocumab on Atherosclerotic Plaque Volume, Architecture and Composition) could link and explain ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) results. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT05465278.
Collapse
Affiliation(s)
| | - Jose L. Díaz-Díaz
- Internal Medicine Department, Hospital Abente y Lago, A Coruña, Spain (J.L.E.-D.)
| | - Manuel J. Romero
- Internal Medicine Department, Hospital Infanta Elena, Huelva, Spain M.J.R.)
| | | | - Juan D. Mediavilla
- Internal Medicine Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.D.M.)
| | - Rosa Argüeso
- Endocrinology Department, Hospital Universitario Lucus Augusti, Lugo, Spain (R.A.)
| | | | - Patricia Rubio
- Internal Medicine Department, Hospital Universitario Jerez de la Frontera, Spain (P.R.)
| | | | - Paola Ponte
- Internal Medicine Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain (P.P.)
| | - Dolores Mañas
- Internal Medicine Department, Hospital General Universitario de Ciudad Real, Spain (D.M.)
| | | | - José María Cepeda
- Internal Medicine Department, Hospital Comarcal Vega Baja, Orihuela, Alicante, Spain (J.M.C.)
| | - Marta Casañas
- Internal Medicine Department, Hospital San Pedro, Logroño, Spain (M.C.)
| | - Francisco Fuentes
- Lipid and Atherosclerosis Unit, CIBERObn, IMBIC. Hospital Universitario Reina Sofia, Córdoba, Spain (F.F.)
| | - Carlos Guijarro
- Internal Medicine Department, Hospital Universitario Fundación Alcorcón-Universidad Rey Juan Carlos, Madrid, Spain (C.G.)
| | - Miguel Ángel Barba
- Internal Medicine Department, Complejo Hospitalario Universitario, Albacete, Spain (M.A.B.)
| | | | - Teresa Padró
- Programa-ICCC Cardiovascular, Institut de Recerca Hospital Santa Creu i Sant Pau, IIB-Sant Pau, CIBERCV, Barcelona, Spain (T.P.)
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain (P.M.)
| |
Collapse
|
12
|
Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. [Consensus document for lipid profile determination and reporting in Spanish clinical laboratories]. Hipertens Riesgo Vasc 2023; 40:75-84. [PMID: 37121876 PMCID: PMC10176999 DOI: 10.1016/j.hipert.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 05/02/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
Collapse
Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicina de Laboratorio (SEQCML), Laboratorio de Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España. Investigador Asociado, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidad de Medicina Interna, Hospital Universitario Fundación de Alcorcón, Universidad Rey Juan Carlos, Madrid, España.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidad de Cardiología, Hospital Universitario Fundación de Alcorcón, Asociación de Riesgo vascular y Rehabilitación Cardiaca de la Sociedad Española de Cardiología, Madrid, España
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiología y Cirugía Vascular (SEACV), Unidad Intercentros Cádiz-Jerez de Angiología y Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, España
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovascular y Endovascular, (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, España
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinología y Nutrición (SEEN), Sección de Endocrinología, Hospital Universitario Lucus Augusti, Lugo, España
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantil y Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (SEMFyC), Medicina Familiar y Comunitaria, CS La Chopera, Alcobendas, Madrid, España
| | - Luis Castilla Guerra
- Sociedad Española de Medicina Interna (SEMI), Unidad de Hipertensión, Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, España
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Unión de Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, España
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, España
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, España
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, España
| |
Collapse
|
13
|
Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile determination and reporting in Spanish clinical laboratories. What parameters should be included in a basic lipid profile? Clin Investig Arterioscler 2023; 35:91-100. [PMID: 36925360 DOI: 10.1016/j.arteri.2022.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 03/16/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
Collapse
Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicina de Laboratorio (SEQCML), Laboratorio de Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España. Investigador Asociado, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidad de Medicina Interna, Hospital Universitario Fundación de Alcorcón, Universidad Rey Juan Carlos, Madrid, España.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidad de Cardiología, Hospital Universitario Fundación de Alcorcón, Asociación de Riesgo vascular y Rehabilitación Cardiaca de la Sociedad Española de Cardiología, Madrid, España
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiología y Cirugía Vascular (SEACV), Unidad Intercentros Cádiz-Jerez de Angiología y Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, España
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, España
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinología y Nutrición (SEEN), Sección de Endocrinología, Hospital Universitario Lucus Augusti, Lugo, España
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantil y Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (SEMFyC), Medicina Familiar y Comunitaria, CS La Chopera, Alcobendas, Madrid, España
| | - Luis Castilla Guerra
- Sociedad Española de Medicina Interna (SEMI), Unidad de Hipertensión, Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, España
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Unión de Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, España
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, España
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, España
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, España
| |
Collapse
|
14
|
Ortiz A, Quiroga B, Díez J, Escalada San Martín FJ, Ramirez L, Pérez Maraver M, Martínez-Berganza Asensio ML, Arranz Arija JÁ, Alvarez-Ossorio Fernández JL, Córdoba R, Brotons Muntó F, Cancelo Hidalgo MJ, Carles Reverter J, Plasencia-Rodríguez C, Carretera Gómez J, Guijarro C, Freijo Guerrero MDM, de Sequera P. The Spanish Scientific Societies before the ESC 2021 guidelines on vascular disease prevention: Generalizing the measurement of albuminuria to identify vascular risk and prevent vascular disease. Nefrologia 2023; 43:245-250. [PMID: 37407308 DOI: 10.1016/j.nefroe.2023.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 07/07/2023] Open
Abstract
The 2021 guidelines on the prevention of vascular disease (VD) in clinical practice published by the European Society of Cardiology (ESC) and supported by 13 other European scientific societies recognize the key role of screening for chronic kidney disease (CKD) in the prevention of VD. Vascular risk in CKD is categorized based on measurements of estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (ACR). Thus, moderate CKD is associated with a high vascular risk and severe CKD with a very high vascular risk requiring therapeutic action, and there is no need to apply other vascular risk scores when vascular risk is already very high due to CKD. Moreover, the ESC indicates that vascular risk assessment and the subsequent decision algorithm should start with measurement of eGFR and ACR. To optimize the implementation of the ESC 2021 guidelines on the prevention of CVD in Spain, we consider that: 1) Urine testing for albuminuria using ACR should be part of the clinical routine at the same level as blood glucose, cholesterolemia, and GFR estimation when these are used to make decisions on CVD risk. 2) Spanish public and private health services should have the necessary means and resources to optimally implement the ESC 2021 guidelines for the prevention of CVD in Spain, including ACR testing.
Collapse
Affiliation(s)
- Alberto Ortiz
- Sociedad Española de Nefrología (S.E.N.); Servicio de Nefrología, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Borja Quiroga
- Sociedad Española de Nefrología (S.E.N.); Servicio de Nefrología, IIS-La Princesa, Hospital Universitario de la Princesa, Madrid, Spain.
| | - Javier Díez
- Sociedad Española de Nefrología (S.E.N.); Center of Applied Medical Research and School of Medicine, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red de la Enfermedades Cardiovasculares (CIBERCV), Carlos III Institute of Health, Madrid, Spain
| | | | - Leblic Ramirez
- Servicio de Angiología y Cirugía Vascular, Hospital Universitario de la Paz, Madrid, Spain; Sociedad Española de Angióloga y Cirugía Vascular (SEACV)
| | - Manuel Pérez Maraver
- Servicio de Endocrinología, Hospital Universitari Bellvitge, Barcelona, Spain; Sociedad Española de Diabetes (SED)
| | | | - José Ángel Arranz Arija
- Servicio de Oncología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Sociedad Española de Oncología Médica (SEOM)
| | | | - Raúl Córdoba
- Servicio de Hematología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; Sociedad Española de Hematología y Hemoterapia (SEHH)
| | - Franscisco Brotons Muntó
- Centro de Salud Trinitat, Valencia, Spain; Sociedad Española de Medicina de Familia y Comunitaria (semFYC)
| | - María Jesús Cancelo Hidalgo
- Servicio de Ginecología y Obstetricia, Hospital Universitario de Guadalajara, Universidad de Alcalá, Guadalajara, Spain; Sociedad Española de Ginecología y Obstetricia (SEGO)
| | - Joan Carles Reverter
- Servicio de Hematología, Hospital Clínic, Barcelona, Spain; Sociedad Española de Trombosis y Hemostasia (SETH)
| | | | - Juana Carretera Gómez
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, Spain; Sociedad Española de Medicina Interna (SEMI)
| | - Carlos Guijarro
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón - Universidad Rey Juan-Carlos, Madrid, Spain; Sociedad Española de Arterioesclerosis (SEA)
| | - M Del Mar Freijo Guerrero
- Sociedad Española de Nefrología (S.E.N.); Servicio de Neurología, Hospital de Cruces, Baracaldo, Spain; En representación del Grupo de Estudio de Enfermedades Cerebrovasculares de la Sociedad Española de Neurología
| | - Patricia de Sequera
- Sociedad Española de Nefrología (S.E.N.); Servicio de Nefrología, Hospital Universitario Infanta Leonor, Universidad Complutense De Madrid, Madrid, Spain
| |
Collapse
|
15
|
Arrobas T, Guijarro C, Campuzano R, Rodríguez Piñero M, Valderrama Marcos JF, Botana López AM, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallarés Carratalà V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Documento de consenso para la determinación e informe del perfil lipídico en laboratorios clínicos españoles. Rev Clín Med Fam 2023. [DOI: 10.55783/rcmf.160106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Las enfermedades cardiovasculares (ECV) siguen siendo la principal causa de muerte en nuestro país. El control adecuado de las alteraciones del metabolismo lipídico es un reto clave en prevención cardiovascular que está lejos de alcanzarse en la práctica clínica real. Existe una gran heterogeneidad en los informes del metabolismo lipídico de los laboratorios clínicos españoles, lo que puede contribuir al mal control del mismo. Por ello, un grupo de trabajo de las principales sociedades científicas implicadas en la atención de los pacientes de riesgo vascular, hemos elaborado este documento con una propuesta básica de consenso sobre la determinación del perfil lipídico básico en prevención cardiovascular, recomendaciones para su realización y unificación de criterios para incorporar los objetivos de control lipídico adecuados al riesgo vascular de los pacientes en los informes de laboratorio.
Palabras clave: consenso, panel de lípidos, enfermedades cardiovasculares, bioquímica, colesterol, lípidos, triglicéridos, lipoproteína (a).
Collapse
Affiliation(s)
- Teresa Arrobas
- Miembro de la Sociedad Española de Medicina de Laboratorio (SEQCML). Laboratorio de Bioquímica Clínica. Hospital Universitario Virgen Macarena. Sevilla (España). Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Carlos Guijarro
- Miembro de la Sociedad Española de Arteriosclerosis (SEA). Unidad de Medicina Interna. Hospital Universitario Fundación de Alcorcón. Universidad Rey Juan Carlos. Madrid (España).Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Raquel Campuzano
- Miembro de la Sociedad Española de Cardiología (SEC). Unidad de Cardiología. Hospital Universitario Fundación de Alcorcón. Madrid (España). Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Manuel Rodríguez Piñero
- Miembro de la Sociedad Española de Angiología y Cirugía Vascular (SEACV). Unidad Intercentros Cádiz - Jerez de Angiología y Cirugía Vascular. Hospital Universitario Puerta del Mar. Cádiz (España)
| | - José Francisco Valderrama Marcos
- Miembro de la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE). Hospital Regional Universitario de Málaga. Málaga (España)
| | - Antonio M. Botana López
- Miembro de la Sociedad Española de Endocrinología y Nutrición (SEEN). Sección de Endocrinología. Hospital Universitario Lucus Augusti de Lugo. Lugo (España)
| | - Ana Morais López
- Miembro de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP). Unidad de Nutrición Infantil y Enfermedades Metabólicas. Hospital Universitario La Paz. Madrid (España)
| | - José Antonio García Donaire
- Miembro de la Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA). Unidad de Hipertensión Arterial. Hospital Clínico Universitario San Carlos. Madrid (España)
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (semFYC). Especialista en Medicina Familiar y Comunitaria. CS La Chopera. Alcobendas. Madrid (España)
| | - Luis Castilla Guerra
- Miembro de la Sociedad Española de Medicina Interna (SEMI). Unidad de Hipertensión, Lípidos y Riesgo Vascular. Servicio de Medicina Interna. Hospital Virgen Macarena. PCDV Departamento de Medicina. Universidad de Sevilla. Sevilla (España)
| | - Vicente Pallarés Carratalà
- Miembro de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Unidad de Vigilancia de la Salud. Unión de Mutuas. Universitat Jaume I. Castellón (España)
| | - Isabel Egocheaga Cabello
- Miembro de la Sociedad Española de Médicos Generales y de Familia (SEMG). Especialista en Medicina Familiar y Comunitaria. CS Isla de Oza. Madrid (España)
| | - Mercedes Salgueira Lazo
- Miembro de la Sociedad Española de Nefrología (SEN). Unidad de Nefrología. Hospital Universitario Virgen Macarena. Sevilla (España)
| | - María Mar Castellanos Rodrigo
- Miembro de la Sociedad Española de Neurología (SEN). Servicio de Neurología. Complejo Hospitalario Universitario A Coruña - Instituto de Investigación Biomédica A Coruña. A Coruña (España). Coordinadora del Grupo de Estudio de Enfermedades Cerebrovasculares de la SEN
| | - José María Mostaza Prieto
- Miembro de la Sociedad Española de Arterioesclerosis (SEA). Unidad de Medicina Interna. Hospital Carlos III de Madrid. Madrid (España)
| | - Juan José Gómez Doblas
- Miembro de la Sociedad Española de Cardiología (SEC). Unidad de Cardiología del Hospital Universitario Virgen de la Victoria. Málaga (España)
| | - Antonio Buño Soto
- Miembro de la Sociedad Española de Medicina de Laboratorio. Servicio de Análisis Clínicos. Hospital Universitario la Paz. Madrid (España)
| |
Collapse
|
16
|
Ortiz A, Quiroga B, Díez J, Martín FJES, Ramirez L, Maraver MP, Lourdes Martínez-Berganza Asensio M, Ángel Arranz Arija J, Luis Alvarez-Ossorio Fernández J, Córdoba R, Muntó FB, Hidalgo MJC, Reverter JC, Plasencia-Rodríguez C, Gómez JC, Guijarro C, del Mar Freijo Guerrero M, Sequera PD. Las Sociedades Científicas españolas ante la guía ESC 2021 de prevención de la enfermedad vascular: generalizar la medida de la albuminuria para identificar el riesgo cardiovascular y prevenir la enfermedad vascular. Nefrologia 2023. [DOI: 10.1016/j.nefro.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
|
17
|
Montejano R, de la Calle-Prieto F, Velasco M, Guijarro C, Queiruga-Parada J, Jiménez-González M, González-Ruano P, Martínez P, Goikoetxea AJ, Ibarrola M, Ciudad M, Gutiérrez Á, Torralba M, Díaz-Brasero A, Ryan P, Marcelo C, Díez C, Ibarra S, Merino E, Estrada V, Marcos J, Novella M, Rivera MA, Ruiz-Muñoz M, de Miguel M, Soler L, del Álamo M, Moreno S, Carcas AJ, Borobia AM, Arribas JR. Tenofovir Disoproxil Fumarate/Emtricitabine and Baricitinib for Patients at High Risk of Severe Coronavirus Disease 2019: The PANCOVID Randomized Clinical Trial. Clin Infect Dis 2022; 76:e116-e125. [PMID: 35906838 PMCID: PMC9384601 DOI: 10.1093/cid/ciac628] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/15/2022] [Accepted: 07/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study was designed to evaluate if patients with high risk for severe coronavirus disease 2019 (COVID-19) would benefit from treatment with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) followed by baricitinib in case of hypoxemia and systemic inflammation. METHODS PANCOVID is an open-label, double-randomized, phase 3 pragmatic clinical trial including adults with symptomatic COVID-19 with ≥2 comorbidities or aged ≥60 years and was conducted between 10 October 2020 and 23 September 2021. In the first randomization, patients received TDF/FTC or no TDF/FTC. In the second randomization, patients with room air oxygen saturation <95% and at least 1 increased inflammatory biomarker received baricitinib plus dexamethasone or dexamethasone alone. The primary endpoint was 28-day mortality. Main secondary endpoint was 28-day disease progression or critical care unit admission or mortality. The trial was stopped before reaching planned sample size due to the decrease in the number of cases and a mortality rate substantially lower than expected. RESULTS Of the 355 included participants, 97% were hospitalized at baseline. Overall, 28-day mortality was 3.1%. The 28-day mortality relative risk (RR) for participants treated with TDF/FTC was 1.76 (95% confidence interval [CI], .52-5.91; P = .379); it was 0.42 (95% CI, .11-1.59; P = .201) for those treated with baricitinib. The 28-day RR for the main secondary combined endpoint for participants treated with TDF/FTC was 0.95 (95% CI, .66-1.40; P = .774); it was 0.90 (95% CI, .61-1.33; P = .687) for those treated with baricitinib. CONCLUSIONS Our results do not suggest a beneficial effect of TDF/FTC; nevertheless, they are compatible with the beneficial effect of baricitinib already established by other clinical trials. CLINICAL TRIALS REGISTRATION EudraCT: 2020-001156-18.
Collapse
Affiliation(s)
| | | | - María Velasco
- Infectious Diseases. Research Unit. University Hospital Fundación Alcorcón. Madrid. Spain
| | - Carlos Guijarro
- Internal Medicine Unit. University Hospital Fundación Alcorcón. Rey Juan Carlos University. Madrid. Spain
| | - Javier Queiruga-Parada
- Clinical Pharmacology Department, La Paz University Hospital, IdiPAZ. Infectious Diseases Unit. La Paz University Hospital. IdiPAZ. Madrid. Spain
| | - María Jiménez-González
- Clinical Pharmacology Department, La Paz University Hospital, IdiPAZ. La Paz University Hospital. IdiPAZ. Spanish Clinical Research Network – SCReN. Madrid. Spain
| | | | - Patricia Martínez
- Internal Medicine Department. University Hospital Infanta Sofía. Madrid. Spain
| | | | - Marta Ibarrola
- Infectious Diseases Unit. Cruces University Hospital. Barakaldo. Spain
| | - Marianela Ciudad
- Infectious Diseases Unit. Internal Medicine Department. La Princesa University Hospital, Madrid, Spain
| | - Ángela Gutiérrez
- Infectious Diseases Unit. Internal Medicine Department. La Princesa University Hospital, Madrid, Spain
| | - Miguel Torralba
- Internal Medicine Department. Guadalajara University Hospital. University of Alcalá. Spain
| | - Ana Díaz-Brasero
- Internal Medicine Department. Guadalajara University Hospital. University of Alcalá. Spain
| | - Pablo Ryan
- Infanta Leonor University Hospital. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC). School of Medicine, Complutense University. Madrid, Spain
| | | | - Cristina Díez
- Clinical Microbiology and Infectious Diseases Department. Gregorio Marañon University Hospital. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid, Spain
| | - Sofía Ibarra
- Infectious Diseases Department. Basurto University Hospital. Basurto. Spain
| | - Esperanza Merino
- Infectious Diseases Unit. Alicante General University Hospital. Alicante Institute of Health and Biomedical Research (ISABIAL). Alicante, Spain
| | - Vicente Estrada
- Infectious Diseases Unit. Internal Medicine Department. Clínico San Carlos University Hospital. IdiSSC. Madrid, Spain
| | - Javier Marcos
- Internal Medicine Department. University Hospital Fundación Alcorcón. Madrid, Spain
| | - María Novella
- Internal Medicine Department. Príncipe de Asturias University Hospital. Alcalá de Henares, Spain
| | - María A Rivera
- Emergency Department. La Paz University Hospital. Madrid, Spain
| | - Manuel Ruiz-Muñoz
- Internal Medicine Department. University Hospital Fundación Alcorcón. Madrid, Spain
| | | | - Llanos Soler
- Internal Medicine Department. University Hospital Infanta Sofía. Madrid. Spain
| | - Mikel del Álamo
- Infectious Diseases Unit. Cruces University Hospital. Barakaldo. Spain
| | - Santiago Moreno
- Infectious Diseases Department. Ramón y Cajal University Hospital. IRYCIS. University of Alcalá School of Medicine. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC). Madrid, Spain
| | | | | | - José R Arribas
- Corresponding author: José R. Arribas, MD Unidad de Enfermedades Infecciosas. Hospital Universitario La Paz. IdiPAZ. Paseo de la Castellana 261, Madrid 28046, Spain. E-mail:
| |
Collapse
|
18
|
Sánchez-Bacaicoa C, Galán J, Guijarro C, Rico-Martín S, Monreal M, Calderón-García JF, Aguilar-Cortés E, Sánchez Muñoz-Torrero JF. Sustained low-density lipoprotein-cholesterol <70 mg/dl is associated with improved cardiovascular outcomes in the clinical setting. Eur J Clin Invest 2022; 52:e13732. [PMID: 34908162 DOI: 10.1111/eci.13732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/10/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS Clinical trials have shown that intensive low-density lipoprotein cholesterol (LDL-C) lowering improves cardiovascular outcomes among patients with atherosclerotic cardiovascular disease (ASCVD), but data are limited in real clinical practice, particularly for patients with ASCVD informing different territories. METHODS FRENA was a prospective registry of consecutive outpatients with coronary, cerebrovascular or peripheral artery disease. We compared the incidence of recurrent events in patients with sustained LDL-C levels <70 mg/dl compared with those with ≥70 mg/dl. RESULTS As of December 2018, 1182 patients were eligible for this study. Among them, 172 (14.5%) had mean LDL-C levels ≤70 mg/dl, and 1010 (85.5%) had <70 mg/dl. Their clinical characteristics at baseline were similar. During 5 years of follow-up, 252 patients (21%) suffered major adverse cardiovascular events (MACE). The incidence rates of MACE were 3.42 events per 100 patient-years (95% confidence interval [95% CI] 2.17-5.14) in patients with levels <70 mg/dl and 5.57 (95% CI, 4.87-6.34) in those with ≥70 mg/dl; the rate ratio was 0.61 (95% CI, 0.39-0.92), p = 0.019. On multivariable analysis, patients with LDL-C levels <70 mg/dl were at lower risk for MACE (hazard ratio [HR]: 0.61 [95% CI, 0.39-0.93] p < 0.05). MACE reduction was driven by a decrease in coronary and peripheral events with no significant effect on stroke. CONCLUSIONS Long-term sustained LDL-C <70 mg/dl in the clinical practice is associated with reduction in cardiovascular and peripheral vascular events with no apparent effect on stroke.
Collapse
Affiliation(s)
| | - Javier Galán
- Department of Internal Medicine, Hospital San Pedro Alcántara, Cáceres, Spain
| | - Carlos Guijarro
- Department of Medical Specialties and Public Heatlh, Alcorcon University Hospital. Rey Juan Carlos University, Madrid, Spain
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Julián F Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | | | | | | |
Collapse
|
19
|
Fernández-de-Las-Peñas C, Martín-Guerrero JD, Navarro-Pardo E, Torres-Macho J, Guijarro C, Pellicer-Valero OJ. Exploring the recovery curve for gastrointestinal symptoms from the acute COVID-19 phase to long-term post-COVID: The LONG-COVID-EXP-CM Multicenter Study. J Med Virol 2022; 94:2925-2927. [PMID: 35315087 PMCID: PMC9088575 DOI: 10.1002/jmv.27727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/18/2022] [Indexed: 11/10/2022]
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - José D Martín-Guerrero
- Intelligent Data Analysis Laboratory, Department of Electronic Engineering, ETSE (Engineering School), Universitat de València (UV), Valencia, Spain
| | - Esperanza Navarro-Pardo
- Department of Developmental and Educational Psychology, Universitat de València (UV), València, Spain
| | - Juan Torres-Macho
- Department of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid, Spain
| | - Carlos Guijarro
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain.,Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Oscar J Pellicer-Valero
- Intelligent Data Analysis Laboratory, Department of Electronic Engineering, ETSE (Engineering School), Universitat de València (UV), Valencia, Spain
| |
Collapse
|
20
|
Sáez-Jiménez R, Esteban-Hernández J, Herreros B, Huelmos A, Guijarro C, Guijarro C, Belinchón JC, Aranda C, Herreros B, González Anglada I, Téllez M, Huelmos AI, López-Bescós L, Sánchez C, Barriga F, Gutiérrez M, Puras E, Casas ML, Tolón R. La albuminuria y la enfermedad polivascular mejoran la capacidad predictiva de los modelos multivariados después de un evento cardiovascular agudo. Cohorte AIRVAG. Rev Clin Esp 2022. [DOI: 10.1016/j.rce.2021.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
21
|
Fernández-de-Las-Peñas C, Torres-Macho J, Velasco-Arribas M, Plaza-Canteli S, Arias-Navalón JA, Hernández-Barrera V, Guijarro C. Preexisting hypertension is associated with a greater number of long-term post-COVID symptoms and poor sleep quality: a case-control study. J Hum Hypertens 2022; 36:582-584. [PMID: 35173268 PMCID: PMC8853057 DOI: 10.1038/s41371-022-00660-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/21/2022] [Accepted: 02/04/2022] [Indexed: 01/04/2023]
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain.
| | - Juan Torres-Macho
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid, Spain.,Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - María Velasco-Arribas
- Department of Infectious Diseases, Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.,Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Susana Plaza-Canteli
- Department of Internal Medicine, Hospital Universitario Severo Ochoa, Madrid, Spain.,School of Medicine, Universidad Alfonso X el Sabio, Madrid, Spain
| | | | | | - Carlos Guijarro
- Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain.,Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| |
Collapse
|
22
|
Fernández-de-Las-Peñas C, Pellicer-Valero OJ, Navarro-Pardo E, Palacios-Ceña D, Florencio LL, Guijarro C, Martín-Guerrero JD. Symptoms Experienced at the Acute Phase of SARS-CoV-2 Infection as Risk Factor of Long-term Post-COVID Symptoms: The LONG-COVID-EXP-CM Multicenter Study. Int J Infect Dis 2022; 116:241-244. [PMID: 35017102 PMCID: PMC8743274 DOI: 10.1016/j.ijid.2022.01.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 11/28/2022] Open
Abstract
Objective This multicenter study investigated clinical risk factors associated with the number of long-term symptoms after COVID. Methods Clinical features, symptoms at hospital admission, hospitalization data, and the number of symptoms after COVID was systematically assessed for patients who recovered from COVID-19 in 4 hospitals in Madrid (Spain) from February 20 to May 31, 2020. Results Overall, 1,969 patients (46.5% women, age: 61, SD: 16 years) were randomly assessed 8.4 months (SD 1.5) after hospital discharge. Female gender (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.57-2.10), number of morbidities (OR 1.182, 95% CI 1.08-1.29), number of symptoms at hospital admission (OR 1.309, 95% CI 1.15-1.49) and days at the hospital (OR 1.01, 95% CI 1.007-1.017) were associated (all, p <0.001) with more long-term symptoms after COVID. Further, vomiting (OR 1.78, 95% CI 1.26-2.52), throat pain (OR 1.36, 95% CI 1.02-1.81), diarrhea (OR 1.51, 95% CI 1.25-1.82), dyspnea (OR 1.20, 95% CI 1.01-1.41), or headache (OR 1.50, 95% CI 1.28-1.75) as symptoms at hospital admission were also associated (all, p <0.01) with a higher number of symptoms after COVID. Conclusion This multicenter study found that a higher number of symptoms at hospital admission were the most relevant risk factor for developing more symptoms after COVID, supporting the assumption that a higher symptom load at the acute phase is associated with a greater likelihood of long-term symptoms after COVID.
Collapse
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain.
| | - Oscar J Pellicer-Valero
- Intelligent Data Analysis Laboratory, Department of Electronic Engineering, ETSE (Engineering School), Universitat de València (UV), Valencia, Spain
| | - Esperanza Navarro-Pardo
- Department of Developmental and Educational Psychology, Universitat de València (UV), València, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Lidiane L Florencio
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Carlos Guijarro
- Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain; Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - José D Martín-Guerrero
- Intelligent Data Analysis Laboratory, Department of Electronic Engineering, ETSE (Engineering School), Universitat de València (UV), Valencia, Spain
| |
Collapse
|
23
|
Fernández-de-Las-Peñas C, Guijarro C, Torres-Macho J, Velasco-Arribas M, Plaza-Canteli S, Hernández-Barrera V, Arias-Navalón JA. Diabetes and the Risk of Long-term Post-COVID Symptoms. Diabetes 2021; 70:2917-2921. [PMID: 34580087 DOI: 10.2337/db21-0329] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022]
Abstract
This study investigated the association of diabetes in patients who recovered from severe acute respiratory syndrome coronavirus 2 infection with the presence of long-term post-coronavirus disease (COVID) symptoms. A case-control study that included individuals hospitalized during the first wave of the pandemic was conducted. Patients with a previous diagnosis of diabetes and under medical control were considered case subjects. Two age- and sex-matched patients without presenting diabetes per case subject were recruited as control subjects. Hospitalization and clinical data were collected from hospital medical records. Patients were scheduled for a telephone interview. A list of post-COVID symptoms was systematically evaluated, but participants were invited to freely report any symptom. The Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index were used to assess anxiety and depressive symptoms, and sleep quality, respectively. Multivariable conditional logistic regression models were constructed. Overall, 145 patients with diabetes and 144 control subjects without diabetes who had recovered from COVID-19 were assessed at 7.2 (SD 0.6) months after hospital discharge. The number of post-COVID symptoms was similar between groups (incident rate ratio 1.06, 95% CI 0.92-1.24, P = 0.372). The most prevalent post-COVID symptoms were fatigue, dyspnea on exertion, and pain. No between-groups differences in any post-COVID symptom were observed. Similarly, no differences in limitations with daily living activities were found between patients with and without diabetes. Diabetes was not a risk factor for experiencing long-term post-COVID symptoms.
Collapse
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Carlos Guijarro
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
- Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Juan Torres-Macho
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - María Velasco-Arribas
- Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
- Research Unit, Department of Infectious Diseases, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Susana Plaza-Canteli
- Department of Internal Medicine, Hospital Universitario Severo Ochoa, Madrid, Spain
- School of Medicine, Universidad Alfonso X el Sabio, Madrid, Spain
| | | | | |
Collapse
|
24
|
Cuende J, Guijarro C. Estimación del riesgo vascular. El tiempo y el lugar importan. Rev Clin Esp 2021. [DOI: 10.1016/j.rce.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
25
|
Martínez-Barranco P, García-Roa M, Trelles-Martínez R, Arribalzaga K, Velasco M, Guijarro C, Marcos J, Campelo C, Acedo-Sanz JM, Villalón L, Ricard P, García-Bueno MJ, Pérez-Fernández E, Rodríguez-Caravaca G, Peñalver FJ. Management of Persistent SARS-CoV-2 Infection in Patients with Follicular Lymphoma. Acta Haematol 2021; 145:384-393. [PMID: 34839289 PMCID: PMC9059018 DOI: 10.1159/000521121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/18/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION There is no consensus on the management of the coronavirus disease (COVID-19) in patients with secondary immunosuppression due to either an underlying hematological disease or to the effects of immunochemotherapy (ICT). Some of them may present persistent infection with multiple relapses of COVID-19, requiring several admissions. This study evaluated the clinical characteristics and outcomes after treatment of 5 patients with follicular lymphoma (FL), previously treated with ICT, who developed several episodes of COVID-19. METHODS We analyzed the clinical evolution and response to treatment with antiviral agent, steroids, and convalescent plasma in 5 patients with FL and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persistent infection. Reverse transcriptase polymerase chain reaction tests and peripheral blood immunophenotype were performed for all patients. RESULTS All patients required hospitalization due to pneumonia with severity criteria and were re-admitted after a median of 22 days (13-42) from the previous discharge. They all showed B-cell depletion by immunophenotyping, and no traces of immunoglobulin antibodies against SARS-CoV-2 were detected in any of the cases. The survival rate was 80%. CONCLUSION The combination therapy evidenced clinical benefits, demonstrating its capacity to control infection in immunosuppressed FL patients treated with ICT.
Collapse
Affiliation(s)
| | - María García-Roa
- Department of Hematology, Hospital Universitario Fundación Alcorcón, Madrid, Spain,
| | | | - Karmele Arribalzaga
- Department of Hematology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - María Velasco
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
- Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Carlos Guijarro
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Javier Marcos
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Carolina Campelo
- Department of Microbiology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Juan Manuel Acedo-Sanz
- Department of Clinical Laboratory, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Lucía Villalón
- Department of Hematology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Pilar Ricard
- Department of Hematology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | | | - Gil Rodríguez-Caravaca
- Department of Preventive Medicine, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | | |
Collapse
|
26
|
Guijarro C, Galán I, Martínez-Ponce D, Pérez-Fernández E, Goyanes MJ, Castilla V, Velasco M. SARS-CoV-2 new infections among health-care workers after the first dose of the BNT162b2 mRNA COVID-19 vaccine. A hospital-wide cohort study. Clin Microbiol Infect 2021; 27:1699.e1-1699.e4. [PMID: 34197936 PMCID: PMC8239210 DOI: 10.1016/j.cmi.2021.06.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/02/2021] [Accepted: 06/15/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To evaluate the effect of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination on the incidence of new SARS-CoV-2 infections in health-care workers (HCW). METHODS The evolution of the incident rate of microbiologically confirmed SARS-CoV-2 infection in a cohort of 2590 HCW after BNT162b2 mRNA SARS-CoV-2 vaccination, compared with the rate in the community (n = 170 513) was evaluated by mixed Poisson regression models. RESULTS A total of 1820 HCW (70.3% of total) received the first dose of the BNT162b2 mRNA vaccine between 10 January and 16 January 2021, and 296 (11.4%) received it the following week. All of them completed vaccination 3 weeks later. Incidence rates of SARS-CoV-2 infection after the first dose of mRNA SARS-CoV-2 vaccine declined by 71% (Incidence Rate Ratio (IRR) 0.286, 95% CI 0.174-0.468; p < 0.001) and by 97% (IRR 0.03, 95% CI 0.013-0.068; p < 0.001) after the second dose, compared with the perivaccine time. SARS-CoV-2 incidence rates in the community (with a negligible vaccination rate) had a much lower decline: 2% (IRR 0.984, 95% CI 0.943-1.028; p 0.47) and 61% (IRR 0.390, 95% CI 0.375-0.406; p < 0.001) for equivalent periods. Adjusting for the decline in the community, the reduction in the incident rates among HCW were 73% (IRR 0.272, 95% CI 0.164-0.451 p < 0.001) after the first dose of the vaccine and 92% (IRR 0.176, 95% CI 0.033-0.174; p < 0.001) after the second dose. CONCLUSIONS mRNA SARS-CoV-2 vaccination is associated with a dramatic decline in new SARS-CoV-2 infection among HCW, even before the administration of the second dose of the vaccine.
Collapse
Affiliation(s)
- Carlos Guijarro
- Internal Medicine Unit Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain; Department of Medical Specialties and Public Health, Health Sciences School, Universidad Rey Juan Carlos, Madrid, Spain; Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Isabel Galán
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Diana Martínez-Ponce
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | | | - Maria José Goyanes
- Microbiology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Virgilio Castilla
- Internal Medicine Unit Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain; Medical Direction, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - María Velasco
- Department of Medical Specialties and Public Health, Health Sciences School, Universidad Rey Juan Carlos, Madrid, Spain; Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Infectious Diseases Section, Internal Medicine Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| |
Collapse
|
27
|
Guijarro C, Civeira F, López-Miranda J, Masana L, Pedro-Botet J, Pintó X, Valdivielso P, Mostaza JM. Situation in 2020 of the requirements for the use of PCSK9 inhibitors in Spain: Results of a national survey. Clin Investig Arterioscler 2021; 34:10-18. [PMID: 34656373 DOI: 10.1016/j.arteri.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
AIMS During 2019 and 2020 a series of meetings over the country were carried out, with the aim of explaining the methodology and criteria for the ellaboration of the recommendations on the use of iPCSK9, published by the Spanish Society of Atherosclerosis (SEA in Spanish). At the end of the meetings, a survey was conducted among the participants, in order to describe the prescription requirements of these drugs in the Spanish regions. METHODOLOGY Butterfly Project was developed by a scientific Committee of experts in lipids. After the ellaboration of the materials for the project, a train the trainers program was carried out, imparted by 17 experts who were the Project coordinators. Later, 16 regional workshops were performed, with the attendance of 169 medical doctors involved in the management of hipercolesterolemia. The attendants responded the survey, where they were asked different questions on the use of iPCSK9 on their clinical practice. RESULTS A high heterogeneity among centers regarding the requirements and difficulties for iPCSK9 prescription was revealed. Twenty one per cent of responders indicated to have low difficulties to prescribe iPCSK9 in their hospitals, whereas 78% found moderate or high difficulties. The difficulties came from burocracy- administrative aspects (18%), restrictions in the indication (41%) and both (38%). In general, the obstacles did not depend on the hospital level, neither the speciality, or the presence of lipid units, although the existance of lipid units was associated with a higher number of patients treated with iPCSK9. The factors which were associated with higher difficulty in the prescription were: the presence of an approval committee in the hospitals, the frequency in the revision of the treatment by hospital pharmacy, the temporal cadence of the prescription, the profile of patients seen and the criteria followed by the specialists for the prescription. CONCLUSION The results show important diferences in the treatment with iPCSK9 in the context of clinical practice in Spain. The analysis of these results will permit to make proposals regarding future actions addressed to reach the equity in the access to iPCSK9 in Spain, with the main aim of maximizing their potential benefit according to the patients profile.
Collapse
Affiliation(s)
- Carlos Guijarro
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - Fernando Civeira
- Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España
| | - José López-Miranda
- Servicio de Medicina Interna, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBEROBN, Córdoba, España
| | - Luis Masana
- Servicio de Medicina Interna, Hospital Universitario de Reus, Universidad Rovira i Virgili, IISPV, CIBERBEM, Reus, Tarragona, España
| | - Juan Pedro-Botet
- Servicio de Medicina Interna, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España
| | - Xavier Pintó
- Servicio de Medicina Interna, Hospital Universitario de Bellvitge-Idibell, Universidad de Barcelona, CIBEROBN, L' Hospitalet de Llobregat, Barcelona, España
| | - Pedro Valdivielso
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
| | | |
Collapse
|
28
|
Fernández-de-Las-Peñas C, Gómez-Mayordomo V, de-la-Llave-Rincón AI, Palacios-Ceña M, Rodríguez-Jiménez J, Florencio LL, Velasco-Arribas M, Fuensalida-Novo S, Cigarán-Méndez M, Ambite-Quesada S, Guijarro C, Cuadrado ML, Arias-Navalón JA, Ortega-Santiago R, Elvira-Martínez CM, Molina-Trigueros LJ, Torres-Macho J, Sebastián-Viana T, Canto-Diez MG, Hernández-Barrera V, Palacios-Ceña D. Anxiety, depression and poor sleep quality as long-term post-COVID sequelae in previously hospitalized patients: A multicenter study. J Infect 2021; 83:496-522. [PMID: 34192525 PMCID: PMC8236125 DOI: 10.1016/j.jinf.2021.06.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022]
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain.
| | - Víctor Gómez-Mayordomo
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain
| | | | - María Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain
| | - Jorge Rodríguez-Jiménez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain
| | - Lidiane L Florencio
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain
| | - María Velasco-Arribas
- Department of Internal Medicine-Infectious Department, Research Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Stella Fuensalida-Novo
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain
| | | | - Silvia Ambite-Quesada
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain
| | - Carlos Guijarro
- Department of Internal Medicine-Infectious Department, Research Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - María L Cuadrado
- Neurology Department, Hospital Clínico San Carlos, Madrid, Spain; Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain
| | | | - Luis J Molina-Trigueros
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain; Department of Physical Therapy, Hospital Universitario Fuenlabrada, Madrid, Spain
| | - Juan Torres-Macho
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid Spain
| | | | - Mª Gabriela Canto-Diez
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid Spain
| | | | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain
| |
Collapse
|
29
|
Cuende JI, Guijarro C. Estimation of vascular risk: Time and place matter. Rev Clin Esp 2021; 221:596-597. [PMID: 34563485 DOI: 10.1016/j.rceng.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 10/20/2022]
Affiliation(s)
- J I Cuende
- Consulta de Riesgo Vascular, Servicio de Medicina Interna, Complejo Asistencial Universitario de Palencia, Palencia, Spain; Departamento de Medicina, Dermatología y Toxicología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
| | - C Guijarro
- Consulta de Riesgo Vascular, Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Madrid, Spain
| |
Collapse
|
30
|
Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Palacios-Ceña M, Rodríguez-Jiménez J, de-la-Llave-Rincón AI, Velasco-Arribas M, Fuensalida-Novo S, Ambite-Quesada S, Guijarro C, Cuadrado ML, Florencio LL, Arias-Navalón JA, Ortega-Santiago R, Elvira-Martínez CM, Molina-Trigueros LJ, Torres-Macho J, Sebastián-Viana T, Canto-Diez MG, Cigarán-Méndez M, Hernández-Barrera V, Arendt-Nielsen L. Fatigue and Dyspnoea as Main Persistent Post-COVID-19 Symptoms in Previously Hospitalized Patients: Related Functional Limitations and Disability. Respiration 2021; 101:132-141. [PMID: 34569550 PMCID: PMC8678253 DOI: 10.1159/000518854] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
Background Multicentre studies focussing on specific long-term post-COVID-19 symptoms are scarce. Objective The aim of this study was to determine the levels of fatigue and dyspnoea, repercussions on daily life activities, and risk factors associated with fatigue or dyspnoea in COVID-19 survivors at long term after hospital discharge. Methods Age, gender, height, weight, symptoms at hospitalization, pre-existing medical comorbidity, intensive care unit admission, and the presence of cardio-respiratory symptoms developed after severe acute respiratory syndrome coronavirus 2 infection were collected from patients who recovered from COVID-19 at 4 hospitals in Madrid (Spain) from March 1 to May 31, 2020 (first COVID-19 wave). The Functional Impairment Checklist was used for evaluating fatigue/dyspnoea levels and functional limitations. Results A total of 1,142 patients (48% women, age: 61, standard deviation [SD]: 17 years) were assessed 7.0 months (SD 0.6) after hospitalization. Fatigue was present in 61% patients, dyspnoea with activity in 55%, and dyspnoea at rest in 23.5%. Only 355 (31.1%) patients did not exhibit fatigue and/or dyspnoea 7 months after hospitalization. Forty-five per cent reported functional limitations with daily living activities. Risk factors associated with fatigue and dyspnoea included female gender, number of pre-existing comorbidities, and number of symptoms at hospitalization. The number of days at hospital was a risk factor just for dyspnoea. Conclusions Fatigue and/or dyspnoea were present in 70% of hospitalized COVID-19 survivors 7 months after discharge. In addition, 45% patients exhibited limitations on daily living activities. Being female, higher number of pre-existing medical comorbidities and number of symptoms at hospitalization were risk factors associated to fatigue/dyspnoea in COVID-19 survivors 7 months after hospitalization.
Collapse
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | | | - María Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Jorge Rodríguez-Jiménez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Ana I de-la-Llave-Rincón
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - María Velasco-Arribas
- Department of Internal Medicine-Infectious, Research Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.,Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Stella Fuensalida-Novo
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Silvia Ambite-Quesada
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Carlos Guijarro
- Department of Internal Medicine-Infectious, Research Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.,Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - María L Cuadrado
- Neurology Department, Hospital Clínico San Carlos, Madrid, Spain.,Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Lidiane L Florencio
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | | | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | | | - Luis J Molina-Trigueros
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain.,Department of Physical Therapy, Hospital Universitario Fuenlabrada, Madrid, Spain
| | - Juan Torres-Macho
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid, Spain
| | | | - María Gabriela Canto-Diez
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid, Spain
| | | | | | - Lars Arendt-Nielsen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, CNAP, Center for Sensory-Motor Interaction (SMI), Aalborg, Denmark
| |
Collapse
|
31
|
Fernández-de-Las-Peñas C, Torres-Macho J, Velasco-Arribas M, Arias-Navalón JA, Guijarro C, Hernández-Barrera V, Canto-Diez MG. Similar prevalence of long-term post-COVID symptoms in patients with asthma: A case-control study. J Infect 2021; 83:237-279. [PMID: 33957161 PMCID: PMC8089027 DOI: 10.1016/j.jinf.2021.04.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 11/18/2022]
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid. Spain.
| | - Juan Torres-Macho
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid Spain; Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Maria Velasco-Arribas
- Department of Infectious Diseases, Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | | | - Carlos Guijarro
- Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain; Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - MGabriela Canto-Diez
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Department of Allergology, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid Spain
| |
Collapse
|
32
|
Sáez-Jiménez R, Esteban-Hernández J, Herreros B, Huelmos A, Guijarro C. Albuminuria and polyvascular disease improve multivariate predictive models after an acute cardiovascular event. The AIRVAG cohort. Rev Clin Esp 2021; 222:138-151. [PMID: 34147423 DOI: 10.1016/j.rceng.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS There is no consensus regarding risk stratification tools for secondary prevention in atherosclerotic cardiovascular disease. Our aim was to compare the discriminative performance of the Framingham, REGICOR, SCORE, and REACH risk functions and the Bohula-TIMI and SMART risk scores, as well as to assess the potential added value of other clinical variables for the prediction of recurrent events in patients with established vascular disease. METHODS A cohort of 269 patients with established vascular disease (52.8% coronary, 32% cerebrovascular, 15.2% PAD) was included. The survival functions of risk groups (low/medium/high) according to commonly used cutoff points for each function/score were compared, and hazard ratios for each were estimated using Cox regression. We calculated Δ Harrell's C statistic, cat-NRI, and cNRI after adding new predictors to a base model including age, sex, total cholesterol, current smoking status, hypertension, and diabetes. RESULTS After six years of follow-up (median 4.82 years), 61 events occurred (23%). High-risk groups had a higher risk of recurrent event: SMART (HR: 3.17 [1.55-6.5]), Framingham (HR: 3.08 [1.65-5.75]), REGICOR (HR: 2.71 [1.39-5.27]), SCORE (HR: 2.14 [1.01-4.5], REACH (HR: 5.74 [2.83-11.7]), B-TIMI (HR: 3.68 [0.88-15.3]). Polyvascular disease (three territories HR: 5.6 [2.2-14.25]), albuminuria (HR: 3.55 [2.06-6.11]), and heart failure (HR: 3.11 [1.34-7.25]) also increased risk. Discrimination (Harrell's C) was low but improved after adding albuminuria and polyvascular disease. Both variables also improved the performance of the base model (cNRI.326 [.036; .607]). CONCLUSIONS The Framingham, REGICOR, SCORE, and REACH functions and the B-TIMI and SMART scores showed low yet similar performance in secondary prevention. Albuminuria and polyvascular disease improved the predictive performance of major classical cardiovascular risk factors.
Collapse
Affiliation(s)
- R Sáez-Jiménez
- Centro de Atención Primaria Presentación Sabio, Móstoles, Madrid, Spain; Área de Salud Pública y Medicina Preventiva, Facultad de Medicina, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - J Esteban-Hernández
- Área de Salud Pública y Medicina Preventiva, Facultad de Medicina, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - B Herreros
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - A Huelmos
- Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - C Guijarro
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Facultad de Medicina, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | | |
Collapse
|
33
|
Velasco M, Galán MI, Casas ML, Pérez-Fernández E, Martínez-Ponce D, González-Piñeiro B, Castilla V, Guijarro C. Impact of Previous Coronavirus Disease 2019 on Immune Response After a Single Dose of BNT162b2 Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine. Open Forum Infect Dis 2021; 8:ofab299. [PMID: 34258322 PMCID: PMC8244747 DOI: 10.1093/ofid/ofab299] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Immune response after a single dose of BNT162b2 vaccine was markedly increased in subjects with previous severe acute respiratory syndrome coronavirus 2 infection, reaching similar immunoglobulin titers to those elicited by the full 2 doses in naive cases, and increased modestly after the second dose. These data may inform the priority of the boosting dose.
Collapse
Affiliation(s)
- María Velasco
- Infectious Diseases and Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Maria Isabel Galán
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Maria Luisa Casas
- Laboratory Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Diana Martínez-Ponce
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | | | - Carlos Guijarro
- Rey Juan Carlos University, Internal Medicine Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | |
Collapse
|
34
|
Fernández-de-Las-Peñas C, Guijarro C, Plaza-Canteli S, Hernández-Barrera V, Torres-Macho J. Prevalence of Post-COVID-19 Cough One Year After SARS-CoV-2 Infection: A Multicenter Study. Lung 2021; 199:249-253. [PMID: 33993321 PMCID: PMC8124095 DOI: 10.1007/s00408-021-00450-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 05/08/2021] [Indexed: 01/31/2023]
Abstract
This multicenter study presents prevalence data and associated risk factors of post-COVID-19 cough one year after hospital discharge in COVID-19 survivors. Individuals recovered from COVID-19 at three public hospitals in Madrid (Spain) were scheduled for a telephonic interview. They were systematically asked about the presence of respiratory symptoms, e.g., fatigue, dyspnea, chest pain, and cough after hospital discharge. Clinical and hospitalization data were collected from hospital records. Overall, 1,950 patients (47% women, mean age:61, SD:16 years) were assessed at 11.2 months (SD 0.5) after hospital discharge. Just 367 (18.8%) were completely free of any respiratory post-COVID -19 symptom. The prevalence of long-term cough, chest pain, dyspnea, and fatigue was 2.5%, 6.5%, 23.3%, and 61.2%, respectively. Clinical and hospitalization factors were not associated with long-term post-COVID-19 cough. In conclusion, the prevalence of post-COVID-19 cough one year after SARS-CoV-2 infection was 2.5% in subjects who had survived hospitalization for COVID-19. No clear risk factor associated to long-term post-COVID-19 cough was identified.
Collapse
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Avenida de Atenas s/n, Alcorcón, 28922, Madrid, Spain.
| | - Carlos Guijarro
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain.,Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Susana Plaza-Canteli
- Department of Internal Medicine, Hospital Universitario Severo Ochoa, Madrid, Spain.,School of Medicine, Universidad Alfonso X el Sabio, Madrid, Spain
| | | | - Juan Torres-Macho
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de La Torre, Madrid, Spain.,Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
35
|
Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Rodríuez-Jiménez J, Palacios-Ceña M, Velasco-Arribas M, Guijarro C, de-la-Llave-Rincón AI, Fuensalida-Novo S, Elvira-Martínez CM, Cuadrado ML, Arias-Navalón JA, Florencio LL, Ortega-Santiago R, Molina-Trigueros LJ, Sebastián-Viana T, Torres-Macho J, Canto-Diez G, Plaza-Canteli S, Cigarán-Méndez M, Ambite-Quesada S, Hernández-Barrera V, Arias-Buría JL, Arendt-Nielsen L. Long-term post-COVID symptoms and associated risk factors in previously hospitalized patients: A multicenter study. J Infect 2021; 83:237-279. [PMID: 33984399 PMCID: PMC8110627 DOI: 10.1016/j.jinf.2021.04.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 12/22/2022]
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | | | - Jorge Rodríuez-Jiménez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - María Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - María Velasco-Arribas
- Department of Internal Medicine-Infectious Department, Research Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Carlos Guijarro
- Department of Internal Medicine-Infectious Department, Research Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Department of Medicine, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Ana I de-la-Llave-Rincón
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Stella Fuensalida-Novo
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | | | - María L Cuadrado
- Department of Neurology, Hospital Clínico San Carlos. Madrid, Spain; Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Lidiane L Florencio
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Luis J Molina-Trigueros
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain; Department of Physical Therapy, Hospital Universitario Fuenlabrada, Madrid, Spain
| | | | - Juan Torres-Macho
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid, Spain
| | - Gabriela Canto-Diez
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Department of Allergy, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid, Spain
| | - Susana Plaza-Canteli
- School of Health Sciences, Universidad Alfonso X el Sabio, Madrid, Spain; Department of Internal Medicine, Hospital Universitario Severo Ochoa, Madrid, Spain
| | | | - Silvia Ambite-Quesada
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | | | - José L Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Lars Arendt-Nielsen
- CNAP, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
36
|
Guijarro C, Pérez-Fernández E, González-Piñeiro B, Meléndez V, Goyanes MJ, Renilla ME, Casas ML, Sastre I, Velasco M. Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain. Rev Clin Esp 2021; 221:264-273. [PMID: 38108497 PMCID: PMC7678416 DOI: 10.1016/j.rce.2020.10.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIAL AND METHODS We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS The crude cumulative incidence among migrants (n=20,419) was higher than among Spaniards (n=131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p<.001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=.007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p<.001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p<.001). CONCLUSIONS Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.
Collapse
Affiliation(s)
- C Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - B González-Piñeiro
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - V Meléndez
- Concejalía de Asuntos sociales, Mayores y Salud Pública, Ayuntamiento de Alcorcón, Alcorcón, Madrid, España
| | - M J Goyanes
- Unidad de Microbiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M E Renilla
- Unidad de Urgencias, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M L Casas
- Unidad de Laboratorio, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - I Sastre
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M Velasco
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Medicina Interna, Sección Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| |
Collapse
|
37
|
Velasco M, Guijarro C. SARS-CoV-2 reinfection in a closed setting: lessons for the community. Lancet Respir Med 2021; 9:675-677. [PMID: 33865505 PMCID: PMC8049587 DOI: 10.1016/s2213-2600(21)00187-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 04/11/2021] [Indexed: 11/30/2022]
Affiliation(s)
- María Velasco
- Infectious Diseases Section and Research Unit, Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, Madrid, Spain.
| | - Carlos Guijarro
- Internal Medicine Unit, Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, Madrid, Spain; Department of Medical Specialities and Public Health, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| |
Collapse
|
38
|
Guijarro C, Pérez-Fernández E, González-Piñeiro B, Meléndez V, Goyanes MJ, Renilla ME, Casas ML, Sastre I, Velasco M. Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain. Rev Clin Esp 2021; 221:264-273. [PMID: 33998512 DOI: 10.1016/j.rceng.2020.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIALS AND METHODS We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS The crude cumulative incidence among migrants (n = 20419) was higher than among Spaniards (n = 131599): 8.81 and 6.51 and per 1000 inhabitants, respectively (p < .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found in people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p = .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p < .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p < .001). CONCLUSIONS Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.
Collapse
Affiliation(s)
- C Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - B González-Piñeiro
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - V Meléndez
- Concejalía de Asuntos Sociales, Mayores y Salud Pública, Ayuntamiento de Alcorcón, Alcorcón, Madrid, Spain
| | - M J Goyanes
- Unidad de Microbiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M E Renilla
- Unidad de Urgencias, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M L Casas
- Unidad de Laboratorio, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - I Sastre
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M Velasco
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Medicina Interna, Sección Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | | |
Collapse
|
39
|
Guijarro C, Civeira F, Masana L. Genetic Confirmation of Monogenic Familial Hypercholesterolemia Advises a More Intensive Lipid-Lowering Approach. JAMA Cardiol 2020; 5:1452-1453. [PMID: 32936217 DOI: 10.1001/jamacardio.2020.4114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Carlos Guijarro
- Internal Medicine Unit, Fundación Alcorcon University Hospital, Rey Juan Carlos University, Madrid, Spain
| | - Fernando Civeira
- Head Lipid Clinic and Lipid Research Group, Miguel Servet University Hospital, Instituto de Investigación Sanitaria Aragon, Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Zaragoza, Spain
| | - Luis Masana
- Lipids and Arteriosclerosis Research Unit, Sant Joan University Hospital, Internal Medicine Department, Institut d'Investigació Sanitària Pere Virgili, Rovira I Virgili University, Catalonia, Spain
| |
Collapse
|
40
|
Guijarro C. COVID-19 and cardiovascular disease. Clin Investig Arterioscler 2020; 32:263-266. [PMID: 33213825 PMCID: PMC7669242 DOI: 10.1016/j.arteri.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Carlos Guijarro
- Unidad de Medicina Interna. Consulta de Riesgo Vascular, Hospital Universitario Fundación Alcorcón. Universidad Rey Juan Carlos, c/ Budapest 1 28922, Madrid.
| |
Collapse
|
41
|
Sánchez B, Guijarro C, Velasco M, Vicente MJ, Galán M, Herreros B. Evaluating the efficacy of an Advanced Care Planning Program for Health Decisions in patients with advanced heart failure: protocol for a Randomized Clinical Trial. BMC Cardiovasc Disord 2020; 20:456. [PMID: 33087061 PMCID: PMC7579909 DOI: 10.1186/s12872-020-01738-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/11/2020] [Indexed: 11/13/2022] Open
Abstract
Background An Advanced Care Planning (ACP) program of health decisions is the result of a process of reflection and relationship-building between the patient, their relatives and health professionals. It is based on respect for patients’ autonomy, involving them in making decisions about their disease in a way that is shared between the medical team, the patient and their relatives. Up until now, the efficacy of an ACP has not been measured in the existing literature, and therefore it is unknown if these programs reach their goal. The main objective of our study is to evaluate the efficacy of an ACP program for decision-making in patients with advanced heart failure (HF) in comparison to usual follow up and care. This objective will be evaluated by the Patient Activation Measure test, which measures the participation and self-management of the patient in decision-making. Secondary objectives: to evaluate the effect of the program on quality of life, to know if the patients wishes expressed through the ACP program are fulfilled, to measure the impact of the program on patients’ caregivers, to determine the satisfaction of patients included in the program and to evaluate the effect on quality of death. Methods Randomized multicentre clinical trial at four hospitals in Madrid. Once they are included in the study, patients’ allocation to groups (control vs intervention) will be made by alternative sampling. ACP will be applied to the intervention group, whereas in the Control Group usual follow-up will be carried out in HF units. All patients will fulfil questionnaires and tests related to the objectives of the study again after a 12-month follow-up period in order to gauge the effect of ACP in patients with advanced HF. Discussion The characteristics of patients with advanced HF make them a model for designing ACP programs, given the high prevalence of this disease, the progressive increase in its incidence and it’s clinical characteristics. Until now, the efficacy of this type of program has not been measured, so this Clinical Trial can provide relevant data for future ACP projects. Trial registration ClinicalTrials.gov Identifier: NCT04424680. Registered 9 June 2020. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04424680?term=NCT04424680&draw=2&rank=1.
Collapse
Affiliation(s)
- Beatriz Sánchez
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Calle Budapest 1, 28922, Alcorcón, Madrid, Spain
| | - Carlos Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Calle Budapest 1, 28922, Alcorcón, Madrid, Spain
| | - María Velasco
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Calle Budapest 1, 28922, Alcorcón, Madrid, Spain
| | - María Jesús Vicente
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Calle Budapest 1, 28922, Alcorcón, Madrid, Spain
| | - Miguel Galán
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Calle Budapest 1, 28922, Alcorcón, Madrid, Spain
| | - Benjamín Herreros
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Calle Budapest 1, 28922, Alcorcón, Madrid, Spain. .,Instituto de Ética Clínica Francisco Vallés, Universidad Europea de Madrid, Madrid, Spain.
| |
Collapse
|
42
|
Guijarro C, Camafort M. PCSK9 inhibitors: Ratification of the role of LDL cholesterol in cardiovascular prevention. Towards a convergence of European and North American prevention guidelines? Rev Clin Esp 2020. [DOI: 10.1016/j.rceng.2019.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
43
|
Guijarro C, Camafort M. Inhibidores de PCSK9: ratificación del papel del colesterol LDL en prevención cardiovascular. ¿Hacia la convergencia en las guías de prevención europeas y norteamericanas? Rev Clin Esp 2020; 220:374-382. [DOI: 10.1016/j.rce.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/25/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
|
44
|
Masana L, López Miranda J, Civeira F, Reinares L, Guijarro C, Plana N, Cuenca R, Sánchez D, Hernández JL, Andrés R, Blanco A, Villamayor S. Clinical profile of patients treated with evolocumab in lipid/internal medicine units of Spain. Observational study (RETOSS-IMU). Clin Investig Arterioscler 2020; 32:183-192. [PMID: 32317124 DOI: 10.1016/j.arteri.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the clinical characteristics, the reasons for initiating therapy, and the effects of treatment in the initial phase of evolocumab availability in lipid/internal medicine units in Spain. METHODS Retrospective, observational study, based on the medical records of consecutive patients initiating treatment with evolocumab (from February 2016 to July 2017) in 20 internal medicine units in Spain. A review was made of the demographic and clinical characteristics of the patients, the lipid lowering treatment, and the evolution of the lipid profiles between 12weeks pre-initiation and 12±4weeks post-initiation of evolocumab. RESULTS A total of 136 patients were analysed, of whom 64.0% were men, and the mean age (standard deviation, SD) was 56.6 (11.5) years. The large majority (75%) had familial hypercholesterolaemia (4 homozygous), and 51.0% of them had suffered at least one cardiovascular event. Atherosclerotic cardiovascular disease (ASCVD) was present in 61% of all patients. At initiation of evolocumab, 61.0% of the patients were taking high-intensity statins, and 60.3% were receiving ezetimibe. The mean (and SD) of LDL-C levels at initiation of evolocumab was 169.1 (56.6) mg/dL. The LDL-C was greater than 160mg/dL in 46.4% of patients, and ≥190mg/dL in 26.5%. During the observation period, evolocumab produced significant reductions in LDL-C of 55.7% (P<.0001), achieving mean values of 74.3mg/dL. At week12, more than half (53.8%) of patients achieved LDL-C levels <70mg/dL, and 26.9% <50mg/dL. CONCLUSIONS In the lipid/internal medicine units, evolocumab was mainly prescribed in patients with familial hypercholesterolaemia, with or without ASCVD. The initial use of evolocumab was in accordance with the guidelines of the Spanish Society of Arteriosclerosis (SEA) of 2016, with LDL-C levels being well above the recommended thresholds for treatment initiation. Evolocumab treatment in clinical practice reduced LDL-C levels by about 55%, a similar reduction to that reported in clinical trials. Most patients achieved LDL-C goals.
Collapse
Affiliation(s)
- Lluís Masana
- Servicio de Medicina Interna, Hospital Universitario Sant Joan, IISPV, CIBERDEM, Reus, Tarragona, España.
| | - José López Miranda
- Servicio de Medicina Interna, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBEROBN, Córdoba, España
| | - Fernando Civeira
- Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España
| | - Leonardo Reinares
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España
| | - Carlos Guijarro
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - Núria Plana
- Servicio de Medicina Interna, Hospital Universitario Sant Joan, IISPV, CIBERDEM, Reus, Tarragona, España
| | - Rafael Cuenca
- Servicio de Medicina Interna, Hospital Alto Guadalquivir, Andújar, Jaén, España
| | - Demetrio Sánchez
- Servicio de Medicina Interna, Hospital Nuestra Señora de Sonsoles, Ávila, España
| | - José Luis Hernández
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, España
| | - Raimundo Andrés
- Servicio de Medicina Interna, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - Agustín Blanco
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España
| | | |
Collapse
|
45
|
Saez R, Esteban J, Herreros B, Casas M, Huelmos A, Sanchez C, Fernandez de Velasco D, Guijarro C. Predictive performance of framingham, regicor, score, reach, b-timi and smart scales in secondary cardiovascular prevention. The airvag cohort. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
46
|
Masana L, Ibarretxe D, Rodríguez-Borjabad C, Plana N, Valdivielso P, Pedro-Botet J, Civeira F, López-Miranda J, Guijarro C, Mostaza J, Pintó X. Toward a new clinical classification of patients with familial hypercholesterolemia: One perspective from Spain. Atherosclerosis 2019; 287:89-92. [PMID: 31238171 DOI: 10.1016/j.atherosclerosis.2019.06.905] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The introduction of singular therapies, such as proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), to lower high cholesterol levels requires better classification of patients eligible for intensive lipid lowering therapy. According to the European Medicines Administration, PCSK9i are recommended in primary prevention only in familial hypercholesterolemia (FH) patients. Therefore, an FH diagnosis is not simply an academic issue, because it has many clinical implications. The bases of a diagnosis of FH are not entirely clear. The availability of genetic testing, including large genome-wide association analyses and whole genome studies, has shown that some patients with a clinical diagnosis of definite FH have no mutations in the genes associated with the disease. This fact does not exclude the very high cardiovascular risk of these patients, and an early and intensive lipid lowering therapy is recommended in all FH patients. Because an FH diagnosis is a cornerstone for decisions about therapies, a precise definition of FH is urgently required. This is an expert consensus document from the Spanish Atherosclerosis Society. We propose the following classification: familial hypercholesterolemia syndrome integrated by (1) heterozygous familial hypercholesterolemia: patients with clinically definite FH and a functional mutation in one allele of the LDLR, ApoB:100, and PCSK9 genes; (2) homozygous familial hypercholesterolemia: mutations affect both alleles; (3) polygenic familial hypercholesterolemia: patients with clinically definite FH but no mutations associated with FH are found (to be distinguished from non-familial, multifactorial hypercholesterolemia); (4) familial hypercholesterolemia combined with hypertriglyceridemia: a subgroup of familial combined hyperlipidaemia patients fulfilling clinically definite FH with associated hypertriglyceridemia.
Collapse
Affiliation(s)
- Luis Masana
- Unitat de Medicina Vascular i Metabolisme. Hospital Universitari Sant Joan. Universitat Rovira i Virgili. IISPV, CIBERDEM. Reus, Spain.
| | - Daiana Ibarretxe
- Unitat de Medicina Vascular i Metabolisme. Hospital Universitari Sant Joan. Universitat Rovira i Virgili. IISPV, CIBERDEM. Reus, Spain
| | - Cèlia Rodríguez-Borjabad
- Unitat de Medicina Vascular i Metabolisme. Hospital Universitari Sant Joan. Universitat Rovira i Virgili. IISPV, CIBERDEM. Reus, Spain
| | - Núria Plana
- Unitat de Medicina Vascular i Metabolisme. Hospital Universitari Sant Joan. Universitat Rovira i Virgili. IISPV, CIBERDEM. Reus, Spain
| | - Pedro Valdivielso
- Department of Medicine and Dermatology, Lipids and Atherosclerosis Laboratory, CIMES, University of Málaga, Virgen de la Victoria University Hospital, IBIMA, Málaga, Spain
| | - Juan Pedro-Botet
- Unitat de Lípids i Risc Vascular. Hospital del Mar. Departament de Medicina. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Civeira
- Unidad de Lípidos, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Jose López-Miranda
- Lipid and Atherosclerosis Unit, Department of Internal Medicine / IMIBIC/Reina Sofia University Hospital/University of Cordoba, CIBEROBN, Spain
| | - Carlos Guijarro
- Internal Medicine Unit, University Hospital Alcorcon Foundation, Rey Juan Carlos University, Madrid, Spain
| | - Jose Mostaza
- Internal Medicine Service, Hospital Carlos III, Madrid, Spain
| | - Xavier Pintó
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | |
Collapse
|
47
|
Ascaso JF, Civeira F, Guijarro C, López Miranda J, Masana L, Mostaza JM, Pedro-Botet J, Pintó X, Valdivielso P. Indications of PCSK9 inhibitors in clinical practice. Recommendations of the Spanish Sociey of Arteriosclerosis (SEA), 2019. Clin Investig Arterioscler 2019; 31:128-139. [PMID: 31130361 DOI: 10.1016/j.arteri.2019.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/11/2019] [Indexed: 02/06/2023]
Abstract
A group of experts convened by the Spanish Society of Arteriosclerosis (SEA) has been in charge of updating the SEA document on the indications of PCSK9 inhibitors (PCSK9i) in clinical practice that was published in 2016. This update is justified by the fact that the data from clinical trials carried out on a large scale with PCSK9i have shown that in addition to their high potency to lower atherogenic cholesterol, they reduce the risk of atherosclerotic cardiovascular disease, both in patients with stable disease, and with recent disease, and with a high degree of security. This update provides the recommendations and level of evidence for the prescription of iPCSK9 in patients with homozygous and heterozygous familial hypercholesterolemia, with atherosclerotic cardiovascular disease, and in primary prevention in patients with very high cardiovascular risk. These recommendations have been established taking into account the concentration of LDL-C, the clinical situation of the patient, the additional risk factors and the cost-effectiveness of their use.
Collapse
Affiliation(s)
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España
| | - Carlos Guijarro
- Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - José López Miranda
- Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBEROBN, Córdoba, España
| | - Luis Masana
- Hospital Universitario de Reus, Universidad Rovira y Virgili, IISPV, CIBERDEM, Reus, Tarragona, España
| | | | - Juan Pedro-Botet
- Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España
| | - Xavier Pintó
- Hospital Universitario de Bellvitge-Idibell, Universidad de Barcelona, CIBEROBN, Hospitalet de Llobregat, Barcelona, España.
| | - Pedro Valdivielso
- Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
| |
Collapse
|
48
|
Marzal D, Rodríguez Padial L, Arnáiz JA, Castro A, Cosín J, Lekuona I, Guijarro C. Use of the cardiovascular polypill 40mg in secondary cardiovascular prevention. Clin Investig Arterioscler 2018; 30:240-247. [PMID: 30017176 DOI: 10.1016/j.arteri.2018.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 04/28/2018] [Indexed: 06/08/2023]
Abstract
Controlling cardiovascular risk factors (CV) is essential for patients with cardiovascular disease. The CV polypill contains aspirin 100mg, atorvastatin 20mg or 40mg, and ramipril 2.5mg, 5mg or 10mg in a fixed combination pill. The objective was to review the evidence on the secondary prevention of cardiovascular disease, to establish the eventual patient profiles suitables to consider the use of CV polypill with atorvastatin 40mg in secondary CV prevention (P40PS), and to define the priority situations most adequate for the use of P40PS. A bibliographic review was carried out, which was complemented with the clinical opinion of 19 specialists. During hospitalization and discharge, P40PS is an option for patients admitted because of an atherothrombotic event, peripheral arterial disease, or other causes, and with the indication of the monocomponents. Its priority use is proposed in: prior intolerance to the highest dose of atorvastatin (80mg), age>75 years, low weight, stage 3 of chronic renal failure, hypothyroidism, drug interactions and Asian origin. Outside the hospital setting, the P40PS is a therapeutic alternative in patients with a need for secondary CV prevention and with indication to receive the monocomponents. The priority situations to receive the P40PS are: to be taking the three components separately, to require polypharmacy, lack of adherence or understanding of the treatment, and lack of control of CV risk factors. This work is the first with proposals for the use of P40PS and can facilitate the treatment of patients with cardiovascular disease in secondary prevention.
Collapse
Affiliation(s)
| | | | | | | | - Juan Cosín
- Hospital Arnau de Vilanova, Valencia, España
| | | | - Carlos Guijarro
- Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
| |
Collapse
|
49
|
Mayordomo JI, Guerra JM, Guijarro C, García-Prats MD, Gómez A, López-Brea M, González R, Hergueta P, López-Pino MA, Martínez-Tello F. Neoplasms of Unknown Primary Site: A Clinicopathological Study of Autopsied Patients. Tumori 2018; 79:321-4. [PMID: 8116074 DOI: 10.1177/030089169307900507] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Malignant neoplasms of an unknown primary site (NUPS) remain a diagnostic and therapeutic challenge in clinical practice. With this in mind, we have reviewed all autopsies performed in patients with NUPS in a single institution. Patients and methods By reviewing 1656 autopsies performed on adults in our Institution (1974-1990), 43 cases of NUPS were found. (NUPS was defined as histologically proven malignant tumor for which a primary site could not be found after anamnesis, complete physical examination, chest X-ray and routine chemistries.) Results There were 24 men (56 %) and 19 women. Mean age was 62 years (76 % of patients were aged 40-75). Clinical presentation included general deterioration (73 %), digestive symptoms (58 %), liver enlargement (58 %) abdominal pain (56 %), respiratory symptoms (45 %), ascites (26 %) and node enlargement (16 %). Abnormalities in analysis and image tests were frequent but nonspecific. Median time from admission to death was 42 days (range, 4-135). Pathologic diagnoses at autopsy were: 23 adenocarcinomas (53 %), arising from pancreas (6), biliary tree (6), lung (3), prostate (2), stomach (1), kidney (1) and unknown (4); 3 squamous carcinomas (5 %) (1 renal pelvis, 1 biliary tree, 1 stomach); 5 undifferentiated carcinomas (1 lung, 4 unknown); and 12 miscellaneous tumors (including 3 lymphomas, 3 neuroendocrine tumors, 3 hepatocarcinomas, 2 mesotheliomas and 1 melanoma). There was a tendency towards a metastatic pattern different from that expected from the primary tumor. Image tests were of little usefulness in the search for the primary tumor. Conclusions 1) Adenocarciomas were the most frequent tumor presenting as NUPS, especially from the pancreas and biliary tree. 2) In this series, at least 11 % of patients were amenable to standard systemic therapies (3 lymphomas and 2 prostatic adenocarcinomas) if a correct pathologic diagnosis could have been established when alive. 3) Presenting symptoms and metastatic pattern differed from those expected for the primary neoplasm eventually found. 4) Image tests were often misleading as regards the primary site, although they were useful to quantify the dissemination of the tumor.
Collapse
Affiliation(s)
- J I Mayordomo
- Department of Medical Oncology, 12 de Octubre University Hospital, Madrid, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Guijarro C. Letter by Guijarro Regarding Article, “Cerebrovascular Outcomes With Proton Pump Inhibitors and Thienopyridines: A Systematic Review and Meta-Analysis”. Stroke 2018; 49:e169. [DOI: 10.1161/strokeaha.118.020990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Carlos Guijarro
- Internal Medicine Unit, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| |
Collapse
|