Manuel Anguita

Junta De Andalucía · Department of Cardiology

Background: The introduction of direct-acting oral anticoagulants (DOACs) has shown to decrease atrial fibrillation (AF)-related stroke and bleeding rates in clinical studies, but there is no certain evidence about their effects at the population level. Our aim was to assess changes in AF-related stroke and major bleeding rates between 2012 and 20...

Simple Summary Childhood cancer survivors have an increased lifetime risk of cardiac problems due to the cardiotoxic effects of cancer treatments. While most research has focused on the left side of the heart, little is known about the effects of these treatments on the right-side chambers. We used cardiac ultrasound to examine the right ventricle...

Background and objectives: Survivors of childhood cancer might be at increased risk of diastolic dysfunction at follow-up due to exposure to cardiotoxic treatment. Although assessment of diastolic function is challenging in this relatively young population, left atrial strain might provide a novel insight in this evaluation. Our aim was to examine...

Introduction and objectives: There is scarce real-world evidence on the management of perioperative antithrombotic treatment according to current recommendations. The aim of this study was to analyze the management of antithrombotic treatment in patients undergoing surgery or another invasive intervention and to assess the consequences of this man...

Introduction and objectives The RECALCAR project (Resources and Quality in Cardiology), an initiative of the Spanish Society of Cardiology, aims to standardize information to generate evidence on cardiovascular health outcomes. The objective of this study was to analyze trends in the resources and activity of cardiology units and/or services and to...

Resumen Introducción y objetivos El proyecto RECALCAR (Recursos y Calidad en Cardiología), iniciativa de la Sociedad Española de Cardiología, pretende estandarizar la información para generar evidencia sobre los resultados en salud cardiovascular. Su objetivo es analizar la evolución de los recursos y la actividad de las unidades y los servicios d...

Introduction: For a long time, vitamin K antagonists (VKA) were the only oral anticoagulation therapy available to reduce adverse events in atrial fibrillation (AF) patients. Direct-acting oral anticoagulants (DOAC) are at least as effective and safe as VKA with few drug interactions, rapid onset and short half-life. Four DOACs, dabigatran, apixab...

Background An integrated and holistic approach is increasingly advocated in patients with atrial fibrillation (AF), based on the “Atrial fibrillation Better Care (ABC) pathway: A, Avoid stroke with anticoagulation; B, better symptom management; C, cardiovascular and comorbidity risk management.” The aim of this study was to examine the prevalence o...

Simple Summary Heart failure is a major problem that affects childhood cancer survivors. Thus, early detection of cardiotoxicity before the onset of symptoms is imperative. Global longitudinal strain (GLS) is an echocardiographic tool that can be used to detect subclinical changes in cardiac function. However, its utility in long-term cardiac monit...

Background Atrial fibrillation (AF) increases the risk of thromboembolism. We investigate the efficacy and safety of oral anticoagulation (OAC) therapy and explored the number needed to treat for net effect (NNTnet) of OAC in the Spanish cohort of the EURObservational Research Programme AF (EORP-AF) Long-term General Registry. Methods The EORP-AF...

Aims: The 4S-AF scheme [Stroke risk, Symptom severity, Severity of atrial fibrillation (AF) burden, Substrate severity] has recently been described as a novel approach to in-depth characterization of AF. We aim to determine if the 4S-AF scheme would be useful for AF characterization and provides prognostic information in real-world AF patients. M...

Background There is a lack of evidence regarding the benefits of β-blocker treatment after invasively managed acute myocardial infarction (MI) without reduced left ventricular ejection fraction (LVEF). Methods and results TREatment with Beta-blockers after myOcardial infarction withOut reduced ejection fraction (REBOOT) trial is a pragmatic, contr...

Background Multimorbidity is common in atrial fibrillation (AF) patients. Charlson comorbidity index (CCI) is used to evaluate multimorbidity in the general population. Limited long-term data are available on the relationship between CCI and AF. We examined the association between CCI, anticoagulation control and outcomes in AF patients. Methods W...

Aims Vitamin K antagonists (VKAs) are effective drugs reducing the risk for stroke in atrial fibrillation (AF), but the benefits derived from such therapy depend on the international normalized ratio (INR) maintenance in a narrow therapeutic range. Here, we aimed to determine independent variables driving poor anticoagulation control [defined as a...

The reduction of low-density lipoprotein cholesterol with lipid lowering therapy has demonstrated to decrease the risk of developing cardiovascular complications during the follow-up in primary and secondary prevention. Unfortunately, a great number of patients do not achieve recommended targets. This is mainly due to an insufficient use of the lip...

Resumen La reducción del colesterol unido a lipoproteínas de baja densidad con el tratamiento hipolipidemiante ha demostrado disminuir el riesgo de presentar complicaciones cardiovasculares durante el seguimiento, tanto en prevención primaria como secundaria. Desafortunadamente, un gran número de pacientes no logran los objetivos de control recomen...

Background There are limited data on sex‐specific outcomes and management of cardiogenic shock complicating ST‐segment elevation myocardial infarction (CS‐STEMI). We investigated whether any sex bias exists in the admission to revascularization capable hospitals (RCH) or intensive cardiac care units (ICCU) and its impact on in‐hospital mortality....

Background: Heart failure (HF) is one of the mayor contributors to cardiovascular morbidity and mortality in patients with diabetes. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated to reduce the risk of hospitalization for HF in patients with type 2 diabetes mellitus (T2D). We aimed to assess the risk for re-hospitalization in...

Resumen A pesar de los avances en el tratamiento de la insuficiencia cardiaca (IC) con fracción de eyección reducida (IC-FEr), las tasas de mortalidad e ingresos hospitalarios continúan siendo muy elevadas. El estudio DAPA-HF demostró que, en comparación con el tratamiento estándar, la adición de dapagliflozina 10 mg/día se asocia con un marcado be...

Aim: To derive a new clinical score to improve the prediction of those at risk of poor International Normalized Ratio control among patients with atrial fibrillation taking vitamin K antagonists. Materials & methods: The score was calculated using PAULA database and validated in the FANTASIIA population. Results: The DAFNE score (cardiovascular Dis...

Introduction and objectives Despite evidence of a reduction in the incidence and mortality of acute coronary syndrome (ACS), some studies have highlighted differences in outcomes between men and women. We aimed to explore sex differences in the management and treatment of patients with ACS in Spain. Methods This ecological cross-sectional study co...

Resumen Diversos estudios de prevención primaria y secundaria han documentado que un mayor grado de reducción en los niveles de colesterol unido a proteínas de baja densidad (cLDL) se asocia a una mayor disminución en las tasas de eventos cardiovasculares. Los inhibidores de la PCSK9 logran disminuciones importantes, rápidas y mantenidas en los niv...

Background Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real‐world patients receiving oral anticoagulant therapy for nonvalvular AF. Methods We prospectively included 1956 patients (mean age 73.8 ± 9.5 yea...

BACKGROUND: Heart failure (HF) is one of the mayor contributors to cardiovascular morbidity and mortality in patients with diabetes. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated to reduce the risk of hospitalization for HF in patients with type 2 diabetes mellitus. We aimed to compare the incidence of readmission in patients...

Resumen Introducción y objetivos Los sistemas de red han mostrado reducciones en el tiempo de reperfusión de los pacientes con infarto de miocardio con elevación del segmento ST (IAMCEST), así como en la mortalidad hospitalaria. Sin embargo, los datos no se han desglosado por sexo. El objetivo de este estudio es analizar la influencia del sistema...

Introduction and objectives: Network systems have achieved reductions in both time to reperfusion and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI). However, the data have not been disaggregated by sex. The aim of this study was to analyze the influence of network systems on sex differences in primary pe...

Previous studies have shown that heart failure is associated with worse health-related quality of life (HRQoL). The existence of differences according to gender remains controversial. We J. Clin. Med. 2020, 9, 2825 2 of 15 studied 1028 consecutive outpatients with heart failure and reduced ejection fraction (HFrEF) from a multicentre cross-sectiona...

Resumen Introducción y objetivos Hay resultados contradictorios sobre si existen diferencias de sexo en la mortalidad tras el infarto agufo de miocardio (IAM). Además, hay escasez de datos sobre el impacto del sexo en los resultados tras un infarto agudo de miocardio con elevación del segmento ST (IAMCEST) o sin elevación del segmento ST (IAMSET)....

Resumen Antecedentes y objetivos La prevalencia de fibrilación auricular (FA) y cardiopatía isquémica (CI) aumenta con la edad. Coexisten en hasta un 20% de los pacientes octogenarios, situación que supone un desafío terapéutico. Los ensayos que han abordado este escenario, que incluyeron un porcentaje bajo de octogenarios, demostraron que la dobl...

Background: Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. Purpose: To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status. Methods: AF patients from FANTASIIA registry were included. Baseline characteristics and comorbidities were record...

Introduction and objectives Conflicting results have been reported on the possible existence of sex differences in mortality after myocardial infarction (MI). There is also a scarcity of data on the impact of sex on outcomes after ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). The aim of this study was to analyze sex dif...

RESUMEN La pandemia producida por la infección del nuevo coronavirus SARS-CoV-2, que da lugar a una enfermedad altamente contagiosa (COVID-19), ha producido un colapso de los sistemas sanitarios de todo el mundo. Se ha descrito que estos pacientes sufren un estado inflamatorio que condiciona un alto riesgo trombótico. Sin embargo, apenas hay inform...

Objective To describe major events at follow up in octogenarian patients with atrial fibrillation (AF) according to anticoagulant treatment: direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs). Methods A total of 578 anticoagulated patients aged ≥80 years with AF were included in a prospective, observational, multicenter study....

Background Obesity and atrial fibrillation ( AF ) frequently coexist and independently increase mortality. We sought to assess the association between obesity and adverse events in patients receiving oral anticoagulants for AF . Methods and Results Consecutive AF outpatients receiving anticoagulant agents (both vitamin K antagonists and direct ora...

The current control of low-density lipoprotein cholesterol among patients with atherosclerotic cardiovascular disease is very low and this is associated with an increase of cardiovascular outcomes. In addition, the latter this happens, the risk will be greater. This is mainly due to an insufficient use of the lipid-lowering therapy currently availa...

Resumen Introducción y objetivos En un estudio de base poblacional, se analizaron las posibles diferencias en función del sexo en la atención al dolor torácico o las palpitaciones como motivo de consulta. Métodos El estudio OFRECE incluyó una muestra aleatoria de la población española de 8.400 participantes de edad ≥ 40 años, de los que 1.132 (13...

Resumen El control actual de la concentración de colesterol unido a lipoproteínas de baja densidad en el paciente con enfermedad cardiovascular ateroesclerótica es muy escaso y esto se asocia con un aumento del riesgo de que se presenten complicaciones cardiovasculares. Además, cuanto más tarde se logren dichos objetivos, el riesgo será mayor. Esto...

ABSTRACT Primary percutaneous coronary intervention (pPCI) is the best modality of reperfusion in ST segment elevation in acute myocardial infarction (STEMI). Its application requires networked assistance systems whose implementation requires significant organizational and logistical changes. In comparison with other scenarios of urgent action, a s...

RESUMEN El intervencionismo coronario percutáneo primario (ICPp) es la mejor forma de reperfusión en el infarto agudo de miocardio con elevación del segmento ST (IAMCEST). Su aplicación requiere sistemas asistenciales en red cuya implementación exige cambios organizativos y logísticos importantes. En comparación con otros escenarios de actuación ur...

The percutaneous treatment of coronary artery disease and some structural cardiovascular diseases has undergone spectacular changes. More and more patients with different types of heart disease are being treated by percutaneous or transcatheter interventions, with no such increase in patients undergoing cardiac surgery. This situation has led to di...

Introduction and objectives: To analyze differences between sexes in the clinical management of patients presenting with symptoms of chest pain and/or palpitations within a population-based study. Methods: The OFRECE study included a random sample of 8400 individuals from the Spanish population aged 40 years and older; 1132 (13.5%) had previousl...

Resumen Introducción y objetivos El tipo de prótesis utilizado en la cirugía de la endocarditis infecciosa sobre la válvula aórtica nativa depende en gran medida de la edad del paciente y de las preferencias del cirujano. Existe poca información sobre el uso de homoinjertos en estos pacientes. Métodos Desde 1997 hasta 2017 se han intervenido en n...

Requisitos y sostenibilidad de los programas de ICP primaria en España en el IAMCEST. Documento de consenso de SEC, AEEC y SEMES RESUMEN El intervencionismo coronario percutáneo primario (ICPp) es la mejor forma de reperfusión en el infarto agudo de miocardio con elevación del segmento ST (IAMCEST). Su aplicación requiere sistemas asistenciales en...

During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. The decision to withdraw antithrombotic th...

During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. Decision of antithrombotic therapy withdra...

Background: One-third of atrial fibrillation (AF) patients have chronic kidney disease (CKD), a condition that itself increases thromboembolic and major bleeding risks, especially in patients with severe CKD. Bleeding would be accentuated by suboptimal anticoagulation control with vitamin K antagonists (VKA). Purpose: This article aimed to investig...

Aims To describe the prevalence and associated factors of inappropriate doses of direct oral anticoagulants (DOAC) in a national registry of patients of real clinical practice. Methods and results Five hundred and thirty outpatients with atrial fibrillation treated with DOAC were included in a prospective, national, multicentre study. The appropri...

Aims: The efficacy and safety of oral anticoagulation (OAC) using the vitamin K antagonists (VKA) are closely associated with the quality of anticoagulation, reflected by time in therapeutic range (TTR). The SAMe-TT2R2 is a risk score developed to predict the quality of anticoagulation control among VKA users. To analyse the quality of anticoagulat...

We investigated the incidence of non-embolic adverse events in 2 cohorts of AF patients and validated the 2MACE score [(metabolic syndrome, age ≥75) [doubled]; (myocardial infarction (MI)/revascularization, congestive heart failure (HF) and stroke/TIA/thromboembolism)] as predictor of major adverse cardiovascular events (MACEs). We recruited 2630 A...

Objectives The prophylaxis regimens for infectious endocarditis recommended by the clinical practice guidelines have recently changed. We do not know whether the current regimens are correctly followed in our setting. Our objective was to describe the approaches of various health professionals concerning these guidelines. Materials and methods We...

Objectives: The prophylaxis regimens for infectious endocarditis recommended by the clinical practice guidelines have recently changed. We do not know whether the current regimens are correctly followed in our setting. Our objective was to describe the approaches of various health professionals concerning these guidelines. Material and methods:...

Background: Several bleeding risk scores have been validated in patients with atrial fibrillation (AF). The ORBIT score has been recently proposed as a simple score with the best ability to predict major bleeding. The present study aimed to test the hypothesis that the ORBIT score was superior to the HAS-BLED score for predicting major bleeding an...

Background: To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations. Methods and results: Randomized trials on self-management interventions conducted between January 1985 and June 2013 were identified...

Objectives: To analyse the effect of the early coadministration of ivabradine and beta-blockers (intervention group) versus beta-blockers alone (control group) in patients hospitalised with heart failure and reduced left ventricular ejection fraction (HFrEF). Methods: A comparative, randomised study was performed to compare the treatment strateg...

Aims Use of cardiac pacing devices has grown in recent years. Our aim was to evaluate changes in epidemiology and clinical features of infective endocarditis (IE) involving pacemaker devices in a large series of IE over the last 27 years (1987–2013). Methods and results From 1987 to December 2013, 413 consecutive IE cases were diagnosed in our hos...

Introduction and objectives: Although heart failure negatively affects the health-related quality of life of Spanish patients there is little information on the clinical factors associated with this issue. Methods: Cross-sectional multicenter study of health-related quality of life. A specific questionnaire (Kansas City Cardiomyopathy Questionna...

La calidad de vida relacionada con la salud de los pacientes con insuficiencia cardiaca está afectada. Hay poca información sobre los factores clínicos asociados a esta mala calidad de vida de la población española con insuficiencia cardiaca.

Heart failure (HF) is commonly described according to the severity of symptoms, using the New York Heart Association (NYHA) classification, and the assessment of ventricular function, by measuring the left ventricular ejection fraction (LVEF). It is important to acknowledge, however, that the severity of symptoms does not systematically correlate w...

Vitamin K antagonists (VKA) have a narrow therapeutic range, and literature analysis reveals poor quality of anticoagulation control. We sought to assess the prevalence of poor anticoagulant control in patients under VKA treatment in the prevention of stroke for atrial fibrillation (AF). Control of anticoagulation with VKA is inadequate in a high p...

The objective of the OFRECE study was to estimate the prevalence of stable angina in Spain. This prevalence is currently unknown, due to a lack of recent studies and to changes in the epidemiology and treatment of ischemic heart disease. This cross-sectional study involved a representative sample of the Spanish population aged 40 years or older, ob...

The objective of the OFRECE study was to estimate the prevalence of stable angina in Spain. This prevalence is currently unknown, due to a lack of recent studies and to changes in the epidemiology and treatment of ischemic heart disease.