Search

Resumen Introduccion y objetivos La calcificacion grave esta presente en mas del 50% de las oclusiones coronarias cronicas totales (OCT) tratadas mediante intervencion percutanea. Nuestro objetivo fue describir el uso contemporaneo de los dispositivos de modificacion de placa (DMP) en este contexto. Metodos Los pacientes se incluyeron en el Registro Iberico de OCT de forma prospectiva y consecutiva (32 centros de Espana y Portugal), de 2015 a 2020. Se compararon en funcion del uso o no de DMP. Resultados Se incluyo a 2.235 pacientes, en 1.900 de los cuales se logro cruzar con exito la lesion con guia. Se utilizo al menos un DMP en un 7% (134 pacientes) y mas de uno en 24 pacientes (1%). Los DMP seleccionados fueron: aterectomia rotacional (35,1%), litotricia (5,2%), laser (11,2%), balones de corte (27,6%), balones OPN (2,9%) o combinaciones de mas de uno (18%). Se utilizaron DMP en pacientes mas ancianos, con mayor riesgo cardiovascular y puntuaciones Syntax y J-CTO mas elevados. Esta mayor complejidad se asocio con procedimientos mas prolongados, pero similar longitud total de stent (52 frente a 57 mm; p = 0,105). Cuando la guia cruzo con exito la oclusion, la tasa de exito final del procedimiento fue del 87,2%, pero se incremento al 96,3% cuando se utilizaron DMP (p = 0,001). Por el contrario, los DMP no se asociaron con mayor tasa de complicaciones en el procedimiento (3,7 frente a 3,2%; p = 0,615). Pese al peor perfil de riesgo basal, a los 2 anos de seguimiento no hubo diferencias en la tasa de supervivencia (94,3% DPM frente a no-DMP: 94,3% no-DPM, respectivamente, p = 0,967). Conclusiones Cuando la guia cruzo con exito una OCT, la tasa de uso de los DMP fue del 7% y se asocio a una tasa de exito final del procedimiento significativamente mayor. Los resultados a medio plazo fueron comparables cuando se precisaron DMP pese a su mayor riesgo basal, lo que sugiere que un mayor uso adecuado de estas tecnicas en este contexto podria conllevar tanto beneficios tecnicos como pronosticos.

INTRODUCTION AND OBJECTIVES: Severe calcification is present in>50% of coronary chronic total occlusions (CTOs) undergoing percutaneous intervention. We aimed to describe the contemporary use and outcomes of plaque modification devices (PMDs) in this context. METHODS: Patients were included in the prospective, consecutive Iberian CTO registry (32 centers in Spain and Portugal), from 2015 to 2020. Comparison was performed according to the use of PMDs. RESULTS: Among 2235 patients, wire crossing was achieved in 1900 patients and PMDs were used in 134 patients (7%), requiring more than 1 PMD in 24 patients (1%). The selected PMDs were rotational atherectomy (35.1%), lithotripsy (5.2%), laser (11.2%), cutting/scoring balloons (27.6%), OPN balloons (2.9%), or a combination of PMDs (18%). PMDs were used in older patients, with greater cardiovascular burden, and higher Syntax and J-CTO scores. This greater complexity was associated with longer procedural time but similar total stent length (52 vs 57mm; P=.105). If the wire crossed, the procedural success rate was 87.2% but increased to 96.3% when PMDs were used (P=.001). Conversely, PMDs were not associated with a higher rate of procedural complications (3.7 vs 3.2%; P=.615). Despite the worse baseline profile, at 2 years of follow-up there were no differences in the survival rate (PMDs: 94.3% vs no-PMDs: 94.3%, respectively; P=.967). CONCLUSIONS: Following successful wire crossing in CTOs, PMDs were used in 7% of the lesions with an increased success rate. Mid-term outcomes were comparable despite their worse baseline profile, suggesting that broader use of PMDs in this setting might have potential technical and prognostic benefits.

The objective of this study was to examine whether the use and addiction of social networks are associated with disordered eating in Spanish adolescents. A cross-sectional study was carried out using data from the Eating Healthy and Daily Life Activities study. The final sample included 653 adolescents (44.0% boys). Social network use (i.e., Facebook, Twitter, Instagram, Snapchat, TikTok) was evaluated by a single item scale with multiple response options. The Short Social Networks Addiction Scale-6 Symptoms was used to determine addiction to social networks. Disordered eating behaviors were assessed with the Sick, Control, One, Fat, Food scale. Adolescents with high social network use had greater odds of disordered eating (odds ratio [OR] = 1.88, 95% confidence intervals [CI] 1.17–3.02). Adolescents with high social network addictive behaviors also showed a higher likelihood of presenting disordered eating (OR = 2.04, 95% CI 1.34–3.12). Social network use and addiction must be considered factors related to disordered eating among adolescents.

The aims of this study were (1) to identify the different food consumption patterns among Spanish preschoolers and (2) to examine the association between having a different food consumption pattern and the odds of having excess weight (i.e., overweight or obesity) or obesity among this population.This was a nationwide cross-sectional study with data from the Spanish National Health Survey-2017. All preschoolers (aged 3-5 years) with complete information on all the variables analyzed were selected. The frequency of consumption of the fourteen food groups was evaluated by a food frequency questionnaire. Excess weight/obesity were computed following the World Health Organization criteria. A hierarchical cluster analysis using Ward's method (i.e., based on squared Euclidean distances) and k-means were performed including all food group consumption. A total sample of 663 was included in the cluster analysis.Three different clusters were established. Compared to the healthiest food consumption pattern (Cluster 1), higher odds of excess weight (OR = 1.51; CI: 95%, 1.02-2.25) and obesity (OR = 1.59; CI: 95%, 1.01-2.51) were found for participants with the unhealthiest food consumption pattern (Cluster 3).Having a food consumption pattern considered unhealthy (i.e., low intake of vegetables/fruits, high consumption of confectionery products, sugar-sweetened beverages, fast-food, and snacks) was associated with presenting excess weight/obesity among Spanish preschoolers.No studies have examined the specific food consumption patterns associated with excess weight or obesity among Spanish preschoolers. The unhealthiest food consumption pattern was characterized by a food consumption pattern that included a lower intake of vegetables and fruits and a higher consumption of confectionery products, sugar-sweetened beverages, fast-food, and snacks. Having a food consumption pattern considered unhealthy was associated with a higher prevalence of excess weight and obesity in comparison with other healthier food consumption patterns.