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Background Despite of the effectiveness and safety profile of Non-vitamin K Antagonists Oral Anticoagulants (NOACs) even in real-world (RW) Atrial Fibrillation (AF) patients, Vitamin K Antagonists (VKAs) have remained widely used in clinical practice worldwide but the comparison with acenocoumarol therapy in RW is unknown. Purpose To estimate the potential absolute benefit in clinical adverse events if the AF patients anticoagulated with VKA therapy had been treated with NOACs. Methods We analyzed anticoagulated AF patients who were prospectively recruited into the multicentre FANTASIIA registry. Patients were treated with VKAs for at least 6 months prior to inclusion. The estimation of clinical adverse events avoided was calculated applying absolute risk reductions, relative risk reductions and hazard ratios from the meta-analysis of RW use of NOACs relative to VKAs. Results We analyzed 1,470 patients under VKA therapy (mean age 74.1±9.5 years; 56.4% male). Stroke rate with acenocoumarol treatment was 0.88%/year. The estimated rates for stroke using NOACs would be 0.80%/year for Dabigatran 150 mg; 0.76%/year for Rivaroxaban and 0.74%/year for Apixaban instead of VKA. No significant differences were observed between the different NOACs and VKA in stroke rate. Major bleeding with acenocoumarol was 3.40%/year. The estimated rates for major bleeding using NOACs would be 2.75%/year for Dabigatran 150 mg; 3.37%/year for Rivaroxaban and 2.18%/year for Apixaban instead of VKA. Apixaban was the only NOAC that showed a significant estimated reduction rates (p=0.046). Finally, the all-cause mortality rate with acenocoumarol was 4.69%/year. The estimated rates of all-cause mortality using NOACs would be 3.28%/year for Dabigatran 150mg; 4.88%/year for Rivaroxaban and 2.67%/year for Apixaban. Dabigatran and Apixaban showed significant estimated reduction rates with the highest reduction with Apixaban (Table). Annual Rate reduction of adverse events Conclusion The absolute estimated effect of NOACs in the AF patients anticoagulated with VKA showed a significant reduction in adverse clinical events. Apixaban performed the highest estimated reduction in major bleeding and all-cause mortality in comparison with acenocoumarol.

Background: The objective was to study the effect of the application of the new diagnostic criteria for diabetes mellitus on its prevalence in Galicia (northwest Spain). Methods: Analysis using ‘old’ and ‘new’ criteria (diabetes under treatment and/or fasting glycaemia ≧140 mg/dl or ≧126 mg/dl respectively) was performed in a cross-sectional study (1,275 participants) in the general population aged 40–69 years. Results: Prevalence of diabetes rose from 7.5 (95% Cl: 6.1–9.1) to 10.4% (95% Cl: 8.8–12.2) with the new criteria. The proportion of non diagnosed diabetes rose from 22.2 to 37.8%. Conclusions: The new diagnostic criteria for diabetes mellitus make it necessary to increase previous prevalence estimates by 30–35% In middle age (40–69 years).

[Abstract] Introduction and objectives. 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. Methods. This cross-sectional study involved a representative sample of the Spanish population aged 40 years or older, obtained via 2-stage random sampling: in the first stage, primary care physicians were randomly selected from each Spanish province, whereas in the second stage 20 people were selected from the population assigned to each physician. The prevalence was weighted by age, sex, and geographical area. Participants were classified as having angina if they met the “definite angina” criteria of the Rose questionnaire and as having confirmed angina if the angina was confirmed by a cardiologist or if they had a history of acute ischemic heart disease or revascularization. Results. Of the 11 831 people invited to participate, 8378 (71%) were analyzed (mean age, 59.2 years). The weighted prevalence of definite angina (Rose) was 2.6% (95% confidence interval, 2.1%-3.1%) and was higher in women (2.9%) than in men (2.2%), whereas that of confirmed angina was 1.4% (95% confidence interval, 1.0%-1.8%), without differences between men (1.5%) and women (1.3%). The prevalence of definite angina (Rose) increased with age (0.7% in patients aged 40 to 49 years and 7.1% in those aged 70 years or older), history of cardiovascular disease, and cardiovascular risk factors, except smoking. Conclusions. The prevalence of definite angina (Rose) in the Spanish population aged 40 years or older was 2.6%, whereas that of confirmed angina was 1.4%. Both prevalences increased with age, cardiovascular risk factors, and cardiovascular history. [Resumen] Introducción y objetivos. El objetivo del estudio OFRECE fue estimar la prevalencia de angina estable en España. Esta es actualmente desconocida por falta de estudios recientes y cambios en la epidemiología y el tratamiento de la cardiopatía isquémica. Métodos. Estudio transversal. Se obtuvo una muestra representativa de la población española de edad mayor o igual a 40 años mediante muestreo aleatorio en dos etapas: la primera fue una selección aleatoria de médicos de atención primaria de cada provincia y la segunda, una selección de 20 individuos de la población asignada a cada médico. La prevalencia se ponderó por edad, sexo y área geográfica. Se clasificó a los participantes como pacientes con angina si cumplían criterios de «angina segura» del cuestionario de Rose y como angina confirmada si además tenían antecedentes de cardiopatía isquémica aguda, revascularización o confirmación tras evaluación cardiológica. Resultados. Se analizó a 8.378 personas (media de edad, 59,2 años), el 71% de las 11.831 invitadas a participar. La prevalencia ponderada de angina segura (Rose) fue del 2,6% (intervalo de confianza del 95%, 2,1-3,1%), mayor en mujeres (2,9%) que en varones (2,2%), y la de angina confirmada, del 1,4% (intervalo de confianza del 95%, 1,0-1,8%) sin diferencias entre varones (1,5%) y mujeres (1,3%). La prevalencia se incrementó con la edad (angina segura, el 0,7% en el grupo de 40-49 años y el 7,1% en el de mayor o igual a 70 años), los antecedentes de enfermedad cardiovascular y los factores de riesgo cardiovascular, salvo el tabaquismo. Conclusiones. La prevalencia de angina segura (Rose) en la población española de edad mayor o igual a 40 años es del 2,6% y la de angina confirmada, del 1,4%, y ambas se incrementan con la edad, los factores de riesgo cardiovascular y los antecedentes cardiovasculares.