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1. Geriatric conditions and invasive management in frail patients with NSTEMI. A subgroup analysis of a randomized clinical trial

Author

Sanchis, Juan, Bueno, Héctor, García-Blas, Sergio, Gómez-Hospital, Joan A., Martí, David, Martínez-Sellés, Manuel, Domínguez-Pérez, Laura, Díez-Villanueva, Pablo, Barrabés, José A., Marín, Francisco, Villa, Adolfo, Sanmartín, Marcelo, Llibre, Cinta, Sionis, Alessandro, Carol, Antoni, Valero, Ernesto, Calvo, Elena, Morales, María José, Elízaga, Jaime, Gómez, Iván, Alfonso, Fernando, García del Blanco, Bruno, Formiga, Francesc, Núñez, Eduardo, Núñez, Julio, and Ariza-Solé, Albert

Published
2024
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2. Invasive Treatment Strategy in Adults With Frailty and Non–ST-Segment Elevation Myocardial Infarction

Author

Sanchis, Juan, primary, Bueno, Héctor, additional, García-Blas, Sergio, additional, Alegre, Oriol, additional, Martí, David, additional, Martínez-Sellés, Manuel, additional, Domínguez-Pérez, Laura, additional, Díez-Villanueva, Pablo, additional, Barrabés, Jose A., additional, Marín, Francisco, additional, Villa, Adolfo, additional, Sanmartín, Marcelo, additional, Llibre, Cinta, additional, Sionís, Alessandro, additional, Carol, Antoni, additional, Fernández-Cisnal, Agustín, additional, Calvo, Elena, additional, Morales, María José, additional, Elízaga, Jaime, additional, Gómez, Iván, additional, Alfonso, Fernando, additional, García del Blanco, Bruno, additional, Formiga, Francesc, additional, Núñez, Eduardo, additional, Núñez, Julio, additional, and Ariza-Solé, Albert, additional

Published
2024
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3. Mortalidad a corto y largo plazo de pacientes con indicación quirúrgica no intervenidos en el curso de la endocarditis infecciosa izquierda

Author

Vallejo Camazón, Nuria, Cediel, Germán, Núñez Aragón, Raquel, Mateu, Lourdes, Llibre, Cinta, Sopena, Nieves, Gual, Francisco, Ferrer, Elena, Quesada, María Dolores, Berastegui, Elisabeth, Teis, Albert, López Ayerbe, Jorge, Juncà, Gladys, Vivero, Ainhoa, Muñoz Guijosa, Christian, Pedro-Botet, Lluisa, and Bayés-Genís, Antoni

Published
2020
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4. Invasive Versus Conservative Strategy in Frail Patients With NSTEMI: The MOSCA-FRAIL Clinical Trial Study Design

Author

Sanchis, Juan, Ariza-Solé, Albert, Abu-Assi, Emad, Alegre, Oriol, Alfonso, Fernando, Barrabés, José Antonio, Baz, José Antonio, Carol, Antonio, Díez Villanueva, Pablo, García del Blanco, Bruno, Elízaga, Jaime, Fernandez, Eduard, García del Egido, Abel, García Picard, Joan, Gómez Blázquez, Iván, Gómez Hospital, Joan Antoni, Hernández-Antolín, Rosana, Llibre, Cinta, Marín, Francisco, Martí Sánchez, David, Martín, Roberto, Martínez Sellés, Manuel, Miñana, Gema, Morales Gallardo, María José, Núñez, Julio, Pérez de Prado, Armando, Pinar, Eduardo, Sanmartín, Marcelo, Sionis, Alessandro, Villa, Adolfo, Marrugat, Jaume, and Bueno, Héctor

Published
2019
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5. An Easy Assessment of Frailty at Baseline Independently Predicts Prognosis in Very Elderly Patients With Acute Coronary Syndromes

Author

Alegre, Oriol, Ariza-Solé, Albert, Bañeras, Jordi, Rafecas, Agnes, Llibre, Cinta, Vives, Miquel, Sionis, Alessandro, Aboal, Jaime, Vilardell, Pau, Bardají, Alfredo, Tomás, Carlos, Macho, Oscar, Peraire, Manuel, Lacal, Ana, Palau, Anna, Martínez-García, Vanessa, Coma, Núria, Carol, Antoni, Campreciós, Marta, Herranz, Susana, Yun, Sergi, Orriols, Maria, Viguer, Josep Mª, Castillo, Juan Carlos, Becerra, Víctor, Cardila, Pilar, Corbí, Miguel, Díaz, Javier López, García-Pardo, Héctor, Perez-Rivera, Jose Ángel, Merino, Ana Merino, Martín-Herrero, Francisco, Garcimartín, Maria Isabel, Sanchís, Juan, Bonanad, Clara, Fabregat, Óscar, Pérez-Roselló, Vícto, López-Palop, Ramon, Rodríguez-Santamarta, Miguel, González-Salvado, Violeta, García de la Villa, Bernardo, Asmarats, Luis, Maristany, Jaume, Torres, Joan, Gómez-Llorente, Marta, García-González, Martín Jesús, Pimienta, Raquel, Viana-Tejedor, Ana, Núñez-Gil, Iván, Ruiz-García, Juan, Beringola, Alejandro Cortés, Bueno, Héctor, Martínez-Sellés, Manuel, Vidán, Mariá T., Díez-Villanueva, Pablo, Marín, Francisco, Munárriz, Aitziber, Salterain, Nahikari, Formiga, Francesc, López-Palop, Ramón, Vidán, María T., Palau-Vendrel, Anna, Rivera, Angel Perez, Abu-Assi, Emad, Castillo, Juan C., and Cequier, Àngel

Published
2018
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6. Evolocumab has no effects on heart failure with reduced ejection fraction injury biomarkers: The EVO‐HF trial

Author

Bayes‐Genis, Antoni, primary, Lupón, Josep, additional, Revuelta‐Lopez, Elena, additional, Llibre, Cinta, additional, Gastelurrutia, Paloma, additional, Domingo, Mar, additional, Cediel, Germán, additional, Codina, Pau, additional, Santiago‐Vacas, Evelyn, additional, Rangel‐Sousa, Diego, additional, Fernández‐Cisnal, Agustín, additional, Miñana, Gema, additional, Mollar, Anna, additional, and Núñez, Julio, additional

Published
2023
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7. Effect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non–ST-Segment Elevation Acute Myocardial Infarction

Author

Sanchis, Juan, primary, Bueno, Héctor, additional, Miñana, Gema, additional, Guerrero, Carme, additional, Martí, David, additional, Martínez-Sellés, Manuel, additional, Domínguez-Pérez, Laura, additional, Díez-Villanueva, Pablo, additional, Barrabés, Jose A., additional, Marín, Francisco, additional, Villa, Adolfo, additional, Sanmartín, Marcelo, additional, Llibre, Cinta, additional, Sionís, Alessandro, additional, Carol, Antoni, additional, García-Blas, Sergio, additional, Calvo, Elena, additional, Morales Gallardo, María José, additional, Elízaga, Jaime, additional, Gómez-Blázquez, Iván, additional, Alfonso, Fernando, additional, García del Blanco, Bruno, additional, Núñez, Julio, additional, Formiga, Francesc, additional, and Ariza-Solé, Albert, additional

Published
2023
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10. Long-Term Intracoronary Structural and Vasomotor Assessment of the ABSORB Bioresorbable Vascular Scaffold

Author

Altisent, Omar Abdul-Jawad, primary, Goncalves-Ramírez, Luis Renier, additional, Fernández, Leticia, additional, Viladés, David, additional, Gutiérrez, Enrique, additional, Mitomo, Satoru, additional, Latib, Azeem, additional, Córdoba-Soriano, Juan Gabriel, additional, Adeliño, Raquel, additional, Amat-Santos, Ignacio, additional, Muñoz, Juan Francisco, additional, Elízaga, Jaime, additional, Bezzera, Hiram, additional, Pereira, Gabriel Tensol Rodrigues, additional, de Prado, Armando Pérez, additional, Carrillo, Xavier, additional, Fernández-Nofrerias, Eduard, additional, Vilalta, Victoria, additional, Rodríguez-Leor, Oriol, additional, Llibre, Cinta, additional, Fadeuilhe, Edgar, additional, Trujillo, Aaron, additional, Mauri, Josepa, additional, de la Torre Hernández, Jose M., additional, Bayes-Genís, Antoni, additional, and Puri, Rishi, additional

Published
2022
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11. Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis

Author

Vallejo Camazon, Nuria, primary, Mateu, Lourdes, additional, Cediel, Germán, additional, Escolà-Vergé, Laura, additional, Fernández-Hidalgo, Nuria, additional, Gurgui Ferrer, Mercedes, additional, Perez Rodriguez, Maria Teresa, additional, Cuervo, Guillermo, additional, Nuñez Aragón, Raquel, additional, Llibre, Cinta, additional, Sopena, Nieves, additional, Quesada, Maria Dolores, additional, Berastegui, Elisabeth, additional, Teis, Albert, additional, Lopez Ayerbe, Jorge, additional, Juncà, Gladys, additional, Gual, Francisco, additional, Ferrer Sistach, Elena, additional, Vivero, Ainhoa, additional, Reynaga, Esteban, additional, Hernández Pérez, Maria, additional, Muñoz Guijosa, Christian, additional, Pedro-Botet, Lluisa, additional, and Bayés-Genís, Antoni, additional

Published
2021
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12. Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis

Author

Vallejo Camazon, Nuria, Mateu, Lourdes, Cediel, Germán, Escolà-Vergé, Laura, Fernández-Hidalgo, Nuria, Gurguí, Mercè, Pérez Rodriguez, María Teresa, Cuervo, Guillermo, Núñez Aragón, Raquel, Llibre, Cinta, Sopena, Nieves, Quesada, María Dolores, Berastegui García, Elisabet, Teis, Albert, López Ayerbe, Jorge, Juncà Puig, Gladys, Gual, Francisoc, Ferrer Sistach, Elena, Vivero, Ainhoa, Reynaga, Esteban, Hernández Pérez, María, Muñoz Guijosa, Christian, Pedro-Botet, Lluïsa, Bayés-Genís, Antoni, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Vallejo Camazon N] Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain. [Mateu L] Unitat Malalties Infeccioses, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. [Cediel G] Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. [Escolà-Vergé L, Fernández-Hidalgo N] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Gurgui Ferrer M] Unitat de Malalties Infeccioses, Hospital Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Male, medicine.medical_specialty, Referral, medicine.drug_class, Antibiotics, Bacterial Infections and Mycoses::Bacterial Infections::Endocarditis, Bacterial [DISEASES], Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Antibiòtics, acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos [COMPUESTOS QUÍMICOS Y DROGAS], Clinical Cardiology, Other subheadings::Other subheadings::/drug therapy [Other subheadings], infecciones bacterianas y micosis::infecciones bacterianas::endocarditis bacteriana [ENFERMEDADES], surgery, Antibiotic therapy, medicine.artery, Ascending aorta, medicine, Medicaments antibacterians - Ús terapèutic, Humans, Endocarditis, In patient, Other subheadings::/therapeutic use [Other subheadings], Aged, Retrospective Studies, Cirurgia, Otros calificadores::/uso terapéutico [Otros calificadores], business.industry, infective endocarditis, Endocarditis, Bacterial, General Medicine, Prognosis, medicine.disease, Anti-Bacterial Agents, Surgery, Multicenter study, Infective endocarditis, suppressive antibiotic treatment, Endocarditis bacteriana - Tractament, Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [CHEMICALS AND DRUGS], Female, Cardiology and Cardiovascular Medicine, business
Abstract

Edocarditis infecciosa; Tractament antibiòtic supressiu; Cirurgia Endocarditis infecciosa; Tratamiento antibiótico supresor: Cirugía Infective endocarditis; Suppressive antibiotic treatment; Surgery Background: To date, there is little information regarding management of patients with infective endocarditis (IE) that did not undergo an indicated surgery. Therefore, we aimed to evaluate prognosis of these patients treated with a long-term antibiotic treatment strategy, including oral long term suppressive antibiotic treatment in five referral centres with a multidisciplinary endocarditis team. Methods: This retrospective, multicenter study retrieved individual patient-level data from five referral centres in Spain. Among a total of 1797, 32 consecutive patients with IE were examined (median age 72 years; 78% males) who had not undergone an indicated surgery, but received long-term antibiotic treatment (LTAT) and were followed by a multidisciplinary endocarditis team, between 2011 and 2019. Primary outcomes were infection relapse and mortality during follow-up. Results: Among 32 patients, 21 had IE associated with prostheses. Of the latter, 8 had an ascending aorta prosthetic graft. In 24 patients, a switch to long-term oral suppressive antibiotic treatment (LOSAT) was considered. The median duration of LOSAT was 277 days. Four patients experienced a relapse during follow-up. One patient died within 60 days, and 12 patients died between 60 days and 3 years. However, only 4 deaths were related to IE. Conclusions: The present study results suggest that a LTAT strategy, including LOSAT, might be considered for patients with IE that cannot undergo an indicated surgery. After hospitalization, they should be followed by a multidisciplinary endocarditis team. Antoni Bayes-Genis was supported by grants from the Ministerio de Educación y Ciencia (SAF2014–59892), Fundació La MARATÓ de TV3 (201502, 201516), CIBER Cardiovascular (CB16/11/00403), and AdvanceCat 2014. María Hernández Pérez is supported by a Juan Rodes research contract (JR17/00006) from Instituto de Salud Carlos III.

Published
2021

13. Trends in Short‐ and Long‐Term ST‐Segment–Elevation Myocardial Infarction Prognosis Over 3 Decades: A Mediterranean Population‐Based ST‐Segment–Elevation Myocardial Infarction Registry

Author

García‐García, Cosme, primary, Oliveras, Teresa, additional, Serra, Jordi, additional, Vila, Joan, additional, Rueda, Ferran, additional, Cediel, German, additional, Labata, Carlos, additional, Ferrer, Marc, additional, Carrillo, Xavier, additional, Dégano, Irene R., additional, De Diego, Oriol, additional, El Ouaddi, Nabil, additional, Montero, Santiago, additional, Mauri, Josepa, additional, Elosua, Roberto, additional, Lupón, Josep, additional, Bayes‐Genis, Antoni, additional, Martínez‐Membrive, Maria José, additional, Zamora, Elisabeth, additional, Caballero, Angel, additional, Llibre, Cinta, additional, Rodríguez‐Leor, Oriol, additional, Fernandez‐Nofrerias, Eduard, additional, Abdul‐Jawad, Omar, additional, and Vilalta, Victoria, additional

Published
2020
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14. Short- and long-term mortality in patients with left-sided infective endocarditis not undergoing surgery despite indication

Author

Vallejo Camazón, Nuria, primary, Cediel, Germán, additional, Núñez Aragón, Raquel, additional, Mateu, Lourdes, additional, Llibre, Cinta, additional, Sopena, Nieves, additional, Gual, Francisco, additional, Ferrer, Elena, additional, Quesada, María Dolores, additional, Berastegui, Elisabeth, additional, Teis, Albert, additional, López Ayerbe, Jorge, additional, Juncà, Gladys, additional, Vivero, Ainhoa, additional, Muñoz Guijosa, Christian, additional, Pedro-Botet, Lluisa, additional, and Bayés-Genís, Antoni, additional

Published
2020
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15. Estrategia invasiva frente a conservadora en pacientes frágiles con IAMSEST. Diseño del ensayo clínico MOSCA-FRAIL

Author

Sanchis, Juan, primary, Ariza-Solé, Albert, additional, Abu-Assi, Emad, additional, Alegre, Oriol, additional, Alfonso, Fernando, additional, Barrabés, José Antonio, additional, Baz, José Antonio, additional, Carol, Antonio, additional, Díez Villanueva, Pablo, additional, García del Blanco, Bruno, additional, Elízaga, Jaime, additional, Fernandez, Eduard, additional, García del Egido, Abel, additional, García Picard, Joan, additional, Gómez Blázquez, Iván, additional, Gómez Hospital, Joan Antoni, additional, Hernández-Antolín, Rosana, additional, Llibre, Cinta, additional, Marín, Francisco, additional, Martí Sánchez, David, additional, Martín, Roberto, additional, Martínez Sellés, Manuel, additional, Miñana, Gema, additional, Morales Gallardo, María José, additional, Núñez, Julio, additional, Pérez de Prado, Armando, additional, Pinar, Eduardo, additional, Sanmartín, Marcelo, additional, Sionis, Alessandro, additional, Villa, Adolfo, additional, Marrugat, Jaume, additional, and Bueno, Héctor, additional

Published
2019
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16. Statin Treatment and Prognosis of Elderly Patients Discharged after Non-ST Segment Elevation Acute Coronary Syndrome

Author

Vicent, Lourdes, primary, Ariza-Solé, Albert, additional, Díez-Villanueva, Pablo, additional, Alegre, Oriol, additional, Sanchís, Juan, additional, López-Palop, Ramón, additional, Formiga, Francesc, additional, González-Salvado, Violeta, additional, Bueno, Héctor, additional, Marín, Francisco, additional, Llibre, Cinta, additional, Llaó, Isaac, additional, Vidán, María T., additional, Abu-Assi, Emad, additional, Aboal, Jaime, additional, and Martínez-Sellés, Manuel, additional

Published
2019
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18. Condiciones geriátricas y estrategia invasiva en pacientes frágiles con IAMSEST. Análisis de subgrupos de un ensayo clínico aleatorizado

Author

Sanchis, Juan, Bueno, Héctor, García-Blas, Sergio, Gómez-Hospital, Joan A., Martí, David, Martínez-Sellés, Manuel, Domínguez-Pérez, Laura, Díez-Villanueva, Pablo, Barrabés, José A., Marín, Francisco, Villa, Adolfo, Sanmartín, Marcelo, Llibre, Cinta, Sionis, Alessandro, Carol, Antoni, Valero, Ernesto, Calvo, Elena, Morales, María José, Elízaga, Jaime, Gómez, Iván, Alfonso, Fernando, Blanco, Bruno García del, Formiga, Francesc, Núñez, Eduardo, Núñez, Julio, and Ariza-Solé, Albert

Abstract

Introduction and objectives Invasive management in frail patients with non–ST-segment elevation myocardial infarction (NSTEMI) remains controversial. We investigated the impact of various geriatric conditions.

Published
2024
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19. Mortalidad a corto y largo plazo de pacientes con indicación quirúrgica no intervenidos en el curso de la endocarditis infecciosa izquierda

Author

Vallejo Camazón, Nuria, Cediel, Germán, Núñez Aragón, Raquel, Mateu, Lourdes, Llibre, Cinta, Sopena, Nieves, Gual, Francisco, Ferrer, Elena, Quesada, María Dolores, Berastegui, Elisabeth, Teis, Albert, López Ayerbe, Jorge, Juncà, Gladys, Vivero, Ainhoa, Muñoz Guijosa, Christian, Pedro-Botet, Lluisa, and Bayés-Genís, Antoni

Abstract

En endocarditis infecciosa (EI), la decisión quirúrgica es difícil. Un alto porcentaje de pacientes con indicación quirúrgica no son intervenidos. El objetivo fue evaluar el pronóstico a corto y largo plazo de los pacientes con indicación quirúrgica, comparando los que se sometieron a cirugía con los que no lo hicieron.

Published
2024
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21. First-in-man Safety and Efficacy of the Adipose Graft Transposition Procedure (AGTP) in Patients With a Myocardial Scar

Author

Bayes-Genis, Antoni, primary, Gastelurrutia, Paloma, additional, Cámara, Maria-Luisa, additional, Teis, Albert, additional, Lupón, Josep, additional, Llibre, Cinta, additional, Zamora, Elisabet, additional, Alomar, Xavier, additional, Ruyra, Xavier, additional, Roura, Santiago, additional, Revilla, Ana, additional, San Román, José Alberto, additional, and Gálvez-Montón, Carolina, additional

Published
2016
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25. Impact of Frailty and Functional Status on Outcomes in Elderly Patients With ST‐Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty: Rationale and Design of the IFFANIAM Study

Author

Ariza‐Solé, Albert, Formiga, Francesc, Vidán, Maria T., Bueno, Héctor, Curós, Antoni, Aboal, Jaime, Llibre, Cinta, Rueda, Ferran, Bernal, Eva, and Cequier, Angel

Subjects
Aged, 80 and over, Time Factors, Frail Elderly, Trial Designs, Age Factors, Myocardial Infarction, Comorbidity, Recovery of Function, Treatment Outcome, Predictive Value of Tests, Research Design, Risk Factors, Spain, Quality of Life, Humans, Prospective Studies, Registries, Angioplasty, Balloon, Coronary, Geriatric Assessment, Aged
Abstract

The IFFANIAM study (Impact of frailty and functional status in elderly patients with ST segment elevation myocardial infarction undergoing primary angioplasty) is an observational multicenter registry to assess the impact of frailty and functional status on outcomes of elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty. STEMI patients age 75 years or older undergoing primary angioplasty will be extensively studied during admission in 4 tertiary care Hospitals in Spain, assessing their baseline functional status (Barthel index, Lawton-Brody index), frailty (Fried criteria, FRAIL scale [fatigue, resistance, ambulation, illnesses, and loss of weight]), comorbidities (Charlson index), nutritional status (Mini Nutritional Assessment-Short Form), and quality of life (Seattle Angina Questionnaire). Participants will be managed according current recommendations. The primary outcome will be the description of 1-year mortality, its causes, and associated factors. Secondary outcomes will be functional capacity and quality of life. Results will help to better understand the impact of frailty and functional ability on outcomes in elderly STEMI patients undergoing primary angioplasty, thus potentially contributing to improving their clinical management. Higher life expectancy has resulted in a large segment of elderly population and an increase in myocardial infarction in these patients. This calls attention to healthcare systems to focus on promoting methods to improve the clinical management of this population.

Published
2013

26. Global Geriatric Assessment and In-Hospital Bleeding Risk in Elderly Patients with Acute Coronary Syndromes: Insights from the LONGEVO-SCA Registry.

Author

Ariza-Solé, Albert, Guerrero, Carme, Formiga, Francesc, Aboal, Jaime, Abu-Assi, Emad, Marín, Francisco, Bueno, Héctor, Alegre, Oriol, López-Palop, Ramón, Vidán, María T., Martínez-Sellés, Manuel, Díez-Villanueva, Pablo, Vilardell, Pau, Sionis, Alessandro, Vives-Borrás, Miquel, Sanchís, Juan, Bañeras, Jordi, Rafecas, Agnès, Llibre, Cinta, and López, Javier

Published
2018
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27. Impact of Frailty and Functional Status on Outcomes in Elderly Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty: Rationale and Design of the IFFANIAM Study

Author

Ariza-Solé, Albert, primary, Formiga, Francesc, additional, Vidán, Maria T., additional, Bueno, Héctor, additional, Curós, Antoni, additional, Aboal, Jaime, additional, Llibre, Cinta, additional, Rueda, Ferran, additional, Bernal, Eva, additional, and Cequier, Angel, additional

Published
2013
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32. Contemporary Yield of 24-hour Holter Monitoring: Role of Inter- Atrial Block Recognition.

Author

Bazan, Victor, Cediel, German, Llibre, Cinta, Sarrias, Axel, Romeo, Isabel, Ibars, Sònia, Escudero, Francisco, Valdivielso, Sandra, Bisbal, Felipe, Villuendas, Roger, Bayes-Genis, Antoni, and Padilla, Ferran

Subjects
*HEALTH facilities, *CHRONIC kidney failure, *ATRIAL fibrillation, *MEDICAL specialties & specialists, *CLINICAL indications
Abstract

Background: The diagnostic yield of 24-hour ECG Holter monitoring (24H) is currently overcome by alternative ECG monitoring techniques and it needs to be optimized. The recognition of inter-atrial block (IAB) has emerged as a reliable indicator of patients at risk of atrial fibrillation relapses, and its role enhancing the yield of 24H is yet to be determined. We hypothesized that a presumably low yield of 24H may be ameliorated by means of incorporating the assessment for IAB. Methods: We retrospectively analyzed 1017 consecutive 24H registers performed in a Multidisciplinary Integrated Health Care Institution, in which a restrictive definition of diagnostic 24H findings was used. A univariate and multivariate regression analysis served to determine the variables associated with a higher 24H's yield, including the requesting medical specialty, type of indication and a number of clinical, echocardiographic and ECG variables, including IAB. Results: The mean age of our population was 62 ± 17 years (55% males). The majority of 24H were indicated from the Cardiology department (48%). The overall yield was 12.8%, higher for the assessment of the integrity of the electrical conduction system (26.1%) and poorer for the assessment of syncope (3.2%) and cryptogenic stroke (4.6%). The variables associated with higher diagnostic performance were indication from Cardiology (p < 0.001), IAB (p = 0.004), structural heart disease (p = 0.008) and chronic renal failure (p = 0.009). Patients = 50 years old only retrieved a 7% yield. In the multivariate analysis, indication from Cardiology and IAB remained significant predictors of higher 24H's yield. In a secondary analysis including echocardiographic data, only identification of IAB remained statistically significant. Conclusions: The recognition of IAB and the type of indication are major determinants of a higher 24H's diagnostic yield and may help to optimize the selection of candidates. [ABSTRACT FROM AUTHOR]

Published
2019
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