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1. Impact of New Onset Atrial Fibrillation in Hospitalized Patients with COVID-19. Results of the 'ACO-VID' Registry

Author

Juan José Cerezo Manchado MD, PhD, Teodoro Iturbe Hernández MD, PhD, María del Carmen Martínez Pacheco MSc, RN, Ignacio Gil Ortega MD, PhD, Desirée Campoy MD, Tania Canals Pernas MD, Laia Martinez Serra MD, Katia Jessica Flores Aparco MD, Cesar Andres Velasquez Escandon MD, Luis García de Guadiana-Romualdo MD, PhD, Antonio Martinez Frances MD, and Pavel Olivera MD

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective To assess the impact of new-onset atrial fibrillation (AF) on patients hospitalized with coronavirus disease 2019 (COVID-19). Methods Multicenter and retrospective study that included subjects >55 years hospitalized with COVID-19 from March to October 2020 in Spanish hospitals. Patients were divided into 3 groups (no AF, new-onset AF, and preexisting AF) and followed-up to 90 days. Results A total of 668 patients were included, of whom 162 (24.3%) had no AF, 107 (16.0%) new-onset AF and 399 (59.7%) preexisting AF. Compared to patients without AF, those patients with new-onset AF were older and had more comorbidities, but without differences with preexisting AF. During hospitalization, in the univariate analysis, compared to patients without AF, major bleeding and cardiovascular mortality were more frequent in patients with new-onset AF (10.3% vs 0.6%; P

Published
2023
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2. Dabigatran in patients with atrial fibrillation after COVID-19 hospitalization: an update of the ANIBAL* protocol

Author

Juan José Cerezo-Manchado, Olga Meca Birlanga, Luis García de Guadiana Romualdo, Ignacio Gil-Ortega, Antonio Martínez Francés, and Teodoro Iturbe-Hernandez

Subjects
atrial fibrillation, covid-19, dabigatran, direct oral anticoagulants, hepatotoxicity, mafld, metabolic syndrome, Therapeutics. Pharmacology, RM1-950
Abstract

COVID-19 increases the risk of atrial fibrillation (AF) and thrombotic complications, particularly in severe cases, leading to higher mortality rates. Anticoagulation is the cornerstone to reduce thromboembolic risk in patients with AF. Considering the risk of hepatotoxicity in patients with severe COVID-19 as well as the risk of drug–drug interactions, drug-induced hepatotoxicity and bleeding, the ANIBAL protocol was developed to facilitate the anticoagulation approach at discharge after COVID-19 hospitalization. However, since the publication of the original algorithm, relevant changes have occurred. First, treatment of COVID-19 pneumonia has been modified with the use of dexamethasone or remdesivir during the first week in patients that require oxygen therapy, and of dexamethasone and/or tocilizumab or baricitinib during the second week in patients that necessitate supplementary oxygen or with a high inflammation state, respectively. On the other hand, metabolic syndrome is common in patients with AF as well as metabolic-associated fatty liver disease, and this could negatively impact the prognosis of patients with COVID-19, including high transaminase levels in patients treated with immunomodulators. The EHRA guidelines update also introduce some interesting changes in drug–drug interaction patterns with the reduction of the level of the interaction with dexamethasone, which is of paramount importance in this clinical context. Considering the new information, the protocol, named ANIBAL II, has been updated. In this new protocol, the anticoagulant of choice in patients with AF after COVID-19 hospitalization is provided according to three scenarios: with/without dexamethasone treatment at discharge and normal hepatic function, transaminases ≤2 times the upper limit of normal, or transaminases >2 times the upper limit of normal.

Published
2022
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3. Dabigatran, the oral anticoagulant of choice at discharge in patients with non-valvular atrial fibrillation and COVID-19 infection: the ANIBAL* protocol

Author

Teodoro Iturbe-Hernandez, Luis García de Guadiana Romualdo, Ignacio Gil Ortega, Antonio Martínez Francés, Olga Meca Birlanga, and Juan José Cerezo-Manchado

Subjects
atrial fibrillation, covid-19, dabigatran, direct oral anticoagulants, hepatotoxicity, Therapeutics. Pharmacology, RM1-950
Abstract

Atrial fibrillation is a frequent complication among patients with severe coronavirus disease-2019 (COVID-19) infection. Both direct and indirect mechanisms through COVID-19 have been described to explain this relationship. COVID-19 infection increases the risk of developing both arterial and venous thrombotic complications through systemic coagulation activation, leading to increased mortality. Chronic oral anticoagulation is essential to reduce the thromboembolic risk among AF patients. Switching to low-molecular-weight heparin has been recommended during hospitalization for COVID-19 infection. Of note, at discharge, the prescription of direct oral anticoagulants may offer some advantages over vitamin K antagonists. However, oral anticoagulants should only be prescribed after the consideration of drug–drug interactions with antiviral therapies as well as of the risk of hepatotoxicity, which is common among individuals with severe COVID-19 pneumonia. Not all anticoagulants have the same risk of hepatotoxicity; dabigatran has shown a good efficacy and safety profile and could have a lower risk of hepatotoxicity. Furthermore, its metabolism by cytochrome P450 is absent and it has a specific reversal agent. Therefore, dabigatran may be considered as a first-line choice for oral anticoagulation at discharge after COVID-19 infection. In this review, the available information on the antithrombotic management of AF patients at discharge after COVID-19 infection is updated. In addition, a practical algorithm, considering renal and liver function, which facilitates the anticoagulation choice at discharge is presented.

Published
2020
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4. Impact of atrial fibrillation and anticoagulation on the risk of death, thromboembolic disease and bleeding in patients with COVID-19: the ACO-VID Registry

Author

Juan José Cerezo Manchado, Teodoro Iturbe Hernández, María del Carmen Martínez Pacheco, Ignacio Gil Ortega, Desirée Campoy, Tania Canals Pernas, Laia Martínez Serra, Katia Jessica Flores Aparco, César Andrés Velásquez Escandón, Antonio Martínez Francés, and Pável Olivera

Subjects
General Medicine
Published
2023
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5. Platelet transcriptome analysis in patients with germline RUNX1 mutations

Author

Verónica Palma-Barqueros, José María Bastida, María José López Andreo, Ana Zámora-Cánovas, Carlo Zaninetti, Juan Francisco Ruiz-Pividal, Natalia Bohdan, José Padilla, Raúl Teruel-Montoya, Ana Marín-Quilez, Nuria Revilla, Ana Sánchez-Fuentes, Agustín Rodriguez-Alen, Rocío Benito, Vicente Vicente, Teodoro Iturbe, Andreas Greinacher, María Luisa Lozano, and José Rivera

Subjects
Hematology
Published
2023
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8. Colaboradores

Author

Tristán, Andrés del Amor Arroyo, Castro, María Artero, Fraselle, Thierry Balmaceda, Piqueras, Mercedes Berenguer, González, Carmen Botía, Pérez, Tomás Bruno, Rodríguez, Valerio Campos, Ruiz, Daniel José Carbonell, Hernández, Almudena Cascales, Guardiola, Beatriz Castillo, Navarro, Antonia Castillo, Almohalla, Catalina Cava, Manchado, Juan José Cerezo, Cotugno, Marilena, Matallana, Catalina de Paco, Rodríguez, Pablo Demelo, Viñas, Paloma Escribano, Puerta, Ana María Fernández, Cerezo, Ana Fernández-Rufete, Ramírez, José David Galián, Candel, Faustino García, Hernández, Ana María García, López, Pedro García, Méndez, María del Mar García, Pérez, Ana García, Pérez, Bartolomé García, Verdú, José Miguel Gómez, Torrecillas, Leticia Guirado, Contreras, María Encarnación Hernández, Vidal, María Julia Hernández, Marín, María Teresa Herranz, Adán, Salud Herrera, Hernández, Teodoro Iturbe, Palomares, Luis Jara, Cano, Sandra Jiménez, Castro, David Jiménez, Barron, Erik Johansson, Ramos, Alberto Kramer, Barceló, Andrea María Leal, Estañ, Francisco Lloret, Herrero, Jesús Lozano, Peiró, Ana Maestre, Cascón, Miguel Martín, Martos, Francisco Martín, Romero, Miguel Martín, Encarnación, Lourdes Martínez, Martínez, Mónica Martínez, Paredes, Yésica Martínez, López, Antonio Mateo, Paredes, Ramón Mateo, Bleda, Enrique Mira, Rodríguez, Miriam Navarro, Peynado, Elizabeth M. Núñez, Ocete, Antonio Ocete, Sánchez, Raquel Oliva, López, Nicolás Ortega, Valderrama, Sonia Otálora, Escribano, Javier Pagán, Pérez, Francisco Pastor, Ballesta, Ana Isabel Peláez, López, Raúl Pérez, Luján, Raquel Pérez, Palao, Gabriel Puche, Solano, Manuel Remezal, Rabasco, Blanca Robles, Sánchez, Daniel Rodríguez, Torres, Rocío Rojano, Gutiérrez, Andrés Fernando Rojas, Piloto, Aychel Elena Roura, Reparaz, Carlota Royo-Villanova, Belmonte, Elena Ruiz, Sará, Jenifer Esther Ruiz, Rosa, Vladimir Salazar, Cámara, Silvia Sánchez, Díaz-Canel, Daniel Sánchez, González, Manuel Santa-Olalla, Tirado, Francisco Sarabia, Conesa, María José Soto, Gutiérrez, Aurelia Tejedor, Sánchez, Gloria Tornel, Saura, Miguel Torralba, Santos, Javier Trujillo, and Berenguer, Alicia Verdú

Published
2024
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10. Dabigatran, the oral anticoagulant of choice at discharge in patients with non-valvular atrial fibrillation and COVID-19 infection: the ANIBAL protocol

Author

Antonio Martínez Francés, Luis García de Guadiana Romualdo, Olga Meca Birlanga, Juan José Cerezo-Manchado, Teodoro Iturbe-Hernandez, and Ignacio Gil Ortega

Subjects
medicine.medical_specialty, hepatotoxicity, 030204 cardiovascular system & hematology, Lower risk, direct oral anticoagulants, Dabigatran, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Antithrombotic, medicine, atrial fibrillation, dabigatran, 030212 general & internal medicine, Original Research, Pharmacology, business.industry, lcsh:RM1-950, Atrial fibrillation, General Medicine, Heparin, medicine.disease, Pneumonia, lcsh:Therapeutics. Pharmacology, covid-19, Molecular Medicine, Liver function, Complication, business, medicine.drug
Abstract

Atrial fibrillation is a frequent complication among patients with severe coronavirus disease-2019 (COVID-19) infection. Both direct and indirect mechanisms through COVID-19 have been described to explain this relationship. COVID-19 infection increases the risk of developing both arterial and venous thrombotic complications through systemic coagulation activation, leading to increased mortality. Chronic oral anticoagulation is essential to reduce the thromboembolic risk among AF patients. Switching to low-molecular-weight heparin has been recommended during hospitalization for COVID-19 infection. Of note, at discharge, the prescription of direct oral anticoagulants may offer some advantages over vitamin K antagonists. However, oral anticoagulants should only be prescribed after the consideration of drug-drug interactions with antiviral therapies as well as of the risk of hepatotoxicity, which is common among individuals with severe COVID-19 pneumonia. Not all anticoagulants have the same risk of hepatotoxicity; dabigatran has shown a good efficacy and safety profile and could have a lower risk of hepatotoxicity. Furthermore, its metabolism by cytochrome P450 is absent and it has a specific reversal agent. Therefore, dabigatran may be considered as a first-line choice for oral anticoagulation at discharge after COVID-19 infection. In this review, the available information on the antithrombotic management of AF patients at discharge after COVID-19 infection is updated. In addition, a practical algorithm, considering renal and liver function, which facilitates the anticoagulation choice at discharge is presented.

Published
2020

12. The Elevation of LIVER Enzymes in Patients with Atrial Fibrillation and COVID-19 Is a Marker of Bad Evolution and Mortality

Author

Katia Flores, Jorge Sierra, Teodoro Iturbe Hernandez, Pável E Olivera, Ramón Salinas, Carlos Rodríguez Rojas, Juan Jose Cerezo Manchado, Verónica Ramos Arenas, Desiree Campoy Castaño, Rubén Cárdenas Gámez, César A Velasquez, María Dolores López Abellán, and Luis García de Guadiana Romualdo

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, education, Immunology, 332.Anticoagulation and Antithrombotic Therapy, Atrial fibrillation, Cell Biology, Hematology, After discharge, medicine.disease, Biochemistry, Family medicine, Liver enzyme, medicine, Statistical analysis, In patient, Peak value, Liver damage, business, health care economics and organizations
Abstract

Introduction: The COVID-19 pandemic reflects liver damage. A study carried out in China (Guan WJ et al. N Engl J Med. 2020) reported that in more than 21% of cases there was an elevation of liver enzymes (ELE), with only 2.1% of them having previous liver disease. ELE is frequent in anticoagulated patients and is associated with an increased cardiovascular risk and bleeding complications2,3. It is necessary to evaluate the impact of ELE in patients with atrial fibrillation (AF) and COVID-19 Methods: Multicenter, retrospective and observational study that consecutively included patients admitted with COVID-19 during the months of March and April 2020. The patients were followed were followed up until 30 days after discharge or death. termino en inglés ¿??Anticoagulation was chosen at the clinical discretion. The main variables investigated were the value of liver enzymes (AST, ALT, GGT) at admission, during the first week (peak value) and at hospital discharge. Patients who achieved a 3-fold higher level of ELE(> 120UI) were described as high-risk transaminasemia (HRT). The number of bleedings, thromboembolic events, as well as all-cause mortality were evaluated. Statistical analysis was performed with SPSS 21.0 (SPSS Inc., Chicago, IL). Results: A total of 235 patients were included. The mean age was 79 years [standard deviation (SD) 7.9. years]. The demographic characteristics of the patients with and without HRT are summarized in Table 1. The median follow-up was 59 days (SD 29 days). In AF patients, ELE values rose significantly on admission with respect to discharge p Disclosures Olivera: Daiichi Sankyo:Consultancy, Speakers Bureau;BAYER:Consultancy;Boehringer Ingelheim:Consultancy, Speakers Bureau;Pfizer:Consultancy, Speakers Bureau.Campoy Castaño:Boehringer Ingelheim:Consultancy;Daiichi Sankyo:Speakers Bureau.Sierra:Astellas:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Novartis:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Abbvie:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Jazz Pharmaceuticals:Research Funding;Pfizer:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Daiichi Sankyo:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Roche:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Gilead-Kite:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees.

Published
2020
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13. Carfilzomib and dexamethasone for extramedullary myeloma with pleuropericardial involvement

Author

Teodoro Iturbe, Felipe de Arriba, Marta Romera, Aurelia Tejedor, María C. García, María Dolores Ruiz López, Antonio Martínez, Jerónima Ibáñez, Ignacio Español, María Dolores Gutiérrez-Meca, and Alfredo Minguela

Subjects
Oncology, medicine.medical_specialty, Case Report, Case Reports, pleuropericardial myelomatous effusion, Disease, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, hemic and lymphatic diseases, Cardiac tamponade, Internal medicine, otorhinolaryngologic diseases, medicine, Overall survival, neoplasms, Multiple myeloma, Dexamethasone, carfilzomib, business.industry, General Medicine, medicine.disease, Carfilzomib, Surgery, stomatognathic diseases, chemistry, 030220 oncology & carcinogenesis, business, 030215 immunology, medicine.drug
Abstract

Key Clinical Message The dismal outcome of pleuropericardial extramedullary multiple myeloma (EMM) reflects both the selection of resistant disease and absence of useful drugs. Carfilzomib and dexamethasone should be explored in advanced EMM patients, even for bortezomib‐resistant patients, as may provide much longer overall survival than previously reported treatments.

Published
2017
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15. Colaboradores

Author

del Amor Arroyo Tristán, Andrés, Castro, María Artero, Fraselle, Thierry Balmaceda, Piqueras, Mercedes Berenguer, González, Carmen Botía, Pérez, Tomás Bruno, Rodríguez, Valerio Campos, Ruiz, Daniel José Carbonell, Hernández, Almudena Cascales, Guardiola, Beatriz Castillo, Navarro, Antonia Castillo, Almohalla, Catalina Cava, Manchado, Juan José Cerezo, Cotugno, Marilena, de Paco Matallana, Catalina, Viñas, Paloma Escribano, Puerta, Ana María Fernández, Cerezo, Ana Fernández-Rufete, Ramírez, José David Galián, Candel, Faustino García, Hernández, Ana María García, López, Pedro García, Pérez, Ana García, del Mar García Méndez, María, Pérez, Bartolomé García, Verdú, José Miguel Gómez, Contreras, María Encarnación Hernández, Marín, María Teresa Herranz, Adán, Salud Herrera, Hernández, Teodoro Iturbe, Cano, Sandra Jiménez, Johansson, Eric, Ramos, Alberto Kramer, Barceló, Andrea María Leal, Estañ, Francisco Lloret, Herrero, Jesús Lozano, Núñez Peynado, Elizabeth M., Peiró, Ana Maestre, Cascón, Miguel Martín, Romero, Miguel Martín, Encarnación, Lourdes Martínez, Martínez, Mónica Martínez, Paredes, Yesica Martínez, López, Antonio Mateo, Paredes, Ramón Mateo, Bleda, Enrique Mira, Rodríguez, Miriam Navarro, Ocete, Antonio Ocete, Sánchez, Raquel Oliva, López, Nicolás Ortega, Ballesta, Ana Isabel Peláez, Valderrama, Sonia Otálora, Pérez, Francisco Pastor, López, Raúl Pérez, Luján, Raquel Pérez, Solano, Manuel Remezal, Rabasco, Blanca Robles, Sánchez, Daniel Rodríguez, Torres, Rocío Rojano, Gutiérrez, Andrés Fernando Rojas, Reparaz, Carlota Royo-Villanova, Reparaz, Mario Royo-Villanova, Piloto, Aychel Elena Roura, Belmonte, Elena Ruiz, Sará, Jenifer Esther Ruiz, Rosa, Vladimir Salazar, Cámara, Silvia Sánchez, González, Manuel Santa-Olalla, Tirado, Francisco Sarabia, Gutiérrez, Aurelia Tejedor, Saura, Miguel Torralba, Sánchez, Gloria Tornel, Santos, Javier Trujillo, and Berenguer, Alicia Verdú

Published
2020
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21. Hypercoagulability state in hip and knee surgery: influence of ABO antigenic system and allogenic transfusion

Author

Cornudella R, Teodoro Iturbe, Teresa Olave, Roberto de Miguel, José Antonio Moreno, M. Gutiérrez, and Luis Callén

Subjects
Adult, Male, Isoantigens, Blood transfusion, medicine.medical_treatment, Arthroplasty, Replacement, Hip, Immunology, Population, Lower risk, ABO Blood-Group System, ABO blood group system, D-dimer, medicine, Humans, Thrombophilia, Transplantation, Homologous, Aprotinin, Blood Transfusion, Risk factor, education, Arthroplasty, Replacement, Knee, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, business.industry, Antithrombin, Hematology, Middle Aged, Anesthesia, Female, business, medicine.drug
Abstract

It is well know that people with blood group O have a lower risk for venous thromboembolic disease (VTED) than does the general population. Moreover blood transfusion has been identified as a risk factor for VTED in patients with major trauma. The aim of this work is to investigate the behaviour of several markers of hypercoagulability before and after substitutive surgery of hip and knee in order to evaluate the relationship between the plasmatic levels of these markers, the ABO antigenic system and the allogenic blood transfusion. The plasmatic levels of D dimer (D–D), thrombin – antithrombin complex (TAT), and fragment 1 + 2 of prothrombin (F1 + 2) have been determined by the ELISA method in 79 patients subject to substitutive surgery of hip or knee one day before and one day after surgery. The 41 patients with blood groups different from O had presurgical levels of F1 + 2 higher than those of group O (p=0.004), while no differences could be found for D–D and TAT. The 28 patients who received allogenic blood presented higher levels of D–D one day after surgery than non-transfused patients (p=0.043); the practice of transfusion did not modify significantly the levels of TAT and F1 + 2 after surgery. In accordance with these results we suggest that blood group and transfusion are risk factors for hypercoagulability, and therefore we advise for a restrictive policy of transfusion practice. New therapies such as aprotinin should be assayed in order to minimize blood loss.

Published
2000

25. Adverse Events Associated with Autologous and Allogenic Blood Transfusion

Author

Alejandro Serrablo, M. Gutiérrez, Cornudella R, and Teodoro Iturbe

Subjects
Male, Pediatrics, medicine.medical_specialty, Blood transfusion, Directed blood donation, business.industry, medicine.medical_treatment, Infant, Newborn, Transfusion Reaction, Blood Donors, General Medicine, medicine.disease, Erythroblastosis, Fetal, Blood Transfusion, Autologous, Hemoglobins, Hemolytic disease of the newborn (ABO), Hemotherapy, Humans, Transplantation, Homologous, Medicine, Orthopedics and Sports Medicine, Surgery, business, Intensive care medicine, Adverse effect
Abstract

To The Editor: We greatly appreciated the article "Hemolytic Disease of the Newborn Caused by Transfusion of a Husband's Directed Blood Donation. A Case Report" (81-A: 1170-1172, Aug. 1999), by Kennedy et al. We agree with the authors, and we wish to focus the attention of readers on the controversy related to the indication for blood transfusion in the case reported. We also wish to comment on some of the risks of hemotherapy. Recently, the Canadian Critical Care Trials Group suggested that the use of a threshold for red-cell transfusion of as low as seventy grams …

Published
2000
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