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Mikel Taibo Urquía

Universidad Alfonso X el Sabio

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Marcelino Cortés

Universidad Alfonso X el Sabio

José Tuñón

Centre for Biomedical Network Research on Rare Diseases

Juan Antonio Franco Peláez

Hospital Universitario Fundación Jiménez Díaz

José María Romero Otero

Hospital Universitario Fundación Jiménez Díaz

José Tuñón Fernández

Hospital Universitario Fundación Jiménez Díaz

Sem Briongos Figuero

Hospital Universitario Infanta Leonor

Jorge Balaguer Germán

Hospital Universitario Fundación Jiménez Díaz

A. M. Lázaro

Hospital Universitario Fundación Jiménez Díaz

José Antonio Esteban Chapel

Hospital Universitario Fundación Jiménez Díaz

Ana Devesa

Cardiovascular Institute of the South

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Hospital Universitario Fundación Jiménez Díaz

Universidad Autónoma de Madrid

Centro de Investigación en Red en Enfermedades Cardiovasculares

Centro de Investigación Biomédica en Red

Instituto de Salud Carlos III

Hospital General Universitario Gregorio Marañón

Hospital Universitario 12 De Octubre

Hospital Universitario Quirónsalud Madrid

Universidad Complutense de Madrid

Hospital Universitario Virgen de la Arrixaca

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4. EXISTE UNA ASOCIACIÓN ENTRE PARÁMETROS DE CONGESTIÓN CLÁSICOS Y LOS MEDIDOS POR BIOIMPEDANCIA ELÉCTRICA EN PACIENTES CON INSUFICIENCIA CARDIACA CON FRACCIÓN DE EYECCIÓN REDUCIDA

Revista Española de Cardiología (2023)

Jorge Balaguer Germán Carlos Rodríguez López Álvaro Aceña Navarro Rocío Carda Barrio Hans Paul Gaebelt Slocker

10.1016/s0300-8932(24)01116-3

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P6289Cardiac resynchronization therapy in elderly patients with chronic kidney disease and low ejection fraction: does it work?

European Heart Journal (2018)

Marta López Marcelino Cortés A.L. Rivero Ana Devesa J. Martinez

10.1093/eurheartj/ehy566.p6289

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Beta-blockers in elderly patients with left ventricular systolic dysfunction and chronic kidney disease: danger or benefit?

European Heart Journal (2020)

J Martinez Milla Marcelino Cortés Marta López‐Castillo A Devesa-Arbiol A.L Rivero-Monteagudo

Abstract Introduction Beta-blockers (BB) have been shown to reduce mortality in patients with HFrEF. However, there is little data on the benefit of these therapies in patients with chronic kidney disease and even less in older patients. The aim of this work is to evaluate the role of beta-blockers in patients ≥75 years along the spectrum of kidney disease. Methods From January 2008 to July 2014, we consecutively enlisted 802 patients aged >75 years that had ejection fraction ≤35%. From this group we included 380 patients that had CKD (defined as a glomerular filtration rate (GFR) ≤60 ml/min/1.73m2). Clinical, echocardiographic and electrocardiographic data were taken from hospital records. Follow-up was made via telephone and hospital records as well. Propensity score matching analysis was made to assess the relationship between treatment with BB and occurrence of major adverse cardiovascular event (MACE) composite of death for any cause or heart failure. hospitalization. Multivariate Cox regression analysis was also made in the different groups of CKD (45–60 ml/min/1.73m2, 30–45 ml/min/1.73m2, <30 ml/min/1.73m2) in order to assess the effect of BB over mortality and CV events in each subgroup. Results 390 patients were included. Male represented 62.3% of all participants, and the mean age was 82.6±4.1 years. The mean ejection fraction was 27.9±6.5%. Ischemic etiology was found in 50.6% of cases. Glomerular filtrate (GF) was 60 to 45 ml/min/1.73 m2 in 50.3% of patients, 45–30 ml/min/1.73 m2 in 37.4% and <30 ml/min/1.73 m2 in 12.3%. At the end of the follow-up, 67.4% of the patients were on beta-blocker treatment. The mean follow-up was 32±23 months. During the study period, 211 patients (54.1%) died and 257 patients (65.9%) had a major cardiovascular event (death or hospitalization for heart failure). After propensity score matching analysis, 178 were considered (89 each group) and they have no significant difference in baseline characteristics. BBs were found to significantly reduce mortality (HR 0.45 (95% CI, 0.27–0.75). When the effect of BB over the different subgroups of CKD was analyzed, it was seen also that BB reduced mortality in patients with eGFR 45–60 ml/min/1.73 m2 (HR 0.47 (95% CI, 0.26–0.86), in patients with eGFR 30–45 ml/min/1.73 m2 (HR 0.55 (95% CI, 0.26–1.06)and in eGFR <30 ml/min/1.73 m2 (HR 0.29 (95% CI, 0.11–0.76) Conclusion The use of beta-blockers in elderly patients with HFrEF and kidney DISEASE was associated with increased survival, regardless of the degree of kidney failure. There is a need to raise awareness of the benefits of beta-blocker use in these patients to promote their use where possible. Funding Acknowledgement Type of funding source: None

Mace

10.1093/ehjci/ehaa946.3231

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New Biomarkers in the Prognostic Assessment of Acute Heart Failure with Reduced Ejection Fraction: Beyond Natriuretic Peptides

Marcelino Cortés Jairo Lumpuy‐Castillo Camila Sofía García-Talavera María Belen Arroyo-Rivera Lara de Miguel

Natriuretic peptides are established biomarkers related to the prognosis of heart failure.New biomarkers have emerged in the area of cardiovascular disease. The prognostic value of these biomarkers in heart failure with reduced LVEF (HFrEF) is not well established.We conducted a prospective, single-centre study, including consecutively (July 2019 to March 2023) 104 patients admitted with a diagnosis of acute HFrEF decompensation.Median follow-up was 23.5 months, during which 20 deaths (19.4%) and 21 readmissions for heart failure (20.2%) were recorded. Plasma biomarkers such as NT-proBNP, GDF-15, sST2, uPAR, and FGF-23 were associated with an increased risk of all-cause mortality. However, a Cox regressionanalysis showed that the strongest predictors of mortality were estimated glomerular filtration rate (HR 0.96 [0.93-0.98]), GDF-15 (HR 1.3 [1.16-1.45]), and sST2 (HR 1.2 [1.11-1.35]). The strongest predictive model was formed by the combination of glomerular filtration rate and sST2 (C-index 0.758). In conclusion, in patients with acute decompensated HFrEF, GDF-15 and sST2 showed the highest predictive power for all-cause mortality, superior to other established biomarkers such as natriuretic peptides. GDF-15 and sST2 may provide additional prognostic information to improve the prognostic assessment.

Brain natriuretic peptide

10.20944/preprints202412.1706.v1

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SURGICAL CORRECTION OF RENOVASCULAR HYPERTENSION

Brito Jm Mikel Taibo Urquía Sanchez-Fernandez Pa De Rábago G

Renovascular Hypertension

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Impact of SGLT2 Inhibitors on Very Elderly Population with Heart Failure with Reduce Ejection Fraction: Real Life Data

Biomedicines (2024)

Jorge Balaguer Germán Marcelino Cortés Carlos Rodríguez López José María Romero Otero Jose Antonio Esteban Chapel

(1) Background: The validation of new lines of therapy for the elderly is required due to the progressive ageing of the world population and scarce evidence in elderly patients with HF with reduced ejection fraction (HFrEF). The purpose of our study is to analyze the effect of SGLT2 inhibitors (SGLT2i) in this subgroup of patients. (2) Methods: A single-center, real-world observational study was performed. We consecutively enrolled all patients aged ≥ 75 years diagnosed with HFrEF and for treatment with SGLT2i, and considered the theoretical indications. (3) Results: A total of 364 patients were recruited, with a mean age of 84.1 years. At inclusion, the mean LVEF was 29.8%. Median follow-up was 33 months, and there were 122 deaths. A total of 55 patients were under SGLT2i treatment. A multivariate Cox logistic regression test for all-cause mortality was performed, and only SGLT2i (HR 0.39 [0.19–0.82]) and glomerular filtration rate (HR 0.98 [0.98–0.99]) proved to be protective factors. In parallel, we conducted a propensity-score-matched analysis, where a significant reduction in all-cause mortality was associated with the use of SGLT2i treatment (HR 0.39, [0.16–0.97]). (4) Conclusions: Treatment with SGLT2i in elderly patients with HFrEF was associated with a lower rate of all-cause mortality. Our data show that SGLT2i therapy could improve prognosis in the elderly with HFrEF in a real-world study.

10.3390/biomedicines12071507

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Colchicine in acutely decompensated heart failure: the COLICA trial

European Heart Journal (2024)

Domingo A. Pascual‐Figal Julio Núñez Teresa Martı́nez José Ramón González‐Juanatey Mikel Taibo Urquía

Abstract Background and Aims Acute heart failure (AHF) promotes inflammatory activation, which is associated with worse outcomes. Colchicine has proven effective in other cardiovascular conditions characterized by inflammatory activation, but has never been evaluated in the setting of AHF. Methods This multicenter, randomized, double-blind and placebo-controlled trial included patients with AHF, requiring ≥40 mg of intravenous furosemide, regardless of their left ventricular ejection fraction (LVEF) and inpatient or outpatient setting. Patients were randomized within the first 24 hours of presentation to receive either colchicine or placebo, with loading dose of 2 mg followed by 0.5 mg every 12 hours for 8 weeks. Results A total of 278 patients (median age 75 years, LVEF 40%, baseline N-terminal pro-B-type natriuretic peptide [NT-proBNP] 4390 pg/mL) were randomized to colchicine (n=141) or placebo (n=137). The primary endpoint, the time-averaged reduction in NT-proBNP levels at 8 weeks, did not differ between the colchicine group (-62.2%, 95% confidence interval [CI] -68.9% to -54.2%) and the placebo group (-62.1%, 95% CI -68.6% to -54.3%) (ratio of change 1.0). The reduction in inflammatory markers was significantly greater with colchicine: ratio of change 0.60 (p<0.001) for C-reactive protein and 0.72 (p=0.019) for interleukin-6. No differences were found in new worsening heart failure episodes (14.9% with colchicine vs. 16.8% with placebo, p=0.698); however, the need for intravenous furosemide during follow-up was lower with colchicine (p=0.043). Diarrhea was slightly more common with colchicine, but it did not result in differences in medication withdrawal (8.5% vs. 8.8%). Conclusions Colchicine was safe and effective in reducing inflammation in patients with AHF, however colchicine and placebo exhibited comparable effects on reducing NT-proBNP and preventing new worsening heart failure events.

Clinical endpoint

Colchicine

10.1093/eurheartj/ehae538

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Beta-blocker therapy in elderly patients with renal dysfunction and heart failure.

Journal of Geriatric Cardiology (2021)

Juan Martínez‐Milla Marcelino Cortés Julia Anna Palfy Mikel Taibo Urquía Marta López Castillo

OBJECTIVE To assess the role of beta-blockers (BB) in patients with chronic kidney disease (CKD) aged ≥ 75 years. METHODS AND RESULTS From January 2008 to July 2014, we included 390 consecutive patients ≥ 75 years of age with ejection fraction ≤ 35% and glomerular filtration rate (GFR) ≤ 60 mL/min per 1.73 m2. We analyzed the relationship between treatment with BB and mortality or cardiovascular events. The mean age of our population was 82.6 ± 4.1 years. Mean ejection fraction was 27.9% ± 6.5%. GFR was 60-45 mL/min per 1.73 m2 in 50.3% of patients, 45-30 mL/min per 1.73 m2 in 37.4%, and < 30 mL/min per 1.73 m 2 in 12.3%. At the conclusion of follow-up, 67.4% of patients were receiving BB. The median follow-up was 28.04 (IR: 19.41-36.67) months. During the study period, 211 patients (54.1%) died and 257 (65.9%) had a major cardiovascular event (death or hospitalization for heart failure). BB use was significantly associated with a reduced risk of death (HR = 0.51, 95% CI: 0.35-0.74;P < 0.001). Patients receiving BB consistently showed a reduced risk of death across the different stages of CKD: stage IIIa (GFR = 30-45 mL/min per 1.73 m 2; HR = 0.47, 95% CI: 0.26-0.86,P < 0.0001), stage IIIb (GFR 30-45 mL/min per 1.73 m 2; HR = 0.55, 95% CI: 0.26-1.06,P = 0.007), and stages IV and V (GFR < 30 mL/min per 1.73 m 2; HR = 0.29, 95% CI: 0.11-0.76;P = 0.047). CONCLUSIONS The use of BB in elderly patients with HFrEF and renal impairment was associated with a better prognosis. Use of BB should be encouraged when possible.

10.11909/j.issn.1671-5411.2021.01.005

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Effects of anti-inflammatory therapy in acute heart failure: a systematic review and meta-analysis

Heart Failure Reviews (2025)

Beth A. Davison Antonio Abbate Gad Cotter Domingo A. Pascual‐Figal Benjamín Van Tassell

10.1007/s10741-025-10491-5

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5. INHIBIDORES DE COTRANSPORTADOR SODIO-GLUCOSA 2 EN INSUFICIENCIA CARDIACA. CARACTERÍSTICAS Y EVENTOS EN UNA COHORTE NO SELECCIONADA EN VIDA REAL. RESULTADOS DEL REGISTRO CÁSTOR-HF

Revista Española de Cardiología (2023)

Juan Górriz Magaña Marta Cobo Marcos Jesús Ángel Perea Egido Glodecinda Isabel Ocaña Sánchez Jesús Álvarez García

10.1016/s0300-8932(24)01487-8

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