Publications by authors named "Juan A Andueza"

Objectives: The aim of the present study was to evaluate the impact of chronic treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) on short-term clinical outcomes after an episode of AHF.

Methods: A secondary analysis of patients included in the EAHFE (Epidemiology of Acute Heart Failure in Emergency Departments) cohort, which includes patients diagnosed with AHF in 45 Spanish Emergency Departments (EDs). The primary outcome was all-cause in-hospital mortality.

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Aims: To investigate whether seasonal influenza and COVID-19 vaccinations influence the severity of decompensations and long-term outcomes of patients with acute heart failure (AHF).

Methods And Results: We included consecutive AHF patients attended at 40 Spanish emergency departments during November and December 2022. They were grouped according to whether they had received seasonal influenza and COVID-19 vaccination.

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Digoxin is commonly used to treat acute heart failure (AHF), especially in patients with concurrent atrial fibrillation (AF). Nonetheless, there is little consensus about in which patients digoxin should be given, the proper time for digoxin initiation, and whether digoxin initiation is associated with improved outcomes. We investigated factors related to digoxin initiation after an episode of AHF and whether patients receiving digoxin presented better short-term outcomes.

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Article Synopsis
  • Intravenous digoxin is commonly used in emergency departments to treat acute heart failure, particularly in patients experiencing rapid atrial fibrillation, but concerns about its risks in older patients and those with kidney issues exist.
  • The study aimed to determine if digoxin influences 30-day mortality rates in patients with acute heart failure, taking into account factors like age, kidney function, and potassium levels.
  • The analysis revealed no significant difference in mortality rates between patients treated with digoxin and those who were not, despite a high median age and serious health conditions among participants.
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To investigate whether the timing of a previous hospital admission for acute heart failure (AHF) is a prognostic factor for AHF patients revisiting the emergency department (ED) in the subsequent 12-month follow-up. All ED AHF patients enrolled in the previously described EAHFE registry were stratified by the presence or absence of an AHF hospitalization admission in the prior 12 months. The primary outcome was 12-month all-cause mortality post ED visit.

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Objective: Both hyperkalemia (HK) and Acute Heart Failure (AHF) are associated with increased short-term mortality, and the management of either may exacerbate the other. As the relationship between HK and AHF is poorly described, our purpose was to determine the relationship between HK and short-term outcomes in Emergency Department (ED) AHF.

Methods: The EAHFE Registry enrolls all ED AHF patients from 45 Spanish ED and records in-hospital and post-discharge outcomes.

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  • The study aimed to investigate the relationship between air pollutants and the severity of decompensated heart failure in patients attending emergency departments in Spain.
  • A total of 5,292 patients, primarily elderly and mostly women, were analyzed, with data collected on pollutants like SO, NO, and CO, among others.
  • The results indicated that only sulfur dioxide (SO) showed a linear correlation with the severity of heart failure, particularly in increasing the likelihood of hospitalization, while other pollutants did not demonstrate clear associations.
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Objectives: To analyze whether short-term outcomes are affected when patients diagnosed with acute heart failure (AHF) spend time in an emergency department observation unit (EDOU) before hospital admission.

Material And Methods: Baseline and emergency episode data were collected for patients diagnosed with AHF in the EDs of 15 Spanish hospitals. We analyzed crude and adjusted associations between EDOU stay and 30-day mortality (primary outcome) and in-hospital mortality and a prolonged hospital stay of more than 7 days (secondary outcomes).

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Aims: To assess whether symptoms/signs of congestion and perfusion in acute heart failure (AHF) evaluated at patient arrival to the emergency department (ED) can predict the severity of decompensation and short-term outcomes.

Methods And Results: We included patients from the Epidemiology of AHF Emergency Registry (EAHFE Registry). We registered seven clinical surrogates of congestion and five of hypoperfusion.

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Objectives: We investigated if the phenotypic classification of acute heart failure (AHF) based on the number of signs/symptoms of congestion and hypoperfusion at emergency department (ED) arrival identifies subgroups in which intravenous (IV) nitroglycerine (NTG) use improves short-term survival.

Methods: We included consecutive AHF patients diagnosed in 45 Spanish EDs, who were grouped according to phenotype severity. The main outcome was 30-day all-cause death.

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Aims: To analyze the frequency with which patients with heart failure with preserved ejection fraction (HFpEF) discharged after an acute heart failure (AHF) episode are treated with antineurohormonal drugs (ANHD), the variables related to ANHD prescription and their relationship with outcomes.

Methods: We included consecutive HFpEF patients (left ventricular ejection fraction ≥50%) discharged after an AHF episode from 45 Spanish hospitals whose chronic medications and treatment at discharge were available. Patients were classified according to whether they were discharged with or without ANHD, including beta-blockers (BB), renin-angiotensin-aldosterone-system inhibitors (RAASi) and mineralcorticosteroid-receptor antagonists (MRA).

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Nasopharyngeal (NP) specimens are commonly used for the detection of influenza, but saliva swabs are easier to obtain and cause less discomfort to the patients. The objective of this study was to evaluate the usefulness of saliva swab specimens for the diagnosis of influenza compared with NP specimens. Influenza virus detection rate in saliva and NP swabs was compared in adult patients admitted to an emergency department from January to March 2020, using the Xpert Xpress Flu/respiratory syncytial virus (RSV) test.

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Article Synopsis
  • The study focused on how the length of hospitalisation (LOH) affects the outcomes of patients with acute heart failure (AHF) after they are discharged, comparing results across different hospital departments.
  • Out of 8,563 patients analyzed, 90-day outcomes showed that longer hospital stays led to higher post-discharge mortality rates, particularly for those staying over 15 days, but readmission rates remained constant regardless of LOH.
  • The research concluded that shorter hospital stays do not lead to worse outcomes, and higher mortality risks associated with longer stays were consistent across various hospital departments.
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  • The study investigates how the risk of malnutrition affects 30-day mortality rates in elderly patients experiencing acute heart failure (AHF) in emergency departments.
  • It analyzed data from 749 patients aged 65 and older, finding that 79.3% were at risk of malnutrition and the overall 30-day mortality rate was 8.8%.
  • The results indicate that malnutrition is a significant independent factor for higher 30-day mortality, suggesting that routine screening for malnutrition could improve patient care and management in emergency settings.
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Objectives: The authors sought to evaluate clinical outcomes of patients after an episode of acute heart failure (AHF) according to their adherence to the Mediterranean diet (MedDiet).

Background: It has been proved that MedDiet is a useful tool in primary prevention of cardiovascular diseases. However, it is unknown whether adherence to MedDiet is associated with better outcomes in patients who have already experienced an episode of AHF.

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Objectives: To determine perception of quality of care for acute heart failure (AHF) of patients discharged from the emergency department in comparison with the perception of admitted patients; to explore the variables associated with perception of quality.

Material And Methods: Prospective, cross-sectional case-control study in 7 emergency departments. Consecutive patients diagnosed with AHF were recruited to answer a telephone survey assessing their view of quality of physician care, nurse care, overall treatment, and degree of resolution of their problem in the emergency department.

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Introduction: Lemierre syndrome (LS) is considered as a forgotten disease since the beginning of Penicillin. The lack of use of beta-lactamase inhibitors antibiotics together with the increase in the use of macrolids or second-generation and third-generation cephalosporins for oropharyngeal processes has led to an increasing incidence. We propose to review all LS cases seen in an Emergency Department over the last 5 years.

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