Publications by authors named "Pablo Dominguez Erquicia"
Background: The predictive value of bleeding risk scores for atrial fibrillation in older patients is not as well known. The goal of this study was to evaluate the predictive value of HASBLED, ORBIT and ATRIA for major bleeding (MB) and intracranial hemorrhage (ICH) in patients ≥ 75 years with atrial fibrillation and oral anticoagulation (OAC).
Methods: A retrospective unicenter study including patients ≥ 75 years with atrial fibrillation (AF) and OAC.
Clinical decision making on anticoagulation in patients with chronic kidney disease with atrial fibrillation (AF) is challenging. The current strategies are based on small observational studies with conflicting results. This study explores the impact of glomerular filtration rate (GFR) in the embolic-hemorrhagic balance among a large cohort of patients with AF.
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- The study aimed to determine how cancer affects the risks of embolic (blood clots) and bleeding events in patients with atrial fibrillation (AF).
- In a cohort of over 16,000 AF patients, only those with active cancer or a history of radiotherapy showed a higher risk of bleeding, but there was no increased risk of embolic events due to cancer.
- The widely used CHADS-VASc and HAS-BLED scores were found to be less effective at predicting risks in nonanticoagulated patients with active cancer.
There is limited knowledge regarding the efficacy and safety of fixed-dose oral anticoagulants in overweight patients because of the possible increased risk of embolism and hemorrhage. This study aimed to evaluate embolic, hemorrhagic, and mortality events in anticoagulated patients, administered both antivitamin K and direct oral anticoagulants based on the body weight (<60 kg, 60 to 100 kg and >100 kg). A retrospective registry-based cohort study including all consecutive patients with a diagnosis of atrial fibrillation between January 2014 and January 2018 in the health area of Vigo (Galicia, Spain) was used (CardioCHUVI-AF registry; ClinicalTrials.
View Article and Find Full Text PDFBackground: Atrial fibrillation (AF) carries a thrombotic risk related to blood stasis in the left atrium. In patients with rheumatic valve disease and AF, the presence of severe mitral regurgitation (MR) has been shown to reduce the risk of atrial thrombosis and stroke. However, in patients without rheumatic disease, the results are controversial.
View Article and Find Full Text PDFLittle is known about the prediction of atrial fibrillation (AF) risk scores in patients with cancer. The aim of this study was to assess the predictive ability of the CHADS-VASc and HAS-BLED scores in patients with AF and cancer. Overall, 16,056 patients with AF diagnosed between 2014 and 2018 from a Spanish health area, including 1,137 patients with cancer, were observed during a median follow-up of 4.
View Article and Find Full Text PDFDespite patients with cancer having a higher incidence of atrial fibrillation (AF), little is known about the predictors of outcomes in this population. This study aimed to assess the incidence and predictors of bleeding in patients with AF and cancer. The study population comprised 16,056 patients from a Spanish health area diagnosed with AF between 2014 and 2018 (1,137 with cancer).
View Article and Find Full Text PDFBackground: The association between digoxin and mortality is an unclear issue. In older patients with atrial fibrillation (AF), where use of digoxin is frequent, the evidence of its safety is scarce. Our aim is to assess the safety of digoxin in nonagenarian patients with AF.
View Article and Find Full Text PDFIntroduction And Objectives: Clinical decision-making on anticoagulation in elderly patients with atrial fibrillation (AF) requires clinicians to consider not only the incidence of embolic and bleeding events, but also the risk of death following these adverse events. We aimed to analyze the trade-off between embolic and bleeding events with respect to mortality in elderly patients with AF.
Methods: The study cohort comprised all patients aged ≥ 75 years from a Spanish health area diagnosed with AF between 2014 and 2017 (n=9365).
Background: The prevalence of atrial fibrillation (AF) increases with age. The prescription of anticoagulation in very elderly patients is controversial and sometimes underused. Our objective is to report the incidence and predictors of major bleeding in anticoagulated nonagenarian patients with non valvular atrial fibrillation (NVAF).
View Article and Find Full Text PDFAngiotensin-Converting Enzyme Inhibitors Versus Angiotensin II Receptor Blockers in Acute Coronary Syndrome and Preserved Ventricular Ejection Fraction.
Angiology
November 2020
Article Synopsis
- ACE inhibitors (ACEi) and angiotensin II receptor blockers (ARB) show similar survival rates in heart failure patients with low ejection fraction, but their effectiveness in those with preserved ejection fraction post-acute coronary syndrome (ACS) is unclear.
- A study of 3,006 patients with preserved LVEF (≥40%) after an ACS found no significant differences in outcome measures like mortality and heart failure when comparing ACEi and ARB treatments over an average follow-up of 3.6 years.
- The results suggest that there is no prognostic advantage of using ACEi over ARB or vice versa in this patient population, highlighting the need for further studies to validate these findings.
Aims: Nutrition is an important determinant of health above the age of 80 years. Malnutrition in the elderly is often underdiagnosed. The aim of this study was to report the prevalence and prognostic value of malnutrition in patients ≥80 years old with atrial fibrillation (AF) with and without anticoagulant therapy.
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- * Conducted on patients aged 85 and older from 2013 to 2018, the study found that while anticoagulation reduced the risk of embolisms, it also increased the risk of bleeding in both dementia and non-dementia groups.
- * Importantly, anticoagulation was linked to lower mortality rates only in patients without dementia, suggesting the need for tailored treatments in this vulnerable population.
Article Synopsis
- A study examined the effects of oral anticoagulation on patients aged 90 and older with atrial fibrillation, finding that this group is often underrepresented in clinical trials.
- Out of 1,750 nonagenarians analyzed over an average follow-up of nearly 24 months, DOACs showed a lower risk of death and embolic events compared to no anticoagulation, while VKAs did not demonstrate a significant difference.
- Both DOACs and VKAs were linked to a higher risk of major bleeding, with VKAs also associated with an increased risk of intracranial hemorrhage, highlighting the need for careful management of anticoagulation in this age group.
Renin-Angiotensin System Blockade and Risk of Heart Failure After Myocardial Infarction Based on Left Ventricular Ejection Fraction: A Retrospective Cohort Study.
Am J Cardiovasc Drugs
October 2019
Article Synopsis
- This study aimed to explore how angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) impact the occurrence of heart failure (HF) following an acute myocardial infarction (AMI), considering patients' left ventricular ejection fraction (LVEF).
- Researchers analyzed data from 8,169 AMI patients discharged from two Spanish hospitals between 2010 and 2016, employing various statistical methods to assess the relationship between ACEI/ARB use and heart failure admissions.
- Findings indicated that while ACEIs/ARBs showed no significant benefit for patients with LVEF over 40%, they significantly reduced HF admissions in patients with LVEF 40% or lower, suggesting