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Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio

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Ponencia presentada por el Dr. Manuel Anguita Sánchez en el directo online ‘Riesgo CV en pacientes españoles con FANV: estudio EMIR tras un año’, realizado el 26 de noviembre de 2019 en la Casa del Corazón.

Published in: Health & Medicine
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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio

  1. 1. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Estudio EMIR “Estudio observacional para la identificación de los factores de riesgo asociados a eventos cardiovasculares Mayores en pacientes con fIbrilación auricular no valvular tratados con Rivaroxaban” Promovido por Bayer Hispania, S.L.
  2. 2. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Francisco Marín Ortuño, Marcelo Sanmartín Fernández, Manuel Anguita Sánchez, Carles Rafols, Alejandro Isidoro Pérez Cabeza, Gonzalo Baron Esquivias, Iñaki Lekuona Goya, José Manuel Vázquez Rodríguez, Juan Cosín Sales, Fernando Arribas Ynsaurriaga, Vivencio Barrios Alonso y Román Freixa Pamias Investigadores del estudio EMIR Estudio EMIR
  3. 3. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez •Objetivos Analizar la incidencia de eventos cardiovasculares distintos al ictus y a las hemorragias mayores en pacientes con FA no valvular tratados con rivaroxaban. Identificar los factores de riesgo asociados a dichos eventos, y, en concreto, el valor del score 2MACE
  4. 4. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Justificación • El ictus es la principal complicación de la FA • La FA se asocia a un riesgo global de ictus 5 veces mayor1 • La FA duplica el riesgo de ictus cuando se hace el ajuste de otros factores de riesgo2 • Sin tratamiento preventivo, cada año aproximadamente 1 de cada 20 pacientes con FA presentará un episodio de ictus3 • Cuando se consideran los AIT y los ictus clínicamente “silentes”, la tasa de isquemia cerebral asociada a FA no valvular supera el 7% anual • La FA es responsable del 15% de todos los ictus, y es la principal causa de ictus embólico4 1. Savelieva I et al. Ann Med 2007;39:371–91; 2. Fuster V et al. European Heart Journal 2006;27:1979–2030; 3. Atrial Fibrillation Investigators. Arch Intern Med 1994;154:1449–57; 4. Benjamin EJ et al. Circulation 1998;98:946–52
  5. 5. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Justificación
  6. 6. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Justificación Piccini JP. Clinical course of atrial fibrillation in older adults: the importance of cardiovascular events beyond stroke. Eur Heart J 2014;35:250–6.
  7. 7. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Justificación Marijon E et al. Circulation. 2013;128:2192-2201
  8. 8. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Justificación Anguita M et al. Estudio FANTASIIA. Rev Esp Cardiol 2019
  9. 9. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Justificación “No todo en la fibrilación auricular es embolismo, ictus o hemorragia”
  10. 10. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Estudio EMIR: diseño Estudio post-autorización observacional, multicéntrico, prospectivo y de ámbito nacional. Población del estudio: cohorte de pacientes con FANV tratados con rivaroxaban durante al menos 6 meses antes de la inclusión. n =1493 con FANV, anticoagulados con rivaroxabán, incluidos de forma consecutiva en el primer semestre de 2017 en 88 centros españoles (en este análisis, n = 1328 pacientes seguidos durante al menos 1 año).
  11. 11. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Estudio EMIR: criterios de inclusión Pacientes de ambos sexos con edad de 18 o más años. Pacientes con fibrilación auricular no valvular. Tratados con rivaroxaban durante al menos 6 meses antes de la inclusión en el estudio Que hayan otorgado el consentimiento informado.
  12. 12. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Estudio EMIR: criterios de exclusión Participación en algún programa de investigación que conlleve alguna intervención más allá de la práctica clínica. Inicio de rivaroxaban después del período de inclusión. Pacientes con prótesis valvulares mecánicas o estenosis mitral significativa. Deterioro cognitivo severo. Infecciones crónicas (VIH, VHC, VHB) o enfermedades autoinmunes sistémicas. Cáncer activo. Insuficiencia hepática significativa (pe: cirrosis)
  13. 13. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Estudio EMIR: score 2MACE Síndrome metabólico. Edad mayor o igual a 75 años. Infarto de miocardio o revascularización coronaria. Ictus, AIT o tromboembolismo.
  14. 14. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez Estudio EMIR: características basales 77,5 22,5 Dosis de rivaroxaban 20 mg/día 15 mg/día
  15. 15. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez N = 1493 Edad (años) 74,1±9,7 Sexo femenino 44,5% Peso (Kg) 79,8±15,9 Talla (cm) 165,4±9,3 IMC(Kg/m2) 29,1±4,9 Perímetro abdominal (cm) 102,3±13,6 Glucosa en ayunas (mg/dl) 111,7±38,4 Triglicéridos (mg/dl) 118,9±60,3 Creatinina sérica (mg/dl) 1,0±0,4 TFG (MDRD-4) (ml/min1,73 m2) 74,7±21,2 HDL colesterol (mg/dl) 53,6±15,5 LDL colesterol (mg/dl) 100,2±30,9 Hemoglobina (g/dl) 14,1±1,6 Estudio EMIR: características basales
  16. 16. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez N = 1493 Nivel de estudios (secundarios o superiores) 44,1% Tabaquismo 9,1% Hipertensión 76,0% Diabetes 25,3% Insuficiencia renal 15,4% EPOC 15,7% Hemorragia mayor 3,3% Cancer previo 6,0% Arteriopatía periférica 3,7% Ictus previo 12,0% Disfunción hepática 0,8% Embolismo no cerebral previo 1,1% Hipertiroidismo 3,2% Estudio EMIR: características basales
  17. 17. Características basales, estratificación del riesgo (2MACE) y resultados globales del estudio Dr. Manuel Anguita Sánchez N = 1493 Cardiopatía previa 50,5% Insuficiencia cardíaca 21,3% Enfermedad coronaria 16,0% Miocardiopatía dilatada 5,9% Valvulopatías 8,1% Stents coronarios 10,5% Bypass coronario 2,9% FA permanente 36,7% Flutter auricular previo 11,4% Ablación de FA previa 6,2% Indice Charlson 1,0±1,0 CHA2DS2-VASC 3,4±1,5 HAS-BLED 1,5±1,0 Estudio EMIR: características basales

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