A comparative analysis of HAS-BLED, ORBIT, DOAC and AF-BLEED bleeding risk scores in anticoagulated patients with atrial fibrillation: A report from the prospective Murcia AF Project III (MAFP-III) cohort.

Introduction: Atrial fibrillation (AF) patients often require oral anticoagulation (OAC), but predicting bleeding risk remains challenging. Classic risk scores like HAS-BLED and ORBIT, along with newer models such as DOAC and AF-BLEED, exhibit only modest predictive performance. Herein, we compared these four scores in AF patients on OAC to evaluate their predictive accuracy and clinical utility.

Evaluation of the Presence of Native Valvular Disease in Patients With Atrial Fibrillation Using the EHRA (Evaluated Heartvalves, Rheumatic, or Artificial) Classification.

Background: Atrial fibrillation (AF) in association with native valvular heart disease (VHD) is very common and both entities perpetuate each other due to volume and pressure overload. In 2017, the new EHRA classification (Evaluated Heartvalves, Rheumatic or Artificial) was proposed: EHRA 1 (mechanical prostheses or moderate/severe mitral stenosis), EHRA 2 (native valvular involvement or biological prosthesis) and EHRA 3 (without valve disease). The objective was to analyze the clinical characteristics as well as adverse events in the follow-up of AF patients under oral anticoagulation classified according EHRA classification.

Remnant-to-LDL cholesterol discordance as a predictor of thromboembolic events in anticoagulated patients with atrial fibrillation: a report from the prospective Murcia AF project III (MAFP-III) cohort study.

Background: Remnant cholesterol (RC) has emerged as an independent contributor to residual cardiovascular risk, beyond low-density lipoprotein cholesterol (LDL-C). As atrial fibrillation (AF) is a common arrhythmia associated with increased thromboembolic risk even despite anticoagulation, we assessed the prognostic value of RC in AF, with a particular focus on its association with LDL-C discordance.

Methods: In this prospective cohort study, AF outpatients initiating oral anticoagulation between January 2016 and November 2021 were enrolled.

The triglyceride-glucose index, a marker of insulin resistance, as a predictor of thrombotic risk in atrial fibrillation.

Background: Atrial fibrillation (AF) increases the risk of stroke making accurate risk stratification central for effective management. The triglyceride-glucose (TyG) index, a marker of insulin resistance, has been associated to cardiovascular diseases. Indeed, it is particularly relevant in the context of diabetes and metabolic syndrome, which are major contributors to cardiovascular risk.

Frailty increases the risk of hospitalization for atrial fibrillation in older adults: a population-based cohort study.

Background And Aims: Atrial fibrillation (AF) is more common with increasing age and older adults have greater prevalence of frailty, multimorbidity and polypharmacy, which may impact clinical outcomes. The present study aims to investigate the relationship between frailty and the risk of hospitalization for AF in older adults, and second, the possible interaction of multimorbidity in this association.

Methods And Results: Data from the Progetto Veneto Anziani (Pro.

Quality of anticoagulation with vitamin K antagonists in Spain: A systematic review with meta-analysis of national registries.

Background: Vitamin K antagonists (VKAs) depend on appropriate time in therapeutic range (TTR). We reviewed studies in Spain providing data on the quality of oral anticoagulation with VKA in atrial fibrillation (AF) patients, to present an overview of the quality of this therapy in our country.

Methods: Systematic review and meta-analysis of national studies.

Spanish Center's Early Experience With Donation Following Circulatory Death in Heart Transplantation.

Heart transplantation using donation after circulatory death (DCD) has recently re-emerged alongside donation after brain death (DBD). This technique can potentially increase the number of available cardiac grafts. However, its clinical outcomes remain limited.

Association between baseline adherence to a healthy lifestyle with ischemic and major cardiovascular events in patients with atrial fibrillation.

Aims: Managing modifiable risk factors and adherence to a healthy lifestyle are key in the holistic integrated care management of atrial fibrillation (AF). This study examines the relationship between a baseline healthy lifestyle and adverse clinical outcomes in AF patients.

Methods: We included AF patients starting oral anticoagulation (OAC) between January 2016 and November 2021.

Experience with ECMO therapy for acute respiratory distress syndrome treatment throughout the COVID-19 pandemic.

Objective: To analyze our experience with extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory distress syndrome (ARDS) treatment during the COVID-19 pandemic.

Design: Retrospective, observational, single center study.

Setting: Third-level hospital in Spain.

Microbial Insights: The Role of Diet in Modulating Gut Microbiota and Metabolites After Acute Coronary Syndrome.

Acute coronary syndrome (ACS) is a leading cause of global mortality, largely due to atherosclerosis influenced by lifestyle factors like diet. Gut microbiota impacts lipid metabolism, inflammation, and endothelial function, all vital in atherosclerosis. Dysbiosis increases intestinal permeability, causing inflammation and plaque instability, elevating cardiac event risk.

What is the impact of dynamic score reassessment for stroke and bleeding risk outcome prediction in atrial fibrillation patients?

Introduction: Dynamic reassessment of stroke and bleeding risks is a cornerstone of patient-centered care in atrial fibrillation (AF) management. Unlike traditional approaches that evaluate these risks only at diagnosis or at initiation of oral anticoagulation, current evidence emphasizes periodic reassessment due to the evolving nature of risks.

Areas Covered: Stroke and bleeding risks in AF patients are influenced by aging, new comorbidities, and worsening health conditions, requiring updates to management plans to optimize outcomes.

The use of oral anticoagulation at the time of acute COVID-19 infection and subsequent development of long-COVID/post-acute sequelae of SARS-CoV-2 infection.

Long COVID (LC) or post-acute sequelae of SARS-CoV-2 infection (PASC) is defined as ongoing, relapsing or new symptoms/conditions persisting after an acute COVID-19 infection. Given the potential role of oral anticoagulants (OAC) in treating thrombotic sequelae of LC/PASC, we investigated whether prevalent OAC use at the time of acute COVID-19 infection was associated with reduced development of LC/PASC. Retrospective cohort study within the TriNetx network.

The Neutrophil-to-Lymphocyte Ratio Is an Independent Inflammatory Biomarker for Adverse Events in Patients With Atrial Fibrillation: Insights From the Murcia AF Project II (MAFP-II) Cohort Study.

Background: Systemic inflammation plays a central role in atrial fibrillation (AF). The neutrophil-to-lymphocyte ratio (NLR) is a simple hematological index that has been shown to be associated with prognosis in different pathologies.

Hypothesis: The NLR is associated with an increased risk of adverse events in patients with AF.

Analysis of key proinflammatory mechanisms in cardiovascular pathology through stimulation with lipopolysaccharide and urban particulate matter in mouse atrial cardiomyocytes.

Air pollution has emerged as one of the leading causes of mortality, aggravating cardiovascular diseases. Urban-particulate matter (PM) can accumulate in the cardiovascular system and through inflammation, trigger systemic damage. One of the key mechanisms of this process could be related to the activation of the inflammasome through the pre-existence of a low-grade endotoxemia and PM presence in the cells.

Atrial fibrillation versus atrial myopathy in thrombogenesis: Two sides of the same coin?

Atrial fibrillation (AF) and atrial myopathy are recognized contributors to cardiovascular morbidity, particularly ischemic stroke. AF poses an elevated risk of thrombogenesis due to irregular heart rhythm leading to blood stasis and clot formation. Atrial myopathy, marked by structural and functional alterations in the atria, is emerging as a crucial factor influencing thromboembolic events, independently of AF.

Impact of prior oral anticoagulation therapies on post-discharge outcomes after COVID-19: Results from a global federated health network analysis.

Background: The impact of chronic oral anticoagulant (OACs) use on long-term post-discharge outcomes after coronavirus disease 2019 (COVID-19) hospitalisation remains unclear. Herein, we compared clinical outcomes up to 2-years after COVID-19 hospitalisation between patients on vitamin K antagonists (VKAs), direct-acting OACs (DOACs) and no OAC therapy.

Methods: Data from TriNetX, a global federated health research network, were used.

Advances in the medical treatment and diagnosis of intracranial hemorrhage associated with oral anticoagulation.

Introduction: With the increasing prevalence of atrial fibrillation (AF), it entails expanding oral anticoagulants (OACs) use, carrying a higher risk of associated hemorrhagic events, including intracranial hemorrhage (ICH). Despite advances in OACs development with a better safety profile and reversal agent for these anticoagulants, there is still no consensus on the optimal management of patients with OACs-associated ICH.

Areas Covered: In this review, the authors have carried out an exhaustive search on the advances in recent years.

Patients with atrial fibrillation and common exclusion criteria from clinical trials are at high risk of clinical events: the Murcia AF Project II (MAFP-II) cohort study.

Background: Some clinical characteristics and comorbidities in atrial fibrillation (AF) patients are exclusion criteria in randomized clinical trials (RCTs) investigating oral anticoagulants (OAC). However, these conditions are present also in everyday clinical practice patients. We compared the risk of adverse clinical outcomes between patients with and without RCT exclusion criteria.

Dynamic assessment of CHADS-VASc and HAS-BLED scores for predicting ischemic stroke and major bleeding in atrial fibrillation patients.

Introduction And Objectives: Stroke and bleeding risks in atrial fibrillation (AF) are often assessed at baseline to predict outcomes years later. We investigated whether dynamic changes in CHADS-VASc and HAS-BLED scores over time modify risk prediction.

Methods: We included patients with AF who were stable while taking vitamin K antagonists.

Reducing bleeding risk in patients on oral anticoagulation therapy.

Introduction: Oral anticoagulation (OAC) significantly mitigates thromboembolism risks in atrial fibrillation (AF) and venous thromboembolism (VTE) patients yet concern about major bleeding events persist. In fact, clinically relevant hemorrhages can be life-threatening. Bleeding risk is dynamic and influenced by factors such as age, new comorbidities, and drug therapies, and should not be assessed solely based on static baseline factors.

Sleep analysis of hospital and out-of-hospital emergency professionals.

Introduction: Sleep deprivation is associated with poorer cognitive functioning and a greater risk of serious diseases. Herein, we analyzed differences in the quality of sleep and excessive daytime sleepiness between hospital emergency services and out-of-hospital emergencies services, and investigated its association with sociodemographic and labor variables.

Method: This is a cross-sectional observational study carried out between April 2019 and February 2020, including healthcare professionals from different emergency departments, who were evaluated through the following instruments: "Pittsburgh Sleep Quality Index" and "Epworth Sleepiness Scale".