Carlos Lahoz Rallo

Hospital Carlos III - Madrid, Madrid, Madrid, Spain

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Publications (10)8.14 Total impact

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    ABSTRACT: The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide. When diagnosed, many patients already have organ damage or advance subclinical atherosclerosis. An early diagnosis could allow the implementation of lifestyle changes and treatment options aimed at delaying the progression of the disease and to avoid cardiovascular complications. Different scores for identifying undiagnosed diabetes have been reported, however, their performance in populations of southern Europe has not been sufficiently evaluated. The main objectives of our study are: to evaluate the screening performance and cut-off points of the main scores that identify the risk of undiagnosed T2DM and prediabetes in a Spanish population, and to develop and validate our own predictive models of undiagnosed T2DM (screening model), and future T2DM (prediction risk model) after 5-year follow-up. As a secondary objective, we will evaluate the atherosclerotic burden of the population with undiagnosed T2DM. Population-based prospective cohort study with baseline screening, to evaluate the performance of the FINDRISC, DANISH, DESIR, ARIC and QDScore, against the gold standard tests: Fasting plasma glucose, oral glucose tolerance and/or HbA1c. The sample size will include 1352 participants between the ages of 45 and 74 years. sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio positive, likelihood ratio negative and receiver operating characteristic curves and area under curve. Binary logistic regression for the first 700 individuals (derivation) and last 652 (validation) will be performed. All analyses will be calculated with their 95% CI; statistical significance will be p<0.05. The study protocol has been approved by the Research Ethics Committee of the Carlos III Hospital (Madrid). The score performance and predictive model will be presented in medical conferences, workshops, seminars and round table discussions. Furthermore, the predictive model will be published in a peer-reviewed medical journal to further increase the exposure of the scores. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 07/2015; 5(7):e007195. DOI:10.1136/bmjopen-2014-007195 · 2.06 Impact Factor
  • Clínica e Investigación en Arteriosclerosis 03/2012; DOI:10.1016/j.arteri.2011.09.004
  • Clínica e Investigación en Arteriosclerosis 11/2011; 23(6). DOI:10.1016/j.arteri.2011.09.005
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    ABSTRACT: Introduction: Numerous studies have shown that statins reduce cardiovascular mortality. While most of the effect is probably due to their lipid-lowering action, other actions of these drugs, independent of cholesterol reduction, have been described that could influence these beneficial action. The aim of this study was to evaluate the effect of statins on the expression of adhesion molecules, cytokines and receptors of peripheral blood monocytes, cells closely linked to development of atherosclerosis. Patients and methods: We selected 22 patients with moderate hypercholesterolemia (59% female, mean age 51 years). After 6 weeks of a low fat they were randomized to receive 40 mg of pravastatin or placebo for 8 weeks. After that period they received for another 8 weeks the other treatment. Results: Treatment with pravastatin significantly reduced the concentration of total cholesterol (22%; p < 0.01) and LDL-cholesterol (30%; p < 0.01). Monocytic intracytoplasmic expression of TNFa was reduced by 17.3% (p = 0,03). Other cellular markers, CD62L, CD162, CD11a, CD11b, CD49d, CD54, MCP-1 and CCR2, did not change their expression. Conclusion: Treatment with pravastatin for 8 weeks in patients with moderate hypercholesterolemia induces a decline in the average intensity of fluorescence with which peripheral blood monocytes express TNFa without changing the expression of other adhesion molecules. Introducción: Numerosos estudios han demostrado que las estatinas reducen la mortalidad cardiovascular. Si bien la mayor parte del efecto es probablemente debido a su acción hipolipemiante, se han descrito otras acciones de estos fármacos, independientes de la reducción del colesterol, que podrían contribuir a este efecto beneficioso. El objetivo del presente estudio fue evaluar el efecto del tratamiento con estatinas sobre la expresión de moléculas de adhesión, citocinas y receptores celulares de monocitos de sangre periférica, células estrechamente ligadas al desarrollo de la arteriosclerosis. Pacientes y métodos: Se seleccionó a 22 pacientes con hipercolesterolemia moderada (59% mujeres, edad media 51 años). Tras seguir durante 6 semanas una dieta baja en grasas, se aleatorizaron a recibir 40 mg/día de pravastatina o placebo durante 8 semanas, tras lo cual recibieron durante otras 8 semanas el tratamiento contrario. Resultados: El tratamiento con pravastatina redujo de manera significativa, respecto al período placebo, la concentración de colesterol total (22%; p < 0,01) y el colesterol unido a lipoproteínas de baja densidad (30%; p < 0,01). La expressión intracitoplasmática monocitaria del factor de necrosis tumoral alfa (TNFa) se redujo en un 17,3% (p = 0,03). No se observaron modificaciones en la expresión de CD62L, CD162, CD11a, CD11b, CD49d, CD54, MCP-1 y CCR2. Conclusión: El tratamiento con pravastatina durante 8 semanas en pacientes con hipercolesterolemia moderada induce un descenso en la intensidad media de fluorescencia con la que los monocitos de sangre periférica expresan TNFa, sin modificar la expresión de otras moléculas de adhesión.
    Clínica e Investigación en Arteriosclerosis 04/2009; DOI:10.1053/S0214-9168(09)70642-4
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    ABSTRACT: To evaluate the understanding of patients receiving statins about the dietary and therapeutic measures taken to control their cholesterol and to relate this to the achievement of therapy objectives. Transversal, multi-centre study, conducted between March and November, 2004. Three-hundred seventy six primary care and specialist doctors from all over the country. A total of 2347 patients, with an average age of 59 (12) and 48% women, being treated with statins. Survey to evaluate understanding of lipid-lowering diet and pharmacological treatment. The percentage of patients achieving therapy objectives in line with ATP III guidelines was determined. Understanding of diet was adequate only for foods with negative effects on the concentration of cholesterol. Overall, understanding was better in the young, those with a higher level of education, those with hyperlipaemia originating in the family, those under treatment for longer, and in those attended in primary care or internal medicine clinics; it was worse in diabetic patients and in those with cardiovascular disease. Patients with more understanding of their treatment reached their therapy objectives to a greater extent. Patients receiving statins treatment have an adequate understanding of diet, but little information on pharmacological treatment. This understanding is associated with the achievement of therapy objectives.
    Atención Primaria 10/2007; 39(9):473-8. · 0.89 Impact Factor
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    ABSTRACT: Objective To evaluate the understanding of patients receiving statins about the dietary and therapeutic measures taken to control their cholesterol and to relate this to the achievement of therapy objectives. Design Transversal, multi-centre study, conducted between March and November, 2004. Setting Three-hundred seventy six primary care and specialist doctors from all over the country. Participants A total of 2347 patients, with an average age of 59 (12) and 48% women, being treated with statins. Method Survey to evaluate understanding of lipid-lowering diet and pharmacological treatment. The percentage of patients achieving therapy objectives in line with ATP III guidelines was determined. Results Understanding of diet was adequate only for foods with negative effects on the concentration of cholesterol. Overall, understanding was better in the young, those with a higher level of education, those with hyperlipaemia originating in the family, those under treatment for longer, and in those attended in primary care or internal medicine clinics; it was worse in diabetic patients and in those with cardiovascular disease. Patients with more understanding of their treatment reached their therapy objectives to a greater extent. Conclusion Patients receiving statins treatment have an adequate understanding of diet, but little information on pharmacological treatment. This understanding is associated with the achievement of therapy objectives.
    Atención Primaria 09/2007; 39(9):473-478. DOI:10.1157/13109497 · 0.89 Impact Factor
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    ABSTRACT: Evaluate the overall achievement of goals in the control of risk factors in secondary prevention in patients who have suffered a coronary event and are followed up in primary care centers. Descriptive, transversal, multicenter study with sampling by consecutive inclusion of the first 5 patients attending the doctor's office who had suffered a coronary event 6 months to 10 years previously. The targets for control were: blood pressure < 140/90 mmHg in the general population and < 130/85 mmHg in diabetics; LDL-cholesterol < 100 mg/dl and no smoking habit. 8,817 patients (73.7% males) were included, with a mean (SD) age of 65.4 (10.3) years; 76.6% were hypertensive, 73.4% dyslipidemic and 32.7% diabetics; 60.2% achieved target blood pressure; 26.3% achieved LDL-cholesterol <100 mg/dl and 11.4% continued smoking; 16.4% fulfilled all recommendations. Factors independently related with good control were a lower age, male sex, patients who had been admitted with acute coronary syndrome without ST elevation (OR = 1.39; CI 95%, 1.01-1.93; p = 0.04) or for revascularization (OR = 1.37; CI 95%; 1.12-1.67; p = 0.002), patients with peripheral arterial disease (OR = 1.43; CI 95%, 1.11-1.84; p = 0.005) and when the physicians proposed suitable objectives (OR = 1.90; CI 95%, 1.48-2.44; p < 0.0001). Control was poorer in hypertensive or dyslipidemic patients. Overall control of risk factors in secondary prevention of coronary disease is achieved in one in six patients attending primary care.
    Medicina Clínica 12/2006; 127(20):765-9. · 1.25 Impact Factor
  • Atención Primaria 11/2006; 38(6):358-61. · 0.89 Impact Factor
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    ABSTRACT: Background and objective Evaluate the overall achievement of goals in the control of risk factors in secondary prevention in patients who have suffered a coronary event and are followed up in primary care centers. Patients and method Descriptive, transversal, multicenter study with sampling by consecutive inclusion of the first 5 patients attending the doctor's office who had suffered a coronary event 6 months to 10 years previously. The targets for control were: blood pressure < 140/90 mmHg in the general population and < 130/85 mmHg in diabetics; LDL-cholesterol < 100 mg/dl and no smoking habit. Results 8,817 patients (73.7% males) were included, with a mean (SD) age of 65.4 (10.3) years; 76.6% were hypertensive, 73.4% dyslipidemic and 32.7% diabetics; 60.2% achieved target blood pressure; 26.3% achieved LDL-cholesterol <100 mg/dl and 11.4% continued smoking; 16.4% fulfilled all recommendations. Factors independently related with good control were a lower age, male sex, patients who had been admitted with acute coronary syndrome without ST elevation (OR = 1.39; CI 95%, 1.01-1.93; p = 0.04) or for revascularization (OR = 1.37; CI 95%; 1.12-1.67; p = 0.002), patients with peripheral arterial disease (OR = 1.43; CI 95%, 1.11-1.84; p = 0.005) and when the physicians proposed suitable objectives (OR = 1.90; CI 95%, 1.48-2.44; p < 0.0001). Control was poorer in hypertensive or dyslipidemic patients. Conclusions Overall control of risk factors in secondary prevention of coronary disease is achieved in one in six patients attending primary care.
    Medicina Clínica 11/2006; 127(20):765-769. DOI:10.1157/13095812 · 1.25 Impact Factor
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    Atención Primaria 10/2006; 38(6):358-361. DOI:10.1157/13093375 · 0.89 Impact Factor