Federico Soria

Consorcio Hospital General Universitario de Valencia, Valencia, Valencia, Spain

Are you Federico Soria?

Claim your profile

Publications (12)40.04 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the prognostic significance of resting heart rate in patients with acute coronary syndrome (ACS), independent of other known factors. Patients 40 years of age or older who had been admitted with acute coronary syndrome (ACS) to one of the 94 hospitals participating in the Prevalence of Peripheral Arterial Disease in Patients with Acute Coronary Syndrome (PAMISCA) study were included. Patients were divided into two groups based on their resting heart rate (HR ≥ or < 70 bpm). Complications were recording during a follow-up period of 1 year. There were 1054 ACS patients analyzed (43.5% with ST segment elevation and 56.5% without elevation). Mean age was 66.6 ± 11.7 years, 70.6% were male and 29.4% of subjects were female. During follow-up, more patients in the HR ≥ 70 bpm group were hospitalized for heart failure and they also had a higher mortality rate. In the multivariate analysis, a heart rate of ≥ 70 bpm was independently related to overall mortality during the follow-up period (hazard ratio 2.5; 95% confidence interval, 1.26-4.97, P = 0.009). A resting heart rate ≥ 70 bpm in patients who survive an ACS is an indicator of a high risk of suffering cardiovascular events during follow-up.
    Full-text · Article · Jan 2012 · World Journal of Cardiology (WJC)
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Diabetes mellitus and low ankle brachial index (ABI) are both conditions associated with an increased cardiovascular risk. In the setting of an acute coronary syndrome (ACS), diabetes is associated with increased mortality, but little is known regarding a low ABI. The aim of the study was to evaluate the prevalence of diabetes and low ABI in patients after an ACS and their prognostic value. 1156 patients ≥40 years admitted with an ACS were screened with ABI previous to hospital discharge to investigate the presence of peripheral arterial disease (PAD) (ABI value≤0.9). 1054 were finally followed for one year. Patients were stratified according to diabetes and PAD status. The primary endpoint of the study was all-cause mortality. The prevalence of diabetes was 36% and PAD was 39.9%. After a median follow up of 382 days, 59 patients died (5.6%), the majority from a cardiovascular event. In both diabetic and nondiabetic patients, the presence of PAD was significantly associated with an increased incidence of the primary event. After adjustment for several prognostic variables, patients with diabetes and PAD had an increased risk of mortality (HR 4.05 (95% CI 1.86-8.83)). PAD and diabetic patients had an intermediate and similar incidence of cardiovascular events. Our results show that the presence of an ABI≤0.9 predicts cardiovascular risk to the same extent as diabetes, and the combination of diabetes and PAD is a powerful tool after an ACS to predict the occurrence of an adverse event.
    Full-text · Article · Aug 2011 · International journal of cardiology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Age is one the factors associated with poor prognosis in acute coronary syndromes (ACS) and elderly patients are a high-risk collective with few parameters for mid-term cardiovascular stratification. We aimed to assess the predictive value of ankle-brachial index (ABI) in patients (> 75 years) for 1-year mortality after an ACS. Prospective, observational and multicentre study of ACS patients in whom ABI was assessed during hospitalization. A total of 1·054 patients were included, mean age 66·6 (11·7) years from whom 26·6% were > 75 years. Elderly patients showed more history of cardiovascular disease and higher prevalence of all risk factors, except current smoking. Angiography and revascularization were performed less frequently in the elderly. Patients > 75 years showed higher presence of three vessel coronary disease and received fewer guideline-recommended treatments. Patients who died through the follow-up, mean time 387·9 ± 7·2 days, had lower ABI (0·73 ± 0·24 vs. 0·92 ± 0·22; P < 0·01), also in the elderly patients (0·73 ± 0·24 vs. 0·86 ± 0·23; P < 0·01). Cox regression analysis identified age > 75 years (HR: 2·30; IC 95% 1·26-4·18; P < 0·01) and ABI < 0·90 (HR: 3·58; IC 95% 1·80-7·15; P < 0·01) as risk factors for to 1-year mortality. Mortality was similar in elderly patients with ABI > 0·90 and young patients with ABI < 0·90; the worst prognosis was observed in elderly patients with ABI < 0·90 (HR: 10·01; 95% CI 3·74-27·15). Elderly patients represent a relevant collective of patients with ACS and are treated less optimally. ABI predicts 1-year mortality after an ACS in elderly patients.
    Full-text · Article · Apr 2011 · European Journal of Clinical Investigation
  • [Show abstract] [Hide abstract]
    ABSTRACT: The impact of target organ damage (TOD) clustering in hypertensive patients with established cardiovascular disease has not been clearly defined. Multicentre, observational and prospective study of 1054 consecutive patients with acute coronary syndromes (ACSs). The objective was describing the impact of TOD on first-year mortality. Ankle-brachial index (ABI), left ventricular hypertrophy and renal dysfunction were assessed during hospital stay. Hypertensive patients accounted for 80% of the cohort and had slightly higher mean age, higher prevalence of risk factors, previous cardiovascular disease and TOD. During follow-up, mean time 387.9 (7.2) days and median 382 (364.0-430.0) days, mortality rate tended to be higher in hypertensive patients (6.1 versus 3.5%; P=0.16). Cox regression survival analysis identified pathological ABI as the only TOD independently associated with mortality. When assessed globally, the presence of at least one TOD predicted mortality only in patients with hypertension and differences in mortality rate appeared very early in the follow-up. A linear increase in mortality rate was observed with the clustering of TOD: 2.0%, if no TOD was present, 7.6% in one TOD, 11.1% in two TODs and 20.0%, if three TODs were present. An increased risk in the combined end point of ischaemic events was observed in hypertensive patients without TOD (odds ratio (OR): 3.18; 95% confidence interval (CI): 1.31-7.70; P=0.01) and was still higher in patients with hypertension and TOD (OR: 4.61; 95% CI: 1.90-11.80; P<0.01). TOD predicts mortality and ischaemic events of hypertensive patients after ACS.
    No preview · Article · Dec 2010 · Journal of human hypertension
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction and objectives The presence of peripheral arterial disease in patients with coronary artery disease is associated with a poor cardiovascular outcome. However, the majority of affected patients are asymptomatic and the condition is underdiagnosed. The ankle-brachial index (ABI) provides a simple method of diagnosis. The aim of this study was to assess the usefulness of an abnormal ABI for identifying multivessel coronary artery disease in patients with acute coronary syndrome (ACS). Methods We analyzed data on all ACS patients included in the PAMISCA multicenter study (with 94 participating hospitals) who underwent catheterization during admission. Patients were diagnosed with multivessel coronary disease if two or more major epicardial vessels or the left main coronary artery, or both, were affected. An ABI ≤0.9 or >1.4 was considered abnormal. Results The study included 1031 patients with a mean age of 67.7 years. Of these, 542 had multivessel disease (52.6%). Compare with those without multivessel disease, these patients were older (66.6 years vs. 62.6 years; P<.001), had higher prevalences of hypertension (65.9% vs. 56.2%; P<.005), diabetes mellitus (40.6% vs. 26.0%; P<.001) and hypercholesterolemia (89.1% vs. 80.4%; P<.001), and were more likely to have a history of cardiovascular disease (30.1% vs. 13.9%; P<.001) or an abnormal ABI (45.4% vs. 30.3%; P<.001). Multivariate analysis showed that the presence of an abnormal ABI was associated with an increased risk of multivessel disease (odds ratio=1.58; 95% confidence interval, 1.16-2.15; P<.05). Conclusions In patients with ACS, an abnormal ABI was independently associated with the risk of multivessel coronary artery disease.
    Full-text · Article · Jan 2010 · Revista Espa de Cardiologia
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The presence of peripheral arterial disease in patients with coronary artery disease is associated with a poor cardiovascular outcome. However, the majority of affected patients are asymptomatic and the condition is underdiagnosed. The ankle-brachial index (ABI) provides a simple method of diagnosis. The aim of this study was to assess the usefulness of an abnormal ABI for identifying multivessel coronary artery disease in patients with acute coronary syndrome (ACS). We analyzed data on all ACS patients included in the PAMISCA multicenter study (with 94 participating hospitals) who underwent catheterization during admission. Patients were diagnosed with multivessel coronary disease if two or more major epicardial vessels or the left main coronary artery, or both, were affected. An ABI <or=0.9 or >1.4 was considered abnormal. The study included 1031 patients with a mean age of 67.7 years. Of these, 542 had multivessel disease (52.6%). Compare with those without multivessel disease, these patients were older (66.6 years vs. 62.6 years; P< .001), had higher prevalences of hypertension (65.9% vs. 56.2%; P< .005), diabetes mellitus (40.6% vs. 26.0%; P< .001) and hypercholesterolemia (89.1% vs. 80.4%; P< .001), and were more likely to have a history of cardiovascular disease (30.1% vs. 13.9%; P< .001) or an abnormal ABI (45.4% vs. 30.3%; P< .001). Multivariate analysis showed that the presence of an abnormal ABI was associated with an increased risk of multivessel disease (odds ratio=1.58; 95% confidence interval, 1.16-2.15; P< .05). In patients with ACS, an abnormal ABI was independently associated with the risk of multivessel coronary artery disease.
    Full-text · Article · Jan 2010 · Revista Espa de Cardiologia
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Observational studies report poor prognosis of patients after acute coronary syndrome (ACS) in the presence of previous peripheral arterial disease (PAD), but data on subclinical PAD are scarce. This study was designed to assess the predictive value of clinical and subclinical PAD in the follow-up of patients after an ACS. We included 1,054 patients hospitalized for an ACS who survived the acute phase. Patients were divided into 3 groups: clinical PAD (previously diagnosed PAD or intermittent claudication), subclinical PAD (defined as ankle-brachial index <or=0.9 or >1.4), and no PAD. Clinical PAD was present in 150 patients (14.2%) and 298 cases of subclinical PAD were detected (28.3%). Patients with PAD (clinical and subclinical PAD) were significantly older and had a higher prevalence of hypertension and diabetes mellitus than those without PAD. During the 1-year follow-up, 59 patients died (5.6%). Previous PAD (hazard ratio 4.38, 95% confidence interval 1.96 to 9.82, p <0.001) and subclinical PAD (hazard ratio 2.35, 95% confidence interval 1.05 to 5.23, p <0.05) were associated with increased cardiovascular mortality. Moreover, patients with clinical PAD had higher rates of major cardiovascular events (myocardial infarction, angina, and heart failure) than patients with subclinical PAD or without PAD. In conclusion, beyond clinical PAD, measurement of ankle-brachial index after ACS provides substantial information on intermediate-term prognosis.
    Full-text · Article · Dec 2009 · The American journal of cardiology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim was to evaluate the usefulness of urinary N-terminal fragment of B-type natriuretic peptide (NTproBNP) measurement for predicting the presence of left ventricular hypertrophy (LVH) in 160 asymptomatic patients with essential hypertension. The urinary NTproBNP/creatinine ratio was higher in patients with LVH than in either those without LVH (P<.0001) or control subjects (P<.0001). Multivariate linear regression analysis identified age (P=.034), left ventricular mass index (P=.026) and serum NT-proBNP level (P=.001) as predictors of the urinary peptide level. The area under the curve for the NT-proBNP/creatinine ratio was 0.71±0.04 (P<.0001) for identifying LVH. Logistic regression analysis showed that the NT-proBNP: creatinine ratio was a predictor of LVH (odds ratio=4.074; P=.009). In conclusion, the urinary NT-proBNP concentration is a new marker that could be useful for identifying LVH in subjects with essential hypertension.
    Full-text · Article · Nov 2009 · Revista Espa de Cardiologia
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim was to evaluate the usefulness of urinary N-terminal fragment of B-type natriuretic peptide (NT-proBNP) measurement for predicting the presence of left ventricular hypertrophy (LVH) in 160 asymptomatic patients with essential hypertension. The urinary NT-proBNP/creatinine ratio was higher in patients with LVH than in either those without LVH (P< .0001) or control subjects (P< .0001). Multivariate linear regression analysis identified age (P=.034), left ventricular mass index (P=.026) and serum NT-proBNP level (P=.001) as predictors of the urinary peptide level. The area under the curve for the NT-proBNP/creatinine ratio was 0.71+/-0.04 (P< .0001) for identifying LVH. Logistic regression analysis showed that the NT-proBNP: creatinine ratio was a predictor of LVH (odds ratio=4.074; P=.009). In conclusion, the urinary NT-proBNP concentration is a new marker that could be useful for identifying LVH in subjects with essential hypertension.
    Full-text · Article · Nov 2009 · Revista Espa de Cardiologia
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Peripheral arterial disease (PAD) is associated with an increased risk of cardiovascular morbidity and mortality. Nevertheless, many patients are asymptomatic, and this condition frequently remains underdiagnosed. An ankle-brachial index (ABI) of less than 0.9 is a noninvasive and simple marker in the diagnosis of PAD and is also predictive of target organ damage in hypertension. The prognostic value of such measurements in hypertensive patients with acute coronary syndrome (ACS) is unknown. The Prevalence of Peripheral Arterial Disease in Patients with Acute Coronary Syndrome registry is a multicentre, observational and prospective study that aims to describe the prevalence of and prognosis for PAD, diagnosed by ABI in hypertensive patients with ACS. One thousand one hundred and one hypertensive patients with ACS and at least 40 years of age were prospectively studied. Mean age of the population was 67.4 (11.4) years, and 67.7% were men. The prevalence of ABI less than 0.9 was 42.6% (469 patients). This subgroup was significantly older, had a higher prevalence of diabetes, previous coronary heart disease or stroke, left ventricular hypertrophy and more severe coronary lesions. Hospital mortality was higher in hypertensive patients with ABI less than 0.9 (2.3 vs. 0.2%; P< 0.01). An ABI less than 0.9 was associated with an increased risk of heart failure after ACS (odds ratio, 1.4; P=0.04), higher hospital mortality (odds ratio, 13.0; P=0.03) and the composite endpoint of mortality, heart failure and angina (odds ratio, 1.4; P=0.03). Asymptomatic PAD is highly prevalent in hypertensive patients with ACS. An ABI less than 0.9 identifies a subset of patients with more extensive target organ damage and higher risk of hospital cardiovascular complications after an ACS.
    Full-text · Article · Feb 2009 · Journal of Hypertension
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A significant proportion of patients with ischemic heart disease have associated peripheral arterial disease (PAD), but many are asymptomatic and this condition remains underdiagnosed. We aimed to study the prevalence of PAD in patients with an acute coronary syndrome (ACS) and to evaluate its influence in hospital clinical outcomes. The PAMISCA register is a prospective, multicenter study involving patients >or=40 years old with ACS admitted to selected Spanish hospitals. All patients had their ankle-brachial index (ABI) measured between days 3 and 7 after the ischemic event. 1410 ACS patients (71.4% male) were included. PAD determined by ABI was documented in 561 patients (39.8%). Factors independently related to PAD were age (OR: 1.04; 95% CI: 1.03-1.06; p<0.001), smoking (OR: 1.88; 95% CI: 1.41-2.49; p<0.0001), diabetes (OR: 1.30; 95% CI: 1.02-1.65; p<0.05), previous cardiac disease (OR: 1.54; 95% CI: 1.22-1.95; p<0.001) and previous cerebrovascular disease (OR: 1.90; 95% CI: 1.28-2.80; p<0.001). Following the ACS, an ABI<or=0.90 was associated with increased cardiovascular mortality (OR: 5.45; 95% CI: 1.16-25.59; p<0.05) and a higher risk of cardiovascular complications. The prevalence of PAD in patients >or=40 years presenting with ACS is high and it is associated with increased cardiovascular risk.
    Full-text · Article · Sep 2008 · European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery
  • [Show abstract] [Hide abstract]
    ABSTRACT: Multiple studies have focused on the influence of obesity on natriuretic peptide levels. However, the effect of obesity on amino-terminal propeptide of B-type natriuretic peptide (NT-proBNP) levels in hypertensive (HT) patients remains uncertain. We studied 252 asymptomatic patients (60 +/- 13 years, 136 men) with essential HT. A routine physical examination, anthropometry, laboratory analyses, echo-Doppler study, and NT-proBNP level determination were performed. NT-proBNP levels were similar in both obese and nonobese HT (median 56 (25-130) pg/ml vs. median 51 (26-129) pg/ml, P = 0.488). No significant differences were found in obese or nonobese patients with left ventricular hypertrophy (LVH) (median 135 (73-425) pg/ml vs. median 151 (64-274) pg/ml, P = 0.597). The area under the curve was 0.89 +/- 0.03 for NT-proBNP to diagnose LVH in the obese HT patients and 0.88 +/- 0.03 in the nonobese. A logistic regression analysis showed that age, gender, and left ventricular mass index (LVMI) were independent predictors of NT-proBNP levels. Body mass index (BMI) was not significantly associated with NT-proBNP in LVH HT patients. Obesity is not statistically associated with NT-proBNP levels in HT asymptomatic patients. The same results were observed in our group of patients with LVH. These data are in contrast with those previously found in heart failure, and raise questions about the role of obesity per se as primary cause of decreased NT-proBNP levels in other pathophysiological conditions.
    No preview · Article · Aug 2008 · American Journal of Hypertension