02.08.01. Investigación y comunicación científica

Use of risk chart algorithms for the identification of psoriatic arthritis patients at high risk for cardiovascular disease: findings derived from the project CARMA cohort after a 7.5-year follow-up period

Wed, 01 Jan 0010 00:00:00 GMT

Use of risk chart algorithms for the identification of psoriatic arthritis patients at high risk for cardiovascular disease: findings derived from the project CARMA cohort after a 7.5-year follow-up period Polo-y-La-Borda, Jessica; Castañeda, Santos; Heras-Recuero, Elena; Sánchez-Alonso, Fernando; Plaza, Zulema; García-Gómez, Carmen; Ferraz-Amaro, Ivan; Sánchez-Costa, Jesús-Tomás; Sánchez-González, Olga-Carmen; Turrión-Nieves, Ana-Isabel; Pérez-Alcalá, Ana| Objective: To assess the predictive value of four cardiovascular (CV) risk algorithms for identifying high-risk psoriatic arthritis (PsA) patients. Methods: Evaluation of patients with PsA enrolled in the Spanish prospective project CARdiovascular in RheuMAtology. Baseline data of 669 PsA patients with no history of CV events at the baseline visit, who were followed in rheumatology outpatient clinics at tertiary centres for 7.5 years, were retrospectively analysed to test the performance of the Systematic Coronary Risk Assessment (SCORE), the modified version (mSCORE) European Alliance of Rheumatology Associations (EULAR) 2015/2016, the SCORE2 algorithm (the updated and improved version of SCORE) and the QRESEARCH risk estimator version 3 (QRISK3). Results: Over 4790 years of follow-up, there were 34 CV events, resulting in a linearised rate of 7.10 per 1000 person-years (95% CI 4.92 to 9.92). The four CV risk scales showed strong correlations and all showed significant associations with CV events (p<0.001). SCORE, mSCORE EULAR 2015/2016 and QRISK3 effectively differentiated between low and high CV risk patients, although the cumulative rate of CV events observed over 7.5 years was lower than expected based on the frequency predicted by these risk scales. Additionally, model improvement was observed when combining QRISK3 with any other scale, particularly the combination of QRISK3 and SCORE2, which yielded the lowest Akaike information criterion (411.15) and Bayesian information criterion (420.10), making it the best predictive model. Conclusions: Risk chart algorithms are very useful for discriminating PsA at low and high CV risk. An integrated model featuring QRISK3 and SCORE2 yielded the optimal synergy of QRISK3's discrimination ability and SCORE2's calibration accuracy.

Risk factors for one-year mortality in 440 femoral peri-implant fractures: insights from the PIPPAS prospective, multicentre, observational study

Thu, 09 Jan 2025 00:00:00 GMT

Risk factors for one-year mortality in 440 femoral peri-implant fractures: insights from the PIPPAS prospective, multicentre, observational study Aguado, Héctor-J; Castillón-Bernal, Pablo; Teixidor-Serra, Jordi; García-Sánchez, Yaiza; Muñoz-Vives, Josep-M; Camacho-Carrasco, Pilar; Jornet-Gibert, Montsant; Ojeda-Thies, Cristina; García-Portabella, Pablo; Pereda-Manso, Adela; Mateos-Álvarez, Elvira; García-Virto, Virginia; Noriega-González, David; Álvarez-Ramos, Begoña-A; Muñoz-Moreno, Mª-F; Arroyo-Hernantes, Irene; Martínez-Sellés, Carmen; Marín-Jiménez, Sergio; Acha, Adriana; Tomás-Hernández, Jordi; Selga-Marsà, Jordi; Andrés-Peiró, José-V; Piedra-Calle, Carlos; Blasco-Casado, Ferrán; Guerra-Farfán, Ernesto; Querolt-Coll, Jordi; de-Santamaría, Guillermo-T; Gil-Aliberas, Carles; Campuzano-Bitterling, Borja; Ajuria-Fernández, Eliam; Díaz-Suárez, Rebeca; Fernández-Manzano, Eugenia; De-Cortázar, Unai-G; Arrieta, Mirentxu; Escobar, Daniel; Castrillo, Estíbaliz; Balvis, Patricia; Denisiuk, Maciej; Moreta, Jesús; Uriarte, Xabier; Vea, Andrea; Jiménez-Tellería, Patricia; Olías-López, Beatriz; Amaya-Espinosa, Patricia; Boluda-Mengod, Juan; Borrás-Cebrián, Juan-C; Martínez-Pérez, Carles; Freile-Pazmiño, Patricio-A; Calavia-Calé, Pablo; Suárez-Suárez, Miguel-Á; García-Arias, Antonio; Valle-Cruz, José; García-Coiradas, Javier; Cano-Leira, María-Á; Bonome-Roel, César; Benjumea-Carrasco, Antonio; Chico-García, Marcos; Sánchez-Pérez, Coral; Priego-Sánchez, Rodrigo-J; Pariza, Ana-L; Fernández-Juan, Alexis; Saura-Sánchez, Eladio; Giménez-Ibáñez, Sandra; Sánchez-Gómez, Plácido; Ricón-Recarey, F-J; Jiménez-Olivares, Jesús; Correoso-Castellanos, Silvia; García, Elena-M; Medrano-Morte, Isabel; Cuadrado-Abajo, Francisco; Laguna-Bercero, María-E; Pozo-Manrique, Pedro-D; Navas-García, Francisco-M-G; García-Paredero, Ester; Robles, Teresa-B; Navas-Pernía, Inés; Gálvez-Márquez, Gonzalo; Villasante-Jirón, Ignasi-D; Vilanova-Laguna, Joan; Videla-Ces, Miquel; Serra-Porta, Teresa; González-Ojeda, Gloria; Becerra, Carmen-C; Pena-Paz, Silvia; Fernández-Dorado, Fátima; Martínez-Menduiña, Amaia; Vaquerizo-García, Víctor; Murcia-Asensio, Antonio; Galián-Muñoz, Elena; Marín-Martínez, Carmelo; Muñoz-Vicente, Adrián; Plaza-Salazar, Nuria; Gámez-Asunción, Carla; Benito-Santamaría, Jennifer; González, Ana-V; Viana, Laura-A; Mingo-Robinet, Juan; Barbería-Biurrun, Amaya; Escudero-Martínez, Emma; Chouza-Montero, Laura; Naharro-Tobío, María; Gasset-Teixidor, Alfons; Domínguez-Ibarrola, Andrea; Peñalver, J-M; Serrano-Sanz, Jorge; Roche-Albero, Adrián; Martín-Hernández, Carlos; Macho-Mier, María; Segura-Nuez, Julián-C; Saló-Cuenca, José-C; Roselló, Jordi-E; Criado-Albillos, Guillermo; Cabello-Benavides, Hugo-G; Nestar, David-A; Martínez-Íñiguez-Blasco, Jorge; Bogallo-Dorado, José-M; Cano-Porras, Juan-R; Marqués-López, Fernando; Martínez-Díaz, Santos; Carabelli, Guido-S; Slullitel, Pablo-I; Astore, Ignacio; Hernández-Pascual, Carlos; Marín-Sánchez, Javier; Dot-Pascuet, Iván; Piñeiro-Borrero, Ana; Pérez-Sánchez, José-M; Mandía-Martínez, Alfonso; Caso-Rodríguez, Julio-D; Martín-Marcuello, Jordi; Benito-Mateo, Miguel; Jaúregui-Garasa, Ainhoa; Gabarain-Morcillo, Imanol; González-Panisello, María-R; Miñana-Barrios, Marta; Iglesias-Fernández, Susana; García-Albea, Raquel; González-López, María-C AIMS: The Peri-Implant and PeriProsthetic Survival AnalysiS (PIPPAS) study aimed to investigate the risk factors for one-year mortality of femoral peri-implant fractures (FPIFs). METHODS: This prospective, multicentre, observational study involved 440 FPIF patients with a minimum one-year follow-up. Data on demographics, clinical features, fracture characteristics, management, and mortality rates were collected and analyzed using both univariate and multivariate analyses. FPIF patients were elderly (median age 87 years (IQR 81 to 92)), mostly female (82.5%, n = 363), and frail: median clinical frailty scale 6 (IQR 4 to 7), median Pfeiffer 4 (1 to 7), median age-adjusted Charlson Comorbidity Index (CCI) 6 (IQR 5 to 7), and 58.9% (n = 250) were American Society of Anesthesiologists grade III. RESULTS: Overall, 90.5% (n = 398) of the patients were treated surgically, 57.0% (n = 227) retained the implant, and 88.7% (n = 353) managed with fixation. Mortality rates were 8.2% (n = 3.6) in-hospital, 11.4% (n = 50) at 30 days, 21.1% (n = 93) at six months, and 21.6% (n = 95) at 12 months. Medical complications, mainly delirium, were common in the acute setting (52.7%, n = 215). The nonunion rate was 4.1% (n = 18). Mortality risk factors in the univariate analysis were age, living at a nursing home, no walking outdoors, frailty variables, fractures in the distal epiphysis, fractures around a proximal nail, discharge to a healthcare facility, and no osteoporotic treatment at discharge. Protective factors against mortality in the univariate analysis were surgical treatment by an experienced surgeon, management without an arthroplasty, allowing full weightbearing, mobilization in the first 48 hours postoperatively, and geriatric involvement. Risk factors for mortality in the multivariate analysis were cognitive impairment (Pfeiffer's questionnaire) (hazard ratio (HR) 1.14 (95% CI 1.05 to 1.23), p = 0.002), age-adjusted CCI (HR 1.18 (95% CI 1.07 to 1.30), p = 0.001), and antiaggregant or anticoagulant medication at admission (HR 2.00 (95% CI 1.19 to 3.38), p = 0.009). Haemoglobin level at admission was protective against mortality (HR 0.85 (95% CI 0.74 to 0.97), p = 0.018). CONCLUSION: Mortality in FPIFs occurs mainly within the first six months of follow-up. Early co-management and clinical optimization, particularly targeting frail older patients, is crucial in reducing mortality following these fractures.

The metabolic score for insulin resistance predicts the risk of cardiovascular disease in patients with psoriatic arthritis: results from the 10-year prospective CARMA cohort

Wed, 01 Jan 2025 00:00:00 GMT

The metabolic score for insulin resistance predicts the risk of cardiovascular disease in patients with psoriatic arthritis: results from the 10-year prospective CARMA cohort Gonzalez-Gay, Miguel-A; Ferraz-Amaro, Ivan; Castañeda, Santos; Pinto-Tasende, José-A; Uriarte-Ecenarro, Miren; Plaza, Zulema; Sánchez-Alonso, Fernando; García-Gómez, Carmen; González-Juanatey, Carlos; Llorca, Javier; Fernández-Sueiro, José-L; Pinto-Tasende, José-A; González-de-Rábago, Eugenia; González-Fernández, María-J; Huguet-Codina, Ramón; Yoldi, Beatriz; Ramentol, Mercedes; Marsal, Sara; Ávila, Gabriela; Alegre, Cayetano; Steiner, Martina; Cobo, Tatiana; Muñoz, Santiago; Gamero, Fernando; Torón, José-García; Moreno-Gil, María-P; Mas, Antonio-J; Espiño, Pilar; Ros, Inmaculada; Ibáñez, Mónica; Tornero, Jesús; Piqueras, José-A; Sanmartí, Raimon; Berman, Horacio; Patón, Oscar-Fontseré; Fernáncez-Gutiérrez, Benjamín; Abasolo, Lydia; Pina-Salvador, José-M; Fábregas, María-D; Romera, Montserrat; Nolla, Joan-M; Uriarte-Ecenarro, Miren; García-Vadillo, Jesús-A; García-de-Vicuña, Rosario; Chamizo-Carmona, Eugenio; Fernández-Nebro, Antonio; Ureña, Inmaculada; Belmonte, María-A; Irigoyen, María-V; Martínez-González, Olga; Belmonte-Gómez, Rebeca; Granados-Bautista, Pastora; Hernández-Sanz, Azucena; Rey, José-Santos; Sánchez-González, Carmen-O; Bachiller, Javier; Zea, Antonio; Manero, Francisco-J; Beltrán-Audera, Chesús; Medrano, Marta; Pecondón, Ángela; Erausquin, Celia; Ojeda, Soledad; Rodríguez-Lozano, Carlos; Babío-Herráez, Jesús; López-Longo, Francisco-J; Monteagudo, Indalecio; del-Pino, Javie; López-González, Ruth; González-Gay, Miguel-A; Corrales, Alfonso; Peiró, María-Enriqueta; Senabre, José-M; Rosas, José-C; Rotés, Isabel; Moreno, Estefanía; Erra, Alba; Calvo, Javier; Rueda, Amalia; Möller, Ingrid; Rodríguez, Isabel; Barbadillo, Carmen; Raya, Enrique; Morales, Pilar; Nieto, Ana; Ruibal-Escribano, Ana; García-Gómez, Carmen; Ros-Expósito, Sergio; Sánchez-Nievas, Ginés; Júdez-Navarro, Enrique; Sianes-Fernández, Manuela; Pardo, Silvia-Martínez; Pujol, Manel; González-Álvarez, Beatriz; Cantabrana, Alberto; Bustabad, Sagrario; Delgado, Esmeralda; Muñoz, Alejandro; Rodríguez-Montero, Sergio; Rivera-Redondo, Javier; González-Hernández, Teresa; González-Polo, Francisco-J; Menor-Almagro, Raúl; Moreno, José-M; Serret, Emilio-Giner; Cebrián-Méndez, Laura; Navío, María-Teresa; Pedraz-Penalva, Teresa; Fernández-Carballido, Cristina; Pagán, Encarnación; Mesa-del-Castillo, Pablo; Naredo, Esperanza; Cruz, Ana; Turrión, Ana; Pérez-Gómez, Ana; Sánchez, Julio; Galindo, María; Collantes, Eduardo; Ruíz, Desireé; Font, Pilar; Bonilla, Gema; López-Meseguer, Antonio; Moreno, Manuel-J; Linares-Ferrando, Luis-Francisco; Morcillo, Mercedes; González-Gómez, María-L; Aramburu, José-M; Rivera, Natalia-A; Fernández-Berrizbeitia, Olaia; Park, Hye-Sang; Riera, Manel; León, Yolanda-María; Pérez-García, Carolina; Maymó, Joan; Amirall, Miriam; Fiter, Jordi; Fernández-Melón, Julia; Espadaler, Luis; Belzunegui, Joaquín; Bañegil, Inmaculada; Díaz, César; Valls, Ramón; Castellví, Iván; Bonet, María; Calvo-Alén, Jaime; Sandoval, Trinidad-Pérez; Revuelta-Evrard, Eva; Godo, Javier-R; González-Fernández, José-Antonio; Miranda-Filloy, José-A OBJECTIVE: To evaluate the predictive value of the metabolic score for insulin resistance (METS-IR) in identifying patients with psoriatic arthritis (PsA) at high risk of cardiovascular (CV) events. METHODS: Assessment of patients with PsA enrolled in the Spanish prospective CARdiovascular in ReuMAtology (CARMA) project. Baseline data from 500 PsA patients without a history of CV events, chronic kidney disease, diabetes mellitus or statin use at the baseline visit were analysed. Patients were prospectively followed for 10 years in rheumatology outpatient clinics at tertiary centres. The performance of the METS-IR in predicting CV events was evaluated. METS-IR was categorised into three groups: <2.25, 2.25-2.48 and >2.48. RESULTS: Over 4788 patient-years of follow-up, 27 individuals experienced at least one CV event. The annualised incidence rate was 5.6 events per 1000 patient-years (95% CI: 3.7 to 8.2). PsA patients with CV events had significantly higher METS-IR scores than those without CV events (2.37±0.24 vs 2.26±0.19; p=0.01). In this regard, patients who had CV events were more commonly included in the METS-IR 2.25-2.48 and >2.48 categories than those without CV events (p=0.008). Adjusted regression models indicated that PsA patients with a METS-IR >2.48 at baseline had an increased risk of experiencing a CV event during the follow-up period. CONCLUSIONS: In PsA patients under close observation in rheumatology units included in the prospective CARMA project, METS-IR serves as a reliable prognostic predictor of CV.

Relapsing laryngeal granuloma resolved after excluding cola drinks from diet: Case report

Mon, 01 Sep 2025 00:00:00 GMT

Relapsing laryngeal granuloma resolved after excluding cola drinks from diet: Case report Raposo-Jiménez, Alberto; Lajara, Jeronimo; García-Purrinos, Francisco-José