Clinical characteristicas of patients suffering atrial fibrillation and diabetes mellitus. The attitude of the clinical cardiologist

Introducción y objetivos: La coexistencia de la fibrilación auricular y la diabetes mellitus es frecuente. Nuestro objetivo es analizar la manera como los cardiólogos tratamos a los pacientes que padecen ambas enfermedades en 2019. Métodos: Dise ̃namos un registro multicéntrico y prospectivo en el que incluimos todos los pacientes atendidos en consultas externas en los que coexistían ambas entidades. Se recogen parámetros clínicos, electrocardiográficos, ecocardiográficos y analíticos, el tratamiento que venían tomando los pacientes y la actitud terapéutica de los cardiólogos. Resultados: Durante 11 meses incluimos 658 pacientes, 55% mujeres, de 73,8 ± 8,5 a ̃nos de edad. Encontra- mos una elevadísima prevalencia de otros factores de riesgo con diferencias significativas entre géneros. No se utiliza el ácido acetilsalicílico y se anticoagula al 96% de aquellos que lo precisan según las guías. Aquellos que siguen tratados con antivitamina K tienen un tiempo en rango terapéutico de Rosendaal de 59,8 ± 31, pero solo se optimiza el tratamiento en el 57,4% (rango de variabilidad entre cardiólogos 10-93%, p = 0,001) de los que tenían un tiempo en rango terapéutico < 65%. La hemoglobina glucosilada era de 7 ± 1,2, y el 37,5% presentaban cifras de hemoglobina glucosilada ≥ 7. Los cardiólogos optimizaron el tratamiento en el 35,2% de ellos (rango de variabilidad entre cardiólogos 6,3-93%, p = 0,0001). Si esta era ≥ 7,5, se optimizaba en el 46,3% y si era ≥ 9 en el 63,2%. Conclusiones: La coexistencia de fibrilación auricular y diabetes mellitus define una población de ele- vadísimo riesgo cardiovascular. La intervención del cardiólogo en el tratamiento anticoagulante y antidiabético es buena, pero mejorable, y hay gran variabilidad entre profesionales.Introduction and objectives: The coexistence of atrial fibrillation and diabetes mellitus is frequent. Our goal was to analyse how cardiologists treated patients with both pathologies in 2019. Methods: We designed a prospective, multicentre registry in which we included all the patients in whom both pathologies coexisted. Clinical, analytical, electrocardiographic, and echocardiographic parameters were collected. In addition, we collected the treatment that patients had been taking and the attitude of cardiologists. Results: Over 11 months we included 658 patients, 55% women, 73.8 ± 8.5 years. We found an extremely high prevalence of other risk factors with significant differences between genders. Acetylsalicylic acid was not used and 96% of those who required it were anticoagulated according to the guidelines. Those who were treated with aVK had a Rosendaal’s time in therapeutic range of 59.8 ± 31, but treatment was only optimized in 57.4% (range of variability between cardiologists 10%-93%, P = .001) of which < 65% had time in therapeutic range. Glycated haemoglobin was 7.0 ± 1.2, and 37.5% had glycated hemoglobin levels ≥ 7.0. Cardiologists optimized treatment in 35.2% of them (range of variability between cardiologists 6.3%-93%, P = .0001). If it was ≥ 7.5, it was optimized in 46.3% and if it was ≥ 9 in 63.2%. Conclusions: The coexistence of atrial fibrillation and diabetes mellitus defines a population with a very high cardiovascular risk. The intervention of the cardiologist in anticoagulant and antidiabetic treatment is good, but it can be improved, and there is great variability among professionals

Clinical characteristicas of patients suffering atrial fibrillation and diabetes mellitus. The attitude of the clinical cardiologist

[ES] [Resumen] Introducción y objetivos: La coexistencia de la fibrilación auricular y la diabetes mellitus es frecuente. Nuestro objetivo es analizar la manera como los cardiólogos tratamos a los pacientes que padecen ambas enfermedades en 2019. Métodos: Diseñamos un registro multicéntrico y prospectivo en el que incluimos todos los pacientes atendidos en consultas externas en los que coexistían ambas entidades. Se recogen parámetros clínicos, electrocardiográficos, ecocardiográficos y analíticos, el tratamiento que venían tomando los pacientes y la actitud terapéutica de los cardiólogos. Resultados: Durante 11 meses incluimos 658 pacientes, 55% mujeres, de 73,8 ± 8,5 años de edad. Encontramos una elevadísima prevalencia de otros factores de riesgo con diferencias significativas entre géneros. No se utiliza el ácido acetilsalicílico y se anticoagula al 96% de aquellos que lo precisan según las guías. Aquellos que siguen tratados con antivitamina K tienen un tiempo en rango terapéutico de Rosendaal de 59,8 ± 31, pero solo se optimiza el tratamiento en el 57,4% (rango de variabilidad entre cardiólogos 10-93%, p = 0,001) de los que tenían un tiempo en rango terapéutico < 65%. La hemoglobina glucosilada era de 7 ± 1,2, y el 37,5% presentaban cifras de hemoglobina glucosilada ≥ 7. Los cardiólogos optimizaron el tratamiento en el 35,2% de ellos (rango de variabilidad entre cardiólogos 6,3-93%, p = 0,0001). Si esta era ≥ 7,5, se optimizaba en el 46,3% y si era ≥ 9 en el 63,2%. Conclusiones: La coexistencia de fibrilación auricular y diabetes mellitus define una población de elevadísimo riesgo cardiovascular. La intervención del cardiólogo en el tratamiento anticoagulante y antidiabético es buena, pero mejorable, y hay gran variabilidad entre profesionales.[EN] Introduction and objectives: The coexistence of atrial fibrillation and diabetes mellitus is frequent. Our goal was to analyse how cardiologists treated patients with both pathologies in 2019. Methods: We designed a prospective, multicentre registry in which we included all the patients in whom both pathologies coexisted. Clinical, analytical, electrocardiographic, and echocardiographic parameters were collected. In addition, we collected the treatment that patients had been taking and the attitude of cardiologists. Results: Over 11 months we included 658 patients, 55% women, 73.8 ± 8.5 years. We found an extremely high prevalence of other risk factors with significant differences between genders. Acetylsalicylic acid was not used and 96% of those who required it were anticoagulated according to the guidelines. Those who were treated with aVK had a Rosendaal's time in therapeutic range of 59.8 ± 31, but treatment was only optimized in 57.4% (range of variability between cardiologists 10%-93%, P = .001) of which < 65% had time in therapeutic range. Glycated haemoglobin was 7.0 ± 1.2, and 37.5% had glycated hemoglobin levels ≥ 7.0. Cardiologists optimized treatment in 35.2% of them (range of variability between cardiologists 6.3%-93%, P = .0001). If it was ≥ 7.5, it was optimized in 46.3% and if it was ≥ 9 in 63.2%. Conclusions: The coexistence of atrial fibrillation and diabetes mellitus defines a population with a very high cardiovascular risk. The intervention of the cardiologist in anticoagulant and antidiabetic treatment is good, but it can be improved, and there is great variability among professionals.Estudio financiado por la Agencia de Investigación de la Sociedad Española de Cardiología, que recibió una beca no condicionada de Boehringer-Ingelheim-España

Modification of the Forms of Self-Determined Regulation and Quality of Life after a Cardiac Rehabilitation Programme: Tennis-Based vs. Bicycle Ergometer-Based

Background: The objective is to analyse and compare the effects of an adapted tennis cardiac rehabilitation programme and a classical bicycle ergometer-based programme on the type of motivation towards sports practice and quality of life in patients classified as low risk after suffering acute coronary syndrome. Methods: The Behavioural Regulation in Exercise Questionnaire (BREQ-2) and Velasco’s Qualityof Life Test were applied. The sample comprised 110 individuals (age = 55.05 ± 9.27) divided into two experimental groups (tennis and bicycle ergometer) and a control group. Results: The intra-group analysis showed a significant increase between pre- and post-test results in intrinsic regulation in the tennis group and in the control group. In identified regulation, the bicycle ergometer group presented significant differences from the control group. On the other hand, in the external regulation variable, only the tennis group showed significant differences, which decreased. Significant improvements in all quality-of-life factors when comparing the pre-test period with the post-test period were only found in the experimental groups. As per the inter-group analysis, significant differences were observed in favour of the tennis group with respect to the control group in the variables of health, social relations and leisure, and work time as well as in favour of the bicycle ergometer group compared with the control group in the variables of health, sleep and rest, future projects and mobility. No significant differences were found in any of the variables between the tennis group and the bicycle ergometer group. Conclusion: It is relevant to enhance the practice of physical exercise in infarcted patients classified as low risk as it improves the forms of more self-determined regulation towards sporting practice and their quality of life