Hernandez-Hernandez, A. (Aitor)
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- Effect of the Mediterranean diet in cardiovascular prevention(Elsevier, 2024) Martinez-Gonzalez, M.A. (Miguel Ángel); Hernandez-Hernandez, A. (Aitor)The Mediterranean diet is the best evidence-based model for cardiovascular prevention. In addition to 2 major randomized secondary prevention trials (Lyon Heart and CORDIOPREV) and 1 primary prevention trial (PREDIMED) that have demonstrated these benefits, there is an unprecedented body of high-quality prospective epidemiological evidence supporting these beneficial effects. The key elements of this traditional pattern are the abundant use of extra-virgin olive oil and high consumption of foods of natural plant-based origin (fruits, vegetables, nuts, and legumes) and fish, along with a reduction in processed meats, red meats, and ultraprocessed products. Moderate consumption of wine, preferably red wine, with meals is an essential element of this traditional pattern. Although removing wine consumption from the Mediterranean diet has been associated with a reduction in its preventive efficacy, doubts have recently arisen about the possible adverse effect of even low or moderate intake of any alcoholic beverages. A new large Spanish trial, UNATI, which will begin in June 2024, will randomize 10 000 drinkers aged 50 to 75 years to abstention or moderate consumption. UNATI aims to answer these doubts with the best possible evidence.
- Better adherence to the mediterranean diet could mitigate the adverse consequences of obesity on cardiovascular disease: The SUN prospective cohort(MDPI, 2015) Martinez-Gonzalez, M.A. (Miguel Ángel); Eguaras, S. (Sonia); Toledo, E. (Estefanía); Hernandez-Hernandez, A. (Aitor); Cervantes-Ibáñez, S. (Sebastián)Strong observational evidence supports the association between obesity and cardiovascular events. In elderly high-risk subjects, the Mediterranean diet (MedDiet) was reported to counteract the adverse cardiovascular effects of adiposity. Whether this same attenuation is also present in younger subjects is not known. We prospectively examined the association between obesity and cardiovascular clinical events (myocardial infarction, stroke or cardiovascular death) after 10.9 years follow-up in 19,065 middle-aged men and women (average age 38 year) according to their adherence to the MedDiet (<6 points or ¥6 points in the Trichopoulou’s Mediterranean Diet Score). We observed 152 incident cases of cardiovascular disease (CVD). An increased risk of CVD across categories of body mass index (BMI) was apparent if adherence to the MedDiet was low, with multivariable-adjusted hazard ratios (HRs): 1.44 (95% confidence interval: 0.93–2.25) for ¥25 – <30 kg/m2 of BMI and 2.00 (1.04–3.83) for ¥30 kg/m2 of BMI, compared to a BMI < 25 kg/m2. In contrast, these estimates were 0.77 (0.35–1.67) and 1.15 (0.39–3.43) with good adherence to MedDiet. Better adherence to the MedDiet was associated with reduced CVD events (p for trend = 0.029). Our results suggest that the MedDiet could mitigate the harmful cardiovascular effect of overweight/obesity.
- La vía de la insulina y el factor de crecimiento similar a la insulina, una nueva diana terapéutica en oncología(Gobierno de Navarra, 2009) Abella, L.E. (L. E.); Hernandez-Hernandez, A. (Aitor); Bosch-Barrera, J. (Joaquim)La biología molecular del cáncer ha permitido identificar nuevas dianas para atacar las células tumorales. Recientemente se ha propuesto la vía de señalización de la insulina y el factor de crecimiento similar a la insulina como una de estas dianas. En esta revisión se describe su función biológica, los datos de laboratorio y estudios poblacionales que alertan de su papel en el cáncer y se describen los elementos claves de esta vía de señalización: los ligandos (insulina, IGF1, IGF2), sus receptores y la cascada de señales intracelular que desencadena su activación. Así mismo se revisan las distintas estrategias que se están investigando para bloquearla, algunas de las cuales ya se encuentran en estudios avanzados fase III. Los datos preliminares indican que los fármacos diseñados para bloquear esta vía pueden ser una nueva arma terapéutica para los pacientes oncológicos en un futuro próximo.
- Dietary inflammatory index and incidence of cardiovascular disease in the SUN cohort(Public Library of Science, 2015) Martinez-Gonzalez, M.A. (Miguel Ángel); Shivappa, N. (Nitin); Toledo, E. (Estefanía); Hernandez-Hernandez, A. (Aitor); Ramallal, R. (Raul); Ruiz-Canela, M. (Miguel); Hebert, J.R. (James R.); Garcia-Arellano, A. (Ana)BACKGROUND: Diet is known to play a key role in atherogenesis and in the development of cardiovascular events. Dietary factors may mediate these processes acting as potential modulators of inflammation. Potential Links between inflammatory properties of diet and the occurrence of cardiovascular events have not been tested previously. OBJECTIVE: We aimed to assess the association between the dietary inflammatory index (DII), a method to assess the inflammatory potential of the diet, and incident cardiovascular disease. METHODS: In the prospective, dynamic SUN cohort, 18,794 middle-aged, Spanish university graduates were followed up for 8.9 years (median). A validated 136-item food-frequency questionnaire was used to calculate the DII. The DII is based on scientific evidence about the relationship between diet and inflammatory biomarkers (C-reactive protein, IL-1β, IL-4, IL-6, IL-10 and TNF-α). Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between the DII and incident cardiovascular disease (myocardial infarction, stroke or cardiovascular death). RESULTS: The risk for cardiovascular events progressively increased with each increasing quartile of DII (ptrend = 0.017). The multivariable-adjusted HR for participants in the highest (most pro-inflammatory) vs. the lowest quartile of the DII was 2.03 (95% CI 1.06-3.88). CONCLUSIONS: A pro-inflammatory diet was associated with a significantly higher risk for developing cardiovascular events.
- Caracterización de la miocarditis por COVID-19 mediante resonancia magnética cardiaca(Sociedad Española de Cardiología, 2020) Bastarrika, G. (Gorka); Garcia-de-Yebenes, M. (Manuel); Hernandez-Hernandez, A. (Aitor); Fuente, A. (Ana) de la; Caballeros, M. (Meylin)Desde su primera descripción en diciembre de 2019 en la ciudad de Wuhan (Hubei, China), un nuevo tipo de coronavirus mutado, llamado coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2), ha infectado a más de 3,6 millones de personas y ha causado más de 257.000 muertos en todo el mundo (hasta el 5 de mayo de 2020). Preocupa cada vez más que la afección respiratoria aguda que tiene lugar en la enfermedad coronavírica de 2019 (COVID-19) tenga fuerte relación con el daño cardiovascular. Los pacientes con COVID-19 corren el riesgo de sufrir arritmias cardiacas, síndromes coronarios agudos, eventos relacionados con insuficiencia cardiaca y miocarditis fulminante. La lesión miocárdica puede ocurrir en distintas fases de la COVID-19 (p. ej., fases viral, pulmonar, inflamatoria y de recuperación), incluso tardíamente tras el inicio de los síntomas.
- Mediterranean alcohol-drinking pattern and arterial hypertension in the "Seguimiento Universidad de Navarra" (SUN) prospective cohort study(2023) Martinez-Gonzalez, M.A. (Miguel Ángel); Eguaras, S. (Sonia); Oliver, D. (David); Toledo, E. (Estefanía); Bes-Rastrollo, M. (Maira); Rosa-Fernández-Pacheco, P.A. (Pedro Antonio) de la; Hernandez-Hernandez, A. (Aitor); Ruiz-Canela, M. (Miguel); Gea, A. (Alfredo)Alcohol drinking patterns may determine the risk of hypertension and may also modify the detrimental effect of high alcohol intake. We prospectively evaluated the effect of the Mediterranean alcohol-drinking pattern and its interaction with the amount of alcohol consumed on the incidence of arterial hypertension. In the Seguimiento Universidad de Navarra (SUN) cohort, we followed-up 13,805 participants, all of them initially free of hypertension, during a maximum period of 16 years. Information about diet, chronic diseases, lifestyle and newly diagnosed hypertension was collected using validated questionnaires. We used a 7-item score (0 to 9 points) that jointly considered moderate alcohol consumption, distributed over the week, with meals, and a preference for red wine and avoidance of binge-drinking. During 142,404 person-years of follow-up, 1443 incident cases of hypertension were identified. Low adherence (score < 2) to the Mediterranean alcohol-drinking pattern was significantly associated with a higher incidence of hypertension (multivariable-adjusted hazard ratio 1.81, 95% confidence interval 1.09-2.99) as compared to the high-adherence (score > 7) category. Among alcohol consumers, a high adherence to the MADP is associated with a lower incidence of hypertension. Compared with abstinence, a high adherence did not seem to differ regarding its effect on hypertension risk.
- Mediterranean alcohol-drinking pattern and the incidence of cardiovascular disease and cardiovascular Mortality: the SUN project(MDPI, 2015) Martinez-Gonzalez, M.A. (Miguel Ángel); Toledo, E. (Estefanía); Bes-Rastrollo, M. (Maira); Hernandez-Hernandez, A. (Aitor); Beunza, J.J. (Juan José); Ruiz-Canela, M. (Miguel); Gea, A. (Alfredo)Background: We assessed the still unclear effect of the overall alcohol-drinking pattern, beyond the amount of alcohol consumed, on the incidence of cardiovascular clinical disease (CVD). Methods: We followed 14,651 participants during up to 14 years. We built a score assessing simultaneously seven dimensions of alcohol consumption to capture the conformity to a traditional Mediterranean alcohol-drinking pattern (MADP). It positively scored moderate alcohol intake, alcohol intake spread out over the week, low spirit consumption, preference for wine, red wine consumption, wine consumed during meals and avoidance of binge drinking. Results: During 142,177 person-years of follow-up, 127 incident cases of CVD (myocardial infarction, stroke or cardiovascular mortality) were identified. Compared with the category of better conformity with the MADP, the low-adherence group exhibited a non-significantly higher risk (HR) of total CVD ((95% CI) = 1.55 (0.58–4.16)). This direct association with a departure from the traditional MADP was even stronger for cardiovascular mortality (HR (95% CI) = 3.35 (0.77–14.5)). Nevertheless, all these associations were statistically non-significant. Conclusion: Better conformity with the MADP seemed to be associated with lower cardiovascular risk in most point estimates; however, no significant results were found and more powered studies are needed to clarify the role of the MADP on CVD.
- Intervencionismo coronario percutáneo en Navarra. Resultados de un centro de bajo volumen intervencionista(Gobierno de Navarra, 2016) Salterain-González, N. (Nahikari); Canepa-Leite, J.P. (J. P.); Calabuig, J. (José); Hernandez-Hernandez, A. (Aitor); Fernandez-Montero, A. (Alejandro); Artaiz, M. (Miguel)Fundamento. El intervencionismo coronario percutáneo (PCI) es una opción terapéutica fundamental en pacientes con enfermedad coronaria. Para realizarla los especialistas deben formarse y acreditarse. Se sabe que el número de procedimientos realizados al año influye en los resultados. Pretendemos mostrar que con un bajo volumen de PCI algunos centros obtienen buenos resultados. Método. Análisis prospectivo de las características clínicas y resultados inmediatos obtenidos en nuestro centro con el PCI entre 2006 y 2012 y análisis retrospectivo de la supervivencia global, supervivencia libre de eventos y reestenosis de los PCI realizados entre 2006 y 2009. Se compararon las características clínicas, los eventos agudos y a largo plazo (complicaciones, supervivencia y mortalidad) entre nuestros pacientes y los de algunos trabajos publicados. Resultados. Nuestra probabilidad de tener cualquier complicación en un PCI fue del 9% con una mortalidad global del 2%. La mortalidad del PCI en situación estable fue del 0,43% y en el síndrome coronario agudo del 6,25%. Las complicaciones en el lugar del acceso vascular fueron del 1,44% y la incidencia de reestenosis a los nueve meses, en pacientes sometidos por primera vez a PCI, fue del 5,2%. Conclusiones. Aunque el alto volumen intervencionista ha demostrado ser importante para tener una baja tasa de complicaciones y una buena evolución a largo plazo, hay centros con bajo volumen intervencionista que por sus características pueden obtener resultados equiparables a los de alto volumen.