Buño-Soto, A. (Antonio)

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    Classification, prevalence, and outcomes of anticancer therapy-induced cardiotoxicity: the CARDIOTOX registry
    (2020) Cardinale, D. (Daniela); González-Costello, J. (José); Rodríguez-Rodríguez, I. (Isabel); Lyon, A.R. (Alexander R.); López-Fernández, T. (Teresa); Feliu-Batlle, J. (Jaime); Farmakis, D. (Dimitrios); Gómez-Prieto, P. (Pilar); González-Juanatey, J. R. (José Ramón); Zamora-Auñon, P. (Pilar); Cadenas-Chamorro, R. (Rosalía); Martínez-Monzonis, A. (Amparo); Buño-Soto, A. (Antonio); Canales-Albendea, M. A. (Miguel Ángel); Álvarez-Ortega, C. (Carlos); Albaladejo, A. (Ainara); Serrano-Antolín, J. M. (José María); López-Sendón, J.L. (J. L.); Mediavilla, G. (Guimoar); Rodríguez-Fraga, O. (Olaia)
    Aim: Cardiotoxicity (CTox) is a major side effect of cancer therapies, but uniform diagnostic criteria to guide clinical and research practices are lacking. Methods and results: We prospectively studied 865 patients, aged 54.7 ± 13.9; 16.3% men, scheduled for anticancer therapy related with moderate/high CTox risk. Four groups of progressive myocardial damage/dysfunction were considered according to current guidelines: normal, normal biomarkers (high-sensitivity troponin T and N-terminal natriuretic pro-peptide), and left ventricular (LV) function; mild, abnormal biomarkers, and/or LV dysfunction (LVD) maintaining an LV ejection fraction (LVEF) ≥50%; moderate, LVD with LVEF 40–49%; and severe, LVD with LVEF ≤40% or symptomatic heart failure. Cardiotoxicity was defined as new or worsening of myocardial damage/ventricular function from baseline during follow-up. Patients were followed for a median of 24 months. Cardiotoxicity was identified in 37.5% patients during follow-up [95% confidence interval (CI) 34.22–40.8%], 31.6% with mild, 2.8% moderate, and 3.1% with severe myocardial damage/dysfunction. The mortality rate in the severe CTox group was 22.9 deaths per 100 patients-year vs. 2.3 deaths per 100 patients-year in the rest of groups, hazard ratio of 10.2 (95% CI 5.5–19.2) (P < 0.001). Conclusions: The majority of patients present objective data of myocardial injury/dysfunction during or after cancer therapy. Nevertheless, severe CTox, with a strong prognostic relationship, was comparatively rare. This should be reflected in protocols for clinical and research practices.
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    Effects of the COVID-19 Pandemic On the Activity of Clinical Laboratories in Spain, Evolution in the 2019-2021 Period
    (2022) Puzo-Foncillas, J. (José); Caballé-Martín, I. (Imma); González-Rodríguez, C. (Concepción); Gonzalez-Hernandez, A. (Alvaro); Buño-Soto, A. (Antonio); Bernabéu-Andreu, F. A. (Francisco A); Lasierra-Monclús, A.B. (Ana Belén); Ibarz, M. (Merce)
    Objectives: To assess the impact of the COVID-19 pandemic on the activity of clinical laboratories in Spain.Methods: A descriptive, observational, retrospective, multicenter study.Results: Between March and December 2020, there was a statistically significant decrease in the number of test requests (-17.7%, p=< 0.001) and total tests performed (-18.3%, p < 0.001) with respect to the same period in 2019. A decrease was observed in the number of requests from primary care (-37.4%) (p < 0.001) and in the number of foecal occult blood (-45.8%); qualitative urine (-30.1%); PSA (-28.5%); TSH (-27.8%); total cholesterol (-27.2%) and HbA(1c) (-24.7%) tests performed, p < 0.001. A significant increase was found in the number of requests from ICUs (76.6%, p < 0.001) and number of IL-6 (+22,350.9), D-dimer (+617.2%), troponin (+46.8%) and arterial blood gas (+3.9%) tests carried out, p < 0.001. During the first months of 2021, there were significant changes in the number of requests for qualitative urine (-8.7%, p < 0.001), PSA (-6.3%, p=0.009), IL-6 (+66,269.2, p < 0.001), D-dimer (+603.6%, p < 0.001), troponin (+28.7%, p < 0.001), arterial blood gas (+26,2%, p=0.014) and ferritin (+16.0%, p=0.002) tests performed.Conclusions: There were changes in the origin and number of test requested to clinical laboratories in Spain. The number of requests for the evaluation and monitoring of COVID-19 patients increased, whereas requests for the control of non-COVID patients and for population screening decreased. Long-term analysis reveals that the volume of tests performed for the control of chronic diseases returned to normal over time, whereas the increase observed in the volume of tests performed for the management of COVID-19 patients is maintained.