Publicaciones

Detection of hidden atrial fibrillation in primary care using a long-term band-based ECG registration system: The DESCUUBRE-FA study

Ximénez-Carrillo Á, Zapata-Wainberg G, Sastre R, Álvarez-Pasquín MJ, Javierre AP, Lozano T, Samir E, Perosanz L, González B, Sobrado M, Vivancos J. J Stroke Cerebrovasc Dis. 2022 Sep;31(9):106642. doi: 10.1016/j.jstrokecerebrovasdis.2022.106642. Epub 2022 Jul 18. PMID: 35863263 

Objective: To assess whether the use of a band-based electrocardiographic (ECG) monitoring system improves the diagnostic accuracy of traditional diagnostic methods for the detection of atrial fibrillation (AF). Methods:Multicenter and observational study of primary care patients at risk of AF. To be included, patients had to be aged 70 years, with no known AF, and have at least 1 major criterion (obesity, hyperthyroidism, heart failure) or 2 minor criteria (hypertension, diabetes, female sex, ischemic stroke, transient ischemic attack or systemic embolism, COPD, dyslipidemia, ischemic heart disease, peripheral artery disease). All patients were monitored using the NuuboTM system for a single 2-week period. Results: A total of 600 patients were included (median age 77 years; 70% women; 84.3% hypertension, 27.2% diabetes, 9.2% prior stroke). The global rate of diagnosis of new AF in the overall population was 2.83%. All patients with AF were anticoagulated. In numerical terms, patients with AF (vs no AF) had a higher number of supraventricular extrasystoles and episodes of supraventricular tachycardia, as well as longer P wave duration; however, these differences did not reach statistical significance. Overall, participants were very satisfied with the device, and no relevant limitations in daily activities were observed during the 2-week study period. Conclusions: In an elderly population at risk of AF, a band-based ECG monitoring approach applied for only 2 weeks detected approximately 3% of new cases of AF, leading to a change in antithrombotic therapy. Most participants considered the device easy to use and comfortable.

This research has been financed by the Carlos III Health Institute (PI18/00361 and RICORS-RD21/0006/0009) and co-financed with ERDF Funds and/or charged to the European funds of the Recovery, Transformation and Resilience Plan and by the NextGenerationEU.

Altered methylation pattern in EXOC4 is associated with stroke outcome: an epigenome-wide association study

Cullell N, Soriano-Tárraga C, Gallego-Fábrega C, Cárcel-Márquez J, Muiño E, Llucià-Carol L, Lledós M, Esteller M, de Moura MC, Montaner J et al. Clin Epigenetics. 2022 Sep 30;14(1):124. doi: 10.1186/s13148-022-01340-5.PMID: 36180927
Results: The meta-analysis revealed an epigenome-wide signifcant association in EXOC4 (p value=8.4× 10–08) and in MERTK (p value=1.56× 10–07). Only the methylation in EXOC4 was also associated in the Discovery and in the Replication Cohorts (p value=1.14× 10–06 and p value=1.3× 10–02, respectively). EXOC4 methylation negatively correlated with the long-term outcome (coefcient=−4.91) and showed a tendency towards a decrease in EXOC4 expression (rho=−0.469, p value=0.091). Pathway enrichment from the meta-analysis revealed signifcant associa‑tions related to the endocytosis and deubiquitination processes. Seventy-nine plasma proteins were diferentially expressed in association with EXOC4 methylation. Pathway analysis of these proteins showed an enrichment in natural killer (NK) cell activation. The cell-type methylation analysis in blood also revealed a diferential methylation in NK cells.
Acknowledgements: We thank the International Stroke Genetics Consortium, the Spanish Stroke Genetics Consortium, the International Stroke Genetics Consor‑tium, the Global Alliance for Stroke acute and long-term outcome, RETICS Network INVICTUS (RD16/0019/0002, RD16/0019/0010, RD16/0019/0011, RD16/0019/0021) and the RICORS Stroke network.