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Consegal M, Barba I, García Del Blanco B, Otaegui I, Rodríguez-Palomares JF, Martí G, Serra B, Bellera N, Ojeda-Ramos M, Valente F, Carmona MÁ, Miró-Casas E, Sambola A, Lidón RM, Bañeras J, Barrabés JA, Rodríguez C, Benito B, Ruiz-Meana M, Inserte J, Ferreira-González I, Rodríguez-Sinovas A. Spontaneous reperfusion enhances succinate concentration in peripheral blood from stemi patients but its levels does not correlate with myocardial infarct size or area at risk. Sci Rep 2023; 13:6907. [PMID: 37106099 PMCID: PMC10140265 DOI: 10.1038/s41598-023-34196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 04/25/2023] [Indexed: 04/29/2023] Open
Abstract
Succinate is enhanced during initial reperfusion in blood from the coronary sinus in ST-segment elevation myocardial infarction (STEMI) patients and in pigs submitted to transient coronary occlusion. Succinate levels might have a prognostic value, as they may correlate with edema volume or myocardial infarct size. However, blood from the coronary sinus is not routinely obtained in the CathLab. As succinate might be also increased in peripheral blood, we aimed to investigate whether peripheral plasma concentrations of succinate and other metabolites obtained during coronary revascularization correlate with edema volume or infarct size in STEMI patients. Plasma samples were obtained from peripheral blood within the first 10 min of revascularization in 102 STEMI patients included in the COMBAT-MI trial (initial TIMI 1) and from 9 additional patients with restituted coronary blood flow (TIMI 2). Metabolite concentrations were analyzed by 1H-NMR. Succinate concentration averaged 0.069 ± 0.0073 mmol/L in patients with TIMI flow ≤ 1 and was significantly increased in those with TIMI 2 at admission (0.141 ± 0.058 mmol/L, p < 0.05). However, regression analysis did not detect any significant correlation between most metabolite concentrations and infarct size, extent of edema or other cardiac magnetic resonance (CMR) variables. In conclusion, spontaneous reperfusion in TIMI 2 patients associates with enhanced succinate levels in peripheral blood, suggesting that succinate release increases overtime following reperfusion. However, early plasma levels of succinate and other metabolites obtained from peripheral blood does not correlate with the degree of irreversible injury or area at risk in STEMI patients, and cannot be considered as predictors of CMR variables.Trial registration: Registered at www.clinicaltrials.gov (NCT02404376) on 31/03/2015. EudraCT number: 2015-001000-58.
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Affiliation(s)
- Marta Consegal
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignasi Barba
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, University of Vic - Central University of Catalonia (UVicUCC), Can Baumann. Ctra. de Roda, 70, 08500, Vic, Spain
| | - Bruno García Del Blanco
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Imanol Otaegui
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - José F Rodríguez-Palomares
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerard Martí
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Bernat Serra
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Neus Bellera
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Ojeda-Ramos
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Filipa Valente
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Ángeles Carmona
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Elisabet Miró-Casas
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonia Sambola
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Rosa María Lidón
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Bañeras
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - José Antonio Barrabés
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Rodríguez
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Institut de Recerca Hospital de la Santa Creu i Sant Pau (IRHSCSP), Barcelona, Spain
| | - Begoña Benito
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Marisol Ruiz-Meana
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Inserte
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Ferreira-González
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
- Departament de Medicina, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain.
- Centro de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública, CIBERESP, Instituto de Salud Carlos III, Madrid, Spain.
| | - Antonio Rodríguez-Sinovas
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
- Departament de Medicina, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain.
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
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Cruz-González I, Torres Saura F, Trejo-Velasco B, Antonio Fernández Díaz J, Fajardo Molina R, del Valle-Fernández R, Moreno Terribas G, Martí Sánchez D, López-Mínguez JR, Gomez-Blazquez I, Sanmartin Pena JC, Botas J, Martin Lorenzo P, Palazuelos J, Albarrán Rincon R, Mohandes M, Rodriguez Entem FJ, Martí G, Valero E, Gutiérrez H, Amat-Santos IJ, Nombela-Franco L, Salinas P, Teruel L, Gomez-Hospital JA, Arzamendi D, Torres Sanabria M, Calle Pérez G, Cañadas Pruaño D, Pérez de Prado A, Benito González T, Arroyo-Úcar E, Estévez-Loureiro R, Caneiro-Queija B, Ibañez Criado JL, Ruiz-Nodar JM. Impact of operatoŕs experience on peri-procedural outcomes with Watchman FLX: Insights from the FLX-SPA registry. Int J Cardiol Heart Vasc 2022; 38:100941. [PMID: 35024431 PMCID: PMC8728396 DOI: 10.1016/j.ijcha.2021.100941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Watchman FLX is a device upgrade of the Watchman 2.5 that incorporates several design enhancements intended to simplify left atrial appendage occlusion (LAAO) and improve procedural outcomes. This study compares peri-procedural results of LAAO with Watchman FLX (Boston Scientific, Marlborough, Massachusetts) in centers with varying degrees of experience with the Watchman 2.5 and Watchman FLX. METHODS Prospective, multicenter, "real-world" registry including consecutive patients undergoing LAAO with the Watchman FLX at 26 Spanish sites (FLX-SPA registry). Implanting centers were classified according to the center's prior experience with the Watchman 2.5. A further division of centers according to whether or not they had performed ≤ 10 or > 10Watchman FLX implants was prespecified at the beginning of the study. Procedural outcomes of institutions stratified according to their experience with the Watchman 2.5 and FLX devices were compared. RESULTS 359 patients [mean age 75.5 (SD8.1), CHA2DS2-VASc 4.4 (SD1.4), HAS-BLED 3.8(SD0.9)] were included. Global success rate was 98.6%, successful LAAO with the first selected device size was achieved in 95.5% patients and the device was implanted at first attempt in 78.6% cases. There were only 9(2.5%) major peri-procedural complications. No differences in efficacy or safety results according to the centeŕs previous experience with Watchman 2.5 and procedural volume with Watchman FLX existed. CONCLUSIONS The Watchman FLX attains high procedural success rates with complete LAA sealing in unselected, real-world patients, along with a low incidence of peri-procedural complications, regardless of operatoŕs experience with its previous device iteration or the number of Watchman FLX devices implanted.
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Affiliation(s)
- Ignacio Cruz-González
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca, Spain
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | | | - Blanca Trejo-Velasco
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca, Spain
| | | | | | | | - Gerardo Moreno Terribas
- Interventional Cardiology Unit, Cardiology Department, University Hospital Clinico San Cecilio Granada, Spain
- Medical School, University of Granada, Spain
| | - David Martí Sánchez
- Cardiology Department, Hospital Central de la Defensa, Madrid, Spain
- Medical School, University of Alcalá, Madrid, Spain
| | - José-Ramón López-Mínguez
- Cardiology Department, Infanta Cristina University Hospital of Badajoz, Spain
- Medical School, University of Extremadura, Badajoz, Spain
| | | | | | - Javier Botas
- Cardiology Department, University Hospital Fundación Alcorcón, Madrid, Spain
- Rey Juan Carlos University School of Medicine, Madrid, Spain
| | - Pedro Martin Lorenzo
- Interventional Cardiology Unit, Cardiology Department, University Hospital of Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain
| | | | - Ramón Albarrán Rincon
- Cardiology and Cardiac Surgery Department, University Clinic of Navarra, Pamplona, Spain
| | - Mohsen Mohandes
- Interventional Cardiology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | | | - Gerard Martí
- Cardiology Department, University Hospital Vall d́Hebron, Barcelona, Spain
| | - Ernesto Valero
- Cardiology Department, Clinic University Hospital of Valencia, Valencia, Spain
| | - Hipólito Gutiérrez
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Department, Clinic University Hospital of Valladolid, Spain
| | - Ignacio J. Amat-Santos
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Department, Clinic University Hospital of Valladolid, Spain
| | | | - Pablo Salinas
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
| | - Luis Teruel
- Cardiology Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan-Antoni Gomez-Hospital
- Cardiology Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Dabit Arzamendi
- Cardiology Department, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mario Torres Sanabria
- Cardiology Department, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | | | - Eduardo Arroyo-Úcar
- Interventional Cardiology Unit, University Hospital del Vinalopó, Elche, Spain
| | | | | | - Jose L. Ibañez Criado
- Cardiology Department, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Spain
| | - Juan M. Ruiz-Nodar
- Cardiology Department, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Spain
- Facultad de Medicina, Universidad Miguel Hernández, Sant Joan, Alicante, Spain
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Otaegui I, Pérez de Prado A, Massotti M, López-Benito M, Sabaté M, Martí G, Bellera N, Serra B, García Del Blanco B, Ferreira González I. Intrapatient Randomization to Study Strut Coverage in Polymer-Free Versus Biodegradable-Polymer Sirolimus-Eluting Stent Implantations. JACC Cardiovasc Interv 2020; 13:899-900. [PMID: 32273102 DOI: 10.1016/j.jcin.2019.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 11/18/2022]
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Galian-Gay L, Gordon B, Marsal JR, Rafecas A, Pijuan Domènech A, Castro MA, Subirana Domènech MT, Sureda C, Miranda B, Martí G, García-Dorado D, Dos Subirà L. Determinantes del resultado a largo plazo de la estenosis de válvula pulmonar reparada. Rev Esp Cardiol (Engl Ed) 2020. [DOI: 10.1016/j.recesp.2019.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Galian-Gay L, Gordon B, Marsal JR, Rafecas A, Pijuan Domènech A, Castro MA, Subirana Domènech MT, Sureda C, Miranda B, Martí G, García-Dorado D, Dos Subirà L. Determinants of long-term outcome of repaired pulmonary valve stenosis. ACTA ACUST UNITED AC 2019; 73:131-138. [PMID: 31130344 DOI: 10.1016/j.rec.2019.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 02/27/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION AND OBJECTIVES Although pulmonary valve stenosis (PVS) is considered a low risk congenital heart disease, there have been reports of complications and the need for reintervention throughout follow-up. The aims of this study were to evaluate the long-term outcome of repaired PVS and to identify predictors of cardiovascular complications and reintervention. METHODS We studied 158 adult patients with repaired PVS (repair procedures performed from 1957 to 2010) receiving active follow-up in a tertiary referral center. RESULTS A total of 95 patients (60%) received surgical treatment, and 63 patients (40%) received percutaneous pulmonary balloon valvuloplasty. At the end of follow-up (27 years, IQR, 20-33 years), most patients (n=134, 84.8%) were in New York Heart Association functional class I, but 61 patients (38.6%) required a reintervention, mainly pulmonary valve replacement (17.7%, n=28), and 19 patients (12%) had at least one cardiovascular complication: 13 (8.2%) supraventricular arrhythmias, 6 (3.8%) heart failure, 5 (3.2%) stroke, 1 (0.6%) death, 1 (0.6%) thromboembolism, and 1 (0.6%) ventricular arrhythmia. Multivariate analysis showed that age at PVS repair (HR, 1.08; 95%CI, 1.04-1.12; P <.001) and the presence of cyanosis before PVS repair (HR, 5.23; 95%CI, 1.99-13.78; P=.001) were independent predictors for cardiovascular complications. CONCLUSIONS Good long-term outcome can be expected after PVS repair, but complications and the need for reintervention may appear. Older age and the presence of cyanosis at PVS repair emerged as predictors of cardiovascular complications and identified a population that may merit stricter control.
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Affiliation(s)
- Laura Galian-Gay
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, España.
| | - Blanca Gordon
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, España
| | - Josep Ramón Marsal
- Unitat d'Epidemiologia, Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBERESP, Barcelona, España
| | - Agnès Rafecas
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, España
| | - Antonia Pijuan Domènech
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Unitat Integrada de Cardiopaties Congènites de l'Adolescent i de l'Adult Vall d'Hebron-Sant Pau, Barcelona, España
| | - Miguel Angel Castro
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Unitat Integrada de Cardiopaties Congènites de l'Adolescent i de l'Adult Vall d'Hebron-Sant Pau, Barcelona, España
| | - Maria T Subirana Domènech
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Unitat Integrada de Cardiopaties Congènites de l'Adolescent i de l'Adult Vall d'Hebron-Sant Pau, Barcelona, España
| | - Carlos Sureda
- Servei de Cirurgia Cardiaca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - Berta Miranda
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Unitat Integrada de Cardiopaties Congènites de l'Adolescent i de l'Adult Vall d'Hebron-Sant Pau, Barcelona, España
| | - Gerard Martí
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, España
| | - David García-Dorado
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, España
| | - Laura Dos Subirà
- Servei de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Unitat Integrada de Cardiopaties Congènites de l'Adolescent i de l'Adult Vall d'Hebron-Sant Pau, Barcelona, España
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Coll-Vinent B, Martí G, Calderón S, Martínez B, Céspedes F, Fuenzalida C. [Domestic violence against women patients seen with chest pain in the emergency department]. Semergen 2018; 45:23-29. [PMID: 30268361 DOI: 10.1016/j.semerg.2018.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/17/2018] [Accepted: 04/09/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES 1) To determine the prevalence of intimate partner violence (IPV) in patients seen in the emergency department with chest pain. 2)To analyse the possible association between IPV and presence/control of vascular risk factors (VRF), psychic manifestations of stress, delay in requesting care, care received, and prognosis. METHODS The study was conducted on 125 women, and included a targeted interview, the Partner Violence Screen (PVS) test, a 30-day follow-up telephone interview, and a one-year follow-up clinical history review. RESULTS A total of 27 patients (21.6%) had a history of IPV, which was present in 4 of them. Women with a history of IPV were younger (53.7±15.0 vs. 64.0±18.4; P=.020), had more anxiety or a depressive syndrome (57.7% vs 13.5%; P<0.001), and consulted later (35.0±65.2days vs 7.9±25.0days; P=.047). Among older women (≥65years), there was more dyslipidaemia (100% vs 60.4%; P=.039) and worse blood pressure control (good control 20% vs 78.4%; P=.007) in those with a history of IPV. There were no differences in the diagnoses, tests, length of stay, admissions or prognosis among patients with or without a history of IPV, and there were no differences according to chronology of IPV. CONCLUSIONS The current or previous existence of IPV in patients who consult for chest pain in the emergency department is high. The existence of IPV is associated with a delay in consultation and greater anxiety, and may contribute to poor control of VRF, but does not affect the prognosis in the medium term.
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Affiliation(s)
- B Coll-Vinent
- Àrea d'Urgències, Hospital Clínic, Barcelona, España; Grup de Recerca «Urgències: processos i patologies», Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
| | - G Martí
- Grup de Recerca «Urgències: processos i patologies», Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - S Calderón
- Àrea d'Urgències, Hospital Clínic, Barcelona, España
| | - B Martínez
- Àrea d'Urgències, Hospital Clínic, Barcelona, España
| | - F Céspedes
- Àrea d'Urgències, Hospital Clínic, Barcelona, España
| | - C Fuenzalida
- Àrea d'Urgències, Hospital Clínic, Barcelona, España; Grup de Recerca «Urgències: processos i patologies», Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
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7
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Bañeras J, Ferreira-González I, Marsal JR, Barrabés JA, Ribera A, Lidón RM, Domingo E, Martí G, García-Dorado D. Short-term exposure to air pollutants increases the risk of ST elevation myocardial infarction and of infarct-related ventricular arrhythmias and mortality. Int J Cardiol 2017; 250:35-42. [PMID: 29056239 DOI: 10.1016/j.ijcard.2017.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/25/2017] [Accepted: 10/02/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The relation between STEMI and air pollution (AP) is scant. We aimed to investigate the short term association between AP and the incidence of STEMI, and STEMI-related ventricular arrhythmias (VA) and mortality. METHODS The study was carried out in the area of Barcelona from January 2010 to December 2011. Daily STEMI rates and incidence of STEMI-related VA and mortality were obtained prospectively. The corresponding daily levels of the main pollutants were recorded as well as the atmospheric variables. Three cohorts were defined in order to minimize exposure bias. The magnitude of association was estimated using a time-series design and was adjusted according to atmospheric variables. RESULTS The daily rate of hospital admissions for STEMI was associated with increases in PM 2.5, PM 10, lead and NO2 concentrations. VA incidence and mortality were associated with increases in PM 2.5 and PM 10 concentrations. In the most specific cohort, BCN (Barcelona) Attended & Resident, STEMI incidence was associated with increases in PM 2.5 (1.009% per 10μg/m3) and PM 10 concentrations (1.005% per 10μg/m3). VA was associated with increases in PM 2.5 (1.021%) and PM 10 (1.015%) and mortality was associated with increases in PM 2.5 (1.083%) and PM 10 (1.045%). CONCLUSIONS Short-term exposure to high levels of PM 2.5 and PM 10 is associated with increased daily STEMI admissions and STEMI-related VA and mortality. Exposure to high levels of lead and NO2 is associated with increased daily STEMI admissions, and NO2 with higher mortality in STEMI patients.
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Affiliation(s)
- Jordi Bañeras
- Department of Cardiology, Vall d'Hebron Hospital, CIBERCV, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
| | - Ignacio Ferreira-González
- Department of Cardiology, Vall d'Hebron Hospital, CIBERCV, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - José A Barrabés
- Department of Cardiology, Vall d'Hebron Hospital, CIBERCV, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Aida Ribera
- Department of Cardiology, Vall d'Hebron Hospital, CIBERCV, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Rosa Maria Lidón
- Department of Cardiology, Vall d'Hebron Hospital, CIBERCV, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Enric Domingo
- Department of Cardiology, Vall d'Hebron Hospital, CIBERCV, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Gerard Martí
- Department of Cardiology, Vall d'Hebron Hospital, CIBERCV, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - David García-Dorado
- Department of Cardiology, Vall d'Hebron Hospital, CIBERCV, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
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8
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García E, Arzamendi D, Jimenez-Quevedo P, Sarnago F, Martí G, Sanchez-Recalde A, Lasa-Larraya G, Sancho M, Iñiguez A, Goicolea J, Garcia-San Roman K, Alonso-Briales JH, Molina E, Calabuig J, Freixa X, Berenguer A, Valdes-Chavarri M, Vazquez N, Diaz JF, Cruz-Gonzalez I. Outcomes and predictors of success and complications for paravalvular leak closure: an analysis of the SpanisH real-wOrld paravalvular LEaks closure (HOLE) registry. EUROINTERVENTION 2017; 12:1962-1968. [DOI: 10.4244/eij-d-16-00581] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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9
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Santos-Ortega A, Sambola A, Martí G, Barrabés JA, Rodríguez R, García-Dorado D. Mixoma gigante e hipoxia refractaria: una combinación inesperada. Rev Esp Cardiol (Engl Ed) 2016. [DOI: 10.1016/j.recesp.2016.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Bañeras J, Buera I, Oristrell G, Sansano I, Fort J, Ibernon M, Martí G, Barrabés JA, Dorado DG. A patient with suspected non-ST elevation acute myocardial infarction and remarkably high brain natriuretic peptide levels. Int J Cardiol 2016; 202:485-7. [PMID: 26440456 DOI: 10.1016/j.ijcard.2015.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 09/19/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Jordi Bañeras
- Cardiology Department, Hospital Universitari Vall Hebron, Barcelona, Spain.
| | - Irene Buera
- Cardiology Department, Hospital Universitari Vall Hebron, Barcelona, Spain
| | - Gerard Oristrell
- Cardiology Department, Hospital Universitari Vall Hebron, Barcelona, Spain
| | - Irene Sansano
- Pathology Department, Hospital Universitari Vall Hebron, Barcelona, Spain
| | - Joan Fort
- Nephrology Department, Hospital Universitari Vall Hebron, Barcelona, Spain
| | - Meritxell Ibernon
- Nephrology Department, Hospital Universitari Vall Hebron, Barcelona, Spain
| | - Gerard Martí
- Cardiology Department, Hospital Universitari Vall Hebron, Barcelona, Spain
| | - José A Barrabés
- Cardiology Department, Hospital Universitari Vall Hebron, Barcelona, Spain
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11
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Figueras J, Barrabés JA, Lidón RM, Sambola A, Bañeras J, Palomares JR, Martí G, Dorado DG. Predictors of moderate-to-severe pericardial effusion, cardiac tamponade, and electromechanical dissociation in patients with ST-elevation myocardial infarction. Am J Cardiol 2014; 113:1291-6. [PMID: 24560064 DOI: 10.1016/j.amjcard.2013.11.071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 11/27/2013] [Accepted: 11/27/2013] [Indexed: 11/15/2022]
Abstract
Occurrence of moderate-to-severe pericardial effusion (PE; ≥10 mm), cardiac tamponade (CT), and sudden electromechanical dissociation (EMD) was investigated in 4,361 patients with ST-elevation myocardial infarction from 1993 to 2011 in 3 different periods: 1993 to 2000 (n: 1,488); 2001 to 2008 (n: 1,844); and 2009 to 2011 (n: 1,014). Their predictors, including the use of no reperfusion therapy (n: 1,186), thrombolysis (n: 1,607), or primary percutaneous coronary intervention (PPCI, n: 1,562), were also evaluated. Incidence of PE (8.7%, 6.8%, and 5.0%), CT (5.0%, 2.9%, and 1.9%), and EMD (3.7%, 1.7%, and 1.0%), declined over the 3 periods as did mortality (12.0% 8.2%, and 5.9%) with different rates of thrombolytic therapy (52%, 37%, and 14%) and PPCI (7%, 38%, and 76%; all p<0.001). In patients treated without reperfusion therapy, thrombolysis, and PPCI, incidence of PE (12.0%, 5.7%, and 4.3%), CT (6.0%, 3.0%, and 2.2%), and EMD (4.1%, 2.2%, and 0.8%) was different as was mortality (14.4%, 8.3%, and 5.9%; all p<0.001). Independent predictors of PE were lateral infarction (odds ratio [OR] 4.09, 95% confidence interval [CI] 2.57 to 6.49), increasing age (OR 1.05, 95% CI 1.04 to 1.07), number of electrocardiographic leads involved (OR 1.34, 95% CI 1.23 to 1.45), and admission delay (OR 1.01, 95% CI 1.01 to 1.02). Increasing ejection fraction (OR 0.97, 95% CI 0.96 to 0.98), thrombolysis (OR 0.53, 95% CI 0.37 to 0.75), and PPCI (OR 0.35, 95% CI 0.25 to 0.50), however, were protectors (all p<0.001). Lateral infarction, age, number of leads involved, ejection fraction, thrombolytic therapy, and PPCI were also predictors/protectors of CT and EMD. In conclusion, PE, CT, and EMD rates in patients with ST-elevation myocardial infarction have objectively fallen in the last 2 decades, and their predictors are lateral site, increasing age, number of leads involved, and lack of reperfusion therapy. Late hospital admission is also a relevant predictor of PE.
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Affiliation(s)
- Jaume Figueras
- Unitat Coronària, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Jose A Barrabés
- Unitat Coronària, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Rosa-Maria Lidón
- Unitat Coronària, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antonia Sambola
- Unitat Coronària, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jordi Bañeras
- Unitat Coronària, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Gerard Martí
- Unitat Coronària, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - David Garcia Dorado
- Unitat Coronària, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Sambola A, Francisco J, García -Del Blanco B, Aguadé S, Candell-Riera J, Martí G, Figueras J, Barrabés JA, Millán X, García-Dorado D. Tissue factor pathway inhibitor is an early biomarker of myocardial injury in patients with ST-segment elevation acute myocardial infarction. Int J Cardiol 2014; 172:279-81. [PMID: 24461489 DOI: 10.1016/j.ijcard.2013.12.240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/30/2013] [Indexed: 10/25/2022]
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13
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Sambola A, García Del Blanco B, Francisco J, Figueras J, Martí G, Roca I, Otaegui I, García-Dorado D. Prognostic impact of tissue factor pathway on long-term ischemic events of ST-elevated myocardial infarction treated with a primary percutaneous coronary intervention. Int J Cardiol 2013; 168:2916-2918. [PMID: 23642812 DOI: 10.1016/j.ijcard.2013.03.188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 03/31/2013] [Indexed: 10/26/2022]
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14
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Ribera A, Ferreira-González I, Del Blanco BG, Marsal JR, Cascant P, Martí G, Cequier AR, Gómez-Hospital JA, Fernandez-Nofrerías E, Carrillo X, López-Pérez MC, Navarro J, Raso R, García-Dorado D, Permanyer-Miralda G. Drug-eluting stents for off-label indications in real clinical world: Evidence based or ‘intuition’ based clinical practice? Int J Cardiol 2013; 164:116-22. [DOI: 10.1016/j.ijcard.2011.06.096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 06/16/2011] [Accepted: 06/18/2011] [Indexed: 11/16/2022]
Affiliation(s)
- Aida Ribera
- Cardiology Department, Àrea del Cor. University Hospital Vall d'Hebron Barcelona, Spain.
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15
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Rodríguez-Palomares JF, Alonso A, Martí G, Aguadé-Bruix S, González-Alujas MT, Romero-Farina G, Candell-Riera J, García del Blanco B, Evangelista A, García-Dorado D. Quantification of myocardial area at risk in the absence of collateral flow: the validation of angiographic scores by myocardial perfusion single-photon emission computed tomography. J Nucl Cardiol 2013; 20:99-110. [PMID: 23143810 DOI: 10.1007/s12350-012-9635-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 10/08/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Our study aimed to compare the area at risk (AAR) determined by single-photon emission computed tomography (SPECT) with the Bypass Angioplasty Revascularization Investigation (BARI) and modified Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) angiographic scores in the setting of patients undergoing coronary angioplasty for either unstable angina or an STEMI. BACKGROUND Radionuclide myocardial perfusion imaging prior to reperfusion has classically been the most widely practised technique for assessing the AAR and has been successfully used to compare the efficacy of various reperfusion strategies in patients with an ST-segment elevation myocardial infarction (STEMI). The BARI and modified APPROACH scores are angiographic methods widely used to provide a rapid estimation of the AAR; however, they have not been directly validated with myocardial perfusion single-photon emission computed tomography (SPECT). METHODS Fifty-five patients with no previous myocardial infarction who underwent coronary angioplasty for single-vessel disease (unstable angina: n = 25 or an STEMI: n = 30) with no evidence of collaterals (Rentrop Collateral Score <2) were included in a prospective study. In STEMI patients, the (99m)Tc-tetrofosmin was injected prior to opening of the occluded vessel and, in patients with unstable angina after 10-15 seconds of balloon inflation. Acquisition was performed with a dual-head gammacamera with a low-energy and high-resolution collimator. A total of 60 projections were acquired using a non-circular orbit. No attenuation or scatter correction was used. Maximal contours of hypoperfusion regions corresponding to each coronary artery occlusion were delineated over a polar map of 17 segments and compared with the estimated AAR determined by two experienced interventional cardiologists using both angiographic scores. RESULTS Mean AAR percentage in SPECT was 35.0 (10.0%-56.0%). A high correlation was found between BARI and APPROACH scores (r = 0.9, P < .001). Furthermore, a high correlation was also observed between BARI versus SPECT and APPROACH versus SPECT to estimate the AAR (r = 0.9, P < .001 and r = 0.8, P < .001, respectively). Better correlations were observed when the left anterior descending artery (LAD) was revascularized (r = 0.8, P < 0.001 with BARI; r = 0.8, P = .001 with APPROACH) compared to other territories (r = 0.8, P = .001 with BARI; r = 0.7, P = .001 with APPROACH). Also, better correlations were observed in patients who underwent an elective rather than a primary percutaneous revascularization procedure. CONCLUSIONS In the absence of collateral flow, BARI and APPROACH scores constitute valid methods for AAR estimation in current clinical practice, with more accurate results when used for the LAD territory; both are useful not only in STEMI patients but also in patients with unstable angina.
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Affiliation(s)
- José F Rodríguez-Palomares
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain.
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16
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Girona J, Martí G, Betrian P, García B. Extended Szabo (anchor-wire) technique concept for stent implantation in congenital heart lesions. Pediatr Cardiol 2012; 33:1089-96. [PMID: 22361739 DOI: 10.1007/s00246-012-0231-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 01/03/2012] [Indexed: 10/28/2022]
Abstract
We report the usefulness of the Szabo (anchor-wire) technique and two modifications of such based on the same concept for stent implantation in congenital heart lesions. The modifications of the original technique are related to the localization of the cell of the stent through which the anchor wire, which stops the stent advancement, is introduced: proximal in the original technique and central or distal in the reported modifications. These techniques were performed in six patients: in two to maintain permeability of the ductus arteriosus, in three to achieve a fenestration of the interatrial septum, and in one to implant a stent in a right ventricle-to-pulmonary artery conduit close to the bifurcation. We describe the technique as well as the most important difficulties and complications encountered. The Szabo or anchor-wire technique concept is a new tool for stent implantation that can provide more accurate stent positioning compared with conventional angiographically guided implantation in different congenital heart defects. As with any new tool, this technique demands a learning curve and knowledge of potential complications.
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Affiliation(s)
- Josep Girona
- Pedatric Cardiology Service, Hemodynamic Unit, Vall d'Hebron Hospital, Pº Vall d'Hebron, 08035, Barcelona, Spain.
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Ferreira-González I, Marsal JR, Ribera A, Permanyer-Miralda G, García-Del Blanco B, Martí G, Cascant P, Masotti-Centol M, Carrillo X, Mauri J, Batalla N, Larrousse E, Martín E, Serra A, Rumoroso JR, Ruiz-Salmerón R, de la Torre JM, Cequier A, Gómez-Hospital JA, Alfonso F, Martín-Yuste V, Sabatè M, García-Dorado D. Double antiplatelet therapy after drug-eluting stent implantation: risk associated with discontinuation within the first year. J Am Coll Cardiol 2012; 60:1333-9. [PMID: 22999716 DOI: 10.1016/j.jacc.2012.04.057] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 04/23/2012] [Accepted: 04/30/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The goal of this study was to assess the risk associated with double antiplatelet therapy (DAT) discontinuation, and specifically, temporary discontinuation, during the first year after drug-eluting stent (DES) implantation. BACKGROUND Doubts remain about the risk of temporary DAT discontinuation within 1 year after DES implantation. METHODS A total of 1,622 consecutive patients undergoing DES implantation at 29 hospitals were followed up at 3, 6, 9, and 12 months to record the 1-year antiplatelet therapy discontinuation (ATD) rate, the number of days without DAT, and the rate of 1-year major cardiac events. Cox regression was used to analyze the association between ATD considered as a time-dependent covariate and 1-year cardiac events. RESULTS One hundred seventy-two (10.6%) patients interrupted at least 1 antiplatelet drug during the first year after DES implantation, although only 1 during the first month. Most (n=111, 64.5%) interrupted DAT temporarily (median: 7 days; range: 5 to 8.5): 79 clopidogrel (31 temporarily), 38 aspirin (27 temporarily), and 55 both drugs (53 temporarily). Discontinuation was followed by acute coronary syndrome in 7 (4.1%; 95% confidence interval [CI]: 1.7 to 8.2), a similar rate of major cardiac events to that in patients without ATD (n=80; 5.5%; 95% CI: 4.4 to 6.8; p=0.23). ATD was not independently associated with 1-year major cardiac events (hazard ratio: 1.32 [95% CI: 0.56 to 3.12]). CONCLUSIONS ATD within the first year and beyond the first month after DES is not exceptional, is usually temporary, and does not appear to have a large impact on risk.
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Affiliation(s)
- Ignacio Ferreira-González
- Epidemiology Unit of the Cardiology Department, Vall d'Hebron Hospital, and Red de Enfermedades Cardiovasculares (RECAVA), Barcelona, Spain.
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18
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Ribera A, Ferreira-González I, Marsal JR, Cascant P, Permanyer-Miralda G, Abdul-Jawad O, Iñigo-Garcia LA, Guarinos-Oltra J, Cequier A, Goicolea-Güemez L, García-Del-Blanco B, Martí G, García-Dorado D. Prognostic value of an abnormal ankle-brachial index in patients receiving drug-eluting stents. Am J Cardiol 2011; 108:1225-31. [PMID: 21872197 DOI: 10.1016/j.amjcard.2011.06.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 06/16/2011] [Accepted: 06/16/2011] [Indexed: 11/30/2022]
Abstract
Advanced atherosclerotic disease increases the risk of stent thrombosis after drug-eluting stent (DES) implantation. We aimed to determine if an abnormal ankle-brachial index (ABI) value as a surrogate of atherosclerotic disease and vascular inflammation provides information on 1-year risk of cardiovascular events after DES implantation. A prospective cohort of 1,437 consecutive patients undergoing DES implantation from January through April 2008 in 26 Spanish hospitals was examined. ABI was calculated by Doppler in a standardized manner. Patients were followed to 12 months after the percutaneous coronary intervention to determine total and cardiovascular mortality, stroke, nonfatal acute coronary syndrome (ACS), and new revascularizations. Association of an abnormal ABI value (i.e., ≤ 0.9 or ≥ 1.4) with outcomes was assessed by conventional logistic regression and by propensity-score analysis. Patients with abnormal ABI values (n = 582, 40.5%) in general had higher global cardiovascular risk, the reason for DES implantation was more often ACS, and had a higher rate of complications during admission (heart failure or stroke or major hemorrhage 11.3% vs 5.3%, p <0.001). An abnormal ABI value was independently associated with 1-year total mortality (odds ratio 2.23, 95% confidence interval 1.13 to 4.4) and cardiovascular mortality (odds ratio 2.06, 95% confidence interval 1.04 to 4.22). No independent association was found between an abnormal ABI value and 1-year nonfatal ACS, stroke, and new revascularizations. In conclusion, although an abnormal ABI value was associated with fatal outcomes in patients receiving DESs, no association was found with nonfatal ACS and new revascularizations. A clear relation between abnormal ABI and surrogates of DES thrombosis could not be established.
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Affiliation(s)
- Aida Ribera
- Epidemiology Unit, Cardiology Department, Hospital Vall d'Hebron, CIBER de Epidemiología y Salud Pública, Red de Enfermedades Cardiovasculares (RECAVA), Barcelona, Spain
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García Del Blanco B, Martí G, Bellera N, Otaegui I, Serra V, Ferreira I, Domingo E, Angel J, Candell J, García-Dorado D. Clinical and procedural evaluation of the Nile Croco® dedicated stent for bifurcations: a single centre experience with the first 151 consecutive non-selected patients. EUROINTERVENTION 2011; 7:216-24. [DOI: 10.4244/eijv7i2a36] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Rodríguez-Palomares JF, Cuéllar H, Martí G, García B, González-Alujas MT, Mahía P, Evangelista A, Tornos P, García-Dorado D. Coronariografía mediante tomografía computarizada de 16 detectores antes de la cirugía de recambio valvular. Rev Esp Cardiol 2011; 64:269-76. [DOI: 10.1016/j.recesp.2010.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 09/20/2010] [Indexed: 11/28/2022]
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Ferreira-González I, Marsal JR, Ribera A, Permanyer-Miralda G, García-Del Blanco B, Martí G, Cascant P, Martín-Yuste V, Brugaletta S, Sabaté M, Alfonso F, Capote ML, De La Torre JM, Ruíz-Lera M, Sanmiguel D, Cárdenas M, Pujol B, Baz JA, Iñiguez A, Trillo R, González-Béjar O, Casanova J, Sánchez-Gila J, García-Dorado D. Background, incidence, and predictors of antiplatelet therapy discontinuation during the first year after drug-eluting stent implantation. Circulation 2010; 122:1017-25. [PMID: 20733100 DOI: 10.1161/circulationaha.110.938290] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Predictors of antiplatelet therapy discontinuation (ATD) during the first year after drug-eluting stent implantation are poorly known. METHODS AND RESULTS This was a prospective study with 3-, 6-, 9-, and 12-month follow-up of patients receiving at least 1 drug-eluting stent between January and April 2008 in 29 hospitals. Individual- and hospital-level predictors of ATD were assessed by hierarchical-multinomial regression analysis. ATD could be assessed in 1622 candidates for follow-up (82.5%). A total of 234 patients (14.4%) interrupted at least 1 antiplatelet therapy drug, predominantly clopidogrel (n=182, 11.8%). Bleeding events or invasive procedures led to ATD in 109 patients. This was predicted by renal impairment (odds ratio [OR] 2.81, 95% confidence interval [CI] 1.48 to 5.34), prior major hemorrhage (OR 3.77, 95% CI 1.41 to 10.03), and peripheral arterial disease (OR 1.78, 95% CI 1.01 to 3.15). Medical decisions led to ATD in 70 patients; this was predicted by long-term use of anticoagulant therapy (OR 3.88, 95% CI 1.26 to 11.98), undergoing the procedure in a private hospital (OR 13.3, 95% CI 1.69 to 105), and not receiving instructions about medication (OR 2.8, 95% CI 1.23 to 6.36). Thirty-nine patients interrupted ATD on their own initiative, mainly immigrants (OR 3.78, 95% CI 1.2 to 11.98) and consumers of psychotropic drugs (OR 2.58, 95% CI 1.3 to 5.12). CONCLUSIONS ATD during the first year after drug-eluting stent implantation is based mainly on patient decision or a medical decision not associated with major bleeding events or major surgical procedures. Individual- and hospital-level variables are important to predict ATD.
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Affiliation(s)
- Ignacio Ferreira-González
- Epidemiology Unit, Cardiology Department, University Hospital Vall d'Hebron, Paseo Vall d'Hebron 119-129, Barcelona 08035, Spain.
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Girona J, Martí G, Betrián P, Gran F, Casaldàliga J. Embolización percutánea de fístulas vasculares con el tapón vascular de Amplatzer o coils. Rev Esp Cardiol 2009. [DOI: 10.1016/s0300-8932(09)71690-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abstract
Graded balloon septostomy, bladed atrial septostomy, fenestrated Amplatzer devices and stent placement have been reported to obtain stable interatrial communications. We expose our favorable experience creating an interatrial septal defect, by the use of two stents concentrically placed. We think it can be a procedure to be taken into account whenever a wide interauricular septal orifice must be achieved.
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Affiliation(s)
- Josep Girona
- Pediatric Cardiology Unit and Adult Cardiology Service, Vall d'Hebron Hospital, 08035 Barcelona, Spain.
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Martí G, Galve E, Huguet J, Soler Soler J. [Cardiac metastases of malignant melanoma mimicking sick sinus syndrome]. Rev Esp Cardiol 2004; 57:589-91. [PMID: 15225508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
We describe a patient with disseminated metastases from malignant melanoma manifested as symptomatic tachycardia and bradycardia that mimicked sick sinus syndrome. Autopsy showed extensive invasion of the right atrium by nodular disease.
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Affiliation(s)
- Gerard Martí
- Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España
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25
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Audí L, Martí G, Esteban C, Oyarzabal M, Chueca M, Gussinyé M, Yeste D, Fernández-Cancio M, Andaluz P, Carrascosa A. VDR gene polymorphism at exon 2 start codon (FokI) may have influenced Type 1 diabetes mellitus susceptibility in two Spanish populations. Diabet Med 2004; 21:393-4. [PMID: 15049946 DOI: 10.1111/j.1464-5491.2004.01126.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Martí G, Galve E, Huguet J, Soler Soler J. Metástasis cardíacas de melanoma maligno manifestadas en forma de enfermedad del nodo sinusal. Rev Esp Cardiol (Engl Ed) 2004. [DOI: 10.1016/s0300-8932(04)77152-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The pharmacokinetics of thiamphenicol (TAP), a broad-spectrum antibiotic, was determined in male mice, rats, rabbits, dogs, pigs, sheep and calves. The relationship between the main pharmacokinetic parameters of TAP and body weight (W) was studied across these seven mammalian species, using double-logarithmic plots. The experimental values of volume of distribution (Vss), clearance (Cl) and elimination half-life (t(1/2)beta) were plotted, and extrapolated values were determined from corresponding allometric equations. These parameters were fitted to the following equations: Vss=0.98W0.92, Cl=15.80W0.76 and t(1/2)beta=0.94W0.20, and present good correlation (Vss: r2=0.997, P < 0.001; Cl: r2=0.976, P < 0.001, t(1/2)beta: r2=0.852, P < 0.005), that is expected of a drug eliminated primarily by renal glomerular filtration, with insignificant hepatic metabolism. For the t(1/2)beta, the extrapolated and observed values were similar. The extrapolated values of Cl were close to the experimental values, except for the mouse and pig mean percent error [(M.E.) equal to 62 and 119%, respectively], while the extrapolated and observed values for the Vss were very similar. The comparison between experimental and extrapolated values suggests that it could be possible to extrapolate, with good prediction, the kinetic parameters of this drug for mammalian species, using allometric scaling, except for the species that eliminate the drug by a combination of renal excretion and hepatic metabolism.
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Affiliation(s)
- G Castells
- Department of Pharmacology and Therapeutics, School of Veterinary Science, Universitat Autònoma de Barcelona, Bellaterra, Spain.
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28
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Cristòfol C, Valladares JE, Martí G, Arboix M. Pharmacokinetics of indomethacin in poultry. Avian Dis 2000; 44:210-4. [PMID: 10737665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Indomethacin (INDO) is a nonsteroidal antiinflammatory drug widely used since the 1970s. The pharmacokinetic behavior of INDO (2 mg/kg) has been studied after intravenous (i.v.) and oral administration to broiler chickens. After i.v. administration, a first fast distribution phase and a later and slower elimination phase were observed. The elimination half-life and mean residence time (MRT) obtained were 1.0 hr and 0.8 hr, respectively. After oral administration, a flip-flop phenomenon was observed giving an elimination half-life and MRT approximately three times and six times higher, respectively, than the i.v. administration. The plasma concentrations after oral administration were sustained during 8-10 hr, giving an antinflammatory cover over the dose producing 50% of maximal effect during this time period.
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Affiliation(s)
- C Cristòfol
- Departament de Farmacologia i de Terapèutica, Facultat de Veterinària, UAB, Bellaterra, Spain
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Castells G, Intorre L, Franquelo C, Cristòfol C, Pérez B, Martí G, Arboix M. Pharmacokinetics of thiamphenicol in dogs. Am J Vet Res 1998; 59:1473-5. [PMID: 9829409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To determine pharmacokinetic parameters of thiamphenicol (TAP) after IV and IM administration in dogs. ANIMALS 6 healthy 2- to 3-year-old male Beagles. PROCEDURE IN a crossover design study, 3 dogs were given TAP IV, and 3 dogs were given TAP IM, each at a dosage of 40 mg/kg of body weight. Three weeks later, the same dogs were given a second dose by the opposite route. At preestablished times after TAP administration, blood samples were collected through a catheter placed in the cephalic vein, and TAP concentration was determined by use of a high-performance liquid chromatography. Results-Kinetics of TAP administered IV were fitted by a biexponential equation with a rapid first disposition phase followed by a slower disposition phase. Elimination half-life was short (1.7+/-0.3 hours), volume of distribution at steady state was 0.66+/-0.05 L/kg, and plasma clearance was 5.3+/-0.7 ml/min/kg. After IM administration, absorption was rapid. Peak plasma concentration (25.1+/-10.3 microg/ml) was reached about 45 minutes after drug administration. The apparent elimination half-life after IM administration (5.6+/-4.6 hours) was longer than that after IV administration probably because of the slow absorption rate from the muscle. Mean bioavailability after IM administration was 96+/-7%. CONCLUSION The pharmacokinetic profile of TAP in dogs suggests that it may be therapeutically useful against susceptible microorganisms involved in the most common infections in dogs, such as tracheobronchitis, enterocolitis, mastitis, and urinary tract infections.
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Affiliation(s)
- G Castells
- Department de Farmacologia i de Terapèutica, Facultat de Veterinaria, Universitat Autònoma de Barcelona, Spain
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Cristòfol C, Pérez B, Pons M, Valladares JE, Martí G, Arboix M. Determination of indomethacin residues in poultry by high-performance liquid chromatography. J Chromatogr B Biomed Sci Appl 1998; 709:310-4. [PMID: 9657230 DOI: 10.1016/s0378-4347(98)00083-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A HPLC method using a C18 column and UV detection (254 nm) is described for the determination of indomethacin residues in chicken tissues (liver, muscle and fat). Drug extraction from tissue homogenate in phosphate buffer (pH 3.5) was performed with dichloromethane. Mobile phase was acetonitrile-acetic acid (0.5% in water) (50:50). Indomethacin detection limit was 20 ng/g for the studied tissues. After administration of an oral dose of indomethacin (2 mg/kg), only three of the eight poultry studied showed drug tissue levels, in those cases the levels were below 50 ng/g.
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Affiliation(s)
- C Cristòfol
- Departament de Farmacologia i de Terapèutica, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Huck H, Jech A, Martí G, Pérez ML, Rossi JJ, Sofía HM. 123Cd level scheme. Phys Rev C Nucl Phys 1989; 40:1384-1389. [PMID: 9966112 DOI: 10.1103/physrevc.40.1384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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32
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Abriola D, Achterberg E, Davidson M, Debray M, Etchegoyen M, Fazzini N, Niello J, Ferrero A, Filevich A, Galia M, Garavaglia R, Bermúdez G, Gettar R, Gil S, Grahmann H, Huck H, Jech A, Kreiner A, Macchiavelli A, Magallanes J, Maqueda E, Martí G, Pacheco A, Pérez M, Pomar C, Ramírez M, Scasserra M. Examination of nuclear measurement conditions in cold fusion experiments. ACTA ACUST UNITED AC 1989. [DOI: 10.1016/0022-0728(89)80206-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Huck H, Jech A, Martí G, Pérez ML, Rossi JJ, Sofí HM. Isomers in the 123Cd and 125Cd decays and level schemes in 123In and 125In. Phys Rev C Nucl Phys 1989; 39:997-1011. [PMID: 9955291 DOI: 10.1103/physrevc.39.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Segura F, Elías J, Bagà R, Martí G. [Cerebral abscess treated with antibiotics and corticotherapy]. Med Clin (Barc) 1984; 83:559-60. [PMID: 6096649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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36
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Güell J, Martí G, Segura F, Favá P. [Streptococcus viridans pneumonias]. Med Clin (Barc) 1984; 82:824. [PMID: 6738207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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37
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Segura F, Martí G, Bagà R, Elías J, Carbonell J. [Infectious spondylitis and paravertebral abscess in a heroin addict patient]. Med Clin (Barc) 1983; 81:186. [PMID: 6621154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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