1
|
Martínez-Guisado A, Cepas-Guillén P, Díez-Villanueva P, López Lluva MT, Jurado-Román A, Bazal-Chacón P, Negreira-Caamaño M, Olavarri-Miguel I, Elorriaga A, Rivera-López R, Escribano D, Salinas P, Vaquero-Luna J, Prieto A, Pérez-Cebey L, Carrasquer A, Llaó I, Torres Mezcúa FJ, Giralt-Borrell T, Matute-Blanco L, Fernández-Cordón C, González C, Arbas-Redondo E, Aritza-Conty D, Díez-Delhoyo F. Influence of sex on the timing of coronary angiography and the prescription of antiplatelet therapy in patients with nonST-segment elevation myocardial infarction. Emergencias 2024; 36:123-130. [PMID: 38597619 DOI: 10.55633/s3me/016.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVES To assess differences in the clinical management of nonST-segment elevation myocardial infarction (NSTEMI), including in-hospital events, according to biological sex. MATERIAL AND METHODS Prospective observational multicenter study of patients diagnosed with NSTEMI and atherosclerosis who underwent coronary angiography. RESULTS We enrolled 1020 patients in April and May 2022; 240 (23.5%) were women. Women were older than men on average (72.6 vs 66.5 years, P .001), and more women were frail (17.1% vs 5.6%, P .001). No difference was observed in pretreatment with any P2Y12 inhibitor (prescribed in 68.8% of women vs 70.2% of men, P = .67); however, more women than men were prescribed clopidogrel (56% vs 44%, P = .009). Women prescribed clopidogrel were more often under the age of 75 years and not frail. Coronary angiography was performed within 24 hours less corooften in women (29.8% vs 36.9%, P = .03) even when high risk was recognized. Frailty was independently associated with deferring coronary angiography in the adjusted analysis; biological sex by itself was not related. The frequency and type of revascularization were the same in both sexes, and there were no differences in in-hospital cardiovascular events. CONCLUSION Women were more often prescribed less potent antithrombotic therapy than men. Frailty, but not sex, correlated independently with deferral of coronary angiography. However, we detected no differences in the frequency of coronary revascularization or in-hospital events according to sex.
Collapse
Affiliation(s)
| | | | | | | | | | - Pablo Bazal-Chacón
- Servicio de Cardiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | | | - Iván Olavarri-Miguel
- Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, España
| | - Ane Elorriaga
- Servicio de Cardiología, Hospital Universitario de Basurto, Bilbao, Vizcaya, España
| | | | - David Escribano
- Servicio de Cardiología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, España
| | - Pablo Salinas
- Servicio de Cardiología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | | | - Alicia Prieto
- Servicio de Cardiología, Hospital Universitario de Albacete, Albacete, España
| | - Lucía Pérez-Cebey
- Servicio de Cardiología, Hospital Universitario de A Coruña, A Coruña, España
| | - Anna Carrasquer
- Servicio de Cardiología, Hospital Joan XXIII, Tarragona, España
| | - Isaac Llaó
- Servicio de Cardiología, Hospital de Bellvitge, L´Hospitalet de Llobregat, Barcelona, España
| | | | | | - Lucía Matute-Blanco
- Servicio de Cardiología, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España
| | | | - Clea González
- Servicio de Cardiología, Hospital Universitario de León, León, España
| | | | - David Aritza-Conty
- Servicio de Cardiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | | |
Collapse
|
2
|
Díez-Delhoyo F, López Lluva MT, Cepas-Guillén P, Jurado-Román A, Bazal-Chacón P, Negreira-Caamaño M, Olavarri-Miguel I, Elorriaga A, Fernández-Sánchez JA, Escribano D, Salinas P, Vaquero-Luna J, Prieto-Lobato A, Pérez-Cebey L, Carrasquer A, Llaóo I, Torres Mezcúa FJ, Giralt-Borrell T, Abellas M, García-Blas S, Matute-Blanco L, Robles-Gamboa C, Martínez-Guisado A, Fernández-Cordón C, González-Maniega C, Díez-Villanueva P. Timing of coronary angiography and use of antiplatelet pretreatment in patients with NSTEACS in Spain. Rev Esp Cardiol (Engl Ed) 2024; 77:234-242. [PMID: 38476000 DOI: 10.1016/j.rec.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/27/2023] [Indexed: 03/14/2024]
Abstract
INTRODUCTION AND OBJECTIVES The optimal timing of coronary angiography in patients admitted with non-ST-segment elevation acute coronary syndrome (NSTEACS) as well as the need for pretreatment are controversial. The main objective of the IMPACT-TIMING-GO registry was to assess the proportion of patients undergoing an early invasive strategy (0-24hours) without dual antiplatelet therapy (no pretreatment strategy) in Spain. METHODS This observational, prospective, and multicenter study included consecutive patients with NSTEACS who underwent coronary angiography that identified a culprit lesion. RESULTS Between April and May 2022, we included 1021 patients diagnosed with NSTEACS, with a mean age of 67±12 years (23.6% women). A total of 87% of the patients were deemed at high risk (elevated troponin; electrocardiogram changes; GRACE score>140) but only 37.8% underwent an early invasive strategy, and 30.3% did not receive pretreatment. Overall, 13.6% of the patients underwent an early invasive strategy without pretreatment, while the most frequent strategy was a deferred angiography under antiplatelet pretreatment (46%). During admission, 9 patients (0.9%) died, while major bleeding occurred in 34 (3.3%). CONCLUSIONS In Spain, only 13.6% of patients with NSTEACS undergoing coronary angiography received an early invasive strategy without pretreatment. The incidence of cardiovascular and severe bleeding events during admission was low.
Collapse
Affiliation(s)
| | | | | | | | - Pablo Bazal-Chacón
- Servicio de Cardiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Iván Olavarri-Miguel
- Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Ane Elorriaga
- Servicio de Cardiología, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain
| | | | - David Escribano
- Servicio de Cardiología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, Spain
| | - Pablo Salinas
- Servicio de Cardiología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | - Lucía Pérez-Cebey
- Servicio de Cardiología, Hospital Universitario de A Coruña, A Coruña, Spain
| | - Anna Carrasquer
- Servicio de Cardiología, Hospital Joan XXIII, Tarragona, Spain
| | - Isaac Llaóo
- Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - María Abellas
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Sergio García-Blas
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | - Lucía Matute-Blanco
- Servicio de Cardiología, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | | | | | | | | | | |
Collapse
|
3
|
Negreira-Caamaño M, Rajjoub EA, Salguero-Bodes R, Arribas-Ynsaurriaga F, Rodríguez-Muñoz D. Paradoxical interatrial conduction recovery after cavotricuspid isthmus ablation: A case report. J Electrocardiol 2024; 82:69-72. [PMID: 38042010 DOI: 10.1016/j.jelectrocard.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/02/2023] [Revised: 11/05/2023] [Accepted: 11/19/2023] [Indexed: 12/04/2023]
Abstract
We present a case of a patient with advanced interatrial block who was admitted for cavotricuspid isthmus ablation as treatment of typical atrial flutter. A baseline advanced interatrial block pattern turned into partial interatrial block pattern and prolonged PR interval after the procedure. We discuss the mechanism underlying that change.
Collapse
Affiliation(s)
| | - Ez Alddin Rajjoub
- Cardiology Department, 12 de Octubre University Hospital, Madrid, Spain.
| | | | | | | |
Collapse
|
4
|
Negreira-Caamaño M, Ramírez-Huaranga MA, García-Vicente AM, Rienda-Moreno MÁ, Otero-Fernández P, Castro-Corredor D, Plasencia-Enzaíne ÁE, Martínez-Del Río J, Blanco-López E, Piqueras-Flores J. Cardiac amyloidosis in patients with spinal stenosis and yellow ligament hypertrophy. Int J Cardiol 2023; 392:131301. [PMID: 37657671 DOI: 10.1016/j.ijcard.2023.131301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/05/2023] [Revised: 08/02/2023] [Accepted: 08/27/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Spinal stenosis (SS) is a manifestation associated with cardiac amyloidosis (CA). However, there is a lack of studies assessing the prevalence of CA among patients with SS. We aimed to address the prevalence of CA among patients with SS and YLH. METHODS We performed a cross-sectional study of consecutive patients older than 65 years with SS and yellow ligament hypertrophy (YLH). All the patients were assessed with an electrocardiogram, echocardiogram and biohumoral evaluation. Patients with CA red flags was further studied with cardiac magnetic resonance and 99mTc-DPD scintigraphy. A cohort of patients with confirmed CA and SS was used to assess clinical features associated with CA. RESULTS 105 patients (75.0 ± 6.6 years old; 45.7% males) with SS and YLH [5.5 [5-7] mm] were screened. Prevalence of red flags of CA was high and 58 patients presented clinical suspicion of CA. One patient (0.95%) was finally diagnosed of CA. Patients with confirmed CA presented a more expressive phenotype than the screened population. Patients with suspected CA had greater YLH than patients without suspicion of CA (6.4 ± 1.3 vs. 5.0 ± 0.8 mm; p < 0.001) and patients with confirmed CA presented greater YLH than the screening population (6.7 ± 1.8 vs. 5.7 ± 1.2 mm; p = 0.018). CONCLUSION Despite red flags of CA are common among patients with SS, the prevalence of confirmed CA was low in our sample of screened patients.
Collapse
Affiliation(s)
- Martín Negreira-Caamaño
- Cardiology Department, Ciudad Real General University Hospital, Spain; Instituto de investigación sanitaria de Castilla La-Mancha (IDISCAM).
| | - Marco Aurelio Ramírez-Huaranga
- Chronic Pain Unit Ciudad Real General University Hospital, Spain; Rheumatology Department, Ciudad Real General University Hospital, Spain
| | - Ana María García-Vicente
- Nuclear Medicine Department, Ciudad Real General University Hospital, Spain; Health Science Department, Medicine Faculty, Castilla-LaMancha University, Spain
| | | | | | | | - Ángel E Plasencia-Enzaíne
- Chronic Pain Unit Ciudad Real General University Hospital, Spain; Rheumatology Department, Ciudad Real General University Hospital, Spain
| | - Jorge Martínez-Del Río
- Cardiology Department, Ciudad Real General University Hospital, Spain; Instituto de investigación sanitaria de Castilla La-Mancha (IDISCAM)
| | | | - Jesús Piqueras-Flores
- Cardiology Department, Ciudad Real General University Hospital, Spain; Instituto de investigación sanitaria de Castilla La-Mancha (IDISCAM); Health Science Department, Medicine Faculty, Castilla-LaMancha University, Spain.
| |
Collapse
|
5
|
Negreira-Caamaño M, Jiménez-Díaz J, Higuera-Sobrino F. Severe sinus node disease in patient with amyloid cardiomyopathy. Arch Cardiol Mex 2023; 93:233-236. [PMID: 37037218 PMCID: PMC10161801 DOI: 10.24875/acm.21000388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Affiliation(s)
| | - Javier Jiménez-Díaz
- Servicio de Cardiología
- Unidad de Arritmias, Servicio de Cardiología. Hospital General Universitario de Ciudad Real, Ciudad Real, Madrid, España
| | - Felipe Higuera-Sobrino
- Servicio de Cardiología
- Unidad de Arritmias, Servicio de Cardiología. Hospital General Universitario de Ciudad Real, Ciudad Real, Madrid, España
| |
Collapse
|
6
|
Anguita-Gámez M, Negreira-Caamaño M, Nuñez I, Marcos-Alberca P, Vidal M, Hernández P, Vivas D, De Agustín JA. Apical left ventricular pseudoaneurysm: Diagnosis by multimodal cardiac imaging. Cardiol J 2022; 29:527-528. [PMID: 35652142 PMCID: PMC9170322 DOI: 10.5603/cj.2022.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/24/2021] [Accepted: 10/28/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | - Ivan Nuñez
- Cardiovascular Institute, San Carlos Clinic Hospital, Madrid, Spain
| | | | - María Vidal
- Radiology Department, San Carlos Clinic Hospital, Madrid, Spain
| | - Paula Hernández
- Radiology Department, San Carlos Clinic Hospital, Madrid, Spain
| | - David Vivas
- Cardiovascular Institute, San Carlos Clinic Hospital, Madrid, Spain
| | | |
Collapse
|
7
|
Negreira-Caamaño M, Martínez-Del-Río J, Nieto-Sandoval-Martín-de-la-Sierra P, Águila-Gordo D, Mateo-Gómez C, Rodríguez-Martínez M, Salas-Bravo D, Piqueras-Flores J. [Differences among renin-angiotensin system inhibitor drugs in prognosis of hypertense patients with COVID-19]. Arch Cardiol Mex 2022; 93:58-65. [PMID: 35389602 DOI: 10.24875/acm.21000185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/01/2021] [Accepted: 02/02/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Concerns have been raised about Renin-angiotensin system inhibitors (RASi) in patients with COVID-19. Although recent trials have proved its security, evidence regarding intrinsic differences between RASi is lacking, especially in patients with arterial hypertension. Our objective was to analyse the prognosis of hypertense patients who received angiotensin converting enzyme inhibitors (ACEi) or angiotensin-2 receptor blockers (ARBs) and were hospitalized due to COVID-19. Materials and methods 392 consecutive patients with hypertension and COVID-19 were analyse. Incidence of the combined event (death or mechanical ventilation need) was the primary endpoint. Secondary, incidence of each event and time to event were analysed. Results 155 received ACEi and 237 ARBs. During the hospitalization, the combined event was observed in the 31,6 % of patients. No differences were observed between those previously treated with ACEi and ARBs (33.5 vs. 30.9%; p = 0.51). In the survival analysis, no differences were observed regarding time to combined event (p = 0.91). In-hospital mortality was similar in both groups (32.3 vs. 29.1%; p = 0.51), as well as the need of mechanical ventilation (3.2 vs. 5.9%; p = 0.23). Conclusions The type of RASi was not associated with in-hospital major events in patients with arterial hypertension hospitalized due to COVID-19.
Collapse
Affiliation(s)
- Martín Negreira-Caamaño
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, España
| | - Jorge Martínez-Del-Río
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, España
| | | | - Daniel Águila-Gordo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, España
| | - Cristina Mateo-Gómez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, España
| | - Marta Rodríguez-Martínez
- Servicio de Farmacia. Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, España
| | - Daniel Salas-Bravo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, España
| | - Jesús Piqueras-Flores
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, España
- Facultad de Medicina, Universidad de Castilla-La Mancha, Ciudad Real, Castilla-La Mancha, España
| |
Collapse
|
8
|
Negreira-Caamaño M, Abellán-Huerta J. La paradoja del consumo de alcohol: cautela ante una evidencia en desarrollo. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.08.010] [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: 10/20/2022]
|
9
|
Negreira-Caamaño M, Abellán-Huerta J. The alcohol-intake paradox: caution in a field of developing evidence. Rev Esp Cardiol (Engl Ed) 2022; 75:190-191. [PMID: 34657830 DOI: 10.1016/j.rec.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Affiliation(s)
| | - José Abellán-Huerta
- Servicio de Cardiología, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain.
| |
Collapse
|
10
|
Negreira-Caamaño M, Martínez-Del Río J, Águila-Gordo D, Mateo-Gómez C, Soto-Pérez M, Piqueras-Flores J. Cardiovascular events after COVID-19 hospitalization: long-term follow-up. Revista Española de Cardiología (English Edition) 2022; 75:100-102. [PMID: 34583913 PMCID: PMC8426288 DOI: 10.1016/j.rec.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Jorge Martínez-Del Río
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Daniel Águila-Gordo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Cristina Mateo-Gómez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Maeve Soto-Pérez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Jesús Piqueras-Flores
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Facultad de Medicina, Universidad de Castilla La-Mancha, Ciudad Real, Spain
| |
Collapse
|
11
|
Águila-Gordo D, Martínez-Del Rio J, Negreira-Caamaño M, Mateo Gómez C, Soto Pérez M, Piqueras-Flores J. [Cardiovascular disease after COVID-19 infection in elderly patients. Results of annual follow-up of a cohort of survivors]. Rev Esp Geriatr Gerontol 2021; 57:100-104. [PMID: 34930633 PMCID: PMC8585603 DOI: 10.1016/j.regg.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/28/2021] [Accepted: 10/14/2021] [Indexed: 11/12/2022]
Abstract
Introducción Si bien el impacto de la infección por SARS-CoV-2 sobre el sistema cardiovascular es conocido en fase aguda, la repercusión cardiovascular de la población anciana superviviente a la infección respiratoria por la COVID-19 a largo plazo no ha sido suficientemente estudiada. Métodos Registro observacional de 240 pacientes ancianos (75 o más años), ingresados de forma consecutiva por infección respiratoria por la COVID-19 y supervivientes a la misma, entre el 1 de marzo y el 30 abril de 2020, en el Hospital General Universitario de Ciudad Real. Se analizó de forma prospectiva la incidencia de eventos cardiovasculares mayores (MACE) (mortalidad cardiovascular, síndrome coronario agudo, accidente cerebrovascular, enfermedad tromboembólica e insuficiencia cardiaca). Resultados La edad media fue de 83,75 ± 5,75 años. Tras un seguimiento medio de 352,2 ± 70,4 días el 13,8% de los pacientes falleció y el 9,6% presentó MACE, siendo el más frecuente la insuficiencia cardiaca, sin diferencias en la gravedad ni evolución general de la enfermedad aguda. En el modelo de regresión de Cox multivariante el riesgo de desarrollar MACE fue mayor en los pacientes con enfermedad pulmonar obstructiva crónica (HR 4,29; IC 95% 1,62-11,39; p = 0,003) y diurético de asa (HR 2,99; IC 95% 1,27-7,07; p = 0,01). Conclusiones En población anciana superviviente a la COVID-19 la incidencia de MACE tras un año de seguimiento es elevada, siendo la principal manifestación la insuficiencia cardiaca.
Collapse
Affiliation(s)
- Daniel Águila-Gordo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
| | - Jorge Martínez-Del Rio
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | | | - Cristina Mateo Gómez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Maeve Soto Pérez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Jesús Piqueras-Flores
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| |
Collapse
|
12
|
Águila-Gordo D, Martínez-Del Río J, Mazoteras-Muñoz V, Negreira-Caamaño M, Nieto-Sandoval Martín de la Sierra P, Piqueras-Flores J. [Mortality and associated prognostic factors in elderly and very elderly hospitalized patients with respiratory disease COVID-19]. Rev Esp Geriatr Gerontol 2021; 56:259-267. [PMID: 33610380 PMCID: PMC7656995 DOI: 10.1016/j.regg.2020.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/16/2020] [Accepted: 09/23/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Elderly patients with COVID-19 has a worse clinical evolution, being more susceptible to develop serious manifestations. The differences between the elderly and very elderly population, mortality and associated prognostic factors of SARS-CoV-2 infection have not been enough studied yet. METHODS An observational study of 416 elderly patients admitted consecutively to Hospital General Universitario de Ciudad Real for COVID-19 respiratory infection from March 1st to April 30th, 2020. Data were collected including patient demographic information, medical history, clinical characteristics, laboratory data, therapeutic interventions and clinical outcomes during the hospitalization and after discharge, until June 15, 2020 with the aim of analyzing mortality, and associated prognostic factors. RESULTS The mean age was 84.43±5.74 years old; elderly patients (75-84 years) were 50.2% of the sample and very elderly (≥85 years) the remaining 49.8%. In Cox regression model, mortality rate was higher in very elderly group (HR = 2.58; 95% CI: 1.23-5.38; P = .01), hypertensive (HR = 3, 45; 95% CI: 1.13-10.5; P = .03) and chronic kidney disease patients (HR = 3.86; 95% CI: 1.3-11.43; P = .02). In contrast, calcium antagonists (HR = 0.27; 95% CI: 0.12-0.62; P = .002) and anticoagulant therapy during hospitalization (HR = 0.26; 95% CI: 0.08 0, 83; P = .02) were associated with a longer time free of mortality. CONCLUSIONS Mortality rate was higher in very eldery patients compared with eldery; and in hypertensive and chronic kidney disease patients. Anticoagulation therapy and calcium chanel bloquers treatment during hospitalization were associated with a higher survival in the short-term follow-up in patients hospitalized with COVID-19.
Collapse
Affiliation(s)
- Daniel Águila-Gordo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
| | - Jorge Martínez-Del Río
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | | | | | | | - Jesús Piqueras-Flores
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| |
Collapse
|
13
|
Negreira-Caamaño M, Río JMD, Águila-Gordo D, Mateo-Gómez C, Soto-Pérez M, Piqueras-Flores J. [Cardiovascular events after COVID-19 hospitalization: long-term follow-up]. Rev Esp Cardiol 2021; 75:100-102. [PMID: 34334882 PMCID: PMC8310722 DOI: 10.1016/j.recesp.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Jorge Martínez-Del Río
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Daniel Águila-Gordo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Cristina Mateo-Gómez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Maeve Soto-Pérez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Jesús Piqueras-Flores
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.,Facultad de Medicina, Universidad de Castilla La-Mancha, Ciudad Real, España
| |
Collapse
|
14
|
Negreira-Caamaño M, Abellán-Huerta J, Lozano-Ruiz-Poveda F, Sánchez-Pérez I, López-Lluva MT, Pérez-Díaz P, López JG, Jurado-Román A. Percutaneous Intervention in Diffuse Coronary Disease: Overlapping Versus Single Very Long Stent Technique. Results From the OVERLONG Registry. Angiology 2021; 72:979-985. [PMID: 33966474 DOI: 10.1177/00033197211014686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Both stent length and stent overlap are associated with worse outcomes in the percutaneous treatment of diffuse coronary artery disease (dCAD). However, evidence comparing these issues is scarce. We aimed to compare the results between the use of single very long stent (VLS) and ≥2 overlapping stents (OS) in the treatment of dCAD. METHODS Seven hundred twenty-four consecutive lesions were included: 275 treated with a single VLS (≥40 mm) and 449 with ≥2 OS. Procedural characteristics were assessed, and survival analysis was performed to compare the incidence of major adverse cardiovascular events (MACE; composite of cardiovascular death, nonfatal myocardial infarction, target lesion revascularization [TLR], or stent thrombosis) during a median follow-up of 31 months. RESULTS Procedures with VLS required less contrast volume (268 ± 122 vs 302 ± 113 cm3; P < .01), fluoroscopy time (16 ± 8 vs 21 ± 16 minutes; P < .01), and procedure duration (37 ± 18 vs 47 ± 27 minutes; P < .01) than the OS procedures. The VLS group showed lower incidence of MACE (4.4% vs 10.7%; P < .01), driven mainly by lower TLR rate (1.1% vs 4.7%; P < .01). The use of OS was an independent predictor of MACE. CONCLUSIONS In this study, the use of VLS for the treatment of dCAD was associated with better outcomes compared to OS.
Collapse
Affiliation(s)
| | - José Abellán-Huerta
- Interventional Cardiology Unit, Cardiology Department, University General Hospital of Ciudad Real, Spain
| | | | - Ignacio Sánchez-Pérez
- Interventional Cardiology Unit, Cardiology Department, University General Hospital of Ciudad Real, Spain
| | | | - Pedro Pérez-Díaz
- Cardiology Department, University General Hospital of Ciudad Real, Spain
| | | | - Alfonso Jurado-Román
- Interventional Cardiology Unit, Cardiology Department, La Paz University Hospital, Madrid, Spain
| |
Collapse
|
15
|
Negreira-Caamaño M, Piqueras-Flores J, Vivo-Ortega I, Arántzazu-González-Marín M, Muñoz-García M, Jiménez-Lozano A. Impact of the creation of specialized units for patients with hypertrophic cardiomyopathy. Revista Portuguesa de Cardiologia (English Edition) 2021. [DOI: 10.1016/j.repce.2020.08.005] [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] Open
|
16
|
Negreira-Caamaño M, Piqueras-Flores J, Vivo-Ortega I, Arántzazu-González-Marín M, Muñoz-García M, Jiménez-Lozano A. Impact of the creation of specialized units for patients with hypertrophic cardiomyopathy. Rev Port Cardiol 2021; 40:221-223. [PMID: 33485728 DOI: 10.1016/j.repc.2020.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/08/2020] [Accepted: 08/07/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES According to current international guidelines, hypertrophic cardiomyopathy (HCM) patients should be managed in specialized units. However, there is lack of data on the impact of the creation of these units in the management of HCM patients. Our goal was to assess the impact of the creation of an Inherited Inherited Diseases Cardiac Unit (ICDU) in the current management of patients with HCM. METHODS We analyzed 114 consecutive patients (62.6±8 years old, 70.2% males) with HCM. Variables related to optimal management of HCM patients and their family study were recorded, as well as guidance on the risk of sudden death. We analyzed whether patients were assessed by the ICDU or at a general cardiology consultation (GCC). RESULTS 50 patients were assessed in the IDCU and 64 in the GCC. Familial screening was more frequent in patients assessed by the IDCU (45.3% vs. 4%; p<0.01), requesting more genetic studies of the index case (70.3% vs. 14%; p<0.01) and cardiac magnetic resonance (53.1% vs. 18%; p<0.01). Sudden death risk score was performed more frequently in patients after the creation of an IDCU (67.2% vs. 28%; p<0.01). Treatment with beta-blockers was similar in both groups (72% vs. 78.1%; p=0.24). An implantable cardiac defibrillator was indicated similarly in both groups (12.5% in ICDU and 6% in GC; p=0.24). CONCLUSIONS The implementation of an IDCU improved the quality of the medical care for HCM patients by performing a better study of the patients and their families.
Collapse
Affiliation(s)
| | - Jesús Piqueras-Flores
- Inherited Cardiac Diseases Unit, Cardiology Department, University General Hospital of Ciudad Real, Spain
| | - Inmaculada Vivo-Ortega
- Inherited Cardiac Diseases Unit, Cardiology Department, University General Hospital of Ciudad Real, Spain
| | | | | | | |
Collapse
|
17
|
Martínez-Del Río J, Piqueras-Flores J, Nieto-Sandoval Martín de la Sierra P, Negreira-Caamaño M, Águila-Gordo D, Mateo-Gómez C, Salas-Bravo D, Rodríguez-Martínez M. [Comparative analysis between the use of renin-angiotensin system antagonists and clinical outcomes of hospitalized patients with COVID-19 respiratory infection]. Med Clin (Barc) 2020; 155:473-481. [PMID: 32782110 PMCID: PMC7381916 DOI: 10.1016/j.medcli.2020.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/13/2020] [Revised: 07/12/2020] [Accepted: 07/15/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Hypertension has been associated with worse outcomes in patients with COVID-19 infection, so concerns have been raised about the possibility that inhibitors of the renin-angiotensin system (RAS) could influence the prognosis of these patients. METHODS This is an observational study of 921 consecutive patients admitted with COVID-19 respiratory infection to Hospital General Universitario Ciudad Real from March 1 to April 30, 2020. Following data were collected including patient demographic information, medical history, clinical characteristics, laboratory data, therapeutic interventions during the hospitalization and clinical outcomes. RESULTS The mean age was 78years, and 59.2% of patients had a history of hypertension. Patients with previous treatment with RAS inhibitor (42.4%) showed lower risk of the primary composite endpoint (mortality or need for invasive mechanical ventilation). Treatment with RAS inhibitor (both outpatient treatment and during hospitalization) had neither effect on mortality nor need for invasive ventilation. There were no differences in time-to-event analysis between groups. CONCLUSIONS RAS inhibitor treatment prior to admission in patients with COVID-19 respiratory infection was associated with lower risk of the primary composite endpoint and did not show neither impact on mortality nor need for invasive mechanical ventilation, even if these drugs were prescribed during hospitalization.
Collapse
Affiliation(s)
- Jorge Martínez-Del Río
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
| | - Jesús Piqueras-Flores
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | | | | | - Daniel Águila-Gordo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Cristina Mateo-Gómez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Daniel Salas-Bravo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | | |
Collapse
|
18
|
Negreira-Caamaño M, Piqueras-Flores J, Martínez-DelRio J, Nieto-Sandoval-Martin-DeLaSierra P, Aguila-Gordo D, Mateo-Gomez C, Salas-Bravo D, Rodriguez-Martinez M, Negreira-Caamaño M. Impact of Treatment with Renin-Angiotensin System Inhibitors on Clinical Outcomes in Hypertensive Patients Hospitalized with COVID-19. High Blood Press Cardiovasc Prev 2020; 27:561-568. [PMID: 32949380 PMCID: PMC7501502 DOI: 10.1007/s40292-020-00409-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 07/19/2020] [Accepted: 09/05/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction Concerns have been raised about the possible harmfulness of angiotensin-converter enzyme inhibitors (ACEi) and aldosterone receptor blockers (ARB) in patients with COVID-19. However, few data from a European population have been published, especially from hypertensive patients. Aim To study the association between ACEi or ARB treatments and major adverse outcomes during hospitalisation in COVID-19 patients. Methods We studied 545 consecutive hypertensive patients
admitted to our institution due to COVID-19 with respiratory involvement. We
analysed the incidence of combined event (death or mechanical ventilatory
support) during hospitalisation, as well as the time to independent events. Results 188 (34.5%) patients presented
the combined endpoint. 182 (33.4%) patients died, and 21 (3.9%) needed
mechanical ventilatory support. Patients with previous treatment with ACEi or
ARB presented similar incidence of the combined endpoint during hospitalisation
(31.6% vs. 41.8%; p = 0.08), with a lower all-cause mortality rate (30.4% vs. 41.2%;
p = 0.03) compared with those without prior treatment. Use of ACEi or ARB was not independently
associated with lower incidence of the combined endpoint [Adjusted OR 0.675 (95% CI 0.298–1.528; p = 0.146)], but it was associated with lower mortality [Adjusted OR 0.550 (95% CI 0.304–0.930; p = 0.047)]. Conclusions The use of ACEi or ARB was associated with less
incidence of all-cause death during hospitalisation among hypertensive patients
admitted with COVID-19 respiratory infection. Electronic supplementary material The online version of this article (10.1007/s40292-020-00409-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Martin Negreira-Caamaño
- Cardiology Department, University General Hospital of Ciudad Real, Avda. del Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain
| | - Jesus Piqueras-Flores
- Cardiology Department, University General Hospital of Ciudad Real, Avda. del Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain
| | - Jorge Martínez-DelRio
- Cardiology Department, University General Hospital of Ciudad Real, Avda. del Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain
| | | | - Daniel Aguila-Gordo
- Cardiology Department, University General Hospital of Ciudad Real, Avda. del Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain
| | - Cristina Mateo-Gomez
- Cardiology Department, University General Hospital of Ciudad Real, Avda. del Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain
| | - Daniel Salas-Bravo
- Cardiology Department, University General Hospital of Ciudad Real, Avda. del Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain
| | | | - Martín Negreira-Caamaño
- Cardiology Department, University General Hospital of Ciudad Real, Avda. del Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain.
| |
Collapse
|
19
|
Abellán-Huerta J, Jurado-Román A, Lozano-Ruiz-Poveda F, López-Lluva MT, Negreira-Caamaño M, Pérez-Díaz P, Requena-Ibañez JA, Sánchez-Pérez I. Clinical Prognosis Associated With the Use of Overlapping Stents With Homogenous Versus Heterogeneous Pharmacological Characteristics for the Treatment of Diffuse Coronary Artery Disease. Cardiovasc Revasc Med 2020; 21:1355-1359. [PMID: 32354584 DOI: 10.1016/j.carrev.2020.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/14/2020] [Revised: 04/11/2020] [Accepted: 04/22/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The clinical impact of percutaneous coronary intervention (PCI) and implantation of overlapping stents (OS) using platforms with the same versus different pharmacological characteristics is unknown. Our objective was to compare the outcomes of PCI with OS according to their pharmacological characteristics. METHODS In this observational single-center registry, we included all PCI performed from April 2014 to December 2018 in which overlapping drug-eluting stents were implanted. Two groups were created according to whether the stents release the same drug [homogeneous: (HO)] or different [heterogeneous: (HE)]. The primary endpoint was the need for target lesion revascularization (TLR). Clinical assessment was performed after the procedure, bianually and at the end of follow-up (June 2019). RESULTS 381 lesions with OS (HO: 209; HE: 172) were included (75.1% male, 66.7 ± 11.6 years). Clinical presentation was stable coronary artery disease in 49.9%. Syntax score was 23.7 ± 13.3. The number of OS implanted was 2.2 ± 0.5 and the total stent length was 59.5 ± 20.1 mm (HE: 61.5 ± 21.6 vs. HO: 57.8 ± 18.8 mm; p < 0.01). After a median follow-up of 21 months, the HE group showed a lower TLR rate than the HO group (HE:2.3% vs HO:7.2%; p = 0.03). The rates of cardiac death (p = 0.44), myocardial infarction (p = 0.36) and stent thrombosis (p = 0.85) were similar between groups. In the multivariate analysis, the OS with homogeneous-drug devices was an independent predictor of a higher rate of TLR. CONCLUSIONS PCI using OS with homogeneous pharmacological characteristics was associated with a higher rate of TLR in comparison with the implantation of OS with heterogeneous pharmacological characteristics.
Collapse
Affiliation(s)
- José Abellán-Huerta
- Interventional Cardiology Unit, University General Hospital of Ciudad Real, Spain.
| | - Alfonso Jurado-Román
- Interventional Cardiology Unit, University General Hospital of Ciudad Real, Spain
| | | | - María T López-Lluva
- Interventional Cardiology Unit, University General Hospital of Ciudad Real, Spain
| | | | - Pedro Pérez-Díaz
- Clinical Cardiology Department, University General Hospital of Ciudad Real, Spain
| | | | | |
Collapse
|