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Amat-Santos IJ, Marengo G, Sánchez-Luna JP, Cortés Villar C, Rivero Crespo F, Jiménez Díaz VA, de la Torre Hernández JM, Pérez de Prado A, Sabaté M, López-Palop R, Vegas Valle JM, Suárez de Lezo J, Fernandez Cordon C, Gonzalez JC, García-Gómez M, Redondo A, Carrasco Moraleja M, San Román JA. Validation of Quantitative Flow Ratio-Derived Virtual Angioplasty with Post-Angioplasty Fractional Flow Reserve-The QIMERA-I Study. J Cardiovasc Dev Dis 2023; 11:14. [PMID: 38248884 PMCID: PMC10816683 DOI: 10.3390/jcdd11010014] [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: 11/30/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Background: Quantitative flow ratio (QFR) virtual angioplasty with pre-PCI residual QFR showed better results compared with an angiographic approach to assess post-PCI functional results. However, correlation with pre-PCI residual QFR and post-PCI fractional flow reserve (FFR) is lacking. Methods: A multicenter prospective study including consecutive patients with angiographically 50-90% coronary lesions and positive QFR results. All patients were evaluated with QFR, hyperemic and non-hyperemic pressure ratios (NHPR) before and after the index PCI. Pre-PCI residual QFR (virtual angioplasty) was calculated and compared with post-PCI fractional flow reserve (FFR), QFR and NHPR. Results: A total of 84 patients with 92 treated coronary lesions were included, with a mean age of 65.5 ± 10.9 years and 59% of single vessel lesions being the left anterior descending artery in 69%. The mean vessel diameter was 2.82 ± 0.41 mm. Procedural success was achieved in all cases, with a mean number of implanted stents of 1.17 ± 0.46. The baseline QFR value was 0.69 ± 0.12 and baseline FFR and NHPR were 0.73 ± 0.08 and 0.82 ± 0.11, respectively. Mean post-PCI FFR increased to 0.87 ± 0.05 whereas residual QFR had been estimated as 0.95 ± 0.05, showing poor correlation with post-PCI FFR (0.163; 95% CI:0.078-0.386) and low diagnostic accuracy (30.9%, 95% CI:20-43%). Conclusions: In this analysis, the results of QFR-based virtual angioplasty did not seem to accurately correlate with post-PCI FFR.
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Affiliation(s)
- Ignacio J. Amat-Santos
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Giorgio Marengo
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Juan Pablo Sánchez-Luna
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Carlos Cortés Villar
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
- Cardiology Department, Hospital Miguel Servet, 50009 Zaragoza, Spain
| | | | | | | | | | - Manel Sabaté
- Cardiology Department, Hospital Clinic Universitari, 08001 Barcelona, Spain
| | - Ramón López-Palop
- Cardiology Department, Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | | | | | - Clara Fernandez Cordon
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Jose Carlos Gonzalez
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Mario García-Gómez
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Alfredo Redondo
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
- Cardiology Department, Hospital Universitario de Santiago, 15706 Santiago de Compostela, Spain
| | | | - J. Alberto San Román
- Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
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Jiménez Díaz VA, Juan-Salvadores P. Valve Thrombosis After TAVR: Beyond HALT and RELM. JACC Cardiovasc Interv 2023; 16:2982-2985. [PMID: 38151312 DOI: 10.1016/j.jcin.2023.10.054] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 12/29/2023]
Affiliation(s)
- Víctor Alfonso Jiménez Díaz
- Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Pontevedra, Spain; Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain.
| | - Pablo Juan-Salvadores
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
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Jiménez Díaz VA, Íñiguez Romo A. Intracoronary artery visualisation of crystalline sirolimus deposits after drug-coated balloon angioplasty for acute coronary syndrome. Lancet 2023; 402:2111-2112. [PMID: 38042617 DOI: 10.1016/s0140-6736(23)02349-8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/30/2023] [Accepted: 10/17/2023] [Indexed: 12/04/2023]
Affiliation(s)
| | - Andrés Íñiguez Romo
- Department of Cardiology, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Pontevedra, Spain
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Busto L, Veiga C, González-Nóvoa JA, Campanioni S, Juan-Salvadores P, Jiménez Díaz VA, Baz JA, Alba-Castro JL, Kütting M, Íñiguez A. Automatic Assessment of Transcatheter Aortic Valve Implantation Results on Four-Dimensional Computed Tomography Images Using Artificial Intelligence. Bioengineering (Basel) 2023; 10:1206. [PMID: 37892936 PMCID: PMC10604882 DOI: 10.3390/bioengineering10101206] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is a procedure to treat severe aortic stenosis. There are several clinical concerns related to potential complications after the procedure, which demand the analysis of computerized tomography (CT) scans after TAVI to assess the implant's result. This work introduces a novel, fully automatic method for the analysis of post-TAVI 4D-CT scans to characterize the prosthesis and its relationship with the patient's anatomy. The method enables measurement extraction, including prosthesis volume, center of mass, cross-sectional area (CSA) along the prosthesis axis, and CSA difference between the aortic root and prosthesis, all the variables studied throughout the cardiac cycle. The method has been implemented and evaluated with a cohort of 13 patients with five different prosthesis models, successfully extracting all the measurements from each patient in an automatic way. For Allegra patients, the mean of the obtained inner volume values ranged from 10,798.20 mm3 to 18,172.35 mm3, and CSA in the maximum diameter plane varied from 396.35 mm2 to 485.34 mm2. The implantation of this new method could provide information of the important clinical value that would contribute to the improvement of TAVI, significantly reducing the time and effort invested by clinicians in the image interpretation process.
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Affiliation(s)
- Laura Busto
- Cardiology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), 36312 Vigo, Spain; (L.B.); (J.A.G.-N.); (S.C.); (P.J.-S.)
| | - César Veiga
- Cardiology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), 36312 Vigo, Spain; (L.B.); (J.A.G.-N.); (S.C.); (P.J.-S.)
| | - José A. González-Nóvoa
- Cardiology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), 36312 Vigo, Spain; (L.B.); (J.A.G.-N.); (S.C.); (P.J.-S.)
| | - Silvia Campanioni
- Cardiology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), 36312 Vigo, Spain; (L.B.); (J.A.G.-N.); (S.C.); (P.J.-S.)
| | - Pablo Juan-Salvadores
- Cardiology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), 36312 Vigo, Spain; (L.B.); (J.A.G.-N.); (S.C.); (P.J.-S.)
| | - Víctor Alfonso Jiménez Díaz
- Cardiology Department, Complexo Hospitalario Universitario de Vigo (SERGAS), Álvaro Cunqueiro Hospital, 36312 Vigo, Spain; (V.A.J.D.); (J.A.B.); (A.Í.)
| | - José Antonio Baz
- Cardiology Department, Complexo Hospitalario Universitario de Vigo (SERGAS), Álvaro Cunqueiro Hospital, 36312 Vigo, Spain; (V.A.J.D.); (J.A.B.); (A.Í.)
| | - José Luis Alba-Castro
- atlanTTic Research Center for Telecommunication Technologies, University of Vigo, 36310 Vigo, Spain;
| | | | - Andrés Íñiguez
- Cardiology Department, Complexo Hospitalario Universitario de Vigo (SERGAS), Álvaro Cunqueiro Hospital, 36312 Vigo, Spain; (V.A.J.D.); (J.A.B.); (A.Í.)
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de la Torre Fonseca LM, Cedeño RA, Díaz VAJ, Cedeño FIL, Juan-Salvadores P. Cardiovascular Complications in Patients Hospitalized for COVID-19: A Cohort Study in Havana, Cuba. Cardiovasc Revasc Med 2023; 52:10-15. [PMID: 36822976 PMCID: PMC9940473 DOI: 10.1016/j.carrev.2023.02.014] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION AND OBJECTIVE At least one in ten patients infected with COVID develop cardiovascular complications during hospitalization, increasing the number of deaths from this cause. However, the determinants of risk are not clearly elucidated. This study aims to determine whether there is a relationship between in-hospital cardiac complications and cardiovascular history and hospital evolution. METHODS Prospective cohort study of 373 patients with a positive diagnosis of SARS-CoV-2 admitted to an Intensive Care Unit between March and October 2021. RESULTS Median age was 69 (IQR: 57-77), 29.2 % of patients presented cardiovascular complications: 21.2 % electrical, 5.9 % acute coronary syndrome and 1.9 % pulmonary thromboembolism. Age RR: 1.02 (95 % CI: 1.00-1.04; p = 0.020) and history of ischemic heart disease RR: 2.23 (95 % CI: 1.27-3.92; p = 0.005) were identified as independent predictors of in-hospital cardiac complications. CONCLUSIONS Age and history of ischemic heart disease were identified as independent predictor variables of cardiovascular complications in patients admitted with severe COVID-19 involvement; being significantly associated with lower survival.
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Affiliation(s)
| | - Robert Alarcón Cedeño
- Interventional Cardiology Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Spain
| | - Víctor Alfonso Jiménez Díaz
- Cardiovascular Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain.
| | | | - Pablo Juan-Salvadores
- Cardiovascular Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain; Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain.
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Juan-Salvadores P, Michel Gómez MS, Jiménez Díaz VA, Martínez Reglero C, Iñiguez Romo A. Patients’ knowledge about their involvement in clinical trials. A non-randomized controlled trial. Front Med (Lausanne) 2022; 9:993086. [PMID: 36203759 PMCID: PMC9531127 DOI: 10.3389/fmed.2022.993086] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background Nowadays, good clinical practice should be established in human research. Patient’s rights and autonomy must be respected above the interest of the researcher, making mandatory to raise patient’s awareness on the implications of participating in a clinical study. Contrary to popular belief, this is not always the case. This means that, after signing the informed consent form, some patients have difficulties understanding their responsibilities as participants. Materials and methods This study is a prospective, multicenter, non-randomized controlled trial comparative survey conducted on patients enrolled in a clinical trial to evaluate and improve their understanding after an educational intervention was applied to the research staff. Results Females were underrepresented in the clinical trials performed in this study, 21.5%. Most of the participants had a low educational level (74.4%). Around 5 and 10% of the research participants were not aware they were part of a clinical study, and more 24% just trusted in the medical decision to be enrolled. After the interventional education, the following items: “given time and resolution of the patient doubts” (p-value = 0.003), “enough written information” (p-value = 0.006), “explanation of the risks of participating in the study,” (p-value = 0.047) and understanding of the information provided to them showed an improvement regarding the study in which they were participating. Conclusion The research participants understanding of their involvement in clinical trials is limited. An educational intervention on the research team can improve the process of empowerment and transit of information.
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Affiliation(s)
- Pablo Juan-Salvadores
- Cardiovascular Research Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- *Correspondence: Pablo Juan-Salvadores,
| | - Marcela Sánchez Michel Gómez
- Cardiovascular Research Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
| | - Víctor Alfonso Jiménez Díaz
- Cardiovascular Research Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Interventional Cardiology Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
| | - Cristina Martínez Reglero
- Methodology and Statistics Unit, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Andrés Iñiguez Romo
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Interventional Cardiology Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
- Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
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de la Torre Fonseca LM, Alarcón Cedeño R, Jiménez Díaz VA, Wang L, Loor Cedeño FI, Juan-Salvadores P. Wellens syndrome as an independent predictor of in-hospital cardiovascular complications. Acta Cardiol 2022:1-7. [PMID: 35969228 DOI: 10.1080/00015385.2022.2093797] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Wellens Syndrome was described for the first time in the eighties, as an equivalent pattern of a critical lesion of the anterior descending artery. Different risk factors have been associated with a worse prognosis during hospitalisation in patients with non-ST segment elevation acute coronary syndrome. However, it is unknown whether the presence of Wellens Syndrome alone contributes to an increase in in-hospital cardiovascular complications. MATERIAL AND METHOD Analytical prospective cohort study in 141 patients with the diagnosis of acute coronary syndrome without ST segment elevation who underwent coronary angiography between 2016 and 2020. RESULTS Wellens syndrome was diagnosed in 64 patients with a mean age of 66.31 ± 12.54, of which 21 patients had a cardiac event during hospitalisation: hemodynamic complication 14 (21.9%), refractory or recurrent angina 4 (6.3%) and Acute myocardial infarction 3 (4.7%) confirming a relative risk (RR): 4.88 (95% confidence interval (CI) 1.92-12.45) p = 0.001. CONCLUSIONS The presence of Wellens Syndrome is independently associated with the appearance of cardiac complications during hospitalisation.Key pointsSW is now known to be a relatively frequent presentation of ACS, not addressed in depth in clinical practice guidelines for NSTEACS. This syndrome is generally caused by a severe ADA occlusion that, if not adequately treated, could evolve into a large infarction. According to the results of the different series published, the incidence of cardiovascular risk factors in SW is similar to other forms of presentation of ischaemic heart disease.At present, the exact relationship between the main cardiovascular risk factors and SW is unknown; in addition to the possible associations of this syndrome with in-hospital cardiovascular complications and its value as a predictor of the occurrence of cardiac complications, elements that are included in the results of the present study.
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Affiliation(s)
| | - Robert Alarcón Cedeño
- Interventional Cardiology Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
| | - Víctor Alfonso Jiménez Díaz
- Interventional Cardiology Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
| | - Lin Wang
- Interventional Cardiology Unit, Cardiology Department, Hospital San Carlos, Madrid, Spain
| | | | - Pablo Juan-Salvadores
- Cardiovascular Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain.,Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
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Núñez-Gil IJ, Cerrato E, Bollati M, Nombela-Franco L, Terol B, Alfonso-Rodríguez E, Camacho-Freire SJ, A. Villablanca P, Amat Santos IJ, Torre-Hernández JMDL, Pascual I, Liebetrau C, Camacho B, Pavani M, Adriano Latini R, Varbella F, Jiménez Díaz VA, Piraino D, Mancone M, Alfonso F, Antonio Linares J, Jiménez-Mazuecos JM, Palazuelos-Molinero J, Lozano y Í, Fernández-Ortiz A. <i>Stents</i> recubiertos o farmacoactivos en aneurismas, resultados del Registro Internacional de Aneurismas Coronarios (CAAR). RECIC 2022. [DOI: 10.24875/recic.m21000238] [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: 11/17/2022] Open
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Juan-Salvadores P, Jiménez Díaz VA, Iglesia Carreño C, Guitián González A, Veiga C, Martínez Reglero C, Baz Alonso JA, Caamaño Isorna F, Iñiguez Romo A. Coronary Artery Disease in Very Young Patients: Analysis of Risk Factors and Long-Term Follow-Up. J Cardiovasc Dev Dis 2022; 9:jcdd9030082. [PMID: 35323630 PMCID: PMC8955526 DOI: 10.3390/jcdd9030082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
Coronary artery disease (CAD) is a common chronic condition in the elderly. However, the earlier CAD begins, the stronger its impact on lifestyle and costs of health and social care. The present study analyzes clinical and angiographic features and the outcome of very young patients undergoing coronary angiography due to suspected CAD, including a nested case-control study of ≤40-year-old patients referred for coronary angiography. Patients were divided into two groups: cases with significant angiographic stenosis, and controls with non-significant stenosis. Of the 19,321 coronary angiographies performed in our center in a period of 10 years, 504 (2.6%) were in patients ≤40 years. The most common cardiovascular risk factors for significant CAD were smoking (OR 2.96; 95% CI 1.65–5.37), dyslipidemia (OR 2.18; 95% CI 1.27–3.82), and family history of CAD (OR 1.95; 95% CI 1.05–3.75). The incidence of major adverse cardiovascular events (MACE) at follow-up was significantly higher in the cases compared to controls (HR 2.71; 95% CI 1.44–5.11). Three conventional coronary risk factors were directly related to the early signs of CAD. MACE in the long-term follow-up is associated to dyslipidaemia and hypertriglyceridemia. Focusing efforts for the adequate control of CAD in young patients is a priority given the high socio-medical cost that this disease entails to society.
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Affiliation(s)
- Pablo Juan-Salvadores
- Cardiovascular Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, 36213 Vigo, Spain;
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, Universidade de Vigo, 36213 Vigo, Spain; (C.V.); (J.A.B.A.); (A.I.R.)
- Correspondence: ; Tel.: +34-986825564
| | - Víctor Alfonso Jiménez Díaz
- Cardiovascular Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, 36213 Vigo, Spain;
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, Universidade de Vigo, 36213 Vigo, Spain; (C.V.); (J.A.B.A.); (A.I.R.)
- Interventional Cardiology Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, 36213 Vigo, Spain
| | - Cristina Iglesia Carreño
- Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, 36213 Vigo, Spain; (C.I.C.); (A.G.G.)
| | - Alba Guitián González
- Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, 36213 Vigo, Spain; (C.I.C.); (A.G.G.)
| | - Cesar Veiga
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, Universidade de Vigo, 36213 Vigo, Spain; (C.V.); (J.A.B.A.); (A.I.R.)
| | - Cristina Martínez Reglero
- Methodology and Statistics Unit, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, Universidade de Vigo, 36213 Vigo, Spain;
| | - José Antonio Baz Alonso
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, Universidade de Vigo, 36213 Vigo, Spain; (C.V.); (J.A.B.A.); (A.I.R.)
- Interventional Cardiology Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, 36213 Vigo, Spain
| | - Francisco Caamaño Isorna
- Department of Preventive Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 15782 Santiago de Compostela, Spain
| | - Andrés Iñiguez Romo
- Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, Universidade de Vigo, 36213 Vigo, Spain; (C.V.); (J.A.B.A.); (A.I.R.)
- Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, 36213 Vigo, Spain; (C.I.C.); (A.G.G.)
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Íñiguez-Romo A, Zueco-Gil JJ, Álvarez-Bartolomé M, Baz Alonso JA, Jiménez Díaz VA, Estévez Loureiro R, Veiga Fernández G, Lee Hwang DH, Martí-Sánchez y B, Cuervo J. Resultados del implante percut�neo de v�lvula a�rtica en Espa�a mediante el Registro de Actividad de Atenci�n Especializada. RECIC 2022. [DOI: 10.24875/recic.m21000256] [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: 11/17/2022] Open
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Jiménez Díaz VA, Hovasse T, Íñiguez A, Copt S, Byrne J, Brunel P, Morice MC, Abizaid A, Tespilli M, Walters D, Ortiz Sáez A, Bastos Fernández G, Stoll HP, Urban P. Impacto del acceso vascular en el pronóstico tras la angioplastia coronaria en pacientes con alto riesgo hemorrágico: subanálisis predefinido del estudio LEADERS FREE. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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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Jiménez Díaz VA, Hovasse T, Íñiguez A, Copt S, Byrne J, Brunel P, Morice MC, Abizaid A, Tespilli M, Walters D, Ortiz Sáez A, Bastos Fernández G, Stoll HP, Urban P. Impact of vascular access on outcome after PCI in patients at high bleeding risk: a pre-specified sub-analysis of the LEADERS FREE trial. ACTA ACUST UNITED AC 2019; 73:536-545. [PMID: 31563471 DOI: 10.1016/j.rec.2019.07.010] [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: 02/05/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES The prognostic impact of bleeding in high bleeding risk (HBR) patients depending on the location of bleeding and prognosis in nonaccess site bleeding is unknown. We aimed to assess the impact of vascular access site on bleeding complications after percutaneous coronary interventions for HBR patients at 30-day and 2-year follow-up. METHODS The LEADERS FREE trial included 2432 HBR PCI patients. A Biolimus A9 drug-coated stent was superior to a bare-metal stent for safety and efficacy. This is a predefined sub-analysis of the LEADERS FREE trial. RESULTS Transradial access (TRA) was used in 1454 patients (59.8%) and transfemoral access (TFA) in 978 (40.2%), according to operator preference. The safety and benefits of drug-coated stents over bare-metal stents were independent of vascular access. At 30 days and 2 years, major bleeding had occurred in 2.4% and 7.5% of TRA patients and 4.6% and 10.9% of TFA patients (P=.003), respectively. Most of these events in both groups (2.1% and 7.0% for TRA; 3.2% and 9.4% for TFA, respectively) were nonaccess site-related. TRA was associated with a significant reduction in adjusted rates of major bleeding both at 30 days (HR, 1.98; 95%CI, 1.25-3.11; P=.003) and at 2 years of follow-up (HR, 1.51; 95%CI, 1.14-2.01; P=.003). This difference was driven by both access and nonaccess bleeding. CONCLUSIONS Operators preferred TRA for most HBR patients, which was associated with a significant reduction in major bleeding events. However, most of these events in this population are unrelated to vascular access.
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Affiliation(s)
- Víctor Alfonso Jiménez Díaz
- Departamento de Cardiología, Hospital Álvaro Cunqueiro, Hospital Universitario de Vigo, Vigo, Pontevedra, Spain
| | - Thomas Hovasse
- Cardiology Department, Hôpital Privé Jacques Cartier, Massy, France
| | - Andrés Íñiguez
- Departamento de Cardiología, Hospital Álvaro Cunqueiro, Hospital Universitario de Vigo, Vigo, Pontevedra, Spain
| | | | - Jonathan Byrne
- Cardiology Department, King's College, London, United Kingdom
| | | | | | - Alex Abizaid
- Cardiology Department, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | | | - Darren Walters
- Cardiology Department, Prince Charles Hospital, Queensland, Australia
| | - Alberto Ortiz Sáez
- Departamento de Cardiología, Hospital Álvaro Cunqueiro, Hospital Universitario de Vigo, Vigo, Pontevedra, Spain
| | - Guillermo Bastos Fernández
- Departamento de Cardiología, Hospital Álvaro Cunqueiro, Hospital Universitario de Vigo, Vigo, Pontevedra, Spain
| | | | - Philip Urban
- Cardiology Department, Hôpital de la Tour, Geneva, Switzerland.
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13
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Hernández Hernández E, Jiménez Díaz VA, Baz Alonso JA, Fernández Barbeira S, Vitela Rodríguez JA, Andrade Pacheco J, Ortiz Sáez A, Bastos Fernández G, De Miguel Castro AA, Iñiguez Romo A. Not All That Blurs is Clot: An Unusual But Not Infrequent Cause of Acute Coronary Syndrome. J Invasive Cardiol 2017; 29:E53-E54. [PMID: 28368850] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 73-year-old man was admitted for non-ST segment elevation acute myocardial infarction. Coronary angiography suggested intrastent thrombosis as the etiology, but optical coherence tomography revealed a non-expanded stent, which was successfuly crushed and covered with a new stent.
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Affiliation(s)
- Etelberto Hernández Hernández
- Hemodynamics & Interventional Cardiology Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital Complex of Vigo, Estrada Clara Campoamor, 341 Vigo, Pontevedra, Spain, 36312.
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14
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Núñez-Gil IJ, Nombela-Franco L, Bagur R, Bollati M, Cerrato E, Alfonso E, Liebetrau C, De la Torre Hernandez JM, Camacho B, Mila R, Amat-Santos IJ, Alfonso F, Rodríguez-Olivares R, Camacho Freire SJ, Lozano Í, Jiménez Díaz VA, Piraino D, Latini RA, Feltes G, Linares JA, Mancone M, Ielasi A, Sánchez-Grande Flecha A, Fernández Cisnal A, Ugo F, Jiménez Mazuecos JM, Omedè P, Pavani M, Villablanca PA, Louka BF, Fernández-Ortiz A. Rationale and design of a multicenter, international and collaborative Coronary Artery Aneurysm Registry (CAAR). Clin Cardiol 2017; 40:580-585. [PMID: 28337781 DOI: 10.1002/clc.22705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/14/2016] [Revised: 01/22/2017] [Accepted: 02/15/2017] [Indexed: 11/09/2022] Open
Abstract
Coronary artery aneurysm is defined as a coronary dilation that exceeds the diameter of adjacent segments or the diameter of the patient's largest normal coronary vessel by 1.5×. It is an uncommon disease that has been diagnosed with increasing frequency since the widespread appearance of coronary angiography. The published incidence varies from 1.5% to 5%, suggesting male dominance and a predilection for the right coronary artery. Although several causes have been described, atherosclerosis accounts for ≥50% of coronary aneurysms in adults. Reported complications include thrombosis and distal embolization, rupture, and vasospasm, causing ischemia, heart failure, or arrhythmias. The natural history and prognosis remain unknown, as definitive data are scarce. Controversies persist regarding the use of medical management (antithrombotic therapy) or interventional/surgical procedures. Only some case reports or small case series are available about this condition. The Coronary Artery Aneurysm Registry (CAAR; http://www.ClinicalTrials.gov NCT02563626) is a multicenter international ambispective registry that aims to provide insights on anatomic, epidemiologic, and clinical aspects of this substantially unknown entity. In addition, the registry will assess management strategies (conservative, interventional, or surgical) and their short- and long-term results in a large cohort of patients. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov. Unique identifier: NCT02563626.
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Affiliation(s)
- Iván J Núñez-Gil
- Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain
| | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain
| | - Rodrigo Bagur
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, and Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Mario Bollati
- Department of Interventional Cardiology, SS Annanziata Hospital, Savigliano, Italy
| | - Enrico Cerrato
- Interventional Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi HOspital, Rivoli (Turin), Italy
| | - Emilio Alfonso
- Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba
| | - Christoph Liebetrau
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Rhein-Main, Frankfurt am Main, Germany
| | | | - Benjamín Camacho
- Department of Interventional Cardiology, Hospital Arnau de Vilanova, Lérida, Spain
| | - Rafael Mila
- Department of Cardiology, Hospital de Clínicas Dr. Manuel Quintela, Montevideo, Uruguay
| | - Ignacio J Amat-Santos
- Department of Interventional Cardiology, Hospital Clínico Universitario de Valladolid, Spain
| | - Fernando Alfonso
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | | | - Íñigo Lozano
- Department of Interventional Cardiology, Hospital de Cabueñes, Gijon, Spain
| | | | - Davide Piraino
- UO di Cardiologia Interventistica ed Hemodinámica, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone,", Palermo, Italy
| | | | - Gisela Feltes
- Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain
| | | | - Massimo Mancone
- Department of Interventional Cardiology, Hospital La Sapienza, Rome, Italy
| | | | | | | | - Fabrizio Ugo
- Department of Interventional Cardiology, Hospital San Giovanni Bosco, Turin, Italy
| | | | - Pierluigi Omedè
- Department of Cardiology, Città della Salute e della Scienza I, Turin, Italy
| | - Marco Pavani
- Department of Cardiology, Città della Salute e della Scienza II, Turin, Italy
| | - Pedro A Villablanca
- Department of Interventional Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York City, New York
| | - Boshra F Louka
- Division of Cardiovascular Diseases, Mayo Clinic, Phoenix, Arizona
| | - Antonio Fernández-Ortiz
- Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain
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