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Gómez-Monterrosas O, Scalone G, Prat S, Sabaté M, Martín-Yuste V. Evaluaci�n funcional de lesiones intermedias en arterias donantes de colaterales en oclusiones totales cr�nicas. RECIC 2021. [DOI: 10.24875/recic.m19000079] [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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Flores-Umanzor E, Cepas-Guillen P, Álvarez-Contreras L, Caldentey G, Castrillo-Golvano L, Fernandez-Valledor A, Salazar-Rodriguez A, Arévalos V, Gabani R, Regueiro A, Brugaletta S, Roqué M, Freixa X, Martín-Yuste V, Sabaté M. Impact of chronic kidney disease in chronic total occlusion management and clinical outcomes. Cardiovasc Revasc Med 2021; 38:75-80. [PMID: 34334336 DOI: 10.1016/j.carrev.2021.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/17/2021] [Revised: 06/25/2021] [Accepted: 07/19/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Data on the impact of chronic kidney disease (CKD) on clinical outcomes in chronic total occlusion (CTO) patients is scarce, and the optimal treatment strategy for this population is not well established. This study aims to compare differences in CTO management and long-term clinical outcomes, including all-cause and cardiac mortalities, according to baseline glomerular filtration rate (GFR). METHODS All patients with at least one CTO diagnosed in our center between 2010 and 2014 were included. Demographic and clinical data were registered. All-cause and cardiac mortalities were assessed during a median follow-up of 4.03 years (IQR 2.6-4.8). Clinical outcomes were compared between patients with CKD (GFR < 60 mL/min/1.73 m2) and without CKD (GFR ≥ 60 mL/min/1.73 m2). RESULTS A total of 1248 patients (67.3 ± 10.9 years; 32% CKD) were identified. CKD patients were older and had a higher prevalence of hypertension, type 2 diabetes, peripheral arterial disease, and severe left ventricular dysfunction compared to patients with normal renal function (p < 0.05). Subjects with renal dysfunction were more often treated with MT alone, compared to patients without CKD (63% vs 45%; p < 0.001), who were more likely to undergo PCI or surgery. During follow-up, 386 patients [31%] died. CKD patients had a higher rate of all-cause and cardiac mortalities compared to patients without CKD (p < 0.001). The independent predictors for all-cause mortality were age, GFR < 60 mL/min/1.73 m2, Syntax Score I, and successful revascularization of the CTO (CABG or PCI-CTO). Among patients with CKD, advanced age, eGFR <30 mL/min/1.73 m2, and CTO successful revascularization were predictors of all-cause mortality. CONCLUSIONS Patients with CKD were more often treated with MT alone. At long-term follow-up, revascularization of the CTO is associated with lower all-cause and cardiac mortalities in this population.
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Affiliation(s)
- Eduardo Flores-Umanzor
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Pedro Cepas-Guillen
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Luis Álvarez-Contreras
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain; ABC Medical Center, Mexico City, Mexico
| | | | | | | | | | - Victor Arévalos
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Rami Gabani
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Ander Regueiro
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Salvatore Brugaletta
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Mercè Roqué
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Xavier Freixa
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Victoria Martín-Yuste
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain; Service de Cardiologie, Centre Hospitalier de Saintonge, Saintes, France
| | - Manel Sabaté
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain; CIBER CV CB16/11/00411, Spain.
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Álvarez-Contreras L, Flores-Umanzor E, Cepas-Guillen P, Ferreira-González I, Freixa X, Regueiro A, Brugaletta S, Sabaté M, Martín-Yuste V. Clinical Impact of Medical Therapy Versus Revascularization in Patients With Chronic Coronary Total Occlusions. J Invasive Cardiol 2021; 33:E2-E8. [PMID: 33385980] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Chronic total occlusions (CTOs) are prevalent angiographic findings in patients with suspected coronary artery disease. Conflicting results of randomized controlled trials and registries have not clarified the therapeutic approach for patients with CTO in clinical practice. Therefore, we sought to analyze variables influencing the decision-making process and their relationship with clinical outcomes according to the type of selected therapy. METHODS A total of 1248 consecutive patients with at least 1 CTO were identified between 2010 and 2014 at our institution. Clinical and angiographic variables were collected to allow the calculation of several predictive scores. Primary outcome was all-cause death at the longest follow-up available. Other endpoints of interest included cardiac mortality and myocardial infarction. Medical therapy (MT) alone was indicated in 719 patients (58%), whereas percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) were used in 240 (19%) and 298 (24%), respectively. Age, acute myocardial infarction, previous CABG, and age, creatinine, ejection fraction (ACEF) score were independently associated with the decision for MT alone. Conversely, the presence of multivessel disease, left main coronary artery involvement, and high SYNTAX score favored the decision for CABG. At a median follow-up of 4.3 years, revascularization strategies were independently associated with all-cause mortality and cardiac mortality (hazard ratio [HR], 0.42; 95% confidence interval [CI] 0.27-0.65; P<.001 and HR, 0.32; 95% CI, 0.17-0.60; P<.001, respectively) for PCI and (HR, 0.39; 95% CI, 0.26-0.58 and HR, 0.51; 95% CI, 0.32-0.81; P<.01, respectively) for CABG. CONCLUSION Several clinical and angiographic parameters influence the decision-making process of patients with CTO. CTO revascularization with either PCI or CABG appeared to be associated with improved clinical outcomes at long-term follow-up as compared with MT alone.
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Affiliation(s)
| | | | | | | | | | | | | | - Manel Sabaté
- Hospital Clínic; C/Villarroel, 170, Cardiology Department, 08036 Barcelona, Spain.
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Nombela-Franco L, Rodés-Cabau J, Cruz-Gonzalez I, Freixa X, Asmarats L, Gutiérrez H, Sahay S, Rodriguez-Gabella T, Moreno-Samos JC, Tirado-Conte G, Goncalves-Ramirez LR, Rama-Merchan JC, Amat-Santos IJ, O'Hara G, Martín-Yuste V, Bethencourt A, Jimenez-Quevedo P, Macaya C. Incidence, Predictors, and Prognostic Value of Acute Kidney Injury Among Patients Undergoing Left Atrial Appendage Closure. JACC Cardiovasc Interv 2019; 11:1074-1083. [PMID: 29880102 DOI: 10.1016/j.jcin.2018.03.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 09/11/2017] [Revised: 03/05/2018] [Accepted: 03/13/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aims of this registry were to determine the incidence, predictors, and prognostic value of periprocedural acute kidney injury (AKI) after left atrial appendage closure (LAAC). BACKGROUND No data exist on the occurrence of AKI after LAAC. METHODS A total of 355 patients undergoing LAAC were included in the study. AKI was defined as an absolute or a relative increase in serum creatinine of >0.3 mg/dl or ≥50%, respectively, after the procedure or the need for hemodialysis during index hospitalization. RESULTS The incidence of AKI was 9%, and patients with worse baseline renal function were at higher risk for developing AKI (odds ratio: 1.32; 95% confidence interval [CI]: 1.09 to 1.61; p = 0.004 for each 10 ml/min decrease in glomerular filtration rate). In-hospital bleeding events occurred more frequently in the AKI group (5.3% vs. 15.6%; p = 0.037). After a median follow-up period of 18 months, patients in the AKI group had higher mortality (hazard ratio [HR]: 2.59; 95% CI: 1.36 to 4.92; p = 0.004), more embolic events (HR: 6.14; 95% CI: 2.23 to 16.92; p = 0.001) and major bleeding events (HR: 2.36; 95% CI: 0.89 to 6.24; p = 0.083). The occurrence of AKI was an independent predictor of midterm mortality (HR: 2.00; 95% CI: 1.02 to 3.91; p = 0.044). CONCLUSIONS The occurrence of AKI was relatively frequent following LAAC, and patients with lower renal glomerular filtration rates were at high risk for developing this complication. AKI identified a group of patients with worse midterm outcomes, highlighting the importance of further preventive strategies in this population.
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Affiliation(s)
- Luis Nombela-Franco
- Instituto Cardiovascular, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.
| | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Ignacio Cruz-Gonzalez
- Cardiology Department, University Hospital of Salamanca, Biomedical Research Institute of Salamanca, CIBER-CV, Salamanca, Spain
| | - Xavier Freixa
- Department of Cardiology, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Luis Asmarats
- Hospital Universitari Son Espases, Palma, Balearic Islands, Spain
| | - Hipólito Gutiérrez
- Institute of Heart Sciences, Hospital Clínico Universitario of Valladolid, Valladolid, Spain
| | - Shweta Sahay
- Instituto Cardiovascular, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | | | - Jose Carlos Moreno-Samos
- Cardiology Department, University Hospital of Salamanca, Biomedical Research Institute of Salamanca, CIBER-CV, Salamanca, Spain
| | | | | | - Juan Carlos Rama-Merchan
- Cardiology Department, University Hospital of Salamanca, Biomedical Research Institute of Salamanca, CIBER-CV, Salamanca, Spain
| | - Ignacio J Amat-Santos
- Institute of Heart Sciences, Hospital Clínico Universitario of Valladolid, Valladolid, Spain
| | - Gilles O'Hara
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Victoria Martín-Yuste
- Department of Cardiology, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | | | | | - Carlos Macaya
- Instituto Cardiovascular, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
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López-Mínguez JR, Nogales-Asensio JM, Infante De Oliveira E, De Gama Ribeiro V, Ruiz-Salmerón R, Arzamendi-Aizpurua D, Costa M, Gutiérrez-García H, Fernández-Díaz JA, Martín-Yuste V, Rama-Merchán JC, Moreno-Gómez R, Benedicto-Buendía A, Íñiguez-Romo A. Reducción de eventos a largo plazo tras el cierre de la orejuela izquierda. Resultados del Registro Ibérico II. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2018.03.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hernández-Enríquez M, Regueiro A, Romaguera R, Andrea R, Gómez-Hospital JA, Pujol-López M, Ferreiro-Gutiérrez JL, Brugaletta S, Roura G, Freixa X, Gómez-Lara J, Martín-Yuste V, Gracida M, Cequier Á, Sabaté M. Thrombocytopenia after transcatheter aortic valve implantation. A comparison between balloon-expandable and self-expanding valves. Catheter Cardiovasc Interv 2018; 93:1344-1351. [PMID: 30244545 DOI: 10.1002/ccd.27907] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 03/01/2018] [Revised: 08/07/2018] [Accepted: 08/29/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Thrombocytopenia after transcatheter aortic valve implantation (TAVI) is common and has been related to higher mortality and major complications. No comparison between balloon-expandable (BEV) and self-expanding valves (SEV) regarding drop platelet count (DPC) has been reported to date. The objectives of this study were to analyze the differences in DPC between BEVs or SEVs and their prognostic implications in clinical outcomes. METHODS We retrospectively analyzed patients undergoing TAVI. Platelet counts after TAVI were collected. Two groups were created: DPC ≤ 30% and DPC > 30%. VARC-2 criteria were used to define outcomes. RESULTS Study population was composed of 195 patients (age 77.5 ± 6.7, 57.4% males). All of them but one experienced DPC (mean DPC 31.9 ± 15.3%). DPC was significantly higher among the patients treated with BEV compared to those treated with SEV (36.3 ± 15.1% vs 27.7 ± 14.4, P < 0.001). After multivariate analysis, the use of BEV was independently associated with a higher rate of DPC > 30% (67.4% vs 36.0%; OR 3.4; 95% CI, 1.42-8.16). At 30 days, the DPC > 30% was associated with a higher rate of life-threatening/major bleeding, major vascular complications, in-hospital sepsis and mortality. At one year, there were no statistically significant differences in the mortality rate between groups (6.35% vs 10.0%, HR 1.54; 95% CI, 0.56-4.25). CONCLUSIONS In this study, the use of BEV was associated with a higher risk of DPC after TAVI. A DPC rate > 30% was associated with an increased risk of major complications at 30 days.
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Affiliation(s)
- Marco Hernández-Enríquez
- Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ander Regueiro
- Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rafael Romaguera
- Cardiology Department, Hospital Universitari Bellvitge, Barcelona, Spain
| | - Rut Andrea
- Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Margarida Pujol-López
- Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Salvatore Brugaletta
- Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Gerard Roura
- Cardiology Department, Hospital Universitari Bellvitge, Barcelona, Spain
| | - Xavier Freixa
- Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Josep Gómez-Lara
- Cardiology Department, Hospital Universitari Bellvitge, Barcelona, Spain
| | - Victoria Martín-Yuste
- Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Montserrat Gracida
- Cardiology Department, Hospital Universitari Bellvitge, Barcelona, Spain
| | - Ángel Cequier
- Cardiology Department, Hospital Universitari Bellvitge, Barcelona, Spain
| | - Manel Sabaté
- Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Cruz-González I, Freixa X, Fernández-Díaz JA, Moreno-Samos JC, Martín-Yuste V, Goicolea J. Cierre de orejuela con dispositivo LAmbre: experiencia inicial. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.02.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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López-Mínguez JR, Nogales-Asensio JM, Infante De Oliveira E, De Gama Ribeiro V, Ruiz-Salmerón R, Arzamendi-Aizpurua D, Costa M, Gutiérrez-García H, Fernández-Díaz JA, Martín-Yuste V, Rama-Merchán JC, Moreno-Gómez R, Benedicto-Buendía A, Íñiguez-Romo A. Long-term Event Reduction After Left Atrial Appendage Closure. Results of the Iberian Registry II. ACTA ACUST UNITED AC 2018; 72:449-455. [PMID: 29754808 DOI: 10.1016/j.rec.2018.03.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/19/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES Many patients with nonvalvular atrial fibrillation are still left without protection due to a contraindication for anticoagulants. This study aimed to establish the occurrence of stroke and major bleeding events in patients with nonvalvular atrial fibrillation and left atrial appendage closure with long-term follow-up and to explore the factors associated with higher long-term mortality. METHODS Analysis of a multicenter single cohort prospectively recruited from 2009 to 2015. Thromboembolic and bleeding events were compared with those expected from CHA2DS2-VASc and HAS-BLED scores. Multivariate analysis examined variables associated with mortality during follow-up. RESULTS A total of 598 patients (1093 patient-years) with a contraindication for anticoagulants were recruited (median 75.4 years). The success rate of left atrial appendage closure device implantation was 95.8%. Thirty patients (5%) experienced periprocedural complications. The rate of events (per 100 patient-years) during follow-up (mean 22.9 months; median 16.1 months) was as follows: death 7.0%; ischemic stroke 1.6% (vs 8.5% expected according to CHA2DS2-VASc; P < .001); intracranial hemorrhage 0.8%; gastrointestinal bleeding 3.2%; severe bleeding 3.9% (vs 6.3% expected by HAS-BLED, P = .002). These results were improved in the subgroup of 176 patients with follow-up > 24 months (mean follow-up 46.6 months, 683 patient-years) for severe bleeding 2.6% (vs 6.3% expected by HAS-BLED, P < .033). The factors significantly associated with higher mortality were age (HR, 1.1), intracranial hemorrhage (HR, 6.8), and stroke during follow-up (HR, 2.7). CONCLUSIONS Left atrial appendage closure significantly reduced the incidence of stroke and bleeding events and the benefit was maintained. Intracranial hemorrhage, age and stroke were associated with higher mortality.
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Affiliation(s)
| | | | | | | | | | | | - Marco Costa
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Regueiro A, Fernández-Rodríguez D, Freixa X, Bosch X, Martín-Yuste V, Brugaletta S, Roqué M, Sabaté M, Masotti M. Falsos positivos en la activación por IAMCEST en una red regional: análisis integral e impacto clínico. Resultados del registro Codi Infart de Cataluña. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.05.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Regueiro A, Fernández-Rodríguez D, Freixa X, Bosch X, Martín-Yuste V, Brugaletta S, Roqué M, Sabaté M, Masotti M. False Positive STEMI Activations in a Regional Network: Comprehensive Analysis and Clinical Impact. Results From the Catalonian Codi Infart Network. ACTA ACUST UNITED AC 2017; 71:243-249. [PMID: 28711360 DOI: 10.1016/j.rec.2017.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 11/08/2016] [Accepted: 05/24/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES ST-segment elevation myocardial infarction (STEMI) network activation by a noncardiologist reduces delay times but may increase the rate of false-positive STEMI diagnoses. We aimed to determine the prevalence, predictors, and clinical impact of false-positive activations within the Catalonian STEMI network (Codi Infart). METHODS From January 2010 through December 2011, all consecutive patients treated within the Codi Infart network were included. Code activations were classified as appropriate if they satisfied both electrocardiogram and clinical STEMI criteria. Appropriate activations were classified as false positives using 2 nonexclusive definitions: a) "angiographic" if a culprit coronary artery was not identified, and b) "clinical" if the discharge diagnosis was other than STEMI. RESULTS In total, 5701 activations were included. Appropriate activation was performed in 87.8% of the episodes. The rate of angiographic false positives was 14.6%, while the rate of clinical false positives was 11.6%. Irrespective of the definition, female sex, left bundle branch block, and previous myocardial infarction were independent predictors of false-positive STEMI diagnoses. Using the clinical definition, hospitals without percutaneous coronary intervention and patients with complications during the first medical contact also had a false-positive STEMI diagnoses rate higher than the mean. In-hospital and 30-day mortality rates were similar for false-positive and true-positive STEMI patients after adjustment for possible confounders. CONCLUSIONS False-positive STEMI diagnoses were frequent. Outcomes were similar for patients with a true-positive or false-positive STEMI diagnosis treated within a STEMI network. The presence of any modifiable predictors of a false-positive STEMI diagnosis warrants careful assessment to optimize the use of STEMI networks.
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Affiliation(s)
- Ander Regueiro
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Bosch
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Victoria Martín-Yuste
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Salvatore Brugaletta
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Mercè Roqué
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Mónica Masotti
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
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Cruz-González I, Freixa X, Fernández-Díaz JA, Moreno-Samos JC, Martín-Yuste V, Goicolea J. Left Atrial Appendage Occlusion With the LAmbre Device: Initial Experience. ACTA ACUST UNITED AC 2017; 71:755-756. [PMID: 28522304 DOI: 10.1016/j.rec.2017.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 02/27/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Ignacio Cruz-González
- Servicio de Cardiología, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain.
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic, Barcelona, Spain
| | | | | | | | - Javier Goicolea
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
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Flores Umanzor EJ, Vannini L, San Antonio R, Sanchez Somonte P, Martín-Yuste V. Wellens' syndrome. Intern Emerg Med 2017; 12:267-268. [PMID: 27277473 DOI: 10.1007/s11739-016-1483-x] [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: 05/20/2016] [Accepted: 06/01/2016] [Indexed: 10/21/2022]
Affiliation(s)
| | - Luca Vannini
- Cardiology Department, Hospital Clínic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain
| | - Rodolfo San Antonio
- Cardiology Department, Hospital Clínic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain
| | - Paula Sanchez Somonte
- Cardiology Department, Hospital Clínic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain
| | - Victoria Martín-Yuste
- Cardiology Department, Hospital Clínic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain
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Fernández-Rodríguez D, Regueiro A, Cevallos J, Bosch X, Freixa X, Trilla M, Brugaletta S, Martín-Yuste V, Sabaté M, Bosa-Ojeda F, Masotti M. Brecha de género en los cuidados médicos en las redes de atención al infarto agudo de miocardio con elevación del segmento ST: hallazgos de la red catalana Codi Infart. Med Intensiva 2017; 41:70-77. [DOI: 10.1016/j.medin.2016.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 05/25/2016] [Accepted: 06/16/2016] [Indexed: 01/30/2023]
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Flores-Umanzor EJ, Hernández-Enríquez M, Jimenez-Britez G, Martín-Yuste V. Successful percutaneous coronary intervention of total chronic occlusion of the left main coronary artery: A feasible option? Int J Cardiol 2016; 229:19-20. [PMID: 27876542 DOI: 10.1016/j.ijcard.2016.11.227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/06/2016] [Accepted: 11/07/2016] [Indexed: 11/26/2022]
Affiliation(s)
| | - Marco Hernández-Enríquez
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Spain
| | - Gustavo Jimenez-Britez
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Spain
| | - Victoria Martín-Yuste
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Spain
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15
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Ishida K, Otsuki S, Giacchi G, Ortega-Paz L, Shiratori Y, Freixa X, Martín-Yuste V, Masotti M, Sabaté M, Brugaletta S. Serial optical coherence tomography assessment of malapposed struts after everolimus-eluting stent implantation. A subanalysis from the HEAL-EES study. Cardiovasc Revasc Med 2016; 18:47-52. [PMID: 27634493 DOI: 10.1016/j.carrev.2016.08.010] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 08/31/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Incomplete stent apposition (ISA) is related to stent thrombosis, which is a serious adverse event. We aim to assess the time-course of ISA after 2nd generation everolimus-eluting stent (EES) implantation. METHODS In HEAL-EES study, we enrolled 36 patients who underwent percutaneous coronary intervention (PCI) with EES. OCT imaging was performed at baseline and follow-up. Patients were randomized 1:1:1 into 3 groups according to the time in which follow-up was performed: group A (6-month), group B (9-month), and group C (12-month). In this subanalysis, patients who had ISA segments at baseline and/or follow-up OCT were analyzed. RESULT At baseline, among 41 lesions in 36 patients, 20 lesions in 18 patients had ISA segments and were analyzed. At baseline, there were 3.0% ISA struts in group A (n=8), 2.8% in group B (n=4), and 4.5% in group C (n=8). At follow-up, ISA struts were present in 0.09%, 0.16% and 0.64%; respectively in groups A, B, and C. At follow-up, there was a significant decrease in the frequency of ISA: group A 3.0% vs. 0.09% (p<0.001), group B 2.8% vs. 0.16% (p<0.001), and group C 4.5% vs. 0.64% (p<0.001). In group A, there was one late acquired ISA at follow-up. CONCLUSIONS In patients undergoing 2nd generation EES implantation, area of acute ISA assessed by OCT, was almost resolved at 6-month follow-up.
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Affiliation(s)
- Kohki Ishida
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Shuji Otsuki
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Giuseppe Giacchi
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Luis Ortega-Paz
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Xavier Freixa
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Victoria Martín-Yuste
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Mónica Masotti
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Manel Sabaté
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Salvatore Brugaletta
- Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
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16
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Regueiro A, Bosch J, Martín-Yuste V, Rosas A, Faixedas MT, Gómez-Hospital JA, Figueras J, Curós A, Cequier A, Goicolea J, Fernández-Ortiz A, Macaya C, Tresserras R, Pellisé L, Sabaté M. Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network. BMJ Open 2015; 5:e009148. [PMID: 26656019 PMCID: PMC4679883 DOI: 10.1136/bmjopen-2015-009148] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate the cost-effectiveness of the ST-segment elevation myocardial infarction (STEMI) network of Catalonia (Codi Infart). DESIGN Cost-utility analysis. SETTING The analysis was from the Catalonian Autonomous Community in Spain, with a population of about 7.5 million people. PARTICIPANTS Patients with STEMI treated within the autonomous community of Catalonia (Spain) included in the IAM CAT II-IV and Codi Infart registries. OUTCOME MEASURES Costs included hospitalisation, procedures and additional personnel and were obtained according to the reperfusion strategy. Clinical outcomes were defined as 30-day avoided mortality and quality-adjusted life-years (QALYs), before (N=356) and after network implementation (N=2140). RESULTS A substitution effect and a technology effect were observed; aggregate costs increased by 2.6%. The substitution effect resulted from increased use of primary coronary angioplasty, a relatively expensive procedure and a decrease in fibrinolysis. Primary coronary angioplasty increased from 31% to 89% with the network, and fibrinolysis decreased from 37% to 3%. Rescue coronary angioplasty declined from 11% to 4%, and no reperfusion from 21% to 4%. The technological effect was related to improvements in the percutaneous coronary intervention procedure that increased efficiency, reducing the average length of the hospital stay. Mean costs per patient decreased from €8306 to €7874 for patients with primary coronary angioplasty. Clinical outcomes in patients treated with primary coronary angioplasty did not change significantly, although 30-day mortality decreased from 7.5% to 5.6%. The incremental cost-effectiveness ratio resulted in an extra cost of €4355 per life saved (30-day mortality) and €495 per QALY. Below a cost threshold of €30,000, results were sensitive to variations in costs and outcomes. CONCLUSIONS The Catalan STEMI network (Codi Infart) is cost-efficient. Further studies are needed in geopolitical different scenarios.
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Affiliation(s)
- Ander Regueiro
- Servicio de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Iniciativa Stent for Life, Spain
| | - Julia Bosch
- Centro de Investigación en Economía y Salud, Universidad Pompeu Fabra, Barcelona, Spain
| | - Victoria Martín-Yuste
- Servicio de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Alba Rosas
- Departament de Salut, Generalitat de Catalunya, Catalonia, Spain
| | | | | | - Jaume Figueras
- Servicio de Cardiología, Hospital Vall d´Hebron, Barcelona, Spain
| | - Antoni Curós
- Servicio de Cardiología, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - Angel Cequier
- Servicio de Cardiología, Hospital Universitari Bellvitge, Barcelona, Spain
| | | | | | | | | | - Laura Pellisé
- Centro de Investigación en Economía y Salud, Universidad Pompeu Fabra, Barcelona, Spain
| | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Iniciativa Stent for Life, Spain
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17
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Regueiro A, Fernández-Rodríguez D, Brugaletta S, Martín-Yuste V, Masotti M, Freixa X, Cequier Á, Íñiguez A, Serruys PW, Sabaté M. Influencia del sexo en los resultados clínicos de los stents liberadores de everolimus en comparación con los stents metálicos sin recubrimiento en el infarto agudo de miocardio con elevación del segmento ST. Perspectivas del ensayo EXAMINATION. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.04.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Freixa X, Scalone G, Martín-Yuste V, Vidal B. Large protruding thrombus over left atrial appendage occlusion device successfully treated with apixaban. Eur Heart J 2015; 36:1427. [DOI: 10.1093/eurheartj/ehv081] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fernández-Rodríguez D, Freixa X, Kasa G, Regueiro A, Cevallos J, Hernández M, Brugaletta S, Martín-Yuste V, Sabaté M, Masotti M. [Benefit of the implementation of a ST-segment elevation myocardial infarction network on women]. Arch Cardiol Mex 2015; 85:96-104. [PMID: 25736036 DOI: 10.1016/j.acmx.2014.12.010] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 12/12/2014] [Accepted: 12/22/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The ST-segment elevation myocardial infarction network "Codi Infart" was implemented in Catalonia (Spain) in June 2009. The objective of this study was to evaluate the impact of the implementation of the Codi Infart on women. METHOD Women referred for primary percutaneous coronary intervention, were divided into two groups according to Codi Infart: Non-Codi Infart group (January 2003 to May 2009) and Codi Infart group (June 2009 to December 2012). Place of first medical contact, time intervals in diagnosis and treatment, treatments received and rate of major cardiovascular adverse events defined as all-cause death, reinfarction or stroke in-hospital, at 30 and 180 days were compared. RESULTS From a total population of 2,426 patients, 501 (20.7%) were women. One-hundred eighty-six women (2.09 cases/month) belonged to Non-Codi Infart group and 315 women (10.16 cases/month) to Codi Infart group. The percentage of women attended increased since the introduction of CI (22.2% vs. 18.5%, P=.028). In addition, the Codi Infart group had a higher percentage of women initially attended outside our institution (84.1% vs. 16.7%, P<.001), and lower total ischemia time (220 [155-380] vs. 272 [196-456], P=.003). However, no differences in 180-day major cardiovascular adverse events were detected (14.2% vs. 15.6%, P=.692). CONCLUSIONS The implementation of the major cardiovascular adverse events allowed to increase the rate and the percentage of women with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention and reducing total ischemic time.
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Affiliation(s)
- Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Clínic, Barcelona, España; Servicio de Cardiología, Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic, Barcelona, España.
| | - Gizem Kasa
- Servicio de Cardiología, Hospital Clínic, Barcelona, España
| | - Ander Regueiro
- Servicio de Cardiología, Hospital Clínic, Barcelona, España; Comité Directivo, Iniciativa Stent for Life, España
| | | | | | | | | | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic, Barcelona, España; Comité Directivo, Iniciativa Stent for Life, España
| | - Mónica Masotti
- Servicio de Cardiología, Hospital Clínic, Barcelona, España
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Subinas A, Sádaba M, Rumoroso JR, Martín-Yuste V, Hernández F, Pan M, Teruel L, Moreu J, De La Torre JM, Vinhas H, Lozano I, Goicolea J, De Prado AP, Moreiras JM, Cascón JD, Súarez A, Cubero JM. CRT-144 Percutaneous Intervention in Chronic Total Coronary Occlusions Due To In-stent Restenosis: A Multicenter Registry. JACC Cardiovasc Interv 2015. [DOI: 10.1016/j.jcin.2014.12.080] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Regueiro A, Freixa X, Fernández-Rodríguez D, Diaz-Ricart M, Escolar G, Martín-Yuste V, Brugaletta S, Sabaté M, Masotti M. Platelet reactivity assessment with VerifyNow®: substitute or complement for light transmission aggregometry? Int J Cardiol 2015; 178:221-2. [PMID: 25464258 DOI: 10.1016/j.ijcard.2014.10.051] [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: 10/17/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Ander Regueiro
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Xavier Freixa
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona.
| | | | - Maribel Diaz-Ricart
- Hemotherapy and Hemostasis Department, Biomedical Diagnostic Center, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Ginés Escolar
- Hemotherapy and Hemostasis Department, Biomedical Diagnostic Center, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Victoria Martín-Yuste
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Salvatore Brugaletta
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Manel Sabaté
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Mónica Masotti
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
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22
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Regueiro A, Fernández-Rodríguez D, Brugaletta S, Martín-Yuste V, Masotti M, Freixa X, Cequier Á, Íñiguez A, Serruys PW, Sabaté M. Sex-related Impact on Clinical Outcome of Everolimus-eluting Versus Bare-metal Stents in ST-segment Myocardial Infarction. Insights From the EXAMINATION Trial. ACTA ACUST UNITED AC 2014; 68:382-9. [PMID: 25444377 DOI: 10.1016/j.rec.2014.09.001] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 04/11/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES The use of second-generation drug-eluting stents compared with bare-metal stents in patients with ST-segment elevation myocardial infarction reduces the rate of major adverse cardiac events. We aimed to evaluate the impact of sex on the performance of everolimus-eluting stents vs bare-metal stents in ST-segment elevation myocardial infarction at 2-year follow-up. METHODS This is a sub-study of the EXAMINATION trial that randomized 1498 patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention to everolimus-eluting or bare-metal stents. Primary end point was combined all-cause death, any recurrent myocardial infarction, and any revascularization. All end points were analyzed according to sex at 2-year follow-up. RESULTS Of 1498 patients included in the trial, 254 (17.0%) were women. Women were older and had higher prevalence of hypertension and lower prevalence of smoking compared with men. In contrast with men, stent diameter was smaller in women. After multivariate analysis, the primary end point was similar between women and men (hazard ratio=0.95; 95% confidence interval, 0.66-1.37), and among women, between those treated with bare-metal vs everolimus-eluting stents (hazard ratio=2.48; 95% confidence interval, 0.95-6.46). Women showed a lower rate of repeat revascularization than men (hazard ratio=0.55; 95% confidence interval, 0.32-0.95) despite worse baseline characteristics. This difference was driven by better performance of the everolimus-eluting stent in women. CONCLUSIONS Despite poorer baseline clinical characteristics, women with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention showed outcomes similar to men. The use of everolimus-eluting stents may represent an added value in women as it showed a reduced rate of repeated revascularization compared to men.
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Affiliation(s)
- Ander Regueiro
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | | | | | | | - Monica Masotti
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Ángel Cequier
- Área de Enfermedades del Corazón, Hospital Universitario de Bellvitge, IDIBELL, Barcelona, Spain
| | - Andrés Íñiguez
- Servicio de Cardiología, Complejo Hospitalario Universitario de Vigo, Pontevedra, Spain
| | - Patrick W Serruys
- Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Barcelona, Spain.
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Scalone G, Brugaletta S, Martín-Yuste V, Seixo F, Cotes C, Gómez-Monterrosas O, Alvarez-Contreras L, Campreciós M, Mirabet S, Brossa V, Sabaté M. RAndomized Comparison of raDIal vs. femorAL Access for Routine Catheterization of Heart Transplant Patients (RADIAL – Heart Transplant Study). Transplant Proc 2014; 46:3262-7. [DOI: 10.1016/j.transproceed.2014.09.147] [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] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/08/2014] [Accepted: 09/23/2014] [Indexed: 02/02/2023]
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Shiratori Y, Cola C, Brugaletta S, Alvarez-Contreras L, Martín-Yuste V, del Blanco BG, Ruiz-Salmeron R, Díaz J, Pinar E, Martí V, García-Picart J, Sabaté M. Randomized Comparison Between Polymer-Free Versus Polymer-Based Paclitaxel-Eluting Stent. Circ Cardiovasc Interv 2014; 7:312-21. [DOI: 10.1161/circinterventions.113.000800] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yoshitaka Shiratori
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Clarissa Cola
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Salvatore Brugaletta
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Luis Alvarez-Contreras
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Victoria Martín-Yuste
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Bruno García del Blanco
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Rafael Ruiz-Salmeron
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Jose Díaz
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Eduardo Pinar
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Vicens Martí
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Juan García-Picart
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
| | - Manel Sabaté
- From the Thorax Institute, Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (Y.S., S.B., M.S.); Cardiology Department, Interventional Cardiology Unit, Sant Pau Hospital, Barcelona, Spain (C.C., L.A.-C., V.M.-Y., V.M., J.G.-P.); Cardiology Department, Interventional Cardiology Unit, Vall d’Hebron Hospital, Barcelona, Spain (B.G.d.B.); Cardiology Department, Interventional Cardiology Unit, Virgen de Macarena
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25
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Fernández-Rodríguez D, Regueiro A, Brugaletta S, Martín-Yuste V, Masotti M, Cequier A, Iñíguez A, Serra A, Hernández-Antolín R, Mainar V, Valgimigli M, Tespili M, den Heijer P, Bethencourt A, Vázquez N, Serruys PW, Sabaté M. Optimization in Stent Implantation by Manual Thrombus Aspiration in ST-Segment–Elevation Myocardial Infarction. Circ Cardiovasc Interv 2014; 7:294-300. [DOI: 10.1161/circinterventions.113.000964] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Diego Fernández-Rodríguez
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Ander Regueiro
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Salvatore Brugaletta
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Victoria Martín-Yuste
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Mónica Masotti
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Angel Cequier
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Andrés Iñíguez
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Antonio Serra
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Rosana Hernández-Antolín
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Vicente Mainar
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Marco Valgimigli
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Maurizio Tespili
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Pieter den Heijer
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Armando Bethencourt
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Nicolás Vázquez
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Patrick W. Serruys
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
| | - Manel Sabaté
- From the Cardiology Department, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (D.F.-R., A.R., S.B., V.M.-Y., M.M., M.S.); Cardiology Department, University Hospital of Bellvitge, Barcelona, Spain (A.C.); Cardiology Department, Hospital do Meixoeiro, Vigo, Spain (A.I.); Cardiology Department, University Hospital of Sant Pau, Barcelona, Spain (A.S.); Cardiology Department, University Hospital San Carlos, Madrid, Spain (R.H.-A.)
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Fernández-Rodríguez D, Martín-Yuste V, Feu F, Brugaletta S, Freixa X, Regueiro A, Sabaté M. Can the vicious cycle of obscure or intractable gastrointestinal bleeding be broken in patients with atrial fibrillation subject to anticoagulant therapy? Rev Esp Enferm Dig 2014; 106:350-353. [PMID: 25287239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Gastrointestinal bleeding of obscure origin or with an intractable cause is particularly common in patients with atrial fibrillation subject to oral anticoagulant therapy. This condition is highly recurrent and therefore gives rise to high morbidity and mortality rates, thus entailing a vicious cycle that is difficult to solve.Percutaneous left atrial appendage closure has become a therapeutic alternative for patients with atrial fibrillation and a contraindication for oral anticoagulation. This technique would allow the discontinuation of oral anticoagulants, thus helping to reduce the risk for gastrointestinal bleeding, and would also be protective against embolic events in this group of patients, thereby eventually breaking this vicious cycle.We report our experience with percutaneous left atrial appendage closure in the management of patients with atrial fibrillation who are subject to oral anticoagulation therapy and suffer from obscure or intractable gastrointestinal bleeding.
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Freixa X, Martín-Yuste V. Percutaneous left atrial appendage occlusion. ACTA ACUST UNITED AC 2014; 66:919-22. [PMID: 24774102 DOI: 10.1016/j.rec.2013.06.005] [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] [Received: 05/18/2013] [Accepted: 06/03/2013] [Indexed: 11/24/2022]
Affiliation(s)
- Xavier Freixa
- Sección de Cardiología Intervencionista, Instituto del Tórax, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain.
| | - Victoria Martín-Yuste
- Sección de Cardiología Intervencionista, Instituto del Tórax, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain
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Regueiro A, Freixa X, Heras M, Penela D, Fernández-Rodríguez D, Brugaletta S, Martín-Yuste V, Masotti M, Sabaté M. Impact of therapeutic hypothermia on coronary flow. Int J Cardiol 2014; 172:228-9. [DOI: 10.1016/j.ijcard.2013.12.224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 12/29/2013] [Indexed: 10/25/2022]
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Fernández D, Cevallos J, Brugaletta S, Martín-Yuste V, Freixa X, Andrea R, Falces C, Regueiro-Cueva A, Masotti M, Sabaté M. Percutaneous transcatheter aortic valve implantation: present and future perspective. Expert Rev Med Devices 2014; 10:185-99. [DOI: 10.1586/erd.12.78] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Otsuki S, Shiratori Y, Brugaletta S, Cola C, García del Blanco B, Ruiz-Salmeron R, Díaz JF, Pinar E, Martí V, García-Picart J, Martín-Yuste V, Sabaté M. Edge Vascular Response After Polymer-Free vs. Polymer-Based Paclitaxel-Eluting Stent Implantation. Circ J 2014; 78:2657-64. [DOI: 10.1253/circj.cj-14-0345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shuji Otsuki
- Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona
| | - Yoshitaka Shiratori
- Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona
| | - Salvatore Brugaletta
- Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona
| | | | | | | | | | - Eduardo Pinar
- Department of Cardiology, Virgen de la Arrixaca Hospital
| | | | | | - Victoria Martín-Yuste
- Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona
| | - Manel Sabaté
- Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona
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Fernández D, Brugaletta S, Martín-Yuste V, Regueiro A, de Mingo A, Santos A, Masotti M, Sabaté M. First experience of a bioresorbable vascular scaffold implantation in left main stenosis. Int J Cardiol 2013; 168:1566-8. [DOI: 10.1016/j.ijcard.2012.12.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 11/19/2012] [Accepted: 12/25/2012] [Indexed: 10/27/2022]
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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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Martín-Yuste V, Barros A, Leta R, Ferreira I, Brugaletta S, Pujadas S, Carreras F, Pons G, Cinca J, Sabate M. Determinantes del éxito de la revascularización de las oclusiones coronarias crónicas: estudio mediante tomografía computarizada con multidetectores. Rev Esp Cardiol 2012; 65:334-40. [DOI: 10.1016/j.recesp.2011.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 11/02/2011] [Indexed: 11/26/2022]
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Martín-Yuste V, Barros A, Leta R, Ferreira I, Brugaletta S, Pujadas S, Carreras F, Pons G, Cinca J, Sabate M. Factors Determining Success in Percutaneous Revascularization of Chronic Total Coronary Occlusion: Multidetector Computed Tomography Analysis. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.rec.2011.11.008] [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: 10/28/2022]
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Regueiro A, Alvarez-Contreras L, Martín-Yuste V, Kasa G, Sabaté M. Right coronary artery dissection following blunt chest trauma. Eur Heart J Acute Cardiovasc Care 2012; 1:50-2. [PMID: 24062888 DOI: 10.1177/2048872612441583] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 02/14/2012] [Indexed: 11/15/2022]
Abstract
Chest trauma is a major health problem with a high mortality. Myocardial infarction secondary to coronary dissection following blunt chest trauma is a rare entity. We describe the case of an inferior MI following blunt chest trauma. A 61-year-old male without any relevant medical history was transported to a hospital after a low-velocity motorcycle accident. The patient was asymptomatic before the accident. The patient developed severe chest pain and an ECG revealed inferior ST segment elevation. After ruling out aortic dissection with angio-CT, a coronary angiograph depicted a proximal occlusion of the right coronary artery. After thrombectomy, a typical image of coronary artery dissection was observed; the image persisted after several runs of thrombectomy and for that reason a bare metal stent was implanted with a good final angiographic result. Five days after admission the patient was discharged home. Cardiac contusion is not uncommon; however acute myocardial infarction is a rare complication of blunt chest trauma. Thorough evaluation with clinical suspicion can lead to optimal medical care.
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Affiliation(s)
- Ander Regueiro
- Cardiology Department. Thorax Institute. Hospital Clinic. Barcelona, Spain
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Martín-Yuste V, Alvarez-Contreras L, Cola C, Brugaletta S, García Picart J, Martí V, Masotti M, Sabaté M. [Usefulness of the Tornus® catheter in nondilatable coronary chronic total occlusion]. Rev Esp Cardiol 2011; 64:935-8. [PMID: 21664754 DOI: 10.1016/j.recesp.2011.01.011] [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] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 01/14/2011] [Indexed: 11/24/2022]
Abstract
The treatment of coronary chronic total occlusions (CTO) remains a challenge for the interventional cardiologist. Failure of balloon angioplasty is the second more common cause of an unsuccessful procedure. We describe our experience with the use of the new Tornus® catheter (Asahi Intecc, Aichi, Japan) designed specifically for the treatment of "nondilatable" CTO. Between November 2008 and March 2010, 17 patients (age 62 years, 88% men, 82% dyslipidemia, 52% hypertension, 29% diabetes) were treated in whom balloon dilatation had failed after crossing the lesion with the guide. The use of Tornus® catheter was successful without complications in 15. All patients underwent clinical follow-up (median, 573 days) with no documented major adverse events. The use of the Tornus® catheter is safe and feasible in those patients with CTO lesions in whom balloon angioplasty has been unsuccessful.
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Affiliation(s)
- Victoria Martín-Yuste
- Sección de Hemodinámica, Servicio de Cardiología, Hospital Clínic, Universidad de Barcelona, Barcelona, España.
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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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