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Montes A, Pozo Osinalde E, Bastante T, Cecconi A, Garcia-Guimaraes M, Rivero F, De Rueda C, Rojas Gonzalez A, Olivera MJ, Salamanca J, De Agustin JA, Caballero P, Aguilar Torres R, Jimenez Borreguero LJ, Alfonso Manterola F. Intracoronary thrombus assessment with cardiac computed tomography angiography in a deferred stenting strategy. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background.
Cardiac computed tomography angiography (CCTA) is precise in non-invasive coronary atherosclerosis characterization but its value in the diagnosis of intracoronary thrombus remains unknown. Therefore, our aim was to evaluate the diagnostic accuracy of CCTA for intracoronary thrombus and stenosis detection in acute coronary syndromes (ACS) with high thrombus burden selected for a deferred stenting (DS) strategy.
Methods.
We systematically performed a CCTA in consecutive DS patients 24 hours before the scheduled repeated coronary angiography that also included optical coherence tomography (OCT) imaging. Intracoronary thrombus and residual stenosis were blindly and independently evaluated by both non-invasive and invasive diagnostic tests. Agreement was determined per lesion using weighted Kappa (K) coefficient and absolute intra-class correlation coefficient (ICC). A stratified analysis according to OCT-detected thrombus burden was also performed.
Results.
Thirty lesions in 28 consecutive patients with a large thrombus burden were analyzed. Concordance between CCTA and repeated coronary angiography in thrombus detection was good (K= 0.554; p< 0.001), but both showed a poor agreement with OCT. CCTA needed >11.5% thrombus burden on OCT to obtain adequate diagnostic accuracy. The lesions detected by angiography were more frequently classified as red thrombus (76.5 vs 33.3%; p= 0.087) on OCT. CCTA showed an excellent concordance with coronary angiography in diameter stenosis (ICC= 0.85; p< 0.001), and was able to identify all the patients with severe residual stenosis.
Conclusion.
CCTA is able to assess intracoronary thrombus. Although CCTA showed just a good concordance with angiography in thrombus detection, the agreement in residual stenosis was excellent. Thus, in patients with a high-thrombus burden CCTA may substitute repeat angiography in patients considered for DS. Abstract Figure.
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Salamanca J, Díez-Villanueva P, Rivero F, Sarraj A, Suarez-Sipmann F, Alfonso F. [Dispositivo de asistencia circulatoria Impella RP ® en shock poscardiotomía por fallo ventricular derecho]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:525-527. [PMID: 33270621 PMCID: PMC8641453 DOI: 10.24875/acm.20000408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Díez-Villanueva P, García-Guimaraes M, Sanz-Ruiz R, Roura G, Macaya F, Barahona Alvarado JC, Tizón-Marcos H, Flores-Ríos X, Masotti M, Lezcano-Pertejo C, Cortés C, Fuertes-Ferre G, Becerra-Muñoz VM, Lozano Ruiz-Poveda F, Valero E, Portero-Portaz JJ, Vera A, Salamanca J, Alfonso F. Spontaneous coronary artery dissection in old patients: clinical features, angiographic findings, management and outcome. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2021; 10:926-932. [PMID: 33620451 DOI: 10.1093/ehjacc/zuaa029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/20/2020] [Accepted: 10/29/2020] [Indexed: 06/12/2023]
Abstract
AIMS Spontaneous coronary artery dissection (SCAD) is a relatively rare but well-known cause of acute coronary syndrome. Clinical features, angiographic findings, management and outcomes of SCAD in old patients (>65 years of age) remain unknown. METHODS AND RESULTS The Spanish multicentre prospective SCAD registry (NCT03607981), included 318 consecutive patients with SCAD. Data were collected between June 2015 and April 2019. All angiograms were analysed in a centralized corelab. For the purposes of this study, patients were classified according to age in two groups <65 and ≥65 years old and in-hospital outcomes were analysed. Fifty-five patients (17%) were ≥65 years old (95% women). Older patients had more often hypertension (76% vs. 29%, P < 0.01) and dyslipidaemia (56% vs. 30%, P < 0.01), and less previous (4% vs. 18%, P < 0.001) or current smoking habit (4% vs. 33%, P < 0.001). An identifiable trigger was less often present in old patients (27% vs. 43%, P = 0.028). They also had more often severe coronary tortuosity (36% vs. 11%, P = 0.036) and showed more frequently coronary ectasia (24% vs. 9%, P < 0.01). Older patients were more often managed conservatively (89% vs. 75%, P = 0.025), with no significant differences in major adverse cardiac events during index admission (7% vs. 8%, P = 0.858). There were no differences between groups in terms of in-hospital stay, new acute myocardial infarction, unplanned coronary angiography or heart failure. CONCLUSION Older patients with SCAD show different clinical and angiographic characteristics compared with younger patients. Initial treatment strategy was different between groups, though in-hospital outcomes do not significantly differ (NCT03607981).
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Bastante T, García-Guimaraes M, Muñiz M, Cuesta J, Rivero F, Antuña P, De Rueda C, Hernández-Muñiz S, Aguilar R, Salamanca J, Pozo-Osinalde E, Jiménez-Borreguero J, Batlle M, Friera A, Alfonso F. <i class="fa fa-video-camera" aria-hidden="true"></i> Manejo contempor�neo de la disecci�n coronaria espont�nea. REC: INTERVENTIONAL CARDIOLOGY 2021. [DOI: 10.24875/recic.m20000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Alvarado T, Rivero F, Diego G, García-Guimaraes M, Salamanca J, Díez-Villanueva P, Cuesta J, Antuña P, Jiménez-Borreguero J, Alfonso F. Transcatheter aortic valve replacement using the new Evolut-Pro system: a prospective comparison with the Evolut-R device. J Thorac Dis 2021; 13:4023-4032. [PMID: 34422332 PMCID: PMC8339791 DOI: 10.21037/jtd-20-2409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 05/12/2021] [Indexed: 11/25/2022]
Abstract
Background Evolut Pro (EVP) is a novel self-expandable aortic valve. This prosthesis consists of an external porcine pericardial wrap designed to reduce paravalvular leak (PVL), maintaining the benefits of its predecessor, the Evolut R (EVR). The aim was to compare the functional and clinical results in the short and medium term of the new EVP with the EVR system. Methods Consecutive patients receiving either the EVR (n=50) or the EVP (n=33) from June 2015 to October 2018 were compared. Baseline characteristics, cardiovascular imaging, procedural outcomes, short and mid-term follow-up outcomes were prospectively collected and assessed. Results Residual mild PVL was common and comparable in the two groups (EVR 79% vs. EVP 70%; P=0.4). In the EVR group, the presence of PVL was directly related to prosthesis size, but this correlation was not observed in the EVP group. Conduction abnormalities were more prevalent with the EVP, but these did not translate into a higher need of permanent pacemaker implantation. Vascular and bleeding complications were infrequent in both groups. At mid-term clinical follow-up (median survival time: EVR 11±0.3 months, EVP 12±0.2 months), the 1-year rate of adverse events was similar (EVR: 24%, EVP: 33%; P=0.3). Conclusions Both protheses are effective for the treatment of severe aortic stenosis with excellent results at mid-term clinical follow up. The EVP remains associated with a significant rate of residual mild PVL that appears to be similar to that observed with EVR.
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de-la-Cuerda F, Díez-Villanueva P, Salamanca J, Acedo-Domínguez N, González E, Alfonso F. Multiple thrombosis with native coronary involvement secondary to heparin-induced thrombocytopenia. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 90:358-360. [PMID: 32952166 DOI: 10.24875/acm.20000246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Vera Sainz A, Cecconi A, Martinez-Vives P, Olivera MJ, Hernandez S, Tejelo J, Lopez Melgar B, Rojas Gonzalez A, Diez-Villanueva P, Salamanca J, Caballero P, Alfonso F, Jimenez-Borreguero LJ. usefulness of the electrocardiogram and cardiac magnetic resonance to differentiate tachycardia induced cardiomyopathy from dilated cardiomyopathy in patients admitted for heart failure. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
In patients admitted for heart failure (HF) with reduced left ventricular ejection fraction (LVEF) and a concomitant high-rate supraventricular tachyarrhythmia (SVT) it is challenging to predict LVEF recovery after heart rate control and distinguish tachycardia-induced cardiomyopathy (TIC) from dilated cardiomyopathy (DC). The role of cardiac magnetic resonance (CMR) and the electrocardiogram (ECG) in this setting remains unsettled.
Methods
Forty-three consecutive patients admitted for HF due to high-rate SVT and LVEF <50% undergoing CMR in the acute phase were retrospectively included. Those who had LVEF >50% at follow up were classified as TIC and those with LVEF <50% were classified as DC. Clinical, laboratory, CMR and ECG findings were analyzed to predict LVEF recovery.
Results
Twenty-five (58%) patients were classified as TIC. Patients with DC had wider QRS (121.2 ± 26 vs 97.7 ± 17.35 ms; p = 0.003). On CRM the TIC group presented with higher LVEF (33.4 ± 11 vs 26.9 ± 6.4% p = 0.019) whereas late gadolinium enhancement (LGE) was more frequent in DC group (61 vs 16% p = 0.004). On multivariate analysis, QRS duration ≥100 ms (p = 0.027), LVEF < 40% on CMR (p = 0.047) and presence of LGE (p = 0.03) were identified as independent predictors of lack of LVEF recovery. Furthermore, during clinical follow-up (median 60 months) DC patients were admitted more frequently for HF (44% vs 0%; p < 0.001) than TIC patients (Figure 1).
Conclusion
In patients with reduced LVEF admitted for HF due to high-rate SVT, QRS duration ≥100 ms, LVEF <40% on CMR and presence of LGE are independently associated with lack of LVEF recovery and worse clinical outcome.
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Díez-Villanueva P, García-Guimaraes MM, Macaya F, Masotti M, Nogales JM, Jimenez-Kockar M, Velázquez M, Lozano Í, Moreu J, Avanzas P, Salamanca J, Alfonso F. Spontaneous Coronary Artery Dissection and Menopause. Am J Cardiol 2021; 148:53-59. [PMID: 33617813 DOI: 10.1016/j.amjcard.2021.02.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 01/28/2023]
Abstract
Spontaneous coronary artery dissection (SCAD) is a relatively rare but well-known cause of acute coronary syndrome in women. The role of sexual hormones has been related to the pathophysiology of SCAD. However, clinical features, angiographic findings, management and outcomes of SCAD women in relation to menopause status remain unknown. The Spanish multicenter prospective SCAD registry (NCT03607981), included 318 consecutive patients with SCAD. All coronary angiograms were analyzed in a centralized Corelab. In this substudy, 245 women were classified according to their menopause state (pre-menopausal and post-menopausal). In-hospital outcomes were analyzed: 148 patients (60.4%) were post-menopausal. These patients were older (57 [52 to 66] vs 49 [44 to 54] years, p <0.01) and had more often hypertension (49% vs 27%, p <0.01) and dyslipidemia (46% vs 25%, p <0.01). Post-menopausal women showed more often previous history of acute coronary syndrome, including previous SCAD (9% vs 3%, p = 0.046), and presented less frequently as ST-segment elevation myocardial infarction on admission, compared with premenopausal women (34% vs 49%, p = 0.014). On the other hand, premenopausal women showed more often proximal and multisegment involvement (24% vs 7%, and 32% vs 18%, respectively, both p <0.01). Post-menopausal women were more often managed conservatively (85% vs 71%, p <0.01) and presented less frequently left ventricular dysfunction (both, p <0.01). There were no differences between groups in terms of in-hospital stay or mortality, new acute myocardial infarction, unplanned coronary angiography or heart failure. In conclusion, post-menopausal women with SCAD show different clinical and angiographic characteristics compared with pre-menopausal SCAD patients. Initial treatment strategy was different between groups, though in-hospital outcomes did not significantly differ (NCT03607981).
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Vera A, Rivero F, Salamanca J, Alvarado-Casas T, Alfonso F. Coronary Plaque Erosion after Abemaciclib Treatment Onset: An Unknown Side Effect? Thromb Haemost 2020; 121:976-978. [PMID: 33260247 DOI: 10.1055/a-1326-7028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The current article describes a 72-year-old woman who suffered an acute myocardial infarction due to plaque erosion (PE) 2 weeks after abemaciclib treatment onset due to advanced breast cancer. Abemaciclib is a cyclin-dependent kinase 4 and 6 inhibitor that has recently demonstrated efficacy and safety in advanced breast cancer. Of major concern, however, reported thromboembolic rates in randomized clinical trials testing this drug range from 0.6 to 5%. To the best of our knowledge this is the first thrombotic coronary side effect ever reported. We suggest that a treatment that increases thromboembolic risk, such abemaciclib, may have triggered PE in our patient, 15 days after abemaciclib initiation. New molecules are promising in cancer treatment; however, care must be paid to their potential cardiotoxic effects.
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Diez Villanueva P, Garcia-Guimaraes M, Vera A, Moreu J, Ojeda S, Nogales J, Salamanca J, Veiga G, Masotti M, Camacho-Freire S, Jimenez-Valero S, Jimenez-Kockar M, Lozano I, Bastante T, Alfonso F. Spontaneous coronary artery dissection in the elderly: clinical features, angiographic findings, management and outcomes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). Clinical features, angiographic findings, management and outcomes of SCAD in elderly patients remain unknown.
Methods
The Spanish multicenter prospective SCAD registry included 318 consecutive patients with SCAD diagnosis. Patients were classified according to age in two groups: <65 and ≥65 years old.
Results
A total of 55 patients (17%) were 65 or older (Table). Elderly patients had more often hypertension (29% vs 76%, p<0.01) and dyslipidemia (30% vs 56%, p<0.01), and less smoking history (51% vs 7%, p<0.01). Previous history of coronary artery disease was also more frequent in older patients (4% vs 11%, p=0.044). Interestingly, an identifiable trigger was more often found among patients under 65. Coronary artery tortuosity (1±0.99 vs 1.4±1, p=0.027) and coronary artery ectasia (9% vs 24%, p<0.01) were both more frequent in elderly patients, who were more often managed conservatively (75% vs 89%, p=0.025). A trend toward a higher mortality rate was found among patients ≥65, with no differences in terms of in hospital stay, new acute myocardial infarction, unplanned coronariography or heart failure.
Conclusions
Elderly patients with SCAD show different clinical and angiographic characteristics and they receive distinct management. Short-term outcomes do not significantly differ from those seen in younger patients.
Funding Acknowledgement
Type of funding source: None
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Salamanca J, Díez-Villanueva P, Martínez P, Cecconi A, González de Marcos B, Reyes G, Salas C, Segovia J, Jiménez-Borreguero LJ, Alfonso F. COVID-19 "Fulminant Myocarditis" Successfully Treated With Temporary Mechanical Circulatory Support. JACC Cardiovasc Imaging 2020; 13:2457-2459. [PMID: 32713771 PMCID: PMC7213962 DOI: 10.1016/j.jcmg.2020.05.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Salamanca J, Díez-Villanueva P, Jiménez-Borreguero L. Dilated phase of hypertrophic cardiomyopathy: A cardiac magnetic resonance evolutive assessment. Rev Clin Esp 2020. [DOI: 10.1016/j.rceng.2019.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Salamanca J, Díez-Villanueva P, Jiménez-Borreguero L. Miocardiopatía hipertrófica en fase dilatada: valoración evolutiva mediante cardio-resonancia magnética. Rev Clin Esp 2020; 220:207-208. [DOI: 10.1016/j.rce.2019.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 01/15/2019] [Indexed: 11/15/2022]
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Díez-Villanueva P, Vicent L, de la Cuerda F, Esteban-Fernández A, Gómez-Bueno M, de Juan-Bagudá J, Iniesta ÁM, Ayesta A, Rojas-González A, Bover-Freire R, Iglesias D, García-Aguado M, Perea-Egido JÁ, Salamanca J, Martínez-Sellés M. Left Ventricular Ejection Fraction Recovery in Patients with Heart Failure and Reduced Ejection Fraction Treated with Sacubitril/Valsartan. Cardiology 2020; 145:275-282. [PMID: 31940620 DOI: 10.1159/000505148] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/01/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND A significant number of heart failure (HF) patients with reduced left ventricular ejection fraction (LVEF) experience ventricular function recovery during follow-up. We studied the variables associated with LVEF recovery in patients treated with sacubitril/valsartan (SV) in clinical practice. METHODS We analyzed data from a prospective and multicenter registry including 249 HF outpatients with reduced LVEF who started SV between October 2016 and March 2017. The patients were classified into 2 groups according to LVEF at the end of follow-up (>35%: group R, or ≤35%: group NR). RESULTS After a mean follow-up of 7 ± 0.1 months, 62 patients (24.8%) had LVEF >35%. They were older (71.3 ± 10.8 vs. 67.5 ± 12.1 years, p = 0.025), and suffered more often from hypertension (83.9 vs. 73.8%, p = 0.096) and higher blood pressure before and after SV (both, p < 0.01). They took more often high doses of beta-blockers (30.6 vs. 27.8%, p = 0.002), with a smaller proportion undergoing cardiac resynchronization therapy (14.8 vs. 29.0%, p = 0.028) and fewer implanted cardioverter defibrillators (ICD; 32.8 vs. 67.9%, p < 0.001), this being the only predictive variable of NR in the multivariate analysis (OR 0.26, 95% CI 0.13-0.47, p < 0.0001). At the end of follow-up, the mean LVEF in group R was 41.9 ± 8.1% (vs. 26.3 ± 4.7% in group NR, p < 0.001), with an improvement compared with the initial LVEF of 14.6 ± 10.8% (vs. 0.8 ± 4.5% in group NR, p < 0.0001). Functional class improved in both groups, mainly in group R (p = 0.035), with fewer visits to the emergency department (11.5 vs. 21.6%, p = 0.07). CONCLUSIONS In patients with LVEF ≤35% treated with SV, not carrying an ICD was independently associated with LVEF recovery, which was related to greater improvement in functional class.
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Vera Sainz A, Diez Villanueva P, Ariza Sole A, Formiga F, Lopez Palop R, Marin F, Vidan M, Martinez Selles M, Salamanca J, Sionis A, Garcia Pardo H, Bueno H, Sanchis J, Abu Assi E, Alfonso F. P6264Mitral regurgitation and prognosis after non-ST-segment elevation myocardial infarction in very old patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mitral regurgitation (MR) after acute coronary syndromes is associated with adverse prognosis. However, the prognostic impact of MR in older patients with Non ST-segment Elevation Myocardial Infarction (NSTEMI) has not been well addressed.
Methods
The multicenter LONGEVO-SCA prospective registry included 532 unselected patients with NSTEMI aged ≥80 years. Echocardiography performed during admission quantified mitral valve parameters in 497 patients, who were classified according to mitral regurgitation (MR) status in two groups: significant (moderate or severe) or no significant MR (absent or mild). We evaluated the impact of MR status on mortality or readmission at 6-months.
Results
Mean age was 84.3±4.1 years, 308 (61.9%) were males. A total of 108 patients (21.7%) had significant MR. Compared with patients without significant MR these patients had lower systolic blood pressure (132±28 vs 141±27 mmHg), higher heart rate (82±21 vs 74±17 bpm), worse Killip class (≥II 49.5% vs 22.5%), lower ejection fraction (47±14% vs 55±11%), higher pulmonary pressure (42±15 vs 35±11 mmHg), as well as more frequent new onset atrial fibrillation (16.4% vs 7.2%) (all p values=0.001). Patients with significant MR also had higher in-hospital mortality (4.6% vs 1.3%, p=0.04) and longer hospital stay (median 8 [5–12] vs 6 [4–10] days, p=0.002),and higher mortality/readmission at 6 months (HR 1,54, 95% CI 1.09–2.18). However, after adjusting for potential confounders, this last association was not significant.
Conclusions
Significant MR is seen in about one fifth of octogenarians with NSTEMI. Patients with significant MR have a poor prognosis, which is mainly determined by their clinical characteristics.
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Díez-Villanueva P, Salamanca J, Ariza-Solé A, Formiga F, Martín-Sánchez FJ, Bonanad Lozano C, Vidán MT, Martínez-Sellés M, Terres B, Jiménez Méndez C, Bueno H, Alfonso F. [Impact of frailty and other geriatric syndromes on the clinical management and prognosis of elderly ambulatory patients with heart failure. A prospective and multicentre study]. Rev Esp Geriatr Gerontol 2019; 55:29-33. [PMID: 31515087 DOI: 10.1016/j.regg.2019.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/22/2019] [Accepted: 08/06/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVES Heart failure (HF) is a chronic disease that is often associated with ageing. There are predictive models based on variables that associate it with a poor prognosis, although those do not include common conditions in the elderly, such as frailty or comorbidity. The aim of this study is to determine the clinical and epidemiological characteristics of a cohort of elderly outpatients with HF followed-up by cardiologists. This will include a study of the prevalence of frailty and other geriatric syndromes, as well as their impact on the prognosis, and to evaluate whether these may improve predictive ability of such predictive models. MATERIAL AND METHODS Observational, prospective, and multicentre study that will include 400 patients ≥75years old with chronic HF followed-up in Spanish tertiary hospitals by cardiology specialists in HF. Patients will undergo a comprehensive geriatric assessment, and prediction of events will be performed based on MAGGIC (Meta-Analysis Global Group in Chronic Heart Failure) and Barcelona-Bio HF calculator scores. The primary endpoint is cardiovascular and overall mortality at 1 and 3years follow-up. RESULTS This study will assess both the characteristics and prognosis of elderly patients with HF followed-up by cardiologists in Spain and the applicability in the elderly population of scores used in the general population with chronic HF. CONCLUSION This is the first prospective study that will systematically assess frailty and other geriatric syndromes in the elderly outpatient with HF in Spain and followed-up by cardiologists, thus contributing to improve knowledge about both its prevalence and impact on our patients.
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Vera Sainz A, De La Cuerda F, Navarrete G, Antuna P, Nogales MT, Salamanca J, Rivero F, Jimenez Borreguero LJ, Alfonso F, Aguilar R. 487Predictors of CMR confirmed microvascular damage after successfully reperfused STEMI. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez123.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cecconi A, Salamanca J, Alvarado T, Antuña P, Pozo E, Viliani D, Nogales-Romo MT, Rivero F, Hernandez Muñiz S, Olivera MJ, Caballero P, Jimenez-Borreguero LJ, Alfonso F. Predictors of oedema in Tako-Tsubo cardiomyopathy. J Cardiovasc Med (Hagerstown) 2019; 20:406-408. [DOI: 10.2459/jcm.0000000000000766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Cecconi A, Salamanca J, Antuna P, Alvarado T, Nogales-Romo MT, Pozo E, Viliani D, Veloso S, Montes A, De Rueda C, Olivera MJ, Hernandez-Muniz S, Caballero P, Jimenez-Borreguero LJ, Alfonso F. P183Appropriate quantification of myocardial edema extension in tako-tsubo syndrome: high correlation between visual and semi-quantitative method of T2 signal intensity ratio. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Díez‐Villanueva P, Vera A, Ariza‐Solé A, Alegre O, Formiga F, López‐Palop R, Marín F, Vidán MT, Martínez‐Sellés M, Salamanca J, Sionis A, García‐Pardo H, Bueno H, Sanchís J, Abu‐Assi E, González‐Salvado V, Llaó I, Alfonso F. Mitral Regurgitation and Prognosis After Non‐ST‐Segment Elevation Myocardial Infarction in Very Old Patients. J Am Geriatr Soc 2019; 67:1641-1648. [DOI: 10.1111/jgs.15926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/10/2019] [Accepted: 03/19/2019] [Indexed: 11/30/2022]
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Alvarado T, Cecconi A, Antuna P, Salamanca J, Nogales-Romo MT, Viliani D, Pozo E, Diego G, Rojas-Gonzalez A, Rivero F, Hernandez Muniz S, Olivera MJ, Caballero P, Jimenez-Borreguero J, Alfonso F. P4394Diabetes paradox in Tako-Tsubo cardiomyopathy: beneficial effect of diabetes on myocardial edema. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vera A, Cecconi A, Nogales-Romo MT, de la Cuerda F, Salamanca J, Jimenez-Borreguero LJ, Alfonso F. Wide QRS Complex Tachycardia: What the Algorithms Fear. Circulation 2018; 137:1407-1409. [PMID: 29581367 DOI: 10.1161/circulationaha.118.033936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Alfonso F, Salamanca J, Pozo E. [Diagnosis of acute coronary syndrome in patients with chest pain in the emergency department: Changes on the horizon?]. EMERGENCIAS : REVISTA DE LA SOCIEDAD ESPANOLA DE MEDICINA DE EMERGENCIAS 2016; 28:6-8. [PMID: 29094819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Alfonso F, Salamanca J, Del Pozo E. [Author's reply]. EMERGENCIAS : REVISTA DE LA SOCIEDAD ESPANOLA DE MEDICINA DE EMERGENCIAS 2016; 28:283-284. [PMID: 29105420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Lozano Á, Bastante T, Salamanca J, Aguilar R, Montes de Oca R, Rodríguez D, Alfonso F. Tako-tsubo cardiomyopathy triggered by Influenza A virus infection. Int J Cardiol 2014; 174:e52-3. [DOI: 10.1016/j.ijcard.2014.04.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 04/02/2014] [Indexed: 11/26/2022]
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