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Carreras-Mora J, Simón-Ramón C, Vidal-Burdeus M, Rodríguez-Sotelo L, Sionis A, Giralt-Borrell T, Izquierdo-Marquisá A, Rodríguez-González C, Farré N, Cainzos-Achirica M, Tizón-Marcos H, Garcia-Picart J, Milà-Pascual L, Vaquerizo B, Rivas-Lasarte M, Ribas-Barquet N. Subclinical congestion assessed by lung ultrasound in ST segment elevation myocardial infarction. Heart 2023; 109:1602-1607. [PMID: 37268410 DOI: 10.1136/heartjnl-2023-322690] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/17/2023] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVE We evaluated the prognostic value of subclinical congestion assessed by lung ultrasound (LUS) in patients admitted for ST segment elevation myocardial infarction (STEMI). METHODS This was a multicentre study that prospectively enrolled 312 patients admitted for STEMI without signs of heart failure (HF) at admission. LUS was performed during the first 24 hours after revascularisation and classified patients as having either wet lung (three or more B-lines in at least one lung field) or dry lung. The primary endpoint was a composite of acute HF, cardiogenic shock or death during hospitalisation. The secondary endpoint was a composite of readmission for HF or new acute coronary syndrome or death during 30-day follow-up. Zwolle score was calculated in all patients to assess predictive improvement by adding the result of the LUS to this score. RESULTS 14 patients (31.1%) in the wet lung group presented the primary endpoint vs 7 (2.6%) in the dry lung group (adjusted RR 6.0, 95% CI 2.3 to 16.2, p=0.007). The secondary endpoint occurred in five patients (11.6%) in the wet lung group and in three (1.2%) in the dry lung group (adjusted HR 5.4, 95% CI 1.0 to 28.7, p=0.049). Addition of LUS improved the ability of the Zwolle score to predict the follow-up composite endpoint (net reclassification improvement 0.99). LUS showed a very high negative predictive value in predicting in-hospital and follow-up endpoints (97.4% and 98.9%, respectively). CONCLUSION Early subclinical pulmonary congestion identified by LUS in patients with Killip I STEMI at hospital admission is associated with adverse outcomes during hospitalisation and 30-day follow-up.
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Affiliation(s)
- José Carreras-Mora
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Clara Simón-Ramón
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María Vidal-Burdeus
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Alessandro Sionis
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- IIB-Sant Pau, Barcelona, Spain
| | - Teresa Giralt-Borrell
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | | | | | - Núria Farré
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
- Heart Diseases Biomedical Research Group, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Miguel Cainzos-Achirica
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
- Heart Diseases Biomedical Research Group, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Helena Tizón-Marcos
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
- CIBERCV, Madrid, Spain
| | - Joan Garcia-Picart
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laia Milà-Pascual
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Beatriz Vaquerizo
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
- Heart Diseases Biomedical Research Group, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Mercedes Rivas-Lasarte
- CIBERCV, Madrid, Spain
- Advanced Heart Failure and Cardiac Transplantation Unit, Puerta de Hierro University Hospital of Majadahonda, Madrid, Spain
| | - Núria Ribas-Barquet
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
- Heart Diseases Biomedical Research Group, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
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Berga Congost G, Martinez Momblan MA, Valverde Bernal J, Márquez López A, Ruiz Gabalda J, Garcia-Picart J, Puig Campmany M, Brugaletta S. Association of sex and age and delay predictors on the time of primary angioplasty activation for myocardial infarction patients in an emergency department. Heart Lung 2023; 58:6-12. [PMID: 36335910 DOI: 10.1016/j.hrtlng.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Time between Emergency Department (ED) and ST-segment elevation acute myocardial infarction (STEMI) activation time is a good indicator of ED quality. STEMI delays are of particular importance in some subgroups, such as women and the elderly. OBJECTIVE To determine the association of sex and age with activation time in STEMI patients admitted to the ED. METHODS An observational retrospective study was conducted including all patients admitted to the ED activated as a STEMI. The main variable was activation time. To evaluate the independent predictors of activation time, a multivariate logistic regression analysis was carried out, variables were sex, age, sex and age combined, chest pain, ST elevation in the electrocardiogram, and first medical contact (FMC) at the hospital's ED. RESULTS A total of 330 patients were included. They were classified by sex: 23.9% (78) women and 76.1% (249) men; and age: 51.1% (167) <65 yo and 48.9% (160) ≥65 yo. Women and elderly patients exhibited a more atypical presentation. Multivariate analysis shows that showed that elderly age (OR=1.976 95%; CI=1.257-3.104; p = 0.003) and FMC prior to attending the ED (OR=1.762; 95% CI=1.117-2.779; p = 0.015) were associated with a longer activation time. Women older than 65 years old showed the longest activation time. CONCLUSION STEMI delays are longer in women and the elderly with atypical presentation. Age ≥65 and FMC outside the ED were associated with an increase in the activation time. This highlights the need to develop strategies to improve activation time for these specific patient groups.
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Affiliation(s)
- Gemma Berga Congost
- Interventional Cardiology Department, Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Biomedical Research Institute, Barcelona, Spain; University of Barcelona Faculty of Medicine and Health Sciences, Barcelona, Spain
| | - Maria Antonia Martinez Momblan
- University of Barcelona Faculty of Medicine and Health Sciences, Barcelona, Spain; Research Networking Centre of Rare Diseases. CIBER-ER, Unit 747, Spain.
| | - Jonatan Valverde Bernal
- Interventional Cardiology Department, Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Biomedical Research Institute, Barcelona, Spain
| | - Adrián Márquez López
- Interventional Cardiology Department, Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Biomedical Research Institute, Barcelona, Spain; University of Barcelona Faculty of Medicine and Health Sciences, Barcelona, Spain
| | - Judit Ruiz Gabalda
- Interventional Cardiology Department, Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Joan Garcia-Picart
- Interventional Cardiology Department, Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mireia Puig Campmany
- Sant Pau Biomedical Research Institute, Barcelona, Spain; Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Salvatore Brugaletta
- University of Barcelona Faculty of Medicine and Health Sciences, Barcelona, Spain; Interventional Cardiology Department, Cardiology, Hospital Clinic, Barcelona, Spain; Biomedical Research Institute IDIBAPS, Barcelona, Spain
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Tizón-Marcos H, Vaquerizo B, Ferré JM, Farré N, Lidón RM, Garcia-Picart J, Regueiro A, Ariza A, Carrillo X, Duran X, Poirier P, Cladellas M, Camps-Vilaró A, Ribas N, Cubero-Gallego H, Marrugat J. Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the Emergency-Intervention “Codi IAM” Network. Front Cardiovasc Med 2022; 9:847982. [PMID: 35548422 PMCID: PMC9082814 DOI: 10.3389/fcvm.2022.847982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDespite the spread of ST-elevation myocardial infarction (STEMI) emergency intervention networks, inequalities in healthcare access still have a negative impact on cardiovascular prognosis. The Family Income Ratio of Barcelona (FIRB) is a socioeconomic status (SES) indicator that is annually calculated. Our aim was to evaluate whether SES had an effect on mortality and complications in patients managed by the “Codi IAM” network in Barcelona.MethodsThis is a cohort study with 3,322 consecutive patients with STEMI treated in Barcelona from 2010 to 2016. Collected data include treatment delays, clinical and risk factor characteristics, and SES. The patients were assigned to three SES groups according to FIRB score. A logistic regression analysis was conducted to estimate the adjusted effect of SES on 30-day mortality, 30-day composite cardiovascular end point, and 1-year mortality.ResultsThe mean age of the patients was 65 ± 13% years, 25% were women, and 21% had diabetes mellitus. Patients with low SES were younger, more often hypertensive, diabetic, dyslipidemic (p < 0.003), had longer reperfusion delays (p < 0.03) compared to participants with higher SES. Low SES was not independently associated with 30-day mortality (OR: 0.95;9 5% CI: 0.7–1.3), 30-day cardiovascular composite end point (OR: 1.03; 95% CI: 0.84–1.26), or 1-year all-cause mortality (HR: 1.09; 95% CI: 0.76–1.56).ConclusionAlthough the low-SES patients with STEMI in Barcelona city were younger, had worse clinical profiles, and had longer revascularization delays, their 30-day and 1-year outcomes were comparable to those of the higher-SES patients.
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Affiliation(s)
- Helena Tizón-Marcos
- Hospital del Mar, Servicio de Cardiología, Barcelona, Spain
- Grupo de Investigación Biomédica en Enfermedades del Corazón, Barcelona, Spain
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- *Correspondence: Helena Tizón-Marcos
| | - Beatriz Vaquerizo
- Hospital del Mar, Servicio de Cardiología, Barcelona, Spain
- Grupo de Investigación Biomédica en Enfermedades del Corazón, Barcelona, Spain
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Josepa Mauri Ferré
- Hospital Universitari GermansTrias I. Pujol, Servicio de Cardiología, Badalona, Spain
- Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Núria Farré
- Hospital del Mar, Servicio de Cardiología, Barcelona, Spain
- Grupo de Investigación Biomédica en Enfermedades del Corazón, Barcelona, Spain
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Rosa-Maria Lidón
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Hospital Universitari de la Valld'Hebron, Servicio de Cardiología, Barcelona, Spain
| | - Joan Garcia-Picart
- Hospital de la Santa Creu I. Sant Pau, Servicio de Cardiología, Barcelona, Spain
| | - Ander Regueiro
- Hospital Clínic i Provincial, Servicio de Cardiología, Barcelona, Spain
| | - Albert Ariza
- Hospital Universitario de Bellvitge, Servicio de Cardiología, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Carrillo
- Hospital Universitari GermansTrias I. Pujol, Servicio de Cardiología, Badalona, Spain
| | - Xavier Duran
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
- AMIB, Assessoria Metodològica i Bioestadística, Barcelona, Spain
| | - Paul Poirier
- Insititut Universitaire de Cardiologie et Pneumologie de Québec, Québec, QC, Canada
| | - Mercè Cladellas
- Hospital del Mar, Servicio de Cardiología, Barcelona, Spain
- Grupo de Investigación Biomédica en Enfermedades del Corazón, Barcelona, Spain
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Anna Camps-Vilaró
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Núria Ribas
- Hospital del Mar, Servicio de Cardiología, Barcelona, Spain
- Grupo de Investigación Biomédica en Enfermedades del Corazón, Barcelona, Spain
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Hector Cubero-Gallego
- Hospital del Mar, Servicio de Cardiología, Barcelona, Spain
- Grupo de Investigación Biomédica en Enfermedades del Corazón, Barcelona, Spain
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Jaume Marrugat
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Tizon Marcos H, Marrugat J, Vaquerizo B, Ariza A, Lidon R, Carrillo X, Garcia-Picart J, Garcia-Munoz J, Millan R, Ribas N, Menendez E, Duran X, Poirier P, Mauri Farre F. The Family Income Ratio of Barcelona and its impact on treatment delays and one-year mortality in 3173 cases of STEMI treated at the Codi IAM network. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
STEMI networks have spread reperfusion and have decreased treatment delays.Increased treatment times have a negative impact on mortality after STEMI.The Family Income Ratio of Barcelona (FIRB) is an indicator that combines economic and socio-cultural welfare that is annually documented at the different Barcelona's neighborhoods by the Barcelona Public Health Office.
Purpose
To evaluate if FIRB has a prognostic impact on STEMI treatment times and mortality on patients of Barcelona city treated in the Codi IAM Network with primary PCI.
Methods
Analysis of all data from “Codi IAM Network” from STEMI treatment in Barcelona city from 2010 to 2016 -including treatment delays, clinical risk factors and 1-year all-cause mortality- and corresponding FIRB for each patient and episode.FIRB is divided into tertiles.Multilevel analysis is performed to obtain factors associated to EKG-opening artery time and cox-regression on 1-year all-cause mortality.
Results
3173 cases of STEMI were included with a mean age of 65±13, 25% women,21% diabetes mellitus and 42% hypertension.Characteristics of population, treatment and mortality per FIRB tertile is shown in Table 1.Multilevel analysis showed that age,diabetes mellitus,heart failure at admission,FIRB and who performed first care were associated to EKG-Opening Artery Time (all p<0.003).However,only age,heart failure at admission,who performed first care and EKG-opening artery time>120min were significantly associated to 1-year all-cause mortality (p<0.005) but not FIRB.
Conclusions
Patients at the lower FIRB treated for STEMI in Barcelona showed younger age,worse cardiovascular profile and longer treatment delays.Longer EKG-open artery time was associated to diabetes mellitus, heart failure, first assistance care and lower FIRB.One-year all-cause mortality was not associated to FIRB.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Tizon Marcos
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - J Marrugat
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - B Vaquerizo
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - A Ariza
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - R.M Lidon
- University Hospital Vall d'Hebron, Cardiology department, Barcelona, Spain
| | - X Carrillo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | | | | | - R Millan
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - N Ribas
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - E Menendez
- Hospital del Mar, Cardiology department, Barcelona, Spain
| | - X Duran
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - P Poirier
- Centre de Recherche de lInstitut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Canada
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Ribera A, Ferreira-Gonzalez I, Marsal JR, Oristrell G, Faixedas MT, Rosas A, Tizón-Marcos H, Rojas S, Labata C, Cardenas M, Homs S, Tomas-Querol C, Garcia-Picart J, Gomez-Hospital JA, Pijoan JI, Masotti M, Mauri J, Garcia Dorado D. Persistence with dual antiplatelet therapy after percutaneous coronary intervention for ST-segment elevation acute coronary syndrome: a population-based cohort study in Catalonia (Spain). BMJ Open 2019; 9:e028114. [PMID: 31340964 PMCID: PMC6661631 DOI: 10.1136/bmjopen-2018-028114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Guidelines recommending 12-month dual antiplatelet therapy (DAPT) in patients with ST-elevation acute coronary syndrome (STEACS) undergoing percutaneous coronary intervention (PCI) were published in year 2012. We aimed to describe the influence of guideline implementation on the trend in 12-month persistence with DAPT between 2010 and 2015 and to evaluate its relationship with DAPT duration regimens recommended at discharge from PCI hospitals. DESIGN Observational study based on region-wide registry data linked to pharmacy billing data for DAPT follow-up. SETTING All PCI hospitals (10) belonging to the acute myocardial infarction (AMI) code network in Catalonia (Spain). PARTICIPANTS 10 711 STEACS patients undergoing PCI between 2010 and 2015 were followed up. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was 12-month persistence with DAPT. Calendar year quarter, publication of guidelines, DAPT duration regimen recommended in the hospital discharge report, baseline patient characteristics and significant interactions were included in mixed-effects logistic regression based interrupted time-series models. RESULTS The proportion of patients on-DAPT at 12 months increased from 58% (56-60) in 2010 to 73% (71-75) in 2015. The rate of 12-month persistence with DAPT significantly increased after the publication of clinical guidelines with a time lag of 1 year (OR=1.20; 95% CI 1.11 to 1.30). A higher risk profile, more extensive and complex coronary disease, use of drug-eluting stents (OR=1.90; 95% CI 1.50 to 2.40) and a 12-month DAPT regimen recommendation at discharge from the PCI hospital (OR=5.76; 95% CI 3.26 to 10.2) were associated with 12-month persistence. CONCLUSION Persistence with 12-month DAPT has increased since publication of clinical guidelines. Even though most patients were discharged on DAPT, only 73% with potential indication were on-DAPT 12 months after PCI. A guideline-based recommendation at PCI hospital discharge was highly associated with full persistence with DAPT. Establishing evidence-based, common prescribing criteria across hospitals in the AMI-network would favour adherence and reduce variability.
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Affiliation(s)
- Aida Ribera
- Cardiology Department, Vall d’Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública CIBERESP, The Spanish Health Institute (ISCIII), Spain
| | - Ignacio Ferreira-Gonzalez
- Cardiology Department, Vall d’Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública CIBERESP, The Spanish Health Institute (ISCIII), Spain
| | - Josep Ramon Marsal
- Cardiology Department, Vall d’Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública CIBERESP, The Spanish Health Institute (ISCIII), Spain
| | - Gerard Oristrell
- Cardiology Department, Vall d’Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red para Enfermedades Cardiovasculares CIBERCV, Spanish Health Institute (ISCIII), Spain
| | | | - Alba Rosas
- Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Helena Tizón-Marcos
- Cardiology Department, Hospital del Mar, and Heart Diseases Biomedical Research Group and IMIM (Hospital del Mar Medical Research Institute), Faculty of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Sergio Rojas
- Cardiology Department, Hospital Universitari de Tarragona Joan XXIII, IISPV, Universidad Rovira Virgili, Tarragona, Spain
| | - Carlos Labata
- Cardiology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Silvia Homs
- Cardiology Department, Hospital Mútua de Terrassa, Barcelona, Spain
| | | | - Joan Garcia-Picart
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Jose Ignacio Pijoan
- Clinical Epidemiology Unit, Hospital Universitario de Cruces. Biocruces Bizkaia Health Research Institute, Bilbao, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública CIBERESP, The Spanish Health Institute (ISCIII), Spain
| | - Monica Masotti
- Institut Clínic Cardio vascular (ICCV), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josepa Mauri
- Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
- Cardiology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | - David Garcia Dorado
- Cardiology Department, Vall d’Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red para Enfermedades Cardiovasculares CIBERCV, Spanish Health Institute (ISCIII), Spain
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Ferreira Gonzalez I, Ribera AR, Marsal JR, Faixedas M, Rosas A, Tizon-Marcos HT, Rojas S, Labata C, Cardenas M, Homs S, Tomas-Querol C, Garcia-Picart J, Roura G, Masotti M, Mauri J. P1719Validity of DAPT score to predict late ischemic and hemorrhagic events in patients with ST-segment-elevation acute coronary syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1719] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - A R Ribera
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J R Marsal
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - A Rosas
- Department of Health, Barcelona, Spain
| | - H T Tizon-Marcos
- Hospital del Mar Medical Research Institute (IMIM), Departament de Salut. Generalitat de Cataluña, Barcelona, Spain
| | - S Rojas
- Hospital Joan XXIII, Barcelona, Spain
| | - C Labata
- University Hospital Trias i Pujol, Barcelona, Spain
| | - M Cardenas
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | - S Homs
- University Hospital Mutua de Terrassa, Terrassa, Spain
| | | | | | - G Roura
- University Hospital of Bellvitge, Barcelona, Spain
| | - M Masotti
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - J Mauri
- University Hospital Trias i Pujol, Barcelona, Spain
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7
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Tizon Marcos H, Carrillo X, Garcia-Picart J, Ariza A, Guarinos J, Cardenas M, Munoz J, Borras M, Massoti M, Lidon R, Jimenez J, Curos Abadal A, Mauri Ferre J. P4656Reperfusion in a STEMI program, still a gender issue? Results from the STEMI program in Catalunya. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4656] [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: 11/14/2022] Open
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Danduch L, Marti V, Garcia-Picart J, Serra A. Radial Artery Embolism: A Rare Complication of Angioplasty. J Invasive Cardiol 2016; 28:E73-E74. [PMID: 27466279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present a 55-year-old man with multivessel coronary artery disease previously treated with stenting of the left main, left anterior descending, right coronary, circumflex, and first diagonal branch. He was diagnosed with in-stent restenosis of a diagonal branch, but treatment was complicated by radial artery coronary embolism, which is a rare complication of radial intervention.
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Affiliation(s)
| | - Vicens Marti
- Hospital de Sant Pau, Hemodynamic Unit, Calle Sant Quintí 89, 08026 Barcelona, Spain.
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Boscarelli D, Vaquerizo B, Miranda-Guardiola F, Arzamendi D, Tizon H, Sierra G, Delgado G, Fantuzzi A, Estrada D, Garcia-Picart J, Cinca J, Serra A. Intracoronary thrombolysis in patients with ST-segment elevation myocardial infarction presenting with massive intraluminal thrombus and failed aspiration. European Heart Journal: Acute Cardiovascular Care 2014; 3:229-36. [DOI: 10.1177/2048872614527008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Daniela Boscarelli
- Department of Cardiology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - Beatriz Vaquerizo
- Department of Cardiology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | | | - Dabit Arzamendi
- Department of Cardiology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - Helena Tizon
- Department of Cardiology, Hospital Parc de salut Mar, Barcelona, Spain
| | - Gilberto Sierra
- Department of Cardiology, Hospital Parc de salut Mar, Barcelona, Spain
| | - Guillermo Delgado
- Department of Cardiology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - Andres Fantuzzi
- Department of Cardiology, Hospital Parc de salut Mar, Barcelona, Spain
| | - Darlene Estrada
- Department of Cardiology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - Joan Garcia-Picart
- Department of Cardiology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - Juan Cinca
- Department of Cardiology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - Antonio Serra
- Department of Cardiology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
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10
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Méndez AB, Colchero T, Garcia-Picart J, Vila M, Subirana MT, Sionis A. Unusual case of new-onset heart failure due to cor triatriatum sinister. Eur J Heart Fail 2014; 15:237-9. [DOI: 10.1093/eurjhf/hfs164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [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: 11/13/2022] Open
Affiliation(s)
- Ana Belén Méndez
- Hospital de Sant Pau, Cardiology; Mas Casanovas, 90 Barcelona 08041 Spain
| | - Teresa Colchero
- Hospital de Sant Pau, Cardiology; Mas Casanovas, 90 Barcelona 08041 Spain
| | - Joan Garcia-Picart
- Hospital de Sant Pau, Cardiology; Mas Casanovas, 90 Barcelona 08041 Spain
| | - Montserrat Vila
- Hospital de Sant Pau, Cardiology; Mas Casanovas, 90 Barcelona 08041 Spain
| | | | - Alessandro Sionis
- Hospital de Sant Pau, Cardiology; Mas Casanovas, 90 Barcelona 08041 Spain
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11
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Martin-Yuste V, Alvarez-Contreras L, Brugaletta S, Ferreira-Gonzalez I, Cola C, Garcia-Picart J, Martí V, Sabate M. Emergent versus elective percutaneous stent implantation in the unprotected left main: long-term outcomes from a single-center registry. J Invasive Cardiol 2011; 23:392-397. [PMID: 21972154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Unprotected left main (ULM) coronary disease is considered by contemporary guidelines a class I indication for surgery. However, percutaneous coronary intervention (PCI) is often carried out in the ULM in either emergent or high-risk elective procedures. The aim of this study was to evaluate ULM-PCI as a feasible and safe procedure in the emergent setting, and to analyze outcomes in both scenarios. METHODS Angiographic and clinical data were collected retrospectively for all patients who underwent emergent or elective PCI on ULM at our center from January 2006 to June 2009. All patients were followed up with a clinical visit or telephone interview. Main outcomes included major adverse cardiac events (MACE) and its individual components: cardiac death, myocardial infarction (MI) and target lesion revascularization. These were analyzed at the longest follow-up available. RESULTS A total of 98 consecutive patients with significant LM disease were included. Fifty-seven of them were treated as a planned procedure (elective group) and 41 as an emergent procedure (emergent group). Procedural success was achieved in 100% of cases in the elective group and in 88% of the emergent group (p = 0.011). Higher use of drug-eluting stents (DES) was recorded in the elective group (75% versus 45% in the emergent group; p <0.002). The emergent group presented a higher in-hospital mortality (24% versus 2% in the elective group; p <0.001). At a mean follow-up of 626 ± 380 days, the overall MACE rate was similar betweeen the two groups (23% in the emergent group versus 17% in the elective group; p = 0.52). Independent predictors of MACE after discharge follow-up were postprocedure minimal diameter and DES use. CONCLUSIONS Emergent PCI of the ULM exhibits worse in-hospital outcomes as compared to elective procedures. However, after discharge, long-term outcomes remain comparably good between groups.
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Affiliation(s)
- Victoria Martin-Yuste
- Department of Cardiology, Clinic Thorax Institute, Hospital Clinic de Barcelona, Villaroel 170, Planta 6 Esc 3, 08036, Barcelona, Spain.
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12
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Marti V, Garcia-Picart J, Balcells J. Coronary stenting after failure of conservative treatment for spontaneous coronary dissection: Usefulness of the intravascular ultrasound. J Clin Ultrasound 2011; 39:175-178. [PMID: 21321943 DOI: 10.1002/jcu.20796] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 12/20/2010] [Indexed: 05/30/2023]
Abstract
Spontaneous coronary dissection of a coronary artery is a rare cause of acute coronary syndrome. Optimal treatment has not yet been established. We describe a woman with spontaneous dissection of the left anterior descending artery who presented transitory angina and electrocardiographic ST segment elevation in precordial leads. Conservative treatment was carried out. The angina and electrocardiographic changes recurred 3 days later. An intravascular vascular ultrasound was performed and the patient was stabilized following stenting. Stress testing was negative at 6-month follow-up and she remained asymptomatic at 18 months. We discuss the usefulness of an intravascular ultrasound study to establish the therapeutic strategy.
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Affiliation(s)
- Vicens Marti
- Department of Cardiology and Cardiac Surgery, Hospital de Sant Pau, Barcelona, Spain.
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13
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Martí V, Garcia-Picart J, Serra A. Coronary acute syndrome due to a large occlusive thrombus in an aortosaphenous vein graft. J Invasive Cardiol 2011; 23:87. [PMID: 21297208] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Vicens Martí
- Hemodynamic Unit, Departament of Cardiology and Cardiac Surgery, Hospital de Sant Pau, Av. Antoni M. Claret, 167, 08025-Barcelona, Spain.
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14
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Guiteras-Val P, Varas-Lorenzo C, Garcia-Picart J, Martí-Claramunt V, Augé-Sanpera JM. Clinical and sequential angiographic follow-up six months and 10 years after successful percutaneous transluminal coronary angioplasty. Am J Cardiol 1999; 83:868-74. [PMID: 10190401 DOI: 10.1016/s0002-9149(98)01070-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Sequential angiographic follow-up is needed for interpreting coronary events that occur after successful percutaneous translumial coronary angioplasty (PTCA). One hundred eight consecutive patients who had undergone successful dilatation were followed for 10 years, and quantitative sequential angiograms were recorded at 6 months (n = 101) and 10 years (n = 68). The 10-year event rate was: 5.8 +/- 2.4% for cardiac death, 9.7 +/- 3.3% for Q-wave acute myocardial infarction, 18.3 +/- 4.5% for additional surgery, and 22.4 +/- 4.9% for repeated angioplasty. Using Cox's proportional-hazards regression, multivessel coronary artery disease (CAD) (RR 5.6; 95% confidence intervals [CI] 1.2 to 24.7; p = 0.02), restenosis within 6 months (RR 7.8; 95% CI 3.1 to 20.0; p = 0.0001), and CAD progression over 10 years (RR 10.6; 95% CI 1.3 to 87.1; p = 0.004) were the strongest predictors of all-cause death, repeated PTCA, and additional surgery, respectively, after controlling for age and coronary risk factors. The minimal luminal diameter of 48 narrowings with complete sequential angiographic follow-up and without restenosis remained stable from 6 months (2.13 +/- 0.60 mm) to 10 years (2.18 +/- 0.61 mm). Disease progression was similar in nondilated arteries and dilated arteries (32% vs 30%). The 10-year risk of coronary events was higher in patients with baseline multivessel CAD than in those with 1-vessel CAD because of more frequent progression of CAD (RR 3.8; 95% CI 1.6 to 6.8; p = 0.001). Thus, early cardiac events after successful PTCA were related to restenosis, and late events to CAD progression. Nevertheless, after the restenosis period, the target lesion remained stable for the next 10 years. Coronary disease progression was not related to the angioplasty procedure.
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Affiliation(s)
- P Guiteras-Val
- Unitat d'Hemodinàmica i Cardiologia Intervencionista de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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