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Panagides V, Cuervo G, Llopis J, Abdel-Wahab M, Mangner N, Habib G, Regueiro A, Mestres CA, Tornos P, Durand E, Selton-Suty C, Ihlemann N, Bruun N, Urena M, Cecchi E, Thiele H, Durante-Mangoni E, Pellegrini C, Eltchaninoff H, Athan E, Søndergaard L, Linke A, Tattevin P, Del Val D, Quintana E, Chu V, Rodés-Cabau J, Miro JM. Infective Endocarditis After Transcatheter Versus Surgical Aortic Valve Replacement. Clin Infect Dis 2024; 78:179-187. [PMID: 37552784 DOI: 10.1093/cid/ciad464] [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: 05/01/2023] [Revised: 07/27/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE after SAVR versus TAVR. METHODS Data were collected from the "Infectious Endocarditis after TAVR International" (enrollment from 2005 to 2020) and the "International Collaboration on Endocarditis" (enrollment from 2000 to 2012) registries. Only patients with an IE affecting the aortic valve prosthesis were included. A 1:1 paired matching approach was used to compare patients with TAVR and SAVR. RESULTS A total of 1688 patients were included. Of them, 602 (35.7%) had a surgical bioprosthesis (SB), 666 (39.5%) a mechanical prosthesis, 70 (4.2%) a homograft, and 350 (20.7%) a transcatheter heart valve. In the SAVR versus TAVR matched population, the rate of new moderate or severe aortic regurgitation was higher in the SB group (43.4% vs 13.5%; P < .001), and fewer vegetations were diagnosed in the SB group (62.5% vs 82%; P < .001). Patients with an SB had a higher rate of perivalvular extension (47.9% vs 27%; P < .001) and Staphylococcus aureus was less common in this group (13.4% vs 22%; P = .033). Despite a higher rate of surgery in patients with SB (44.4% vs 27.3%; P < .001), 1-year mortality was similar (SB: 46.5%; TAVR: 44.8%; log-rank P = .697). CONCLUSIONS Clinical presentation, type of causative microorganism, and treatment differed between patients with an IE located on SB compared with TAVR. Despite these differences, both groups exhibited high and similar mortality at 1-year follow-up.
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Affiliation(s)
- Vassili Panagides
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Guillermo Cuervo
- Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jaume Llopis
- Department of Genetics, Microbiology, and Statistics, University of Barcelona, Barcelona, Spain
| | | | - Norman Mangner
- Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universität Dresden, Dresden, Germany
| | - Gilbert Habib
- Cardiology Department, Assistance Publique des Hôpitaux de Marseille, La Timone Hospital, Marseille, France
| | - Ander Regueiro
- Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Carlos A Mestres
- Department of Cardiac Surgery, University Hospital Zürich, Zurich, Switzerland
| | - Pilar Tornos
- Department of Cardiology, Hospital Quiron Barcelona, Barcelona, Spain
| | - Eric Durand
- Department of Cardiology, Normandie University, CHU Rouen, France
| | | | | | - Niels Bruun
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Marina Urena
- Cardiology Department, Bichat Hospital, Paris, France
| | - Enrico Cecchi
- Cardiology Department, Hospital Maria Vittoria, Turin, Italy
| | - Holger Thiele
- Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Emanuele Durante-Mangoni
- Department of Precision Medicine, University of Campania 'L. Vanvitelli', Monaldi Hospital, Naples, Italy
| | | | | | - Eugene Athan
- Department of Infectious Disease, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | | | - Axel Linke
- Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universität Dresden, Dresden, Germany
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - David Del Val
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Eduard Quintana
- Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Vivian Chu
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
- Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jose M Miro
- Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
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2
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Panagides V, Cuervo G, Llopis J, Regueiro A, Mestres C, Tornos P, del Val D, Quintana E, Rodés-Cabau J, Miro J. ENDOCARDITIS INFECCIOSA TRAS LA IMPLANTACIÓN DE LA VÁLVULA AÓRTICA TRANSCATéTER VERSUS QUIRÚRGICA. Cirugía Cardiovascular 2023. [DOI: 10.1016/j.circv.2022.12.021] [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: 02/16/2023] Open
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3
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Kong WKF, Salsano A, Giacobbe DR, Popescu BA, Laroche C, Duval X, Schueler R, Moreo A, Colonna P, Piper C, Calvo-Iglesias F, Badano LP, Srdanovic I, Boutoille D, Huttin O, Stöhr E, Timóteo AT, Vaskelyte JJ, Sadeghpour A, Tornos P, Abid L, Poh KK, Habib G, Lancellotti P. Outcomes of culture-negative vs. culture-positive infective endocarditis: the ESC-EORP EURO-ENDO registry. Eur Heart J 2022; 43:2770-2780. [PMID: 35695691 PMCID: PMC9459867 DOI: 10.1093/eurheartj/ehac307] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/21/2022] [Accepted: 05/25/2022] [Indexed: 12/13/2022] Open
Abstract
AIM Fatality of infective endocarditis (IE) is high worldwide, and its diagnosis remains a challenge. The objective of the present study was to compare the clinical characteristics and outcomes of patients with culture-positive (CPIE) vs. culture-negative IE (CNIE). METHODS AND RESULTS This was an ancillary analysis of the ESC-EORP EURO-ENDO registry. Overall, 3113 patients who were diagnosed with IE during the study period were included in the present study. Of these, 2590 (83.2%) had CPIE, whereas 523 (16.8%) had CNIE. As many as 1488 (48.1%) patients underwent cardiac surgery during the index hospitalization, 1259 (48.8%) with CPIE and 229 (44.5%) with CNIE. The CNIE was a predictor of 1-year mortality [hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.04-1.56], whereas surgery was significantly associated with survival (HR 0.49, 95% CI 0.41-0.58). The 1-year mortality was significantly higher in CNIE than CPIE patients in the medical subgroup, but it was not significantly different in CNIE vs. CPIE patients who underwent surgery. CONCLUSION The present analysis of the EURO-ENDO registry confirms a higher long-term mortality in patients with CNIE compared with patients with CPIE. This difference was present in patients receiving medical therapy alone and not in those who underwent surgery, with surgery being associated with reduced mortality. Additional efforts are required both to improve the aetiological diagnosis of IE and identify CNIE cases early before progressive disease potentially contraindicates surgery.
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Affiliation(s)
- William K F Kong
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Antonio Salsano
- Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy.,Division of Cardiac Surgery, Ospedale Policlinico San Martino-IRCCS, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Daniele Roberto Giacobbe
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Bogdan A Popescu
- Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila' Euroecolab, Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania
| | - Cécile Laroche
- EORP, European Society of Cardiology, Sophia-Antipolis, France
| | - Xavier Duval
- INSERM Clinical Investigation Center 1425, Université Paris Diderot, Sorbonne Paris-Cité, IAME 1138, Paris, France.,AEPEI Service de Maladies Infectieuses et Tropicales, APHP, Hôpital Bichat, Paris, France
| | | | - Antonella Moreo
- Dipartimento CardioToracoVascolare 'De Gasperis', ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Paolo Colonna
- Cardiology Hospital, Policlinico University Hospital of Bari, Bari, Italy
| | - Cornelia Piper
- Clinic for General and Interventional Cardiology/Angiology, Herz-und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | | | - Luigi P Badano
- University of Milano-Bicocca, Milano, Italy.,Department of Cardiovascular, Neural and Metabolic Sciences; Istituto Auxologico Italiano, IRCCS-San Luca Hospital, Milano, Italy
| | - Ilija Srdanovic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia
| | - David Boutoille
- Department of Infectious Diseases, CIC UIC 1413 INSERM, University Hospital, Nantes, France
| | - Olivier Huttin
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, Nancy, France.,CIC-Plurithématique 1433, Inserm U1116, CHRU Nancy, Université de Lorraine, CIC-IT, U1433, CHRU de Nancy, France.,INSERM U1254, IADI, Université de Lorraine, Nancy, France
| | | | - Ana Teresa Timóteo
- Secretária-Geral Sociedade Portuguesa Cardiologia, Lisbon, Portugal.,Assistente Hospitalar Graduada Cardiologia, Hospital Santa Marta, Centro Hospitalar Universitário Lisbon Central, Lisbon, Portugal.,NOVA Medical School, Lisbon, Portugal
| | | | - Anita Sadeghpour
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran.,Duke Cardiovascular MR Center, Durham, NC, USA
| | - Pilar Tornos
- Cardiology Service, Hospital Quiron, Barcelona, Spain
| | | | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gilbert Habib
- Department of Cardiology, APHM, La Timone Hospital, Marseille, France.,University Hospital of Liege (CHU), Liege, Belgium
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Roque A, Pizzi MN, Fernández-Hidalgo N, Permanyer E, Cuellar-Calabria H, Romero-Farina G, Ríos R, Almirante B, Castell-Conesa J, Escobar M, Ferreira-González I, Tornos P, Aguadé-Bruix S. Correction to: Morpho-metabolic post-surgical patterns of non-infected prosthetic heart valves by [18F]FDG PET/CTA: "normality" is a possible diagnosis. Eur Heart J Cardiovasc Imaging 2022; 23:e273. [PMID: 35134859 DOI: 10.1093/ehjci/jeac023] [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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Roque A, Pizzi MN, Fernández-Hidalgo N, Permanyer E, Cuellar-Calabria H, Romero-Farina G, Ríos R, Almirante B, Castell-Conesa J, Escobar M, Ferreira-González I, Tornos P, Aguadé-Bruix S. Morpho-metabolic post-surgical patterns of non-infected prosthetic heart valves by [18F]FDG PET/CTA: "normality" is a possible diagnosis. Eur Heart J Cardiovasc Imaging 2021; 21:24-33. [PMID: 31539031 DOI: 10.1093/ehjci/jez222] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/17/2019] [Indexed: 02/07/2023] Open
Abstract
AIMS To define characteristic PET/CTA patterns of FDG uptake and anatomic changes following prosthetic heart valves (PVs) implantation over time, to help not to misdiagnose post-operative inflammation and avoid false-positive cases. METHODS AND RESULTS Prospective evaluation of 37 post-operative patients without suspected infection that underwent serial cardiac PET/CTA examinations at 1, 6, and 12 months after surgery, in which metabolic features (FDG uptake distribution pattern and intensity) and anatomic changes were evaluated. Standardized uptake values (SUVs) were obtained and a new measure, the valve uptake index (VUI), (SUVmax-SUVmean)/SUVmax, was tested to homogenize SUV results.In total, 111 PET/CTA scans were performed in 37 patients (19 aortic and 18 mitral valves). FDG uptake was visually detectable in 79.3% of patients and showed a diffuse, homogeneous distribution pattern in 93%. Quantitative analysis yielded a mean maximum standardized uptake value (SUVmax) of 4.46 ± 1.50 and VUI of 0.35 ± 0.10. There were no significant differences in FDG distribution or uptake values between 1, 6, or 12 months. No abnormal anatomic changes or endocarditis lesions were detected in any patient during follow-up. CONCLUSIONS FDG uptake, often seen in recently implanted PVs, shows a characteristic pattern of post-operative inflammation and, in the absence of associated anatomic lesions, could be considered a normal finding. These features remain stable for at least 1 year after surgery, so questioning the recommended 3-month safety period. A new measure, the VUI, can be useful for evaluating the FDG distribution pattern.
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Affiliation(s)
- Albert Roque
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain.,IDI (Institut de Diagnòstic per la Imatge), Spain.,Universitat Autònoma de Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - María N Pizzi
- Universitat Autònoma de Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Passeig Vall d'Hebron 119-129, Barcelona, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - Nuria Fernández-Hidalgo
- Universitat Autònoma de Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Passeig Vall d'Hebron 119-129, Barcelona, Spain.,Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - Eduard Permanyer
- Department of Cardiac Surgery, Quirónsalud Teknon Heart Institute, Carrer de Vilana 12, Barcelona, Spain
| | - Hug Cuellar-Calabria
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain.,IDI (Institut de Diagnòstic per la Imatge), Spain.,Universitat Autònoma de Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - Guillermo Romero-Farina
- Vall d'Hebron Institut de Recerca (VHIR), Passeig Vall d'Hebron 119-129, Barcelona, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - Remedios Ríos
- Universitat Autònoma de Barcelona, Spain.,Department of Cardiac Surgery, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - Benito Almirante
- Universitat Autònoma de Barcelona, Spain.,Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - Joan Castell-Conesa
- IDI (Institut de Diagnòstic per la Imatge), Spain.,Universitat Autònoma de Barcelona, Spain.,Department of Nuclear Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Manuel Escobar
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain.,IDI (Institut de Diagnòstic per la Imatge), Spain
| | - Ignacio Ferreira-González
- Universitat Autònoma de Barcelona, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Pilar Tornos
- Universitat Autònoma de Barcelona, Spain.,Department of Cardiology, Hospital Quirónsalud, Plaça d'Alfonso Comín 5, Barcelona, Spain
| | - Santiago Aguadé-Bruix
- Universitat Autònoma de Barcelona, Spain.,Department of Nuclear Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Habib G, Erba PA, Iung B, Donal E, Cosyns B, Laroche C, Popescu BA, Prendergast B, Tornos P, Sadeghpour A, Oliver L, Vaskelyte JJ, Sow R, Axler O, Maggioni AP, Lancellotti P. Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. Eur Heart J 2020; 40:3222-3232. [PMID: 31504413 DOI: 10.1093/eurheartj/ehz620] [Citation(s) in RCA: 349] [Impact Index Per Article: 87.3] [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: 04/26/2019] [Revised: 06/25/2019] [Accepted: 08/12/2019] [Indexed: 12/22/2022] Open
Abstract
AIMS The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE). METHODS AND RESULTS Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. CONCLUSION Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.
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Affiliation(s)
- Gilbert Habib
- Cardiology Department, APHM, La Timone Hospital, Boulevard Jean Moulin, Marseille, France.,Aix Marseille University, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Paola Anna Erba
- Nuclear Medicine, Department of Translational Research and New Technology, Medicine University of Pisa and Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,Medical Imaging Center, University Medical Center Groningen, Groningen, The Netherlands
| | - Bernard Iung
- Bichat Hospital, APHP, DHU Fire, Paris Diderot University, Paris, France
| | - Erwan Donal
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Bernard Cosyns
- Center for Cardiovascular Diseases (CHVZ), University Hospital Brussel, Brussels, Belgium
| | - Cécile Laroche
- EURObservational Research Programme (EORP), European Society of Cardiology, Sophia-Antipolis, France
| | - Bogdan A Popescu
- Department of Cardiology, University of Medicine and Pharmacy "Carol Davila" Euroecolab, Emergency Institute of Cardiovascular Diseases "Prof. Dr C. C. Iliescu", Bucharest, Romania
| | - Bernard Prendergast
- Department of Cardiology, Guy's and St Thomas' Hospital, London, Great Britain
| | - Pilar Tornos
- Department of Cardiology, Hospital Quiron Barcelona
| | - Anita Sadeghpour
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Leopold Oliver
- Department of Cardiovascular Medicine, SOS Endocardites Unit, Henri-Mondor University Hospital, AP-HP, Creteil, France
| | | | | | - Olivier Axler
- Cardiology Department, Gaston Bourret Hospital Centre, New Caledonia University, Noumea, New Caledonia, France
| | - Aldo P Maggioni
- EURObservational Research Programme, European Society of Cardiology, France
| | - Patrizio Lancellotti
- ANMCO Research Center, Florence, Italy.,Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
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7
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Abstract
Infective endocarditis (IE) is a complex disease with cardiac involvement and multiorgan complications. Its prognosis depends on prompt diagnosis that leads to an aggressive therapeutic management combining antibiotic therapy and early cardiac surgery when indicated. However, IE diagnosis always poses a challenge, and echocardiography remains diagnostically imperfect in cases of prosthetic valve IE or cardiac implantable electronic device infection. In recent years, other imaging modalities (computed tomography, magnetic resonance imaging, nuclear imaging) have experienced significant technical improvements, and their application to the detection of cardiac and extracardiac IE-related lesions seems to be a strategic way forward in the management of patients with suspected IE. However, the scientific evidence in the literature remains limited; current guidelines address the use of the multimodality imaging in the field of IE with caution; the incremental value of each technique and their combinations is debated; and their use varies across countries. Despite these limitations, healthcare providers and surgeons should be aware of the possibilities offered by the multimodal imaging approach when appropriate. Here, we emphasize the value of a multidisciplinary heart valve team, the endocarditis team, underlining the importance of cardiac and extracardiac imaging experts in playing a key role in informing the diagnosis and management of patients with IE. Illustrative cases, critical appraisal of contemporary data, and conceptual and practical suggestions for clinicians that may help to improve the prognosis of patients with IE are provided in this review article.
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Affiliation(s)
- Paola A Erba
- Nuclear Medicine, Department of Translational Research and New Technology in Medicine, University of Pisa, Italy (P.A.E.).,University of Groningen, University Medical Center Groningen, Medical Imaging Center, The Netherlands (P.A.E.)
| | - Maria N Pizzi
- Departments of Cardiology (M.N.P.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Spain (M.N.P., A.R., P.T.)
| | - Albert Roque
- Radiology (A.R.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Spain (M.N.P., A.R., P.T.)
| | - Erwan Salaun
- APHM, La Timone Hospital, Cardiology Department, Marseille, France (E.S., G.H.)
| | - Patrizio Lancellotti
- Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Belgium (P.L.).,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy (P.L.)
| | - Pilar Tornos
- Department of Cardiology, Hospital Quirónsalud, Barcelona, Spain (P.T.)
| | - Gilbert Habib
- APHM, La Timone Hospital, Cardiology Department, Marseille, France (E.S., G.H.).,Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, France (G.H.)
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8
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Habib G, Lancellotti P, Erba PA, Sadeghpour A, Meshaal M, Sambola A, Furnaz S, Citro R, Ternacle J, Donal E, Cosyns B, Popescu B, Iung B, Prendergast B, Laroche C, Tornos P, Pazdernik M, Maggioni A, Gale CP. The ESC-EORP EURO-ENDO (European Infective Endocarditis) registry. Eur Heart J Qual Care Clin Outcomes 2019; 5:202-207. [PMID: 30957862 DOI: 10.1093/ehjqcco/qcz018] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 03/23/2019] [Accepted: 04/04/2019] [Indexed: 09/12/2023]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) European Endocarditis (EURO-ENDO) registry aims to study the care and outcomes of patients diagnosed with infective endocarditis (IE) and compare findings with recommendations from the 2015 ESC Clinical Practice Guidelines for the management of IE and data from the 2001 Euro Heart Survey. METHODS AND RESULTS Patients (n = 3116) aged over 18 years with a diagnosis of IE based on the ESC 2015 IE diagnostic criteria were prospectively identified between 1 January 2016 and 31 March 2018. Individual patient data were collected across 156 centres and 40 countries. The primary endpoint is all-cause mortality in hospital and at 1 year. Secondary endpoints are 1-year morbidity (all-cause hospitalization, any cardiac surgery, and IE relapse), the clinical, epidemiological, microbiological, and therapeutic characteristics of patients, the number and timing of non-invasive imaging techniques, and adherence to recommendations as stated in the 2015 ESC Clinical Practice Guidelines for the management of IE. CONCLUSION EURO-ENDO is an international registry of care and outcomes of patients hospitalized with IE which will provide insights into the contemporary profile and management of patients with this challenging disease.
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Affiliation(s)
- Gilbert Habib
- Cardiology Department, APHM, La Timone Hospital, Boulevard Jean Moulin, Marseille, France
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Patrizio Lancellotti
- Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Avenue de l'hôpital, n1, ège, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Paola-Anna Erba
- Department of Nuclear Medicine, University of Pisa, Pisa, Italy
- University of Groningen, University Medical Center Groningen, Medical Imaging Center, Groningen, The Netherlands
| | - Anita Sadeghpour
- Rajaie Cardiovascular Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Marwa Meshaal
- Cairo University Hospitals (Kasr Al Ainy Hospitals), Cairo, Egypt
| | - Antonia Sambola
- Department of Cardiology University Hospital Vall d'Hebron, Barcelona, Spain
| | - Shumaila Furnaz
- National Institute of Cardiovascular Disease, Karachi, Pakistan
| | - Rodolfo Citro
- University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Julien Ternacle
- Department of cardiology, SOS Endocardites, Henri Mondor Hospital, Creteil, France
| | - Erwan Donal
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Bernard Cosyns
- Centrum voor Hart en Vaatziekten (CHVZ), Unversitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussel, Belgium
| | - Bogdan Popescu
- Department of Cardiology, University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Emergency Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, Sector 2, Bucharest, Romania
| | | | | | - Cécile Laroche
- EURObservational Research programme (EORP), European Society of Cardiology, Sophia-Antipolis, France
| | - Pilar Tornos
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Michal Pazdernik
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Aldo Maggioni
- EURObservational Research Programme, European Society of Cardiology, France ANMCO Research Center, Florence, Italy
| | - Chris P Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
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9
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Ribera A, Slof J, Ferreira-González I, Serra V, García-Del Blanco B, Cascant P, Andrea R, Falces C, Gutiérrez E, Del Valle-Fernández R, Morís-de laTassa C, Mota P, Oteo JF, Tornos P, García-Dorado D. The impact of waiting for intervention on costs and effectiveness: the case of transcatheter aortic valve replacement. Eur J Health Econ 2018; 19:945-956. [PMID: 29170843 DOI: 10.1007/s10198-017-0941-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The economic crisis in Europe might have limited access to some innovative technologies implying an increase of waiting time. The purpose of the study is to evaluate the impact of waiting time on the costs and benefits of transcatheter aortic valve replacement (TAVR) for the treatment of severe aortic stenosis. METHODS This is a cost-utility analysis from the perspective of the Spanish National Health Service. Results of two prospective hospital registries (158 and 273 consecutive patients) were incorporated into a probabilistic Markov model to compare quality adjusted life years (QALYs) and costs for TAVR after waiting for 3-12 months, relative to immediate TAVR. We simulated a cohort of 1000 patients, male, and 80 years old; other patient profiles were assessed in sensitivity analyses. RESULTS As waiting time increased, costs decreased at the expense of lower survival and loss of QALYs, leading to incremental cost-effectiveness ratios for eliminating waiting lists of about 12,500 € per QALY. In subgroup analyses prioritization of patients for whom higher benefit was expected led to a smaller loss of QALYs. Concerning budget impact, long waiting lists reduced spending considerably and permanently. CONCLUSIONS A shorter waiting time is likely to be cost-effective (considering commonly accepted willingness-to-pay thresholds in Europe) relative to 3 months or longer waiting periods. If waiting lists are nevertheless seen as unavoidable due to severe but temporary budgetary restrictions, prioritizing patients for whom higher benefit is expected appears to be a way of postponing spending without utterly sacrificing patients' survival and quality of life.
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Affiliation(s)
- Aida Ribera
- Cardiovascular Clinical Epidemiology Unit, Cardiology Department, University Hospital Vall d'Hebron, Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain
- Cardiology Department (CIBERCV), University Hospital Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - John Slof
- Department of Business, Universitat Autònoma de Barcelona, B2, Av. de l'Eix Central, s/n, 08193 Cerdanyola del Vallès, Barcelona, Spain
| | - Ignacio Ferreira-González
- Cardiovascular Clinical Epidemiology Unit, Cardiology Department, University Hospital Vall d'Hebron, Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
- Cardiology Department (CIBERCV), University Hospital Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - Vicente Serra
- Cardiology Department (CIBERCV), University Hospital Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Bruno García-Del Blanco
- Cardiology Department, Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | - Purificació Cascant
- Cardiovascular Clinical Epidemiology Unit, Cardiology Department, University Hospital Vall d'Hebron, Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Rut Andrea
- Cardiology Department, Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | - Carlos Falces
- Cardiology Department, Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | - Enrique Gutiérrez
- Cardiology Department, Departamento de Medicina, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Calle del Dr. Esquerdo, 46, 28007, Madrid, Spain
| | - Raquel Del Valle-Fernández
- Unidad de Hemodinamica y Cardiología Intervencionista, Area del Corazón, Hospital Universitario Central de Asturias, Av. De Roma, 33011, Oviedo, Asturias, Spain
| | - César Morís-de laTassa
- Unidad de Hemodinamica y Cardiología Intervencionista, Area del Corazón, Hospital Universitario Central de Asturias, Av. De Roma, 33011, Oviedo, Asturias, Spain
| | - Pedro Mota
- Servicio de Cardiología, ICICOR, Hospital Clínico Universitario, Av. Ramón y Cajal, 3, 47003, Valladolid, Spain
| | - Juan Francisco Oteo
- Servicio de Cardiología, Hospital Puerta de Hierro, C/Manuel de Falla, 1, Majadahonda, 28222, Madrid, Spain
| | - Pilar Tornos
- Cardiology Department (CIBERCV), University Hospital Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - David García-Dorado
- Cardiology Department (CIBERCV), University Hospital Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain
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Lozano Torres J, Rodriguez Palomares JF, Dentamaro I, Gutierrez Garcia L, Valente F, Teixido G, Galian L, Fernandez-Galera R, Evangelista A, Garcia-Dorado D, Tornos P, Gonzalez-Alujas MT. P1596Clinical and imaging determinants of clinical outcomes and survival in redo surgery in tricuspid regurgitation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1596] [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)
- J Lozano Torres
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - I Dentamaro
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - F Valente
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - G Teixido
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - A Evangelista
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - D Garcia-Dorado
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - P Tornos
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
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11
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Roque A, Pizzi MN, Fernandez-Hidalgo N, Cuellar-Calabria H, Rios R, Ferreira N, Sambola A, Almirante B, Garcia-Dorado D, Castell J, Escobar M, Tornos P, Aguade-Bruix S. 524918F-FDG-PET/CTA of prosthetic cardiac valves: postsurgical inflammatory patterns and its temporal evolution. Can we question the 3-month limit of the current guidelines? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5249] [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 Roque
- University Hospital Vall d'Hebron, Radiology, Barcelona, Spain
| | - M N Pizzi
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | | | - R Rios
- University Hospital Vall d'Hebron, Cardiac Surgery, Barcelona, Spain
| | - N Ferreira
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Sambola
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - B Almirante
- University Hospital Vall d'Hebron, Infectious Diseases, Barcelona, Spain
| | - D Garcia-Dorado
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - J Castell
- University Hospital Vall d'Hebron, Nuclear Medicine, Barcelona, Spain
| | - M Escobar
- University Hospital Vall d'Hebron, Radiology, Barcelona, Spain
| | - P Tornos
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - S Aguade-Bruix
- University Hospital Vall d'Hebron, Nuclear Medicine, Barcelona, Spain
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12
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Pizzi MN, Fernandez-Hidalgo N, Cuellar-Calabria H, Gonzalez-Alujas MT, Ferreira-Gonzalez I, Maisterra-Santos O, Rios R, Sambolla-Ayala A, Garcia-Dorado D, Almirante B, Tornos P, Aguade-Bruix S, Castell-Conesa J, Roque A. P2274First assessment of the clinical impact and confirmation of the diagnostic ability of the 18F-FDG-PET/CTA prosthetic valve endocarditis. New data supports initial results. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2274] [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: 11/14/2022] Open
Affiliation(s)
- M N Pizzi
- Hospital Vall d'Hebron, Cardiology Department, Epidemiology Unit, Barcelona, Spain
| | - N Fernandez-Hidalgo
- University Hospital Vall d'Hebron, Infectious Diseases Department, Barcelona, Spain
| | - H Cuellar-Calabria
- University Hospital Vall d'Hebron, Radiology Department, Barcelona, Spain
| | - M T Gonzalez-Alujas
- Hospital Vall d'Hebron, Cardiology Department, Epidemiology Unit, Barcelona, Spain
| | - I Ferreira-Gonzalez
- Hospital Vall d'Hebron, Cardiology Department, Epidemiology Unit, Barcelona, Spain
| | | | - R Rios
- University Hospital Vall d'Hebron, Cardiovascular Surgery, Barcelona, Spain
| | - A Sambolla-Ayala
- Hospital Vall d'Hebron, Cardiology Department, Epidemiology Unit, Barcelona, Spain
| | - D Garcia-Dorado
- Hospital Vall d'Hebron, Cardiology Department, Epidemiology Unit, Barcelona, Spain
| | - B Almirante
- University Hospital Vall d'Hebron, Infectious Diseases Department, Barcelona, Spain
| | - P Tornos
- Hospital Vall d'Hebron, Cardiology Department, Epidemiology Unit, Barcelona, Spain
| | - S Aguade-Bruix
- Universitary Hospital Vall d'Hebron, Nuclear Medicine Department, Barcelona, Spain
| | - J Castell-Conesa
- Universitary Hospital Vall d'Hebron, Nuclear Medicine Department, Barcelona, Spain
| | - A Roque
- University Hospital Vall d'Hebron, Radiology Department, Barcelona, Spain
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13
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Fernández-Hidalgo N, Ferreria-González I, Marsal JR, Ribera A, Aznar ML, de Alarcón A, García-Cabrera E, Gálvez-Acebal J, Sánchez-Espín G, Reguera-Iglesias JM, De La Torre-Lima J, Lomas JM, Hidalgo-Tenorio C, Vallejo N, Miranda B, Santos-Ortega A, Castro MA, Tornos P, García-Dorado D, Almirante B. A pragmatic approach for mortality prediction after surgery in infective endocarditis: optimizing and refining EuroSCORE. Clin Microbiol Infect 2018; 24:1102.e7-1102.e15. [PMID: 29408350 DOI: 10.1016/j.cmi.2018.01.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 11/06/2017] [Revised: 01/13/2018] [Accepted: 01/20/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To simplify and optimize the ability of EuroSCORE I and II to predict early mortality after surgery for infective endocarditis (IE). METHODS Multicentre retrospective study (n = 775). Simplified scores, eliminating irrelevant variables, and new specific scores, adding specific IE variables, were created. The performance of the original, recalibrated and specific EuroSCOREs was assessed by Brier score, C-statistic and calibration plot in bootstrap samples. The Net Reclassification Index was quantified. RESULTS Recalibrated scores including age, previous cardiac surgery, critical preoperative state, New York Heart Association >I, and emergent surgery (EuroSCORE I and II); renal failure and pulmonary hypertension (EuroSCORE I); and urgent surgery (EuroSCORE II) performed better than the original EuroSCOREs (Brier original and recalibrated: EuroSCORE I: 0.1770 and 0.1667; EuroSCORE II: 0.2307 and 0.1680). Performance improved with the addition of fistula, staphylococci and mitral location (EuroSCORE I and II) (Brier specific: EuroSCORE I 0.1587, EuroSCORE II 0.1592). Discrimination improved in specific models (C-statistic original, recalibrated and specific: EuroSCORE I: 0.7340, 0.7471 and 0.7728; EuroSCORE II: 0.7442, 0.7423 and 0.7700). Calibration improved in both EuroSCORE I models (intercept 0.295, slope 0.829 (original); intercept -0.094, slope 0.888 (recalibrated); intercept -0.059, slope 0.925 (specific)) but only in specific EuroSCORE II model (intercept 2.554, slope 1.114 (original); intercept -0.260, slope 0.703 (recalibrated); intercept -0.053, slope 0.930 (specific)). Net Reclassification Index was 5.1% and 20.3% for the specific EuroSCORE I and II. CONCLUSIONS The use of simplified EuroSCORE I and EuroSCORE II models in IE with the addition of specific variables may lead to simpler and more accurate models.
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Affiliation(s)
- N Fernández-Hidalgo
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - I Ferreria-González
- Unitat d'Epidemiologia, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - J R Marsal
- Unitat d'Epidemiologia, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Unitat de Suport a la Recerca Lleida-Pirineus, IDIAP Jordi Gol, Lleida, Spain
| | - A Ribera
- Unitat d'Epidemiologia, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - M L Aznar
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A de Alarcón
- Universitat Autònoma de Barcelona, Barcelona, Spain; Unidad Clínica de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain; Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas, Spain
| | - E García-Cabrera
- Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas, Spain
| | - J Gálvez-Acebal
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas, Spain; Unidad Clínica de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Hospital Universitario Virgen Macarena, Sevilla, Spain; Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - G Sánchez-Espín
- Unidad de Gestión Clínica del Corazón, Instituto de Investigación Biomédica de Málaga (BIMA), Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - J M Reguera-Iglesias
- Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas, Spain; Servicio de Enfermedades Infecciosas, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - J De La Torre-Lima
- Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas, Spain; Grupo de Enfermedades Infecciosas de la Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - J M Lomas
- Unitat de Suport a la Recerca Lleida-Pirineus, IDIAP Jordi Gol, Lleida, Spain; Unidad de Enfermedades Infecciosas, Hospitales Juan Ramón Jiménez-Infanta Elena, Huelva, Spain
| | - C Hidalgo-Tenorio
- Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas, Spain; Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - N Vallejo
- Servicio de Cardiología, Grupo de Trabajo de Endocarditis Infecciosa, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - B Miranda
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Santos-Ortega
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M A Castro
- Servei de Cirurgia Cardíaca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - P Tornos
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - D García-Dorado
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - B Almirante
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
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14
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Quintana E, Falces C, Ambrosioni J, Delahaye F, Selton-Suty C, Tribouilloy C, Tornos P, Cecci E, Hannan M, Wang A, Chu V, Llopis J, Miró J. Risk factors and outcomes of fistulous tract formation in infective aortic endocarditis: A prospective ice cohort study. Cirugía Cardiovascular 2018. [DOI: 10.1016/j.circv.2017.12.008] [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: 11/27/2022] Open
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16
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Tissot-Dupont H, Casalta JP, Gouriet F, Hubert S, Salaun E, Habib G, Fernandez-Gerlinger MP, Mainardi JL, Tattevin P, Revest M, Lucht F, Botelho-Nevers E, Gagneux-Brunon A, Snygg-Martin U, Chan KL, Bishara J, Vilacosta I, Olmos C, San Román JA, López J, Tornos P, Fernández-Hidalgo N, Durante-Mangoni E, Utili R, Paul M, Baddour LM, DeSimone DC, Sohail MR, Steckelberg JM, Wilson WR, Raoult D. International experts' practice in the antibiotic therapy of infective endocarditis is not following the guidelines. Clin Microbiol Infect 2017; 23:736-739. [PMID: 28323194 DOI: 10.1016/j.cmi.2017.03.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 03/06/2017] [Accepted: 03/10/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The management of infective endocarditis (IE) may differ from international guidelines, even in reference centres. This is probably because most recommendations are not based on hard evidence, so the consensus obtained for the guidelines does not represent actual practices. For this reason, we aimed to evaluate this question in the particular field of antibiotic therapy. METHODS Thirteen international centres specialized in the management of IE were selected, according to their reputation, clinical results, original research publications and quotations. They were asked to detail their actual practice in terms of IE antibiotic treatment in various bacteriological and clinical situations. They were also asked to declare their IE-related in-hospital mortality for the year 2015. RESULTS The global compliance with guidelines concerning antibiotic therapy was 58%, revealing the differences between theoretical 'consensus', local recommendations and actual practice. Some conflicts of interest were also probably expressed. The adherence to guidelines was 100% when the protocol was simple, and decreased with the seriousness of the situation (Staphylococus spp. 54%-62%) or in blood-culture-negative endocarditis (0%-15%) that requires adaptation to clinical and epidemiological data. CONCLUSION Worldwide experts in IE management, although the majority of them were involved and co-signed the guidelines, do not follow international consensus guidelines on the particular point of the use of antibiotics.
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Affiliation(s)
- H Tissot-Dupont
- URMITE, Aix Marseille Université, UMR 7278, IRD 198, INSERM 1095, IHU-Méditerranée Infection, Marseille, France
| | - J P Casalta
- URMITE, Aix Marseille Université, UMR 7278, IRD 198, INSERM 1095, IHU-Méditerranée Infection, Marseille, France
| | - F Gouriet
- URMITE, Aix Marseille Université, UMR 7278, IRD 198, INSERM 1095, IHU-Méditerranée Infection, Marseille, France
| | - S Hubert
- Département de Cardiologie, Centre Hospitalier Universitaire, Hôpital de La Timone, AP-HM, Aix-Marseille Université, Marseille, France
| | - E Salaun
- Département de Cardiologie, Centre Hospitalier Universitaire, Hôpital de La Timone, AP-HM, Aix-Marseille Université, Marseille, France
| | - G Habib
- Département de Cardiologie, Centre Hospitalier Universitaire, Hôpital de La Timone, AP-HM, Aix-Marseille Université, Marseille, France
| | - M P Fernandez-Gerlinger
- Unité Mobile de Microbiologie Clinique, Service de Microbiologie, Hôpital européen Georges-Pompidou, Université Paris Descartes, Paris, France
| | - J L Mainardi
- Unité Mobile de Microbiologie Clinique, Service de Microbiologie, Hôpital européen Georges-Pompidou, Université Paris Descartes, Paris, France
| | - P Tattevin
- Service des Maladies Infectieuses et de Réanimation Médicale, Hôpital Pontchaillou, Université Rennes-I, Rennes, France
| | - M Revest
- Service des Maladies Infectieuses et de Réanimation Médicale, Hôpital Pontchaillou, Université Rennes-I, Rennes, France
| | - F Lucht
- Infectious Diseases Department, University Hospital of Saint-Etienne, France
| | - E Botelho-Nevers
- Infectious Diseases Department, University Hospital of Saint-Etienne, France
| | - A Gagneux-Brunon
- Infectious Diseases Department, University Hospital of Saint-Etienne, France
| | - U Snygg-Martin
- Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - K L Chan
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - J Bishara
- Infectious Disease Unit Rabin Medical Centre, Beilinson Hospital Sackler Faculty of Medicine, Tel-Aviv University, Jabotinsky 39, Petah-Tiqva, Israel
| | - I Vilacosta
- Servicio de Cardiología, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
| | - C Olmos
- Servicio de Cardiología, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
| | - J A San Román
- Servicio de Cardiología, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - J López
- Servicio de Cardiología, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - P Tornos
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - N Fernández-Hidalgo
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - E Durante-Mangoni
- Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy
| | - R Utili
- Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy
| | - M Paul
- Ramban Health Care Campus, Haifa, Israel
| | - L M Baddour
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - D C DeSimone
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - M R Sohail
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - J M Steckelberg
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - W R Wilson
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - D Raoult
- URMITE, Aix Marseille Université, UMR 7278, IRD 198, INSERM 1095, IHU-Méditerranée Infection, Marseille, France.
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Tornos P, Ribera A. A Decade of Experience With Transcatheter Aortic Valve Replacement: Now Is the Time to Resolve Doubts About Long-term Effectiveness. ACTA ACUST UNITED AC 2017; 70:234-235. [PMID: 28109851 DOI: 10.1016/j.rec.2016.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/03/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Pilar Tornos
- Servicio de Cardiología, Hospital Vall d'Hebron y Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - Aida Ribera
- Unidad de Epidemiología, Servicio de Cardiología, Hospital Vall d'Hebron y Vall d'Hebron Institut de Recerca (VHIR), CIBER de Epidemiología y Salud Pública, Barcelona, Spain
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Castrodeza J, Amat-Santos IJ, Serra V, Nombela-Franco L, Brinster DR, Gutiérrez-Ibanes E, Rojas P, Tornos P, Carnero M, Cortes C, Tobar J, Di Stefano S, Gomez I, San Román JA. Therapeutic alternatives after aborted sternotomy at the time of surgical aortic valve replacement in the TAVI Era-Five centre experience and systematic review. Int J Cardiol 2016; 223:1019-1024. [PMID: 27592044 DOI: 10.1016/j.ijcard.2016.08.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND We aimed to analyze causes, management, and outcomes of the unexpected need to abort sternotomy in aortic stenosis (AS) patients accepted for surgical aortic valve replacement (SAVR) in the transcatheter aortic valve implantation (TAVI) era. METHODS Cases of aborted sternotomy (AbS) were gathered from 5 centers between 2009 and 2014. A systematic review of all published cases in the same period was performed. RESULTS A total of 31 patients (71% males, 74±8years, LogEuroSCORE 11.9±7.4%) suffered an AbS (0.19% of all sternotomies). Main reasons for Abs included previously unknown porcelain aorta (PAo) in 83.9%, mediastinal fibrosis due to radiotherapy in 12.9%, and chronic mediastinitis in 3.2%. Median time between AbS and next intervention was 2.3months (IQR: 0.7-5.8) with no mortality within this period. Only a case was managed with open surgery. In 30 patients (96.8%) TAVI was performed with a rate of success of 86.7%. Three patients (9.7%) presented in-hospital death and 17 (54.8%) had in-hospital complications including heart failure (9.6%), major bleeding (6.9%), and acute kidney injury (9.6%). Older patients (76±8 vs. 70±8years, p=0.045), previous cardiac surgery (60% vs. 15.4%, p=0.029), and shorter time from AbS to next intervention (5.1±5 vs. 1±0.7months, p=0.001) were related to higher six-month mortality (22.6%). CONCLUSIONS The main reason for AbS was PAo. This entity was associated to a higher rate of complications and mortality, especially in older patients and with prior cardiac surgery. A preventive strategy in these subgroups might be based on imaging evaluation. TAVI was the most extended therapy.
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Affiliation(s)
- Javier Castrodeza
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Ignacio J Amat-Santos
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain.
| | - Vicenç Serra
- Cardiology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Luis Nombela-Franco
- Cardiology Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | | | | | - Paol Rojas
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Pilar Tornos
- Cardiology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Manuel Carnero
- Cardiac Surgery Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Carlos Cortes
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Javier Tobar
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Salvatore Di Stefano
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Itziar Gomez
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - José A San Román
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
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Pizzi MN, Roque A, Cuéllar-Calabria H, Fernández-Hidalgo N, Ferreira-González I, González-Alujas MT, Igual-Barceló A, Garcia-Dorado D, Almirante B, Castell-Conesa J, Escobar Amores M, Tornos P, Aguadé-Bruix S. 18F-FDG-PET/CTA of Prosthetic Cardiac Valves and Valve-Tube Grafts: Infective Versus Inflammatory Patterns. JACC Cardiovasc Imaging 2016; 9:1224-1227. [PMID: 27639767 DOI: 10.1016/j.jcmg.2016.05.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [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: 04/07/2016] [Revised: 05/26/2016] [Accepted: 05/26/2016] [Indexed: 01/09/2023]
Affiliation(s)
- María N Pizzi
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Albert Roque
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain
| | - Hug Cuéllar-Calabria
- Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain
| | - Nuria Fernández-Hidalgo
- Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ignacio Ferreira-González
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Alberto Igual-Barceló
- Department of Cardiac Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - David Garcia-Dorado
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Benito Almirante
- Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Joan Castell-Conesa
- Universitat Autònoma de Barcelona, Barcelona, Spain; IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain; Department of Nuclear Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Manuel Escobar Amores
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain
| | - Pilar Tornos
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Santiago Aguadé-Bruix
- Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Nuclear Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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20
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Galian L, Tornos P. Resultados esperanzadores para una patología de alto riesgo: la estenosis aórtica severa con disfunción ventricular izquierda. Cirugía Cardiovascular 2016. [DOI: 10.1016/j.circv.2016.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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21
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Sambola A, Mutuberría M, García del Blanco B, Alonso A, Barrabés JA, Bueno H, Alfonso F, Cequier A, Zueco J, Rodríguez-Leor O, Tornos P, García-Dorado D. Impact of Triple Therapy in Elderly Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention. PLoS One 2016; 11:e0147245. [PMID: 26808678 PMCID: PMC4726489 DOI: 10.1371/journal.pone.0147245] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 01/03/2016] [Indexed: 11/29/2022] Open
Abstract
Background and Purpose Selecting an ideal antithrombotic therapy for elderly patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) can be challenging since they have a higher thromboembolic and bleeding risk than younger patients. The current study aimed to assess the efficacy and safety of triple therapy (TT: oral anticoagulation plus dual antiplatelet therapy: aspirin plus clopidogrel) in patients ≥75 years of age with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). Methods A prospective multicenter study was conducted from 2003 to 2012 at 6 Spanish teaching hospitals. A cohort study of consecutive patients with AF undergoing PCI and treated with TT or dual antiplatelet therapy (DAPT) was analyzed. All outcomes were evaluated at 1-year of follow-up. Results Five hundred and eighty-five patients, 289 (49%) of whom were ≥75 years of age (79.6±3.4 years; 33% women) were identified. TT was prescribed in 55.9% of patients at discharge who had a higher thromboembolic risk (CHA2DS2VASc score: 4.23±1.51 vs 3.76±1.40, p = 0.007 and a higher bleeding risk (HAS-BLED ≥3: 88.6% vs 79.2%, p = 0.02) than those on DAPT. Therefore, patients on TT had a lower rate of thromboembolism than those on DAPT (0.6% vs 6.9%, p = 0.004; HR 0.08, 95% CI: 0.01–0.70, p = 0.004). Major bleeding events occurred more frequently in patients on TT than in those on DAPT (11.7% vs 2.4%, p = 0.002; HR 5.2, 95% CI: 1.53–17.57, p = 0.008). The overall mortality rate was similar in both treatment groups (11.9% vs 13.9%, p = 0.38); however, after adjustment for confounding variables, TT was associated with a reduced mortality rate (HR 0.33, 95% CI: 0.12–0.86, p = 0.02). Conclusions In elderly patients with AF undergoing PCI, the use of TT compared to DAPT was associated with reduced thromboembolism and mortality rates, although a higher rate of major bleeding.
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Affiliation(s)
- Antonia Sambola
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- * E-mail:
| | - Maria Mutuberría
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bruno García del Blanco
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albert Alonso
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José A. Barrabés
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Héctor Bueno
- Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Fernando Alfonso
- Cardiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Angel Cequier
- Cardiology Department, Hospital Universitari de Bellvitge, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Javier Zueco
- Cardiology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Oriol Rodríguez-Leor
- Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Pilar Tornos
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David García-Dorado
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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22
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Sambola A, Mutuberría M, García del Blanco B, Alonso A, Barrabés JA, Alfonso F, Bueno H, Cequier A, Zueco J, Rodríguez-Leor O, Bosch E, Tornos P, García-Dorado D. Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification. Circ J 2016; 80:354-62. [DOI: 10.1253/circj.cj-15-0923] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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)
- Antonia Sambola
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
| | - Maria Mutuberría
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
| | - Bruno García del Blanco
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
| | - Albert Alonso
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
| | - José A. Barrabés
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
| | - Fernando Alfonso
- Cardiology Department, Hospital Universitario Clínico San Carlos
| | - Héctor Bueno
- Cardiology Department, Hospital General Universitario Gregorio Marañón
| | - Angel Cequier
- Cardiology Department, Hospital Universitari de Bellvitge
| | - Javier Zueco
- Cardiology Department, Hospital Universitario Marqués de Valdecilla
| | | | - Eduard Bosch
- Cardiology Department, Hospital Universitari Parc Taulí
| | - Pilar Tornos
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
| | - David García-Dorado
- Cardiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
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23
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Mutuberría-Urdaniz M, Rodríguez-Palomares JF, Ferreira I, Bañeras J, Teixidó G, Gutiérrez L, Zavala G, González-Alujas MT, Evangelista A, Tornos P, García-Dorado D. Non-obstructive prosthetic heart valve thrombosis (NOPVT): Really a benign entity? Int J Cardiol 2015; 197:16-22. [PMID: 26113471 DOI: 10.1016/j.ijcard.2015.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 05/03/2015] [Accepted: 06/16/2015] [Indexed: 11/25/2022]
Abstract
AIMS To assess the effectiveness of different treatment strategies in patients with non-obstructive prosthetic valve thrombosis (NOPVT) during hospitalization and long-term follow-up. METHODS NOPVT was diagnosed by transesophageal echocardiography. Resolution was defined as the disappearance or reduction of the thrombus under anticoagulation. All cases were first managed with optimization of anticoagulation. At discharge, patients received oral anticoagulation (OAC) alone or OAC and antiplatelet therapy (double treatment). Adverse events were defined as cardiovascular death, recurrence, thromboembolic events or major bleeding. RESULTS From 1997 to 2012, 47 patients (mean age: 65years; women: 60%) were diagnosed with NOPVT (mitral valve: 97%). Previous poor anticoagulation control was documented in 66% of patients. Twenty-one patients (45%) were treated with unfractionated heparin (UFH), especially those with thrombus size >10mm (19/21). Optimization of OAC was performed in the remaining patients. Treatment failed in 13 (27.6%) patients, mostly in those who received UFH (10/13), requiring surgery (53.8%) or fibrinolysis (30.7%). Forty-two patients survived and, at discharge, 44% of patients received OAC alone and 56% the double treatment. At follow-up (median 23months; range 0.03-116months), 59.5% of patients presented cardiovascular events, however no differences in outcome were observed with double treatment or OAC alone (p=0.385). CONCLUSIONS NOPVT is a high-risk complication, not only during hospitalization but also during follow-up. Optimization of anticoagulation is efficient in most patients except in thrombi ≥10mm treated with UFH. The double treatment does not prevent adverse events or complications during follow-up.
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Affiliation(s)
- María Mutuberría-Urdaniz
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - José F Rodríguez-Palomares
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignacio Ferreira
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Bañeras
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gisela Teixidó
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Gutiérrez
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - German Zavala
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria T González-Alujas
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Artur Evangelista
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Tornos
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David García-Dorado
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Barcelona, Spain; Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
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24
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Goya M, Casellas M, Merced C, Pijuan-Domenech A, Galián L, Dos L, Casaldáliga J, Subirana M, Pedrosa V, Rojas M, Martínez C, Ferreira I, Monts M, Gascón A, Mendoza M, Baró F, Suy A, Lopez-Gil V, Manrique S, Tornos P, García-Dorado D, Carreras E, Cabero L. Predictors of obstetric complications in women with heart disease. J Matern Fetal Neonatal Med 2015; 29:2306-11. [PMID: 26371393 DOI: 10.3109/14767058.2015.1085012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The objective of this study is to evaluate obstetric outcomes in women with heart disease and determine whether current multidisciplinary management approaches adversely affect the mother, the neonate, or both. Also to compare the accuracy of several risk scores (RS) including the modified World Health Organization classification (mWHO) and CARPREG to predict obstetric and neonatal complications and to study the addition value of Uteroplacental-Doppler flow (UDF) parameters to predict obstetric complications. METHODS A prospective cohort study examined outcomes in women with heart disease (HD), the majority of whom had corrective surgery and delivered between January 2007 and March 2012. RESULTS One hundred and seventy-four patients with 179 pregnancies were included in the study. Obstetric complications, including premature labor, arose in 87 patients (48.6%). Neonatal complications were observed in 11 cases (7%). On multivariate analysis, maternal heart disease was predictive of adverse perinatal events (46 cases, 25.7%) and mode of delivery (Thierry's spatula) of third- or fourth-degree perineal tears (six cases, 3.2%). mWHO classification predicted obstetric complications (p = 0.0001) better than the CARPREG study. Impaired UDF (uterine artery pulsatility index-20 weeks and umbilical artery pulsatility index-32 weeks in HD versus healthy women: 20w 1.12 versus 1.34, p = 0.005; 32w 0.87 versus 1.09, p = 0.008) was associated with adverse obstetric and offspring outcome in the group of HD pregnant women. CONCLUSIONS Nearly 50% of pregnancies were associated with an adverse obstetric outcome, particularly IUGR. mWHO was better at predicting obstetric and neonatal complications that CARPREG in all categories. Furthermore, compromised UDF combined with mWHO improved the prediction of obstetric and offspring complications in this population.
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Affiliation(s)
| | | | | | | | - Laura Galián
- b Department of Cardiology , Congenital Heart Disease Unit , and
| | - Laura Dos
- b Department of Cardiology , Congenital Heart Disease Unit , and
| | | | - Mayte Subirana
- b Department of Cardiology , Congenital Heart Disease Unit , and
| | - Valle Pedrosa
- b Department of Cardiology , Congenital Heart Disease Unit , and
| | | | | | - Ignacio Ferreira
- b Department of Cardiology , Congenital Heart Disease Unit , and
| | | | | | | | | | | | - Victoria Lopez-Gil
- c Department of Anesthesiology , Hospital Vall D'hebron , Barcelona , Spain
| | - Susana Manrique
- c Department of Anesthesiology , Hospital Vall D'hebron , Barcelona , Spain
| | - Pilar Tornos
- b Department of Cardiology , Congenital Heart Disease Unit , and
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25
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Pijuan-Domènech A, Galian L, Goya M, Casellas M, Merced C, Ferreira-Gonzalez I, Marsal-Mora J, Dos-Subirà L, Subirana-Domènech M, Pedrosa V, Baró-Marine F, Manrique S, Casaldàliga-Ferrer J, Tornos P, Cabero L, Garcia-Dorado D. Cardiac complications during pregnancy are better predicted with the modified WHO risk score. Int J Cardiol 2015; 195:149-54. [DOI: 10.1016/j.ijcard.2015.05.076] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/06/2015] [Accepted: 05/14/2015] [Indexed: 10/23/2022]
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26
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Pizzi MN, Roque A, Fernández-Hidalgo N, Cuéllar-Calabria H, Ferreira-González I, Gonzàlez-Alujas MT, Oristrell G, Gracia-Sánchez L, González JJ, Rodríguez-Palomares J, Galiñanes M, Maisterra-Santos O, Garcia-Dorado D, Castell-Conesa J, Almirante B, Aguadé-Bruix S, Tornos P. Improving the Diagnosis of Infective Endocarditis in Prosthetic Valves and Intracardiac Devices With 18F-Fluordeoxyglucose Positron Emission Tomography/Computed Tomography Angiography: Initial Results at an Infective Endocarditis Referral Center. Circulation 2015; 132:1113-26. [PMID: 26276890 DOI: 10.1161/circulationaha.115.015316] [Citation(s) in RCA: 264] [Impact Index Per Article: 29.3] [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: 01/04/2015] [Accepted: 07/13/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND The diagnosis of infective endocarditis (IE) in prosthetic valves and intracardiac devices is challenging because both the modified Duke criteria (DC) and echocardiography have limitations in this population. The added value of (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) and (18)F-FDG PET/CT angiography (PET/CTA) was evaluated in this complex scenario at a referral center with a multidisciplinary IE unit. METHODS AND RESULTS Ninety-two patients admitted to our hospital with suspected prosthetic valve or cardiac device IE between November 2012 and November 2014 were prospectively included. All patients underwent echocardiography and PET/CT, and 76 had cardiac CTA. PET/CT and echocardiography findings were evaluated and compared, with concordant results in 54% of cases (κ=0.23). Initial diagnoses with DC at admission, PET/CT, and DC+PET/CT were compared with the final diagnostic consensus reached by the IE Unit. DC+PET/CT enabled reclassification of 90% of cases initially classified as possible IE with DC and provided a conclusive diagnosis (definite/rejected) in 95% of cases. Sensitivity, specificity, and positive and negative predictive values were 52%, 94.7%, 92.9%, and 59.7% for DC; 87%, 92.1%, 93.6%, and 84.3% for PET/CT; and 90.7%, 89.5%, 92%, and 87.9% for DC+PET/CT. Use of PET/CTA yielded even better diagnostic performance values than PET/nonenhanced CT (91%, 90.6%, 92.8%, and 88.3% versus 86.4%, 87.5%, 90.2%, and 82.9%) and substantially reduced the rate of doubtful cases from 20% to 8% (P<0.001). DC+PET/CTA reclassified an additional 20% of cases classified as possible IE with DC+PET/nonenhanced CT. In addition, PET/CTA enabled detection of a significantly larger number of anatomic lesions associated with active endocarditis than PET/nonenhanced CT (P=0.006) or echocardiography (P<0.001). CONCLUSIONS (18)F-FDG PET/CT improves the diagnostic accuracy of the modified DC in patients with suspected IE and prosthetic valves or cardiac devices. PET/CTA yielded the highest diagnostic performance and provided additional diagnostic benefits.
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Affiliation(s)
- María N Pizzi
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
| | - Albert Roque
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Nuria Fernández-Hidalgo
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Hug Cuéllar-Calabria
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Ignacio Ferreira-González
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - María T Gonzàlez-Alujas
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Gerard Oristrell
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Laura Gracia-Sánchez
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Juan J González
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - José Rodríguez-Palomares
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Manuel Galiñanes
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Olga Maisterra-Santos
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - David Garcia-Dorado
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Joan Castell-Conesa
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Benito Almirante
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Santiago Aguadé-Bruix
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
| | - Pilar Tornos
- From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.)
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Ferreira M, Robalo M, Saraiva T, Cunha M, Goncalves L, Albuquerque A, Ramos D, Costa G, Lima J, Pego M, Peovska I, Davceva Pavlovska J, Pop Gorceva D, Zdravkovska M, Vavlukis M, Kostova N, Bulugahapitiya DS, Feben A, Avison M, Foley J, Martin J, De Graaf MA, Van Den Hoogen I, Leen A, Kharagjitsingh A, Kroft L, Jukema J, Bax J, Scholte A, Patel K, Mahan M, Ananthasubramaniam K, Durmus Altun G, Alpay M, Altun A, Andreini D, Pontone G, Mushtaq S, Bertella E, Conte E, Segurini C, Volpato V, Petulla M, Baggiano A, Pepi M, Van Dijk J, Huizing E, Jager P, Slump C, Ottervanger J, Van Dalen J, Yambao E, Calleja H, Sibulo A, Ramirez Moreno A, Siles Rubio J, Noureddine M, Munoz-Bellido J, Bravo R, Martinez F, Valle A, Milan A, Inigo-Garcia L, Velasco T, Ramaiah VL, Devanbu JS, Taywade SK, Hejjaji VS, Zafrir N, Bental T, Gutstein A, Solodky A, Mats I, Kornowski R, Lagan J, Hasleton J, Meah M, Mcshane J, Trent R, Massalha S, Israel O, Koskosi A, Kopelovich M, Marai I, Venuraju S, Jeevarethinam A, Dumo A, Ruano S, Darko D, Cohen M, Nair D, Rosenthal M, Rakhit R, Lahiri A, Pizzi MN, Roque A, Fernandez-Hidalgo N, Cuellar-Calabria H, Gonzalez-Alujas M, Oristrell G, Rodriguez-Palomares J, Tornos P, Aguade-Bruix S, Smettei O, Abazid R, Ahmed WMK, Samy W, Behairy N, Tayeh O, Hassan A, Berezin A, Kremzer A, Samura T, Berezina T, Scrima G, Bertuccio G, Canseco Nadia N, Cruz Raul C, Gonzalez Cristian G, Hernandez Salvador S, Alexanderson Erick E, Zerahn B, Shugushev Z, Maximkin D, Chepurnoy A, Volkova O, Tsedenova A, Faibushevich A, Baranovich V, Yoshida H, Mizukami A, Matsumura A, Keller M, Silber S, Falcao A, Imada R, Azouri L, Giorgi M, Santos R, Mello S, Kalil Filho R, Meneghetti J, Chalela W, Kanni L, Ohrman T, Nygren AT, Irabi R, Falcao A, Imada R, Azouri L, Parisotto T, Soares J, Kalil Filho R, Meneghetti J, Chalela W, Burrell S, Burrell S, Lo C, Zavadovskyi K, Gulya M, Lishmanov Y, Amin A, Kandeel A, Shaban M, Nawito Z, Caobelli F, Soffientini A, Thackeray J, Bengel F, Pizzocaro C, Guerra U, Hellberg S, Silvola J, Kiugel M, Liljenback H, Savisto N, Thiele A, Laine V, Knuuti J, Roivainen A, Saraste A, Ismail B, Hadizad T, Dekemp R, Beanlands R, Dasilva JN, Hyafil F, Sorbets E, Duchatelle V, Rouzet F, Le Guludec D, Feldman L, Martire V, De Pierris C, Martire M, Pis Diez E, Ramaiah V, Devanbu JS, Hejjaji VS, Lebasnier A, Legallois D, Peyronnet D, Desmonts C, Zalcman G, Bienvenu B, Agostini D, Manrique A, Solomyanyy V, Mintale I, Zabunova M, Narbute I, Ratniece M, Jakobsons E, Kaire K, Kamzola G, Briede I, Jegere S, Erglis A, Mostafa S, Abdelkader M, Abdelkader H, Abdelkhlek S, Khairy E, Huidu S, Popescu A, Lacau S, Huidu A, Dimulescu D, Abazid R, Smettei O, Sayed S, Al Harby F, Habeeb A, Saqqah H, Merganiab S, Selvanayagam J, Harms H, Tolbod L, Hansson N, Kero T, Orndahl L, Kim W, Bouchelouche K, Wiggers H, Frokiaer J, Sorensen J, Hansson N, Tolbod L, Harms H, Wiggers H, Kim W, Hansen E, Zaremba T, Frokiaer J, Sorensen J, Harms H, Tolbod L, Hansson N, Kero T, Orndahl L, Kim W, Bouchelouche K, Wiggers H, Frokiaer J, Sorensen J. Poster Session 3: Tuesday 5 May 2015, 08:30-12:30 * Room: Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev054] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sharir T, Pinskiy M, Brodkin B, Rochman A, Prochorov V, Bojko A, Merzon K, Pardes A, Ghotbi A, Hasbak P, Christensen T, Engstroem T, Lassen M, Kjaer A, Ficaro E, Murthy V, Corbett J, Zoccarato O, Marcassa C, Matheoud R, Savi A, Indovina L, Ren Kaiser S, Bom MJ, Van Der Zee P, Cornel J, Van Der Zant F, Knol R, Pizzi MN, Roque A, Fernandez-Hidalgo N, Cuellar-Calabria H, Gonzalez-Alujas M, Oristrell G, Rodriguez-Palomares J, Tornos P, Aguade-Bruix S, Berezin A, Kremzer A, Gautier M, Legallois D, Belin A, Agostini D, Manrique A. Moderated Poster Session 2: Sunday 3 May 2015, 15:30-16:30 * Room: Moderated Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev048] [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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Ribera A, Slof J, Andrea R, Falces C, Gutiérrez E, del Valle-Fernández R, Morís-de la Tassa C, Mota P, Oteo JF, Cascant P, Altisent OAJ, Sureda C, Serra V, García-del Blanco B, Tornos P, Garcia-Dorado D, Ferreira-González I. Transfemoral transcatheter aortic valve replacement compared with surgical replacement in patients with severe aortic stenosis and comparable risk: Cost–utility and its determinants. Int J Cardiol 2015; 182:321-8. [DOI: 10.1016/j.ijcard.2014.12.109] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 12/22/2014] [Accepted: 12/25/2014] [Indexed: 10/24/2022]
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Mutuberria Urdaniz M, Rodriguez JF, Baneras J, Acosta JG, Buera I, Gonzalez-Alujas MT, Teixido G, Evangelista A, Tornos P, Garcia-Dorado D. Predictors of long term outcome in survivors of prosthetic valve thrombosis: role of medical treatment at discharge. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2129] [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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Alonso Gómez ÁM, Gómez de Diego JJ, Barba J, Barón G, Borrás X, Evangelista A, Fernández González ÁL, García Orta R, Gómez Doblas JJ, Hernández Antolín R, Hernández García JM, Mahía P, Sáez de Ibarra JI, Bermejo J, Cuenca Castillo J, García Fernández MÁ, García Fuster R, López J, López Haldón JE, Tornos P, San Román A, Sitges M, Vilacosta I, Zamorano JL, Anguita M, Cequier Á, Comín J, Diaz-Buschmann I, Fernández Lozano I, Fernández-Ortiz A, Pan M, Wornerm F. Comments on the ESC guidelines on the management of valvular heart disease (version 2012). A report of the Task Force of the Clinical Practice Guidelines Committee of the Spanish Society of Cardiology. Rev Esp Cardiol (Engl Ed) 2013; 66:85-89. [PMID: 24775380 DOI: 10.1016/j.rec.2012.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 10/30/2012] [Indexed: 06/03/2023]
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Lancellotti P, Rosenhek R, Pibarot P, Iung B, Otto CM, Tornos P, Donal E, Prendergast B, Magne J, La Canna G, Piérard LA, Maurer G. ESC Working Group on Valvular Heart Disease position paper--heart valve clinics: organization, structure, and experiences. Eur Heart J 2013; 34:1597-606. [PMID: 23293304 DOI: 10.1093/eurheartj/ehs443] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [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] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND With an increasing prevalence of patients with valvular heart disease (VHD), a dedicated management approach is needed. The challenges encountered are manifold and include appropriate diagnosis and quantification of valve lesion, organization of adequate follow-up, and making the right management decisions, in particular with regard to the timing and choice of interventions. Data from the Euro Heart Survey have shown a substantial discrepancy between guidelines and clinical practice in the field of VHD and many patients are denied surgery despite having clear indications. The concept of heart valve clinics (HVCs) is increasingly recognized as the way to proceed. At the same time, very few centres have developed such expertise, indicating that specific recommendations for the initial development and subsequent operating requirements of an HVC are needed. AIMS The aim of this position paper is to provide insights into the rationale, organization, structure, and expertise needed to establish and operate an HVC. Although the main goal is to improve the clinical management of patients with VHD, the impact of HVCs on education is of particular importance: larger patient volumes foster the required expertise among more senior physicians but are also fundamental for training new cardiologists, medical students, and nurses. Additional benefits arise from research opportunities resulting from such an organized structure and the delivery of standardized care protocols. CONCLUSION The growing volume of patients with VHD, their changing characteristics, and the growing technological opportunities of refined diagnosis and treatment in addition to the potential dismal prognosis if overlooked mandate specialized evaluation and care by dedicated physicians working in a specialized environment that is called the HVC.
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Affiliation(s)
- Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Heart Valve Clinic, University of Liège Hospital, Liège, Belgium.
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Fernández-Hidalgo N, Almirante B, Tornos P, González-Alujas MT, Planes AM, Galiñanes M, Pahissa A. Immediate and long-term outcome of left-sided infective endocarditis. A 12-year prospective study from a contemporary cohort in a referral hospital. Clin Microbiol Infect 2012; 18:E522-30. [PMID: 23077981 DOI: 10.1111/1469-0691.12033] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of this study was to describe the immediate and long-term prognosis of a contemporary cohort of patients with left-sided infective endocarditis (LSIE). A prospective observational cohort study was conducted in a referral centre. Between January 2000 and December 2011, all consecutive adult patients with LSIE were followed-up until death, relapse, recurrence, need for late surgery, or last control. During the active phase of IE, 174 of 438 patients underwent surgery (40% overall; 43% native valve (NVIE), 30% prosthetic valve (PVIE)) and 125 died (29% overall; 26% NVIE, 39% PVIE). The median follow-up in survivors was 3.2 years (interquartile range (IQR) 1.0-6.0 years). Relapses occurred in seven patients (2.2%; 95% CI, 1.1-4.5) and recurrences in eight (2.6%; 95% CI, 1.3-5.0), with an incidence density of 0.0067 per patient-year (95% CI, 0.0029-0.0133) and high mortality (75% of recurrences). Only four of 130 survivors (3.1%; 95% CI, 1.2-7.6) who were treated surgically during the active phase of the disease, and 14/183 (7.7%; 95% CI, 4.6-12.4) of those not undergoing surgery needed operation during follow-up (p 0.09). In the 313 survivors, actuarial survival was 86% at 1 year (87% NVIE, 83% PVIE), 79% at 2 years (81% NVIE, 72% PVIE) and 68% at 5 years (71% NVIE, 57% PVIE). At 1 year, 115 of 397 patients (29.0%; 95% CI, 24.7-33.6) remained alive, with no surgery requirement, relapse or recurrence. LSIE is associated with considerable in-hospital and long-term mortality, especially PVIE. However, relapses, recurrences and the need for late surgery are uncommon.
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Affiliation(s)
- N Fernández-Hidalgo
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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Barba I, Villacorta E, Bratos-Perez MA, Antolín M, Varela E, Sanchez PL, Tornos P, Garcia-Dorado D. Aortic valve-derived calcifyng nanoparticles: no evidence of life. Rev Esp Cardiol 2012; 65:813-8. [PMID: 22748635 DOI: 10.1016/j.recesp.2012.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 03/15/2012] [Indexed: 01/30/2023]
Abstract
INTRODUCTION AND OBJECTIVES Calcifying nanoparticles, also known as "nanobacteria," are very small bacteria-like structures (0.1-0.5 μm) with the ability to facilitate the precipitation and growth of calcium phosphate in pathological conditions and have been associated with aortic valve calcification. The status of nanobacteria is controversial; some have proposed that they are a new class of living organism while others describe calcifying nanoparticles as mineralo-fetuin complexes. The objective of the present study is to elucidate if calcifying nanoparticles are living entities, based on whether or not they have metabolic activity, a characteristic of life, irrespective of their composition. METHODS Calcifying nanoparticles were grown from 6 different valves randomly chosen among 84 consecutively explanted aortic valves, as described in the literature. The (1)H-NMR spectra were acquired from calcifying nanoparticles culture media to assess metabolic changes and the presence of 16sRNA in the culture media was investigated by real-time polymerase chain reaction. RESULTS After 6 weeks in culture, calcifying nanoparticles could be seen clearly attached to the surface of culture flasks. All samples were negative for 16sRNA, discarding the presence of known bacteria. (1)H-NMR spectra showed no difference between calcifying nanoparticles and 6-week-old sterile culture media maintained under the same conditions. CONCLUSIONS Our results show that calcifying nanoparticles cannot be considered as living organisms.
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Affiliation(s)
- Ignasi Barba
- Institut de Recerca, Àrea del Cor, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Ferreira-González I, Pinar-Sopena J, Ribera A, Marsal JR, Cascant P, González-Alujas T, Evangelista A, Brotons C, Moral I, Permanyer-Miralda G, García-Dorado D, Tornos P. Prevalence of calcific aortic valve disease in the elderly and associated risk factors: a population-based study in a Mediterranean area. Eur J Prev Cardiol 2012; 20:1022-30. [PMID: 22679252 DOI: 10.1177/2047487312451238] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [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] [Indexed: 11/15/2022]
Abstract
AIMS To determine the prevalence of aortic valve sclerosis (ASC) and stenosis (AS) in the elderly in a Mediterranean area and to identify associated clinical factors. METHODS AND RESULTS Population cross-sectional study in a random sample of 1068 people ≥65 years in a Mediterranean area. ASC was categorized as absent, mild-to-moderate, or moderate-to-severe depending on the severity of thickening and calcification. The relation between the severity of ASC and potential risk factors was assessed by multinomial logistic regression analysis. Some degree of thickening and/or calcification was present in 45.4%, of the sample, 73.5% in >85 years. AS prevalence was 3% for the total cohort and 7.4% in >85 years. Adjusting for gender it was found that age, smoking habit, hypertension, waist circumference, and ankle-brachial index <0.9 were associated with degrees of ASC. Except for waist circumference, there was a gradient between the magnitude of association and the severity of ASC. The OR for age was 1.56 (95% CI 1.39-1.76) for mild-to-moderate ASC and 2.03 (95% CI 1.72-2.4) for moderate-to-severe ASC, and for smoking habit 1.59 (95% CI 1.08-2.34) for mild-to-moderate ASC and 2.13 (95% CI 1.19-3.78) for moderate-to-severe ASC. Diabetes and renal impairment were associated with advanced but not with early stages of ASC. CONCLUSIONS The prevalence of ASC and AS in people ≥65 years is similar to that reported in other regions. The gradient in the association of cardiovascular risk factors with the severity of ASC suggests that they may be causally implied in the pathogenesis of the disease.
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Naber CK, Prendergast B, Thomas M, Vahanian A, Iung B, Rosenhek R, Tornos P, Otto CM, Antunes MJ, Kappetein P, Lange R, Wendler O. An interdisciplinary debate initiated by the European Society of Cardiology Working Group on Valvular Heart Disease. EUROINTERVENTION 2012; 7:1257-74. [DOI: 10.4244/eijv7i11a201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Alonso Gómez AM, Comín J, Borrás X, del Castillo S, Elvira González A, Mazón P, Monserrat L, Pijuan A, Salvador Sanz A, Anguita M, Cequier A, Fernández-Ortiz A, Pan M, Worner F, Alonso Gómez AM, Comín J, Alonso C, Bardají A, Cobo M, García-Pavía P, González Costello J, Oliver JM, Pedreira M, Serrano JM, Subirana M, Tornos P. Comments on the ESC guidelines on the management of cardiovascular diseases during pregnancy. A critical vision of Spanish cardiology. Rev Esp Cardiol 2012; 65:113-8. [PMID: 22265198 DOI: 10.1016/j.recesp.2011.12.001] [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] [Received: 12/12/2011] [Accepted: 12/12/2011] [Indexed: 02/06/2023]
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Fernández‐Hidalgo N, Almirante B, Tornos P, González‐Alujas M, Planes A, Larrosa M, Sambola A, Igual A, Pahissa A. Prognosis of left‐sided infective endocarditis in patients transferred to a tertiary‐care hospital—prospective analysis of referral bias and influence of inadequate antimicrobial treatment. Clin Microbiol Infect 2011; 17:769-75. [DOI: 10.1111/j.1469-0691.2010.03314.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rodríguez-Palomares JF, Cuéllar H, Martí G, García B, González-Alujas MT, Mahía P, Evangelista A, Tornos P, García-Dorado D. Coronariografía mediante tomografía computarizada de 16 detectores antes de la cirugía de recambio valvular. Rev Esp Cardiol 2011; 64:269-76. [DOI: 10.1016/j.recesp.2010.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 09/20/2010] [Indexed: 11/28/2022]
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Rosenhek R, Iung B, Tornos P, Antunes MJ, Prendergast BD, Otto CM, Kappetein AP, Stepinska J, Kaden JJ, Naber CK, Acartürk E, Gohlke-Bärwolf C. ESC Working Group on Valvular Heart Disease Position Paper: assessing the risk of interventions in patients with valvular heart disease. Eur Heart J 2011; 33:822-8, 828a, 828b. [PMID: 21406443 DOI: 10.1093/eurheartj/ehr061] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Risk scores provide an important contribution to clinical decision-making, but their validity has been questioned in patients with valvular heart disease (VHD), since current scores have been mainly derived and validated in adults undergoing coronary bypass surgery. The Working Group on Valvular Heart Disease of the European Society of Cardiology reviewed the performance of currently available scores when applied to VHD, in order to guide clinical practice and future development of new scores. METHODS AND RESULTS The most widely used risk scores (EuroSCORE, STS, and Ambler score) were reviewed, analysing variables included and their predictive ability when applied to patients with VHD. These scores provide relatively good discrimination, i.e. a gross estimation of risk category, but cannot be used to estimate the exact operative mortality in an individual patient because of unsatisfactory calibration. CONCLUSION Current risk scores do not provide a reliable estimate of exact operative mortality in an individual patient with VHD. They should therefore be interpreted with caution and only used as part of an integrated approach, which incorporates other patient characteristics, the clinical context, and local outcome data. Future risk scores should include additional variables, such as cognitive and functional capacity and be prospectively validated in high-risk patients. Specific risk models should also be developed for newer interventions, such as transcatheter aortic valve implantation.
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Affiliation(s)
- Raphael Rosenhek
- Department of Cardiology, Medical University of Vienna, Vienna, Austria.
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41
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Lopez J, Fernandez-Hidalgo N, Revilla A, Vilacosta I, Tornos P, Almirante B, Sevilla T, Gomez I, Pozo E, Sarria C, San Roman JA. Internal and external validation of a model to predict adverse outcomes in patients with left-sided infective endocarditis. Heart 2011; 97:1138-42. [DOI: 10.1136/hrt.2010.200295] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Baumgartner H, Bonhoeffer P, De Groot NMS, de Haan F, Deanfield JE, Galie N, Gatzoulis MA, Gohlke-Baerwolf C, Kaemmerer H, Kilner P, Meijboom F, Mulder BJM, Oechslin E, Oliver JM, Serraf A, Szatmari A, Thaulow E, Vouhe PR, Walma E, Bax J, Ceconi C, Dean V, Filippatos G, Funck-Brentano C, Hobbs R, Kearney P, McDonagh T, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas P, Widimsky P, McDonagh T, Swan L, Andreotti F, Beghetti M, Borggrefe M, Bozio A, Brecker S, Budts W, Hess J, Hirsch R, Jondeau G, Kokkonen J, Kozelj M, Kucukoglu S, Laan M, Lionis C, Metreveli I, Moons P, Pieper PG, Pilossoff V, Popelova J, Price S, Roos-Hesselink J, Uva MS, Tornos P, Trindade PT, Ukkonen H, Walker H, Webb GD, Westby J. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010; 31:2915-57. [PMID: 20801927 DOI: 10.1093/eurheartj/ehq249] [Citation(s) in RCA: 1511] [Impact Index Per Article: 107.9] [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: 12/14/2022] Open
Affiliation(s)
- Helmut Baumgartner
- Adult Congenital and Valvular Heart Disease Center (EMAH-Zentrum) Muenster, Department of Cardiology and Angiology, University Hospital Muenster, Albert-Schweitzer-Str. 33, D-48149 Muenster, Germany.
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Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, Moreillon P, Antunes MDJ, Thilen U, Lekakis J, Lengyel M, Muller L, Naber CK, Nihoyannopoulos P, Moritz A, Zamorano JL, Evseev MO. GUIDELINES ON THE PREVENTION, DIAGNOSIS, AND TREATMENT OF INFECTIVE ENDOCARDITIS (NEW VERSION 2009). Racionalʹnaâ farmakoterapiâ v kardiologii 2010. [DOI: 10.20996/1819-6446-2010-6-5-733-746] [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: 11/22/2022] Open
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Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, Moreillon P, Antunes MDJ, Thilen U, Lekakis J, Lengyel M, Muller L, Naber CK, Nihoyannopoulos P, Moritz A, Zamorano JL, Evseev MO. GUIDELINES ON THE PREVENTION, DIAGNOSIS, AND TREATMENT OF INFECTIVE ENDOCARDITIS (NEW VERSION 2009). Racionalʹnaâ farmakoterapiâ v kardiologii 2010. [DOI: 10.20996/1819-6446-2010-6-6-902-928] [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: 11/22/2022] Open
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Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, Moreillon P, de Jesus Antunes M, Thilen U, Lekakis J, Lengyel M, Müller L, Naber CK, Nihoyannopoulos P, Moritz A, Luis Zamorano J. Guía de práctica clínica para prevención, diagnóstico y tratamiento de la endocarditis infecciosa (nueva versión 2009). Rev Esp Cardiol 2009. [DOI: 10.1016/s0300-8932(09)73131-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, Moreillon P, de Jesus Antunes M, Thilen U, Lekakis J, Lengyel M, Müller L, Naber CK, Nihoyannopoulos P, Moritz A, Zamorano JL, Vahanian A, Auricchio A, Bax J, Ceconi C, Dean V, Filippatos G, Funck-Brentano C, Hobbs R, Kearney P, McDonagh T, McGregor K, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas P, Widimsky P, Vahanian A, Aguilar R, Bongiorni MG, Borger M, Butchart E, Danchin N, Delahaye F, Erbel R, Franzen D, Gould K, Hall R, Hassager C, Kjeldsen K, McManus R, Miro JM, Mokracek A, Rosenhek R, San Roman Calvar JA, Seferovic P, Selton-Suty C, Uva MS, Trinchero R, van Camp G. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J 2009; 30:2369-413. [PMID: 19713420 DOI: 10.1093/eurheartj/ehp285] [Citation(s) in RCA: 1213] [Impact Index Per Article: 80.9] [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: 12/12/2022] Open
Affiliation(s)
- Gilbert Habib
- Service de Cardiologie, CHU La Timone, Bd Jean Moulin, 13005 Marseille, France.
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Fernández-Hidalgo N, Almirante B, Tornos P, González-Alujas M, Sambola A, Pahissa A. 007 LOW PREVALENCE AND GOOD PROGNOSIS OF CULTURE-NEGATIVE INFECTIVE ENDOCARDITIS (CNIE) IN AN EUROPEAN TERTIARY-CARE HOSPITAL. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70026-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sambola A, Ferreira-Gonzalez I, Angel J, Alfonso F, Maristany J, Rodriguez O, Bueno H, Lopez-Minguez JR, Zueco J, Fernandez-Aviles F, Roman AS, Prendergast B, Mainar V, Garcia-Dorado D, Tornos P. Therapeutic strategies after coronary stenting in chronically anticoagulated patients: the MUSICA study. Heart 2009; 95:1483-8. [DOI: 10.1136/hrt.2009.167064] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gudiol F, Aguado JM, Pascual A, Pujol M, Almirante B, Miró JM, Cercenado E, Domínguez MDLA, Soriano A, Rodríguez-Baño J, Vallés J, Palomar M, Tornos P, Bouza E. [Consensus document for the treatment of bacteremia and endocarditis caused by methicillin-resistent Staphylococcus aureus. Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica]. Enferm Infecc Microbiol Clin 2009; 27:105-15. [PMID: 19254641 DOI: 10.1016/j.eimc.2008.09.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 12/10/2008] [Indexed: 12/15/2022]
Abstract
Bacteremia and endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) are prevalent and clinically important. The rise in MRSA bacteremia and endocarditis is related with the increasing use of venous catheters and other vascular procedures. Glycopeptides have been the reference drugs for treating these infections. Unfortunately their activity is not completely satisfactory, particularly against MRSA strains with MICs > 1 microg/mL. The development of new antibiotics, such as linezolid and daptomycin, and the promise of future compounds (dalvabancin, ceftobiprole and telavancin) may change the expectatives in this field.The principal aim of this consensus document was to formulate several recommendations to improve the outcome of MRSA bacteremia and endocarditis, based on the latest reported scientific evidence. This document specifically analyzes the approach for three clinical situations: venous catheter-related bacteremia, persistent bacteremia, and infective endocarditis due to MRSA.
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Affiliation(s)
- Francisco Gudiol
- Servicio de Enfermedades Infecciosas, IDIBELL, Hospital Universitario de Bellvitge, Barcelona, España
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