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García-Guimarães M, Bastante T, Del Val D, Fernández-Rodríguez D, Guiberteau-Diaz T, Salamanca J, Rivero F, Alfonso F. Angiographic patterns in spontaneous coronary artery dissection: novel diagnostic insights. Expert Rev Cardiovasc Ther 2024; 22:167-175. [PMID: 38683109 DOI: 10.1080/14779072.2024.2349103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Spontaneous coronary artery dissection (SCAD) is a rare but well-recognized cause of acute coronary syndrome, especially important in women. Invasive coronary angiography (ICA) is the fundamental diagnostic technique for the confirmation of SCAD. Knowing the angiographic patterns suggestive of SCAD is essential for the correct identification of patients with this entity. AREAS COVERED In this narrative review, the main angiographic characteristics of SCAD lesions as detected by ICA are presented and discussed. EXPERT OPINION In addition to the specific angiographic classification of SCAD, several authors have described complementary angiographic patterns suggestive of SCAD. Knowledge and correct identification of these angiographic patterns is essential for the correct diagnosis of patients with clinical suspicion of SCAD.
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Affiliation(s)
- Marcos García-Guimarães
- Cardiology Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain
- Cardiology Department, Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Teresa Bastante
- Cardiology Department. Hospital Universitario de La Princesa, Universidad Autónoma de Madrid. IIS-IP. CIBER-CV, Madrid, Spain
| | - David Del Val
- Cardiology Department. Hospital Universitario de La Princesa, Universidad Autónoma de Madrid. IIS-IP. CIBER-CV, Madrid, Spain
| | - Diego Fernández-Rodríguez
- Cardiology Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain
- Cardiology Department, Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | | | - Jorge Salamanca
- Cardiology Department. Hospital Universitario de La Princesa, Universidad Autónoma de Madrid. IIS-IP. CIBER-CV, Madrid, Spain
| | - Fernando Rivero
- Cardiology Department. Hospital Universitario de La Princesa, Universidad Autónoma de Madrid. IIS-IP. CIBER-CV, Madrid, Spain
| | - Fernando Alfonso
- Cardiology Department. Hospital Universitario de La Princesa, Universidad Autónoma de Madrid. IIS-IP. CIBER-CV, Madrid, Spain
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Rivera K, Fernández-Rodríguez D, Bullones J, Gorriño S, Sánchez Espino A, Garcia-Guimarães M, Casanova-Sandoval J, Irigaray P, Costa-Mateu J, Arroyo-Calpe D, Roig-Boira O, Tornel-Cerezo M, Baiget-Pons A, Worner F, Ferreiro JL. Impact of sex differences on the feasibility and safety of distal radial access for coronary procedures: a multicenter prospective observational study. Coron Artery Dis 2024:00019501-990000000-00200. [PMID: 38433727 DOI: 10.1097/mca.0000000000001348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
BACKGROUND Conventional transradial access in women is associated with a lower success rate and a higher incidence of spasm compared to men. To date, the effect of sex on the performance of distal radial access (DRA) has not been fully elucidated. The aim of this study was to assess the impact of sex on catheterization success and other performance parameters of DRA procedures. METHODS This is a prospective three-center observational study. From August 2020 to September 2022, data from all consecutive patients who underwent DRA for coronary procedures were collected. RESULTS A total of 868 procedures were registered and stratified into two groups according to sex: women (n = 258) and men (n = 610). Female patients had less favorable baseline characteristics than male patients in terms of absent or weak pulse (29% vs. 17%; P < 0.001), distal radial diameter (2.2 ± 0.3 vs. 2.4 ± 0.4 mm; P < 0.001) and proximal radial diameter (2.5 ± 0.7 vs. 2.7 ± 0.7 mm; P = 0.001). No differences in success rates were found in women compared to men (94.2% vs. 96.6%; P = 0.135), with a higher presence of arterial spasm in women (5.8% vs. 3.0%; P = 0.044). The preprocedural ultrasound evaluation was the only predictor of DRA success [odds ratio = 20.0 (4.739-83.333); P < 0.001]. CONCLUSION In patients undergoing coronary procedures, the success rate of DRA was high regardless of sex, with a higher incidence of arterial spasm in women.
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Affiliation(s)
- Kristian Rivera
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
- Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida
| | - Diego Fernández-Rodríguez
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
- Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida
| | - Juan Bullones
- Department of Cardiology, Regional University Hospital, Málaga
| | - Susana Gorriño
- Department of Cardiology, Regional University Hospital, Málaga
| | | | - Marcos Garcia-Guimarães
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
- Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida
| | - Juan Casanova-Sandoval
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
- Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida
| | - Patricia Irigaray
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
- Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida
| | - Joan Costa-Mateu
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
| | - David Arroyo-Calpe
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
| | - Oriol Roig-Boira
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
| | - María Tornel-Cerezo
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
| | - Anna Baiget-Pons
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
| | - Fernando Worner
- Department of Cardiology, Arnau de Vilanova University Hospital, Institut Català de la Salut
- Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida
| | - José Luis Ferreiro
- Department of Cardiology, Joan XXIII University Hospital - IISPV, CIBER-CV, Tarragona, Spain
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Garcia-Guimarães M, Fernández-Rodríguez D. Spontaneous coronary artery dissection: A look back to build momentum. Int J Cardiol 2024; 397:131557. [PMID: 37913958 DOI: 10.1016/j.ijcard.2023.131557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Affiliation(s)
- Marcos Garcia-Guimarães
- Cardiology Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain.
| | - Diego Fernández-Rodríguez
- Cardiology Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
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Rivera K, Zielonka M, Ramírez-Martínez T, Pueyo-Balsells N, Fernández-Rodríguez D. Late-onset multivalvular carcinoid heart disease. Arch Cardiol Mex 2024. [PMID: 38306488 DOI: 10.24875/acm.23000165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024] Open
Affiliation(s)
- Kristian Rivera
- Department of Cardiology, Arnau de Vilanova University Hospital, Lleida, Spain
- Institut de Reserca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain
| | - Marta Zielonka
- Department of Cardiology, Arnau de Vilanova University Hospital, Lleida, Spain
- Institut de Reserca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain
| | - Tania Ramírez-Martínez
- Department of Cardiology, Arnau de Vilanova University Hospital, Lleida, Spain
- Institut de Reserca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain
| | - Nuria Pueyo-Balsells
- Department of Cardiology, Arnau de Vilanova University Hospital, Lleida, Spain
- Institut de Reserca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain
| | - Diego Fernández-Rodríguez
- Department of Cardiology, Arnau de Vilanova University Hospital, Lleida, Spain
- Institut de Reserca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain
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Rivera K, Fernández-Rodríguez D, García-Guimarães M, Ramírez Martínez T, Casanova-Sandoval J. Intravascular ultrasound-guided percutaneous exclusion of a complicated coronary artery aneurysm presenting as ST-segment elevation myocardial infarction. Coron Artery Dis 2023; 34:527-528. [PMID: 37799052 DOI: 10.1097/mca.0000000000001272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Affiliation(s)
- Kristian Rivera
- Cardiology Department, University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
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Pereyra E, González-Sucarrats S, Fernández-Rodríguez D. Antiplatelet therapy at discharge for takotsubo syndrome: could propensity matching and/or sensitivity analysis be of value? Response. Rev Port Cardiol 2023:S0870-2551(23)00223-8. [PMID: 37105275 DOI: 10.1016/j.repc.2023.04.007] [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: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 04/29/2023] Open
Affiliation(s)
- Eduardo Pereyra
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Reçerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Silvia González-Sucarrats
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Reçerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Diego Fernández-Rodríguez
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Reçerca Biomèdica de Lleida (IRBLleida), Lleida, Spain.
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Matute-Blanco L, Fernández-Rodríguez D, Casanova-Sandoval J, Belmonte T, Benítez ID, Rivera K, Garcia-Guimaraes M, Cortés Villar C, Peral Disdier V, Millán Segovia R, Barriuso I, de Gonzalo-Calvo D, Barbé F, Worner F. Study protocol for the epigenetic characterization of angor pectoris according to the affected coronary compartment: Global and comprehensive assessment of the relationship between invasive coronary physiology and microRNAs. PLoS One 2023; 18:e0283097. [PMID: 37167303 PMCID: PMC10174526 DOI: 10.1371/journal.pone.0283097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/01/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND MicroRNAs (miRNAs) are noncoding RNAs involved in post-transcriptional genetic regulation with a proposed role in intercellular communication. miRNAs are considered promising biomarkers in ischemic heart disease. Invasive physiological evaluation allows a precise assessment of each affected coronary compartment. Although some studies have associated the expression of circulating miRNAs with invasive physiological indexes, their global relationship with coronary compartments has not been assessed. Here, we will evaluate circulating miRNAs profiles according to the coronary pattern of the vascular compartment affectation. STUDY AND DESIGN This is an investigator-initiated, multicentre, descriptive study to be conducted at three centres in Spain (NCT05374694). The study will include one hundred consecutive patients older than 18 years with chest pain of presumed coronary cause undergoing invasive physiological evaluation, including fractional flow reserve (FFR) and index of microvascular resistance (IMR). Patients will be initially classified into four groups, according to FFR and IMR: macrovascular and microvascular affectation (FFR≤0.80 / IMR≥25), isolated macrovascular affectation (FFR≤0.80 / IMR<25), isolated microvascular affectation (FFR>0.80 / IMR ≥25) and normal coronary indexes (FFR>0.80 / IMR<25). Patients with isolated microvascular affectation or normal indexes will also undergo the acetylcholine test and may be reclassified as a fifth group in the presence of spasm. A panel of miRNAs previously associated with molecular mechanisms linked to chronic coronary syndrome will be analysed using RT-qPCR. CONCLUSIONS The results of this study will identify miRNA profiles associated with patterns of coronary affectation and will contribute to a better understanding of the mechanistic pathways of coronary pathology.
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Affiliation(s)
- Lucía Matute-Blanco
- Department of Cardiology, Institut de Reçerca Biomèdica de Lleida (IRBLleida), University Hospital Arnau de Vilanova, Lleida, Spain
| | - Diego Fernández-Rodríguez
- Department of Cardiology, Institut de Reçerca Biomèdica de Lleida (IRBLleida), University Hospital Arnau de Vilanova, Lleida, Spain
| | - Juan Casanova-Sandoval
- Department of Cardiology, Institut de Reçerca Biomèdica de Lleida (IRBLleida), University Hospital Arnau de Vilanova, Lleida, Spain
| | - Thalía Belmonte
- Institut de Reçerca Biomèdica de Lleida (IRBLleida), Translational Research in Respiratory Medicine Group, Lleida, Spain
- Institute of Health Carlos III, CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Iván D Benítez
- Institut de Reçerca Biomèdica de Lleida (IRBLleida), Translational Research in Respiratory Medicine Group, Lleida, Spain
- Institute of Health Carlos III, CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Kristian Rivera
- Department of Cardiology, Institut de Reçerca Biomèdica de Lleida (IRBLleida), University Hospital Arnau de Vilanova, Lleida, Spain
| | - Marcos Garcia-Guimaraes
- Department of Cardiology, Institut de Reçerca Biomèdica de Lleida (IRBLleida), University Hospital Arnau de Vilanova, Lleida, Spain
| | | | | | - Raúl Millán Segovia
- Department of Cardiology, University Hospital Son Espases, Palma de Mallorca, Spain
| | - Ignacio Barriuso
- Department of Cardiology, Institut de Reçerca Biomèdica de Lleida (IRBLleida), University Hospital Arnau de Vilanova, Lleida, Spain
| | - David de Gonzalo-Calvo
- Institut de Reçerca Biomèdica de Lleida (IRBLleida), Translational Research in Respiratory Medicine Group, Lleida, Spain
- Institute of Health Carlos III, CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Ferran Barbé
- Institut de Reçerca Biomèdica de Lleida (IRBLleida), Translational Research in Respiratory Medicine Group, Lleida, Spain
- Institute of Health Carlos III, CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Fernando Worner
- Department of Cardiology, Institut de Reçerca Biomèdica de Lleida (IRBLleida), University Hospital Arnau de Vilanova, Lleida, Spain
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Ortega-Paz L, Arévalos V, Fernández-Rodríguez D, Jiménez-Díaz V, Bañeras J, Campo G, Rodríguez-Santamarta M, Díaz JF, Scardino C, Gómez-Álvarez Z, Pernigotti A, Alfonso F, Amat-Santos IJ, Silvestro A, Rampa L, de la Torre Hernández JM, Bastidas G, Gómez-Lara J, Bikdeli B, García-García HM, Angiolillo DJ, Rodés-Cabau J, Sabaté M, Brugaletta S. One-year cardiovascular outcomes after coronavirus disease 2019: The cardiovascular COVID-19 registry. PLoS One 2022; 17:e0279333. [PMID: 36583998 PMCID: PMC9803130 DOI: 10.1371/journal.pone.0279333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The long-term cardiovascular (CV) outcomes of COVID-19 have not been fully explored. METHODS This was an international, multicenter, retrospective cohort study conducted between February and December 2020. Consecutive patients ≥18 years who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 were included. Patients were classified into two cohorts depending on the nasopharyngeal swab result and clinical status: confirmed COVID-19 (positive RT-PCR) and control (without suggestive symptoms and negative RT-PCR). Data were obtained from electronic records, and clinical follow-up was performed at 1-year. The primary outcome was CV death at 1-year. Secondary outcomes included arterial thrombotic events (ATE), venous thromboembolism (VTE), and serious cardiac arrhythmias. An independent clinical event committee adjudicated events. A Cox proportional hazards model adjusted for all baseline characteristics was used for comparing outcomes between groups. A prespecified landmark analysis was performed to assess events during the post-acute phase (31-365 days). RESULTS A total of 4,427 patients were included: 3,578 (80.8%) in the COVID-19 and 849 (19.2%) control cohorts. At one year, there were no significant differences in the primary endpoint of CV death between the COVID-19 and control cohorts (1.4% vs. 0.8%; HRadj 1.28 [0.56-2.91]; p = 0.555), but there was a higher risk of all-cause death (17.8% vs. 4.0%; HRadj 2.82 [1.99-4.0]; p = 0.001). COVID-19 cohort had higher rates of ATE (2.5% vs. 0.8%, HRadj 2.26 [1.02-4.99]; p = 0.044), VTE (3.7% vs. 0.4%, HRadj 9.33 [2.93-29.70]; p = 0.001), and serious cardiac arrhythmias (2.5% vs. 0.6%, HRadj 3.37 [1.35-8.46]; p = 0.010). During the post-acute phase, there were no significant differences in CV death (0.6% vs. 0.7%; HRadj 0.67 [0.25-1.80]; p = 0.425), but there was a higher risk of deep vein thrombosis (0.6% vs. 0.0%; p = 0.028). Re-hospitalization rate was lower in the COVID-19 cohort compared to the control cohort (13.9% vs. 20.6%; p = 0.001). CONCLUSIONS At 1-year, patients with COVID-19 experienced an increased risk of all-cause death and adverse CV events, including ATE, VTE, and serious cardiac arrhythmias, but not CV death. STUDY REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT04359927.
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Affiliation(s)
- Luis Ortega-Paz
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States of America
| | - Victor Arévalos
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
| | | | | | - Jordi Bañeras
- Department of Cardiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Gianluca Campo
- Department of Cardiology, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | | | | | - Claudia Scardino
- Department of Cardiology, Hospital Universitario Joan XXIII, Tarragona, Spain
| | | | - Alberto Pernigotti
- Department of Cardiology, Hospital de Tortosa Verge de la Cinta, Tarragona, Spain
| | - Fernando Alfonso
- Department of Cardiology, Hospital Universitario La Princesa, Madrid, Spain
| | - Ignacio J. Amat-Santos
- Department of Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Antonio Silvestro
- Department of Cardiology, Azienda Ospedaliera Bolognini Seriate, Bérgamo, Italy
| | - Lorenzo Rampa
- Department of Cardiology, Clinical Institute Saint Ambrogio, Milano, Italy
| | | | - Gabriela Bastidas
- Department of Cardiology, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | - Josep Gómez-Lara
- Department of Cardiology, Hospital de Bellvitge, Barcelona, Spain
| | - Behnood Bikdeli
- Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Center for Outcomes Research and Evaluation (CORE), Yale School of Medicine, New Haven, Connecticut, United States of America
- Cardiovascular Research Foundation (CRF), New York, New York, United States of America
| | - Hector M. García-García
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Dominick J. Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States of America
| | - Josep Rodés-Cabau
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
| | - Manel Sabaté
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
| | - Salvatore Brugaletta
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
- * E-mail:
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Barriuso I, Pueo E, Gil MI, Fernández-Rodríguez D, Viles D, Worner F. Heart failure and pericardial mass leading to diagnosis of a rare hematologic disease. Rev Port Cardiol 2022; 41:1055-1056. [PMID: 36257496 DOI: 10.1016/j.repc.2021.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/26/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ignacio Barriuso
- Department of Cardiology, Hospital Universitario Arnau de Vilanova, IRBLleida, Lleida, Spain.
| | - Eva Pueo
- Department of Cardiology, Hospital Universitario Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - María Isabel Gil
- Department of Radiology, Hospital Universitario Arnau de Vilanova, IRBLleida, Lleida, Spain
| | | | - Dolors Viles
- Department of Cardiology, Hospital Universitario Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - Fernando Worner
- Department of Cardiology, Hospital Universitario Arnau de Vilanova, IRBLleida, Lleida, Spain
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Rivera K, Fernández-Rodríguez D, Zielonka M, Barriuso I, Pueyo N, Casanova-Sandoval J. Litotricia intracoronaria como rescate de un stent infraexpandido. ACM 2022; 92:556-558. [DOI: 10.24875/acm.21000317] [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: 11/06/2022] Open
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Pereyra E, Fernández-Rodríguez D, González-Sucarrats S, Almendro-Delia M, Martín A, de Miguel IM, Andrés M, Duran-Cambra A, Sánchez-Grande-Flecha A, Worner-Diz F, Núñez-Gil IJ. Antiplatelet therapy at discharge and long-term prognosis in Takotsubo syndrome: Insights from the Spanish National Registry (RETAKO). Rev Port Cardiol 2022; 41:S0870-2551(22)00359-6. [PMID: 36241580 DOI: 10.1016/j.repc.2021.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/07/2021] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Endothelial dysfunction and platelet activation have been highlighted as possible mediators in Takotsubo syndrome (TTS). Nevertheless, to date, evidence on the usefulness of antiplatelet therapy in TTS remains controversial. The aim of our study is to evaluate long-term prognosis in TTS patients treated with antiplatelet therapy (APT) at hospitalization discharge. MATERIAL AND METHODS An ambispective cohort study from the Spanish National Takotsubo Registry database was performed (June 2002 to March 2017). Patients were divided into two groups: those who received APT at hospital discharge (APT cohort) and those who did not (non-APT cohort). Primary endpoint was all-cause death. Secondary endpoints included the composite of recurrence or readmission and a composite of death, recurrence or readmission. RESULTS From a total of 741 patients, 728 patients were alive at discharge. Follow-up was performed in 544 patients, who were included in the final analysis: 321 patients (59.0%) in the APT cohort and 223 patients (41.0%) in the non-APT cohort. The APT cohort had a better clinical presentation and received more heart failure and acute coronary syndrome-like therapies (angiotensin converting enzyme inhibitors/angiotensin receptor blockers: 75.1% vs. 51.1%; p<0.001, betablockers: 71.3% vs. 50.7%; p<0.001, statins: 67.9% vs. 33.2%; p<0.001). After adjusting for confounder factors, APT at discharge was a protective factor for all-cause death (adjusted hazard ratio (HR) 0.315, 95% confidence interval (CI): 0.106-0.943; p=0.039) and the composite endpoint of all-cause death, recurrence or readmission (adjusted HR 0.318, 95% CI: 0.164-0.619; p=0.001) at month 25 of follow-up. CONCLUSION Patients with TTS receiving APT at discharge presented better prognosis up to two-years of follow-up compared with their counterparts not receiving APT.
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Affiliation(s)
- Eduardo Pereyra
- Department of Cardiology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | | | | | | | - Agustín Martín
- Department of Cardiology, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | - Mireia Andrés
- Department of Cardiology, Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | - Fernando Worner-Diz
- Department of Cardiology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Iván J Núñez-Gil
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain.
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Fernández-Rodríguez D, Casanova-Sandoval J, Barriuso I, Rivera K, Otaegui I, del Blanco BG, Jiménez TG, López-Pérez M, Rodríguez-Esteban M, Torres-Saura F, Díaz VJ, Ocaranza-Sánchez R, Disdier VP, Elvira GS, Worner F. Ajustando a RFR por Preditores de Discordância, “A RFR Ajustada”: Uma Metodologia Alternativa para Melhorar a Capacidade Diagnóstica dos Índices Coronarianos. Arq Bras Cardiol 2022; 119:705-713. [DOI: 10.36660/abc.20220176] [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] [Received: 03/20/2022] [Accepted: 06/15/2022] [Indexed: 01/10/2023] Open
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Rivera K, Fernández-Rodríguez D, Zielonka M, Casanova-Sandoval J. Reply to the Letter to the Editor: Takotsubo syndrome in the setting of COVID-19: Pathogenetic and diagnostic implications. Rev Port Cardiol 2022; 41:895. [PMID: 35965741 PMCID: PMC9359531 DOI: 10.1016/j.repc.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kristian Rivera
- University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Diego Fernández-Rodríguez
- University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Marta Zielonka
- University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Juan Casanova-Sandoval
- University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
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Pueyo-Balsells N, Irigaray P, Calaf I, Fernández-Rodríguez D. Temporary pacing with active fixation leads: Should the femoral approach be the access of choice? Med Intensiva 2022; 46:290-291. [PMID: 35248511 DOI: 10.1016/j.medine.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 06/14/2023]
Affiliation(s)
- N Pueyo-Balsells
- Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, Spain
| | - P Irigaray
- Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, Spain
| | - I Calaf
- Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, Spain
| | - D Fernández-Rodríguez
- Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, Spain.
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Barriuso I, Irigaray P, Rivera K, Fernández-Rodríguez D. To: Predictors of coronary artery disease in cardiac arrest survivors: coronary angiography for everyone? A single-center retrospective analysis. Rev Bras Ter Intensiva 2022; 34:303-304. [PMID: 35946663 DOI: 10.5935/0103-507x.20220030-pt] [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: 09/28/2021] [Accepted: 10/05/2021] [Indexed: 11/20/2022] Open
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Barriuso I, Irigaray P, Rivera K, Fernández-Rodríguez D. To: Predictors of coronary artery disease in cardiac arrest survivors: coronary angiography for everyone? A single-center retrospective analysis. Rev Bras Ter Intensiva 2022. [PMID: 35946663 PMCID: PMC9354118 DOI: 10.5935/0103-507x.20220030-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Diego Fernández-Rodríguez
- Hospital Universitari Arnau de Vilanova - Lleida, España
- Corresponding author: Diego Fernández-Rodríguez, Hospital Universitari Arnau de Vilanova de Lleida, Av. Rovira Roure, 80, Zip code: 25196, Lleida, Spain, E-mail:
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Rivera K, Fernández-Rodríguez D, Zielonka M, Casanova-Sandoval J. Diagnosis of Takotsubo syndrome in the COVID-19 era. Rev Port Cardiol (Engl Ed) 2021; 40:899-901. [PMID: 34857167 PMCID: PMC8628165 DOI: 10.1016/j.repce.2021.10.027] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022] Open
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Barriuso I, Ramírez-Martínez T, Pueyo N, Fernández-Rodríguez D. Pharmacoinvasive strategy: An essential tool to avoid the reperfusion paradox in STEMI networks. Arch Cardiol Mex 2021; 91:542-543. [PMID: 34428200 PMCID: PMC8641472 DOI: 10.24875/acm.21000105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/21/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Ignacio Barriuso
- Cardiology Department, Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, Spain
| | - Tania Ramírez-Martínez
- Cardiology Department, Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, Spain
| | - Núria Pueyo
- Cardiology Department, Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, Spain
| | - Diego Fernández-Rodríguez
- Cardiology Department, Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, Spain
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Rivera K, Fernández-Rodríguez D, Zielonka M, Casanova-Sandoval J. Diagnosis of Takotsubo syndrome in the COVID-19 era. Rev Port Cardiol 2021; 40:899-901. [PMID: 34511716 PMCID: PMC8423814 DOI: 10.1016/j.repc.2020.09.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/28/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kristian Rivera
- University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Diego Fernández-Rodríguez
- University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Marta Zielonka
- University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Juan Casanova-Sandoval
- University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
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Rivera K, Fernández-Rodríguez D, Zielonka M, Casanova-Sandoval J. Massive thrombus over an aneurysmatic left main coronary artery: Non-interventional therapy? Rev Port Cardiol 2021; 40:699-700. [PMID: 34503712 DOI: 10.1016/j.repce.2020.07.023] [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: 04/06/2020] [Accepted: 07/08/2020] [Indexed: 10/20/2022] Open
Affiliation(s)
- Kristian Rivera
- Cardiology Department, University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain.
| | - Diego Fernández-Rodríguez
- Cardiology Department, University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain
| | - Marta Zielonka
- Cardiology Department, University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain
| | - Juan Casanova-Sandoval
- Cardiology Department, University Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLLEIDA), Lleida, Spain
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Pueyo-Balsells N, Irigaray P, Calaf I, Fernández-Rodríguez D. Temporary pacing with active fixation leads: Should the femoral approach be the access of choice? Med Intensiva 2021; 46:S0210-5691(21)00038-3. [PMID: 33863604 DOI: 10.1016/j.medin.2021.03.003] [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: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022]
Affiliation(s)
- N Pueyo-Balsells
- Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, España
| | - P Irigaray
- Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, España
| | - I Calaf
- Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, España
| | - D Fernández-Rodríguez
- Hospital Universitari Arnau de Vilanova de Lleida, IRBLLeida (Institut de Recerca Biomèdica de Lleida), Lleida, España.
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Matute-Blanco L, Casanova-Sandoval J, Rivera K, Fernández-Rodríguez D. [Recurrent severe pericardial effusion and senile cardiac amyloidosis: Usefulness of balloon pericardiotomy]. Rev Esp Geriatr Gerontol 2021; 56:320-322. [PMID: 33775432 DOI: 10.1016/j.regg.2021.02.009] [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: 12/19/2020] [Revised: 02/09/2021] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Lucía Matute-Blanco
- Servicio de Cardiología, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España.
| | - Juan Casanova-Sandoval
- Servicio de Cardiología, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España
| | - Kristian Rivera
- Servicio de Cardiología, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España
| | - Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España
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Fernández-Rodríguez D, Costa-Mateu J, Rivera K, Casanova J, Bosch-Gaya A, Tomás-Querol C, Zielonka M, Pereyra-Acha E, Matute-Blanco L, Worner F. Comparison of one-catheter strategy versus conventional two-catheter strategy on the volume of radiological contrast and diagnostic coronary catheterization performance by transradial access: A systematic review and meta-analysis of randomized clinical trials. Arch Cardiol Mex 2020; 90:442-451. [PMID: 33373351 DOI: 10.24875/acm.19000352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background One-catheter strategy, based in multipurpose catheters, allows exploring both coronary arteries with a single catheter. This strategy could simplify coronary catheterization and reduce the volume of contrast administration, by reducing radial spasm. To date, observational studies showed greater benefits regarding contrast consumption and catheterization performance than controlled trials. The aim of this work is to perform the first systematic review and meta-analysis of randomized clinical trials (RCT) to adequately quantify the benefits of one-catheter strategy, with multipurpose catheters, over conventional two-catheter strategy on contrast consumption, and catheterization performance. Methods A search in PubMed, CINALH, and CENTRAL databases was conducted to identify randomized trials comparing one-catheter and two-catheter strategies. The primary outcome was volume of iodinated contrast administrated. Secondary endpoints, evaluating coronary catheterization performance included: arterial spasm, fluoroscopy time, and procedural time. Results Five RCT were included for the final analysis, with a total of 1599 patients (802 patients with one-catheter strategy and 797 patients with two-catheter strategy). One-catheter strategy required less administration of radiological contrast (difference in means [DiM] [95% confidence interval (CI)]; -3.831 mL [-6.165 mL to -1.496 mL], p = 0.001) as compared to two-catheter strategy. Furthermore, less radial spasm (odds ratio [95% CI], 0.484 [0.363 to 0.644], p < 0.001) and less procedural time (DiM [95% CI], -72.471 s [-99.694 s to -45.249 s], p < 0.001) were observed in one-catheter strategy. No differences on fluoroscopy time were observed. Conclusions One-catheter strategy induces a minimal reduction on radiological contrast administration but improves coronary catheterization performance by reducing arterial spasm and procedural time as compared to conventional two-catheter strategy.
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Affiliation(s)
- Diego Fernández-Rodríguez
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Joan Costa-Mateu
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Kristian Rivera
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Juan Casanova
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Anna Bosch-Gaya
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Carlos Tomás-Querol
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Marta Zielonka
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Eduardo Pereyra-Acha
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Lucía Matute-Blanco
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
| | - Fernando Worner
- Department of Cardiology, University Hospital Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, University of Lleida, Lleida, Spain
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Calaf Vall I, Gayán Ordas J, Fernández-Rodríguez D. Takotsubo cardiomyopathy post pericardiocentesis. Med Clin (Barc) 2020; 157:202-203. [PMID: 32819763 DOI: 10.1016/j.medcli.2020.05.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Immaculada Calaf Vall
- Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Lleida, España; Institut de Recerca Biomèdica Lleida, Lleida, España.
| | - Jara Gayán Ordas
- Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Lleida, España; Institut de Recerca Biomèdica Lleida, Lleida, España
| | - Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Lleida, España; Institut de Recerca Biomèdica Lleida, Lleida, España
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Costa-Mateu J, Fernández-Rodríguez D, Rivera K, Casanova J, Irigaray P, Zielonka M, Pereyra-Acha E, Aldomá A, Worner F. Impact of One-Catheter Strategy with TIG I Catheter on Coronary Catheterization Performance and Economic Costs. Arq Bras Cardiol 2019; 113:960-968. [PMID: 31800721 PMCID: PMC7020970 DOI: 10.5935/abc.20190232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 04/24/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Coronary angiography with two catheters is the traditional strategy for diagnostic coronary procedures. TIG I catheter permits to cannulate both coronary arteries, avoiding exchanging catheters during coronary angiography by transradial access. OBJECTIVE The aim of this study is to evaluate the impact of one-catheter strategy, by avoiding catheter exchange, on coronary catheterization performance and economic costs. METHODS Transradial coronary diagnostic procedures conducted from January 2013 to June 2017 were collected. One-catheter strategy (TIG I catheter) and two-catheter strategy (left and right Judkins catheters) were compared. The volume of iodinated contrast administered was the primary endpoint. Secondary endpoints included radial spasm, procedural duration (fluoroscopy time) and exposure to ionizing radiation (dose-area product and air kerma). Direct economic costs were also evaluated. For statistical analyses, two-tailed p-values < 0.05 were considered statistically significant. RESULTS From a total of 1,953 procedures in 1,829 patients, 252 procedures were assigned to one-catheter strategy and 1,701 procedures to two-catheter strategy. There were no differences in baseline characteristics between the groups. One-catheter strategy required less iodinated contrast [primary endpoint; (60-105)-mL vs. 92 (64-120)-mL; p < 0.001] than the two-catheter strategy. Also, the one-catheter group presented less radial spasm (5.2% vs. 9.3%, p = 0.022) and shorter fluoroscopy time [3.9 (2.2-8.0)-min vs. 4.8 (2.9-8.3)-min, p = 0.001] and saved costs [149 (140-160)-€/procedure vs. 171 (160-183)-€/procedure; p < 0.001]. No differences in dose-area product and air kerma were detected between the groups. CONCLUSIONS One-catheter strategy, with TIG I catheter, improves coronary catheterization performance and reduces economic costs compared to traditional two-catheter strategy in patients referred for coronary angiography.
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Affiliation(s)
- Joan Costa-Mateu
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
| | - Diego Fernández-Rodríguez
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
| | - Kristian Rivera
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
| | - Juan Casanova
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
| | - Patricia Irigaray
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
| | - Marta Zielonka
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
| | - Eduardo Pereyra-Acha
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
| | - Albina Aldomá
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
| | - Fernando Worner
- Cardiology Department, University Hospital Arnau de Vilanova, IRB, University of Lleida, Lleida - Spain
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Fernández-Rodríguez D, Rivera K, Casanova J. Deferring stenting in primary angioplasty: A critical view based on available evidence. Arch Cardiol Mex 2019; 89:187-188. [PMID: 31702742 DOI: 10.24875/acme.m19000047] [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] [Indexed: 11/17/2022] Open
Affiliation(s)
- Diego Fernández-Rodríguez
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida. Lleida, Spain
| | - Kristian Rivera
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida. Lleida, Spain
| | - Juan Casanova
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida. Lleida, Spain
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Fernández-Rodríguez D, Rivera K, Casanova J. Diferir la implantación de stents coronarios en la angioplastia primaria: una visión crítica basada en la evidencia disponible. ACM 2019; 89:201-202. [DOI: 10.24875/acm.19000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Fernández-Rodríguez D, Anmad Shihadeh L, Martos-Maine JL, Couto-Comba P, Quijada-Fumero A, Pimienta R, Grillo-Pérez JJ, Rodríguez-Esteban M, Pérez-Hernández H, Hernández-Afonso J, Bosa Ojeda F. Impacto de la angiografía coronaria rotacional en la cantidad total de contraste administrado y la exposición a las radiaciones ionizantes en pacientes en los que se realizan procedimientos coronarios invasivos: revisión sistemática y metaanálisis. Archivos de Cardiología de México 2018; 88:277-286. [DOI: 10.1016/j.acmx.2017.08.002] [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] [Received: 08/02/2016] [Revised: 08/02/2017] [Accepted: 08/06/2017] [Indexed: 11/30/2022] Open
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Regueiro A, Fernández-Rodríguez D, Freixa X, Bosch X, Martín-Yuste V, Brugaletta S, Roqué M, Sabaté M, Masotti M. Falsos positivos en la activación por IAMCEST en una red regional: análisis integral e impacto clínico. Resultados del registro Codi Infart de Cataluña. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.05.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fernández-Rodríguez D, Grillo-Pérez JJ, Pérez-Hernández H, Rodríguez-Esteban M, Pimienta R, Acosta-Materán C, Rodríguez S, Yanes-Bowden G, Vargas-Torres MJ, Sánchez-Grande Flecha A, Hernández-Afonso J, Bosa-Ojeda F. Prospective evaluation of the development of contrast-induced nephropathy in patients with acute coronary syndrome undergoing rotational coronary angiography vs. conventional coronary angiography: CINERAMA study. Nefrologia 2017; 38:169-178. [PMID: 28734584 DOI: 10.1016/j.nefro.2017.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 03/04/2017] [Revised: 05/17/2017] [Accepted: 05/23/2017] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Rotational coronary angiography (RCA) requires less contrast to be administered and can prevent the onset of contrast-induced nephropathy (CIN) during invasive coronary procedures. The aim of the study is to evaluate the impact of RCA on CIN (increase in serum creatinine ≥0.5mg/dl or ≥25%) after an acute coronary syndrome. METHODS From April to September 2016, patients suffering acute coronary syndromes who underwent diagnostic coronary angiography, with the possibility of ad hoc coronary angioplasty, were prospectively enrolled. At the operator's discretion, patients underwent RCA or conventional coronary angiography (CCA). CIN (primary endpoint), as well as analytical, angiographic and clinical endpoints, were compared between groups. RESULTS Of the 235 patients enrolled, 116 patients received RCA and 119 patients received CCA. The RCA group was composed of older patients (64.0±11.8 years vs. 59.7±12.1 years; p=0.006), a higher proportion of women (44.8 vs. 17.6%; p<0.001), patients with a lower estimated glomerular filtration rate (76±25 vs. 86±27ml/min/1.73 m2; p=0.001), and patients who underwent fewer coronary angioplasties (p<0.001) compared with the CCA group. Furthermore, the RCA group, received less contrast (113±92 vs. 169±103ml; p<0.001), including in diagnostic procedures (54±24 vs. 85±56ml; p<0.001) and diagnostic-therapeutic procedures (174±64 vs. 205±98ml; p=0.049) compared with the CCA group. The RCA group presented less CIN (4.3 vs. 22.7%; p<0.001) compared to the CCA group, and this finding was maintained in the regression analysis (Adjusted relative risk: 0.868; 95% CI: 0.794-0.949; p=0.002). There were no differences in clinical endpoints between the groups. CONCLUSIONS RCA was associated with lower administration of contrast during invasive coronary procedures in acute coronary syndrome patients, resulting in lower incidence of CIN, in comparison with CCA.
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Affiliation(s)
- Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España; Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Lérida, España.
| | - José J Grillo-Pérez
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
| | - Horacio Pérez-Hernández
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
| | - Marcos Rodríguez-Esteban
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
| | - Raquel Pimienta
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
| | - Carlos Acosta-Materán
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
| | - Sara Rodríguez
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad de Laguna, San Cristóbal de la Laguna, Tenerife, España
| | - Geoffrey Yanes-Bowden
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad de Laguna, San Cristóbal de la Laguna, Tenerife, España
| | - Manuel J Vargas-Torres
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad de Laguna, San Cristóbal de la Laguna, Tenerife, España
| | - Alejandro Sánchez-Grande Flecha
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad de Laguna, San Cristóbal de la Laguna, Tenerife, España
| | - Julio Hernández-Afonso
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
| | - Francisco Bosa-Ojeda
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad de Laguna, San Cristóbal de la Laguna, Tenerife, España
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Regueiro A, Fernández-Rodríguez D, Freixa X, Bosch X, Martín-Yuste V, Brugaletta S, Roqué M, Sabaté M, Masotti M. False Positive STEMI Activations in a Regional Network: Comprehensive Analysis and Clinical Impact. Results From the Catalonian Codi Infart Network. ACTA ACUST UNITED AC 2017; 71:243-249. [PMID: 28711360 DOI: 10.1016/j.rec.2017.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 05/24/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES ST-segment elevation myocardial infarction (STEMI) network activation by a noncardiologist reduces delay times but may increase the rate of false-positive STEMI diagnoses. We aimed to determine the prevalence, predictors, and clinical impact of false-positive activations within the Catalonian STEMI network (Codi Infart). METHODS From January 2010 through December 2011, all consecutive patients treated within the Codi Infart network were included. Code activations were classified as appropriate if they satisfied both electrocardiogram and clinical STEMI criteria. Appropriate activations were classified as false positives using 2 nonexclusive definitions: a) "angiographic" if a culprit coronary artery was not identified, and b) "clinical" if the discharge diagnosis was other than STEMI. RESULTS In total, 5701 activations were included. Appropriate activation was performed in 87.8% of the episodes. The rate of angiographic false positives was 14.6%, while the rate of clinical false positives was 11.6%. Irrespective of the definition, female sex, left bundle branch block, and previous myocardial infarction were independent predictors of false-positive STEMI diagnoses. Using the clinical definition, hospitals without percutaneous coronary intervention and patients with complications during the first medical contact also had a false-positive STEMI diagnoses rate higher than the mean. In-hospital and 30-day mortality rates were similar for false-positive and true-positive STEMI patients after adjustment for possible confounders. CONCLUSIONS False-positive STEMI diagnoses were frequent. Outcomes were similar for patients with a true-positive or false-positive STEMI diagnosis treated within a STEMI network. The presence of any modifiable predictors of a false-positive STEMI diagnosis warrants careful assessment to optimize the use of STEMI networks.
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Affiliation(s)
- Ander Regueiro
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Bosch
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Victoria Martín-Yuste
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Salvatore Brugaletta
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Mercè Roqué
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Mónica Masotti
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
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Anmad Shihadeh L, Fernández-Rodríguez D, Trugeda-Padilla A, Hernández-Afonso J. Ictus isquémicos: ¿es obligatorio descartar trombosis aórtica? Archivos de Cardiología de México 2017; 87:228-230. [DOI: 10.1016/j.acmx.2017.01.003] [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] [Received: 09/08/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 10/20/2022] Open
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Fernández-Rodríguez D, Regueiro A, Cevallos J, Bosch X, Freixa X, Trilla M, Brugaletta S, Martín-Yuste V, Sabaté M, Bosa-Ojeda F, Masotti M. Brecha de género en los cuidados médicos en las redes de atención al infarto agudo de miocardio con elevación del segmento ST: hallazgos de la red catalana Codi Infart. Med Intensiva 2017; 41:70-77. [DOI: 10.1016/j.medin.2016.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 05/25/2016] [Accepted: 06/16/2016] [Indexed: 01/30/2023]
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Couto-Comba P, Fernández-Rodríguez D, Lloréns-León R, Hernández-Afonso J. Estenosis aórtica severa secundaria a ocronosis: ¿qué tipo de prótesis valvular está indicada? Cirugía Cardiovascular 2017. [DOI: 10.1016/j.circv.2016.04.006] [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: 11/26/2022] Open
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35
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Acosta-Materán C, Díaz-Oliva E, Fernández-Rodríguez D, Hernández-Afonso J. QT interval prolongation and torsade de pointes: Synergistic effect of flecainide and H1 receptor antagonists. J Pharmacol Pharmacother 2016; 7:102-5. [PMID: 27440957 PMCID: PMC4936076 DOI: 10.4103/0976-500x.184776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A high percentage of patients having atrial fibrillation (AF) presents with paroxysmal AF. Flecainide, the prototypic class Ic anti-arrhythmic drug is the most effective drug to maintain sinus rhythm in this subgroup of patients, though the drug has potential pro-arrhythmic effects. Furthermore, the H1 receptor antagonists are the most commonly prescribed drugs for the symptomatic treatment of pruritus. Despite having low number of adverse effects, the H1 receptor antagonists have cardiotoxic effects. Flecainide and H1 receptor antagonists present arrhythmic complications including QT interval prolongation and torsade de pointes (TdP). The case presented here is a 65-year-old female who was diagnosed of atrial fibrillation and presented with rashes in lower extremities. The patient was treated using flecainide and H1 receptor antagonists (loratadine and hydroxyzine) that prolonged QT interval and induced TdP. The concomitant administration of flecainide and H1 receptor antagonists seems to have a synergistic effect in QT interval prolongation and subsequent TdP. The concurrent administration of H1 receptor antagonists to patients receiving class Ic anti-arrhythmic drugs should be avoided in order to reduce arrhythmic risk in this population.
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Affiliation(s)
- Carlos Acosta-Materán
- Department of Cardiology, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Eloy Díaz-Oliva
- Department of Cardiology, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Diego Fernández-Rodríguez
- Department of Cardiology, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Julio Hernández-Afonso
- Department of Cardiology, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain
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Fernández-Rodríguez D, Shihadeh LA, Hernández-Afonso J. [Scientific research in medicine: When logic opposes evidence]. Arch Cardiol Mex 2016; 86:292-3. [PMID: 27344511 DOI: 10.1016/j.acmx.2016.05.007] [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: 04/07/2016] [Revised: 05/17/2016] [Accepted: 05/18/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España.
| | - Leydimar A Shihadeh
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
| | - Julio Hernández-Afonso
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
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37
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Fernández-Rodríguez D, Martos-Maine JL, Rodríguez-Esteban M, Bosa-Ojeda F. [Chest pain without electrocardiographic confirmation of a diagnosis: Should we prefer anatomical or functional evaluation?]. Emergencias 2016; 28:206. [PMID: 29105456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | - José L Martos-Maine
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | - Marcos Rodríguez-Esteban
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | - Francisco Bosa-Ojeda
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, España
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Fernández-Rodríguez D, Grillo JJ, Martos-Maine JL, Bosa-Ojeda F. Octogenarians: Too Old for Surgical Myocardial Revascularization? ACTA ACUST UNITED AC 2016; 69:711-2. [PMID: 27236273 DOI: 10.1016/j.rec.2016.03.012] [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: 02/26/2016] [Accepted: 03/07/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Spain.
| | - José J Grillo
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - José L Martos-Maine
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Francisco Bosa-Ojeda
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
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Fernández-Rodríguez D, Cevallos J, Rodríguez-García M, Hernández-Afonso J. Heart Team Decision-making in Spain: Is There Room for Improvement? Response. Rev Esp Cardiol (Engl Ed) 2016; 69:534-535. [PMID: 27005759 DOI: 10.1016/j.rec.2016.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 02/03/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de La Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Spain.
| | - Joaquim Cevallos
- Intensive Care Unit, St.Thomas' Hospital, Guy's and St.Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Julio Hernández-Afonso
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de La Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
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40
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Fernández-Rodríguez D, Rodríguez-García M, Cevallos J, Hernández-Afonso J. Heart Team Decision-making: Democracy or Dictatorship? Rev Esp Cardiol (Engl Ed) 2016; 69:224-226. [PMID: 26723903 DOI: 10.1016/j.rec.2015.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/13/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain.
| | | | - Joaquim Cevallos
- Intensive Care Unit, St. Thomas' Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Julio Hernández-Afonso
- Servicio de Cardiología, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
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Prieto Robles C, Argibay Lago A, Hernanz Del Río A, Rodríguez Castaño IM, Fernández-Rodríguez D. [OPTIMIZATION OF GLUCOSE METABOLISM IN PATIENTS UNDERGOING THERAPEUTIC HYPOTHERMIA AFTER SUDDEN CARDIAC ARREST]. Rev Enferm 2015; 38:46-50. [PMID: 26685566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Therapeutic hypothermia (TH) is recommended to improve survival and neurologic prognosis in sudden cardiac arrest (SCA) survivors. There are few data aboutglycemic levels in these patients. The aim of this study is to evaluate the glycemic control using a specific protocol in this group ofpeople. METHOD A retrospective analysis of the patients receiving TH in our institution, between January 2010 and March 2013,. was performed. Baseline characteristics, in-hospital prognosis and glycemic levels during different stages of the TH were analyzed. RESULTS From a total of 55 patients suffering a SCA, 49 patients underwent TH and received a specific insulin protocol. The mean age was 57.5 ± 12.8 years, the main cause of SCA was ischemic (76%) and ventricular fibrillation was the most frequent first rhythm detected (55%). Regarding glycemic alterations as each stage of TH, a high rate of glycemic alteration was observed in the induction stage, decreasing after starting the insulin protocol (induction stage: 95.9%; maintenance stage: 89.8%; rewarming stage: 69.4%; p = 0.001). With respectto clinicresults, there were low rates of severe hypoglycemia (12%), in-hospital mortality (20%) and anoxic encephalopathy (27%), with a high rate of infections (75%). CONCLUSIONS The implementation of a specific insulin protocol in patients receiving TH contributes to improve the blood glucose levels. Further studies are needed to evaluate the clinical impact of these protocols in this group ofpatients.
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Regueiro A, Fernández-Rodríguez D, Brugaletta S, Martín-Yuste V, Masotti M, Freixa X, Cequier Á, Íñiguez A, Serruys PW, Sabaté M. Influencia del sexo en los resultados clínicos de los stents liberadores de everolimus en comparación con los stents metálicos sin recubrimiento en el infarto agudo de miocardio con elevación del segmento ST. Perspectivas del ensayo EXAMINATION. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.04.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fernández-Rodríguez D, Freixa X, Kasa G, Regueiro A, Cevallos J, Hernández M, Brugaletta S, Martín-Yuste V, Sabaté M, Masotti M. [Benefit of the implementation of a ST-segment elevation myocardial infarction network on women]. Arch Cardiol Mex 2015; 85:96-104. [PMID: 25736036 DOI: 10.1016/j.acmx.2014.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 12/12/2014] [Accepted: 12/22/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The ST-segment elevation myocardial infarction network "Codi Infart" was implemented in Catalonia (Spain) in June 2009. The objective of this study was to evaluate the impact of the implementation of the Codi Infart on women. METHOD Women referred for primary percutaneous coronary intervention, were divided into two groups according to Codi Infart: Non-Codi Infart group (January 2003 to May 2009) and Codi Infart group (June 2009 to December 2012). Place of first medical contact, time intervals in diagnosis and treatment, treatments received and rate of major cardiovascular adverse events defined as all-cause death, reinfarction or stroke in-hospital, at 30 and 180 days were compared. RESULTS From a total population of 2,426 patients, 501 (20.7%) were women. One-hundred eighty-six women (2.09 cases/month) belonged to Non-Codi Infart group and 315 women (10.16 cases/month) to Codi Infart group. The percentage of women attended increased since the introduction of CI (22.2% vs. 18.5%, P=.028). In addition, the Codi Infart group had a higher percentage of women initially attended outside our institution (84.1% vs. 16.7%, P<.001), and lower total ischemia time (220 [155-380] vs. 272 [196-456], P=.003). However, no differences in 180-day major cardiovascular adverse events were detected (14.2% vs. 15.6%, P=.692). CONCLUSIONS The implementation of the major cardiovascular adverse events allowed to increase the rate and the percentage of women with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention and reducing total ischemic time.
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Affiliation(s)
- Diego Fernández-Rodríguez
- Servicio de Cardiología, Hospital Clínic, Barcelona, España; Servicio de Cardiología, Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic, Barcelona, España.
| | - Gizem Kasa
- Servicio de Cardiología, Hospital Clínic, Barcelona, España
| | - Ander Regueiro
- Servicio de Cardiología, Hospital Clínic, Barcelona, España; Comité Directivo, Iniciativa Stent for Life, España
| | | | | | | | | | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic, Barcelona, España; Comité Directivo, Iniciativa Stent for Life, España
| | - Mónica Masotti
- Servicio de Cardiología, Hospital Clínic, Barcelona, España
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Fernández-Rodríguez D, Regueiro A, Brugaletta S, Gómez-Monterrosas O, Pomar JL, Sabaté M. Restauración ventricular: nuevos enfoques terapéuticos. Rev Esp Cardiol (Engl Ed) 2015. [DOI: 10.1016/j.recesp.2014.10.012] [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: 10/24/2022]
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Fernández-Rodríguez D, Regueiro A, Brugaletta S, Gómez-Monterrosas O, Pomar JL, Sabaté M. Ventricular restoration: new therapeutic approaches. ACTA ACUST UNITED AC 2015; 68:257-9. [PMID: 25656435 DOI: 10.1016/j.rec.2014.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/10/2014] [Indexed: 10/24/2022]
Affiliation(s)
| | - Ander Regueiro
- Servicios de Cardiología y Cirugía Cardiovascular, Hospital Clínic, Barcelona, Spain
| | - Salvatore Brugaletta
- Servicios de Cardiología y Cirugía Cardiovascular, Hospital Clínic, Barcelona, Spain
| | | | - José Luis Pomar
- Servicios de Cardiología y Cirugía Cardiovascular, Hospital Clínic, Barcelona, Spain
| | - Manel Sabaté
- Servicios de Cardiología y Cirugía Cardiovascular, Hospital Clínic, Barcelona, Spain.
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Regueiro A, Freixa X, Fernández-Rodríguez D, Diaz-Ricart M, Escolar G, Martín-Yuste V, Brugaletta S, Sabaté M, Masotti M. Platelet reactivity assessment with VerifyNow®: substitute or complement for light transmission aggregometry? Int J Cardiol 2015; 178:221-2. [PMID: 25464258 DOI: 10.1016/j.ijcard.2014.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Ander Regueiro
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Xavier Freixa
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona.
| | | | - Maribel Diaz-Ricart
- Hemotherapy and Hemostasis Department, Biomedical Diagnostic Center, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Ginés Escolar
- Hemotherapy and Hemostasis Department, Biomedical Diagnostic Center, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Victoria Martín-Yuste
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Salvatore Brugaletta
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Manel Sabaté
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Mónica Masotti
- Cardiology Department, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona
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Regueiro A, Fernández-Rodríguez D, Brugaletta S, Martín-Yuste V, Masotti M, Freixa X, Cequier Á, Íñiguez A, Serruys PW, Sabaté M. Sex-related Impact on Clinical Outcome of Everolimus-eluting Versus Bare-metal Stents in ST-segment Myocardial Infarction. Insights From the EXAMINATION Trial. ACTA ACUST UNITED AC 2014; 68:382-9. [PMID: 25444377 DOI: 10.1016/j.rec.2014.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 04/11/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES The use of second-generation drug-eluting stents compared with bare-metal stents in patients with ST-segment elevation myocardial infarction reduces the rate of major adverse cardiac events. We aimed to evaluate the impact of sex on the performance of everolimus-eluting stents vs bare-metal stents in ST-segment elevation myocardial infarction at 2-year follow-up. METHODS This is a sub-study of the EXAMINATION trial that randomized 1498 patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention to everolimus-eluting or bare-metal stents. Primary end point was combined all-cause death, any recurrent myocardial infarction, and any revascularization. All end points were analyzed according to sex at 2-year follow-up. RESULTS Of 1498 patients included in the trial, 254 (17.0%) were women. Women were older and had higher prevalence of hypertension and lower prevalence of smoking compared with men. In contrast with men, stent diameter was smaller in women. After multivariate analysis, the primary end point was similar between women and men (hazard ratio=0.95; 95% confidence interval, 0.66-1.37), and among women, between those treated with bare-metal vs everolimus-eluting stents (hazard ratio=2.48; 95% confidence interval, 0.95-6.46). Women showed a lower rate of repeat revascularization than men (hazard ratio=0.55; 95% confidence interval, 0.32-0.95) despite worse baseline characteristics. This difference was driven by better performance of the everolimus-eluting stent in women. CONCLUSIONS Despite poorer baseline clinical characteristics, women with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention showed outcomes similar to men. The use of everolimus-eluting stents may represent an added value in women as it showed a reduced rate of repeated revascularization compared to men.
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Affiliation(s)
- Ander Regueiro
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | | | | | | | - Monica Masotti
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Ángel Cequier
- Área de Enfermedades del Corazón, Hospital Universitario de Bellvitge, IDIBELL, Barcelona, Spain
| | - Andrés Íñiguez
- Servicio de Cardiología, Complejo Hospitalario Universitario de Vigo, Pontevedra, Spain
| | - Patrick W Serruys
- Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic, IDIBAPS, Barcelona, Spain.
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Gómez-Monterrosas O, Regueiro A, Santos A, Otsuki S, Scalone G, Fernández-Rodríguez D, Sabaté M. Recanalized thrombus treated with bioresorbable vascular scaffold: insights from optical coherence tomography. JACC Cardiovasc Interv 2014; 7:1453-5. [PMID: 25457058 DOI: 10.1016/j.jcin.2014.07.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/02/2014] [Accepted: 07/05/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Omar Gómez-Monterrosas
- Cardiology Department, Thorax Institute, Hospital Clínic, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ander Regueiro
- Cardiology Department, Thorax Institute, Hospital Clínic, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Alejandro Santos
- Cardiology Department, Hospital Dr. Domingo Luciani, Caracas Venezuela
| | - Shuji Otsuki
- Cardiology Department, Thorax Institute, Hospital Clínic, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Giancarla Scalone
- Cardiology Department, Catholic University of Sacred Heart, Rome, Italy
| | - Diego Fernández-Rodríguez
- Cardiology Department, Thorax Institute, Hospital Clínic, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Manel Sabaté
- Cardiology Department, Thorax Institute, Hospital Clínic, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
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Argibay-Lago A, Fernández-Rodríguez D, Ferrer-Sala N, Prieto-Robles C, Hernanz-del Río A, Castro-Rebollo P. Valoración de la carga de trabajo de Enfermería en pacientes sometidos a hipotermia terapéutica. Enfermería Clínica 2014; 24:323-9. [DOI: 10.1016/j.enfcli.2014.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 07/29/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
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Fernández-Rodríguez D, Brugaletta S, Otsuki S, Sabaté M. Acute Absorb bioresorbable vascular scaffold thrombosis in ST-segment elevation myocardial infarction: to stent or not to stent? EUROINTERVENTION 2014; 10:600; discussion 600. [DOI: 10.4244/eijv10i5a103] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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