Fracción aminoterminal del propéptido natriurético cerebral y troponina ultrasensible en el dolor torácico agudo de origen incierto. Un subestudio del estudio PITAGORAS

Resumen Introduccion y objetivos La troponina ultrasensible ha mejorado el diagnostico del sindrome coronario agudo en los pacientes que se presentan con dolor toracico y troponina convencional normal. Nuestro objetivo es analizar si la fraccion aminoterminal del propeptido natriuretico cerebral aporta informacion adicional. Metodos Se estudio a 398 pacientes, incluidos en el estudio PITAGORAS, que acudieron a urgencias por dolor toracico con troponina convencional normal en dos muestras seriadas (a la llegada y a las 6-8 h). Se midio de forma centralizada la troponina T ultrasensible en las dos muestras y la fraccion aminoterminal del propeptido natriuretico cerebral en la segunda. Los obj…

Comparative Study of Ambient Air Particles in Patients Hospitalized for Heart Failure and Acute Coronary Syndrome

Introduction and objectives: Currently air pollution is considered as an emerging risk factor for cardiovascular disease. Our objective was to study the concentrations of particulate matter in ambient air and analyze their relationship with cardiovascular risk factors in patients admitted to a cardiology department of a tertiary hospital with the diagnosis of heart failure or acute coronary syndrome (ACS). Methods: We analyzed 3950 consecutive patients admitted with the diagnosis of heart failure or ACS. We determined the average concentrations of different sizes of particulate matter (<10, <2.5, and <1 mm and ultrafine particles) from 1 day or up to 7 days prior to admission (1 to 7 days l…

Prognostic role of tapse to pasp ratio in patients undergoing mitraclip procedure

Producción Científica

Clinical and echocardiographic outcomes of transcatheter mitral valve repair in atrial functional mitral regurgitation.

Background: Isolated atrial fibrillation can cause mitral regurgitation (MR) in patients with normal left ventricular systolic function and no organic disease of the mitral valve. Little information is available regarding outcomes of Mitraclip in patients with atrial functional mitral regurgitation (AFMR). We aimed to evaluate 12-month clinical and echocardiographic outcomes of transcatheter mitral valve repair (TMVR) with MitraClip in patients with AFMR compared to those with ventricular functional or degenerative/mixed MR. Methods: Registry-based analysis of all consecutive patients who underwent TMVR and were included in the Spanish Registry of Mitraclip. Changes in MR and NYHA functiona…

Estudio comparativo de las partículas en aire ambiente en pacientes ingresados por insuficiencia cardiaca y síndrome coronario agudo

Resumen Introduccion y objetivos Actualmente se considera la contaminacion atmosferica como un factor de riesgo emergente de enfermedades cardiovasculares. Nuestro objetivo fue comparar las concentraciones de particulas atmosfericas en aire ambiente y analizar su relacion con los factores de riesgo cardiovascular en pacientes que ingresan en un servicio de cardiologia de un hospital terciario con el diagnostico de insuficiencia cardiaca y sindrome coronario agudo (SCA). Metodos Analizamos a un total de 3.950 pacientes ingresados de forma consecutiva con el diagnostico de insuficiencia cardiaca y SCA. Se determinaron las concentraciones medias de material particulado con tamano Resultados No…

Microvascular obstruction in non-STEMI related areas: An uninvited guest in STEMI?

Identifying the patient subset with highest inflammation levels in acute coronary syndromes

N-terminal Pro-brain Natriuretic Peptide and High-sensitivity Troponin in the Evaluation of Acute Chest Pain of Uncertain Etiology. A PITAGORAS Substudy

Abstract Introduction and objectives High-sensitivity troponin assays have improved the diagnosis of acute coronary syndrome in patients presenting with chest pain and normal troponin levels as measured by conventional assays. Our aim was to investigate whether N-terminal pro-brain natriuretic peptide provides additional information to troponin determination in these patients. Methods A total of 398 patients, included in the PITAGORAS study, presenting to the emergency department with chest pain and normal troponin levels as measured by conventional assay in 2 serial samples (on arrival and 6 h to 8 h later) were studied. The samples were also analyzed in a central laboratory for high-sensi…

Transcatheter Mitral Repair for Functional Mitral Regurgitation According to Left Ventricular Function: A Real-Life Propensity-Score Matched Study

Background: Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip&reg

Effect of implantation technique on outcomes in patients receiving bioresorbable scaffolds in various clinical scenarios

ABSTRACT Introduction and objectives: The PSP (pre-dilation, sizing and post-dilation) score, derived from the GHOST-EU registry, has evaluated the relationship between the implantation technique of bioresorbable scaffolds and the clinical outcomes. The objective was to perform an external validation of the PSP technique and to determine its effect on adverse cardiac events in various clinical and anatomical scenarios. Methods: Data from the REPARA registry (2230 patients) were used for external validation, whereas a common database combining REPARA and GHOST-EU (3250 patients) data was used to evaluate the effect of PSP technique in various clinical and anatomical scenarios. PSP-1 and PSP-…

Selecting the best candidates for revascularization: A challenging issue in stable coronary artery disease.

Relación entre exposición a corto plazo a dióxido de azufre atmosférico y lesiones obstructivas en el síndrome coronario agudo

Resumen Fundamentos y objetivo Los contaminantes del aire urbano estan constituidos por una mezcla heterogenea de sustancias presentes en estado gaseoso y aerosoles. El objetivo del presente estudio fue comparar los efectos causados por la exposicion a contaminantes en fase gas y particulas atmosfericas en aire ambiente en pacientes que ingresan por un sindrome coronario agudo (SCA), en relacion con la presencia o no de lesiones obstructivas significativas (LOS) en arterias coronarias epicardicas. Pacientes y metodo Analizamos de forma prospectiva a un total de 2.110 pacientes con el diagnostico de SCA. Se determinaron las concentraciones medias de contaminantes en fase gas y particulas atm…

Acute Kidney Injury After Percutaneous Edge-to-Edge Mitral Repair.

BACKGROUND In catheter-based procedures, acute kidney injury (AKI) is a frequent, serious complication ranging from 10% to 30%. In MitraClip (Abbott Vascular, Santa Clara, California), a usually contrast-free procedure, there is scarce data about its real incidence and impact. OBJECTIVES This study aimed to evaluate incidence, predictive factors, and midterm outcomes of AKI in patients with significant mitral regurgitation (MR) undergoing transcatheter valve repair with MitraClip. METHODS A total of 721 patients undergoing MitraClip were included. AKI was defined as an absolute or a relative increase in serum creatinine of >0.3 mg/dl or >= 50%, respectively, or the need for hemodialysis dur…