0000000000393727

AUTHOR

Rosana Hernández-antolín

Estrategia invasiva frente a conservadora en pacientes frágiles con IAMSEST. Diseño del ensayo clínico MOSCA-FRAIL

Resumen Introduccion y objetivos Aunque las guias de practica clinica recomiendan una estrategia invasiva para el infarto agudo de miocardio sin elevacion del segmento ST (IAMSEST), en la practica clinica esta estrategia se infrautiliza en ancianos fragiles. Ademas estos enfermos habitualmente quedan excluidos de los ensayos clinicos, por lo que la evidencia es escasa. Nuestra hipotesis es que una estrategia invasiva para el anciano con fragilidad y IAMSEST mejorara el pronostico. Metodos Se trata de un estudio prospectivo, multicentrico y aleatorizado que compara una estrategia invasiva frente a una conservadora en ancianos fragiles con IAMSEST. Los criterios de inclusion son: IAMSEST, eda…

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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…

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Invasive Versus Conservative Strategy in Frail Patients With NSTEMI: The MOSCA-FRAIL Clinical Trial Study Design

Abstract Introduction and objectives Although clinical guidelines recommend invasive management in non–ST-segment elevation myocardial infarction (NSTEMI), this strategy is underused in frail elderly patients in the real world. Furthermore, these patients are underrepresented in clinical trials and therefore the evidence is scarce. Our hypothesis is that an invasive strategy will improve prognosis in elderly frail patients with NSTEMI . Methods This will be a prospective, multicenter, randomized trial, in which the conservative and invasive strategies will be compared in patients meeting all of the following inclusion criteria: NSTEMI diagnosis, age ≥ 70 years, and frailty defined by a cate…

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