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Infarto agudo de miocardio sin elevación del segmento ST con coronarias sin lesiones angiográficas significativas: epidemiología, predictores e impac…
2020
La presente tesis doctoral se plantea los siguientes objetivos:- Objetivo 1: Identificar variables predictoras de CN en pacientes consecutivos con IAMSEST sometidos a coronariografía - Objetivo 2: Evaluar el impacto pronóstico del diagnóstico de MINOCA vs IAM con lesiones coronarias en cuanto a la aparición de eventos cardiovasculares mayores en el seguimiento: mortalidad total, mortalidad cardiovascular, reinfarto y nuevas revascularizaciones - Objetivo 3: Evaluar el impacto pronóstico de la anatomía coronaria dentro del diagnóstico de MINOCA vs IAM con lesiones coronarias en cuanto a la aparición de eventos cardiovasculares mayores en el seguimiento: mortalidad total, mortalidad cardiovas…
Estudio de la afectación del ventrículo derecho en el infarto anterior reperfundido
2015
La afectación del ventrículo derecho (VD) en el seno de un infarto agudo de miocardio de localización inferior, es de sobra conocida. Sin embargo, la vascularización de la cara anterior del VD depende de ramas de la arteria descendente anterior (ADA), siendo escasos los trabajos que estudian la afectación del VD que se produce durante un infarto agudo de miocardio de localización anterior. Evaluamos la afectación del VD que se produce tras la oclusión del ADA en un grupo experimental de 9 cerdos, al que le realizamos un modelo de isquemia-reperfusión percutánea mediante el hinchado de un balón de angioplastia en la ADA media durante 90 minutos, y en un grupo de pacientes con un primera infa…
STEM CELLS FOR TREATMENT OF CARDIOVASCULAR DISEASES: AN UMBRELLA REVIEW OF RANDOMIZED CONTROLLED TRIALS
2021
AIMS:\ud \ud Stem cells are a promising therapy for various medical conditions. The literature regarding their adoption for the clinical care of cardiovascular diseases (CVD) is still conflicting. Therefore, our aim is to assess the strength and credibility of the evidence on clinical outcomes and application of stem cells derived from systematic reviews and meta-analyses of intervention studies in CVD.\ud \ud METHODS and RESULTS:\ud \ud Umbrella review of systematic reviews with meta-analyses of randomized controlled trials (RCTs) using placebo/no intervention as control group. For meta-analyses of RCTs, outcomes with a random-effect p-value< 0.05, the GRADE (Grading of Recommendations Ass…
Obstrucción microvascular derivada de la resonancia margnética cardiaca tras un infarto miocárdico con elevación del ST –asociación con marcadores de…
2013
Este trabajo, que se dividió en tres partes, pretendió determinar la asociación entre la obstrucción microvascular (MVO) estimada mediante resonancia magnética cardiaca (RMC) con determinados marcadores ampliamente disponibles en el contexto del infarto agudo de miocardio con elevación del segmento-ST (IAMCEST). La RMC permite una exhaustiva evaluación de los pacientes con IAMCEST. En este sentido, la aparición de MVO ha mostrado ser un factor asociado a episodios cardiovasculares adversos mayores y remodelado negativo tras un IAMCEST. En la primera parte de este trabajo, pretendimos explorar la asociación entre el sumatorio de las derivaciones con ST elevado (sum-ST) y la resolución del se…
Myocardial infarction in Young adults: risk factors, clinical characteristics and prognosis according to our experience
2013
Objectives. Myocardial infarction is a relatively unusual phenomenon in young subjects. The aim if this work is to characterize the risk profile and factors influencing outcomes of these patients since it makes possible to manage prevention interventions. Patients and Methods. We examined cardiovascular risk factors, clinical presentation, angiographic picture and outcome of a group of young patients hospitalized for a myocardial infarction. We enrolled 121 young patients consecutively admitted to our hospital for a myocardial infarction and examined them not only at the initial stage, but also after 3 months and one year; finally a long-term telephonic follow up was performed, when possibl…
Role of genetic polymorphisms in myocardial infarction at young age
2010
Acute myocardial infarction (AMI) in young adult presents a typical pattern of risk factors, clinical, angiographic and prognostic characteristics. In the last years we demonstrated that hemorheological profile is altered in these patients in a persistent way and independently of the number of risk factors and of the extent of coronary lesions. Thus, the hyperviscosity syndrome following AMI could be considered an intrinsic characteristic of these patients. Consequently it is possible to hypothesise the presence of a genetic background at the origin of this predisposition. If this background is able to influence the risk of ischemic heart disease, this should be particularly evident in youn…
Relation between Tissue Factor Pathway Inhibitor Activity and Cardiovascular Risk Factors and Diseases in a Large Population Sample.
2021
Abstract Objective Tissue factor pathway inhibitor (TFPI) is a potent anticoagulant protein in the extrinsic coagulation pathway. In the present study, we aim to identify the cardiovascular determinants for total TFPI activity and its association with cardiovascular disease (CVD) and total mortality. Methods Total TFPI activity was assessed in a selection of the population-based Gutenberg Health Study (n = 5,000). Statistical analysis was performed to identify the determinants for total TFPI activity as well as the associations with CVD and mortality. Results Multivariable linear regression analysis identified smoking (β 0.095 [0.054–0.136]) as a positive determinant for total TFPI activity…
Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology …
2019
Aims The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5…
Asymptomatic carotid lesions add to cardiovascular risk prediction.
2010
AIM To show that subclinical atherosclerosis (subclinical-ATS) of carotid arteries [intima-media thickness (IMT) or asymptomatic carotid plaque (ACP)], may provide additional information for risk stratification, in asymptomatic patients, aged greater than 45 years, with a cluster of risk factors (RFs). METHODS AND RESULTS We studied 558 asymptomatic patients (235 males). RFs for atherosclerosis were assessed and the 10-year-risk was calculated according to the Italian risk score. Doppler ultrasound of carotid arteries identified the presence of IMT greater than 0.9 mm in 183 patients and ACP in 147 patients. One hundred and fifty-three patients developed cerebrovascular or cardiovascular (C…
Effects of PCSK9 inhibitors on HDL cholesterol efflux and serum cholesterol loading capacity in familial hypercholesterolemia subjects: a multi-lipid…
2022
Proprotein convertase subtilisin/kexin type 9 (PCSK9), beyond regulating LDL cholesterol (LDL-c) plasma levels, exerts several pleiotropic effects by modulating lipid metabolism in extrahepatic cells such as macrophages. Macrophage cholesterol homeostasis depends on serum lipoprotein functions, including the HDL capacity to promote cell cholesterol efflux (CEC) and the serum capacity to promote cell cholesterol loading (CLC). The aim of this observational study was to investigate the effect of PCSK9 inhibitors (PCSK9-i) treatment on HDL-CEC and serum CLC in patients with familial hypercholesterolemia (FH). 31 genetically confirmed FH patients were recruited. Blood was collected and serum is…