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Background: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensin-converting-enzyme (ACE)2 and patient's susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment.Methods: The ISACS-STEMI COVID-19 registry retrospectively assessed STEMI patients treated with primary percutaneous coronary intervention (PPCI) in March/June 2019 and 2020 in 109 European high-volume primary PCI centers. This subanalysis assessed the prognostic impact of chronic RASI therapy at admission on mortality and SARS-CoV2 infection among diabetic patients.Results: Our population is represented by 3812 diabetic STEMI patients undergoing mechanical reperfusion, 2038 in 2019 and 1774 in 2020. Among 3761 patients with available data on chronic RASI therapy, between those ones with and without treatment there were several differences in baseline characteristics, (similar in both periods) but no difference in the prevalence of SARS-CoV2 infection (1.6% vs 1.3%, respectively, p = 0.786). Considering in-hospital medication, RASI therapy was overall associated with a significantly lower in-hospital mortality (3.3% vs 15.8%, p < 0.0001), consistently both in 2019 and in 2010.Conclusions: This is first study to investigate the impact of RASI therapy on prognosis and SARS-CoV2 infection of diabetic patients experiencing STEMI and undergoing PPCI during the COVID-19 pandemic. Both pre-admission chronic RASI therapy and in-hospital RASI did not negatively affected patients' survival during the hospitalization, neither increased the risk of SARS-CoV2 infection.Trial registration number: NCT04412655.

The Solitaire stent is a self-expanding nitinol, fully retrievable stent that was originally designed for applications in cerebral circulation. Expanded indications for its use in mechanical embolectomy during acute ischemic stroke have proven safe and effective. Herein, we describe a novel use of this stent to perform a mechanical thrombectomy of a large left main coronary artery thrombus. © 2016 Wiley Periodicals, Inc.

Objetivodescribir la incidencia y el pronóstico de la vasculopatía del injerto cardíaco (CAV: cardiac allograft vasculopathy, su sigla en Inglés), de acuerdo con la clasificación propuesta por la Sociedad Internacional de Trasplante de Corazón y Pulmón (ISHLT).Metodologíaestudio de cohortes de trasplantados cardíacos, llevado a cabo entre febrero de 2003 y noviembre de 2011 con seguimiento angiográfico; el desenlace principal fue CAV de acuerdo con la ISHLT. Se utilizaron pruebas de chi-cuadrado para variables cualitativas y t de student para las cuantitativas. Se hizo análisis de supervivencia de Kaplan-Meier.Resultadosse incluyeron 118 pacientes; 83,1% fueron hombres con mediana de edad de 46,4 RIQ (38,4-55,6) años. El seguimiento promedio fue de 5 ± 4,7 años con 2,4 ± 1,6 coronariografías/ paciente. La incidencia total de CAV fue de 23,7%; grado 1 (leve) 11,9%, grado 2 (moderada) 7,6% y grado 3 (severa) 4,2%. El único factor con una asociación modesta fue la hipertensión pulmonar con RR 2,54 (1,1-6,1) p=0,05. La mortalidad de los pacientes de acuerdo con el grado de vasculopatía fue: leve 0%; grado 2 (moderada) 42% RR 2,59 IC95% (1,14-5,9) p=0,024; grado 3 (severa) 72% RR 4,44 IC95% (2,27-8,6) p

Introduccion el aneurisma aortico es frecuente; su ruptura depende del diametro. La cirugia es el manejo de eleccion; como alternativa esta el implante intraluminal de stents. Objetivo analizar el impacto del implante percutaneo de los stents aorticos en pacientes de alto riesgo quirurgico con seguimiento minimo de un ano. Metodo estudio descriptivo llevado a cabo desde diciembre de 2005 hasta marzo de 2010, en el que se incluyeron 125 pacientes con aneurisma de aorta toracica o abdominal, criterio quirurgico por su diametro y que ademas fueron rechazados por cirugia dado su alto riesgo. Los desenlaces fueron: muerte intraoperatoria, por cualquier causa y relacionada con el aneurisma a uno, seis y doce meses. Las complicaciones se definieron como las vasculares ocurridas durante los primeros treinta dias. Resultados el aneurisma abdominal fue mas frecuente (70,4%). La mortalidad total a un seguimiento de 25,7 meses fue 14,8%; de este porcentaje 5,2% fallecieron por causas relacionadas con el aneurisma. Un paciente fallecio durante la intervencion. Se reintervinieron 4,3% por fugas. Hubo mayor mortalidad relacionada con el aneurisma en los toracicos (14,7 vs. 1,2% p = 0,003) y tendencia en los de mayor diametro (6,9 vs. 5,7 cm p = 0,210). No hubo relacion entre mortalidad y diabetes mellitus, tabaquismo, enfermedad coronaria, hipertension arterial o dislipidemia. Conclusiones la mortalidad relacionada con el aneurisma en pacientes intervenidos con stent graft aortico es baja. Esta se asocio a la toracica y al mayor diametro aneurismatico. Las complicaciones no significaron un aumento en mortalidad. En conclusion, en pacientes con aneurisma aortico y alto riesgo quirurgico rechazados para cirugia abierta, el abordaje percutaneo es un tratamiento seguro y eficaz a un seguimiento a mediano plazo.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). Consequently, its presentation and optimal treatment are yet to be clearly defined. In the current literature, all case series report less than 50 patients, most of whom are either young peripartum women or women who have used oral contraceptives over long periods. All information in this study was compiled by the database service from two hospitals, the first one between 2003 and 2012 and the second one between 2007 and 2012, to include the clinical characteristics, angiography. and treatment approaches in the study population. The study population consisted in four women (50%) and four men (50%) whose ages ranged between 28 and 57 years. Two women had a history of oral contraceptive use and three women presented during peripartum. None of the patients had traditional cardiovascular risk factors or previous heart disease. In 88% of the cases, the principal diagnoses were non-ST segment elevation myocardial infarction and unstable angina. All patients underwent emergency coronary angiography and percutaneous coronary intervention. Half of them were treated with drug-eluting stents and the other half with bare metal stents. The most frequent type of dissection was NIHBL Type E, and the right coronary artery was the most frequently compromised. SCAD is a rare cause of ACS; however, its identification has improved due to the availability of angiography and new complementary techniques. Regarding treatment, PCI seems effective with adequate long-term results.

In order to fulfill the Mexican Electric Utility's (CFE) modernization demands, the Electrical Research Institute (IIE) developed at the Process Super Vision Department an improved Human Machine Interface (HMI) modernization for a Combined Cycle Power Plant (CCPP) to replace the old one based on VAX workstations with a microcomputer base system using personal computers(pc), maintaining the same functionali1y and integrating management capabilities as well as processing functions currently performed by a proprietary system. The HMI modernization provided to CFE an integral solution through a single interface allowing the system tointerface not only to current proprietary controllers but also to commercial controllers, PLCs or other Intelligent Electronic Device by integrating opc technology. Data analysis is possible in the improved HMI due to a powerful database back-end engine added to the system. Integrating new technology to legacy systems in order to preserve its life span and be able to integrate modem devices represented a challenge to be resolved. This paperalsodescribes how suitable these new technologies promises were accomplished in the IHM modernization. Improvements to the HMI also included an intuitive color-base navigation in a multi-level model. Improvements in communications involved the replacement of the current PC-based communication concentrators with a pair of high performance servers to improve the overall system flexibility and robustness. Among the more challenging tasks was the integration of a modem commercial redundancy system to work with current proprietary controllers.

The number of percutaneous interventions with stent implantation has increased dramatically in recent years, although the frequent use of this device in reports of infections is extremely rare. In this article we report two cases of mycotic aneurysm after implantation of stents with different clinical presentations and outcomes.

En años recientes, el número de intervenciones percutáneas con implantación de stents ha incrementado de manera dramática, y a pesar del gran auge del dispositivo los reportes de infecciones son extremadamente raros. En este artículo se reportan dos casos de aneurismas micóticos luego de la implantación de stents con presentación y evolución clínicas diferentes.In recent years, the number of percutaneous interventions with stent implantation has increased dramatically. Despite the boom in this device, reports of infections are extremely rare. This article reports two cases of mycotic aneurysms after implantation of stents with different clinical presentation and evolution.