4 results on '"Morillo, Raquel"'
Search Results
2. Right heart thrombi in pulmonary embolism
- Author
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Barrios, Deisy, Rosa-Salazar, Vladimir, Jimenez, David, Morillo, Raquel, Muriel, Alfonso, del Toro, Jorge, Lopez-Jimenez, Luciano, Farge-Bancel, Dominique, Yusen, Roger, Monreal, Manuel, RIETE Investigators, [Barrios, Deisy] Ramon & Cajal Hosp, Resp Dept, Madrid, Spain, [Jimenez, David] Ramon & Cajal Hosp, Resp Dept, Madrid, Spain, [Morillo, Raquel] Ramon & Cajal Hosp, Resp Dept, Madrid, Spain, [Muriel, Alfonso] Ramon & Cajal Hosp, Resp Dept, Madrid, Spain, [Barrios, Deisy] Univ Alcala IRYCIS, Madrid, Spain, [Jimenez, David] Univ Alcala IRYCIS, Madrid, Spain, [Morillo, Raquel] Univ Alcala IRYCIS, Madrid, Spain, [Muriel, Alfonso] Univ Alcala IRYCIS, Madrid, Spain, [Rosa-Salazar, Vladimir] Hosp Clin Univ Virgen Arrixaca, Dept Internal Med, Murcia, Spain, [del Toro, Jorge] Hosp Gen Univ Gregorio Maranon, Dept Internal Med, Madrid, Spain, [Lopez-Jimenez, Luciano] Hosp Gen Univ Gregorio Maranon, Dept Internal Med, Madrid, Spain, [Farge-Bancel, Dominique] Hosp Gen Univ Gregorio Maranon, Dept Internal Med, Madrid, Spain, [Jimenez, David] Hosp Univ Reina Sofia, Dept Internal Med, Cordoba, Spain, [Farge-Bancel, Dominique] Hosp Univ Reina Sofia, Dept Internal Med, Cordoba, Spain, [Barrios, Deisy] Dept Internal Med & Pathol, Hdpital St Louis, Paris, France, [Morillo, Raquel] Washington Univ Sch Med, Div Pulm & Crit Care Med & Gen Med Sci, St Louis, MO USA, [Farge-Bancel, Dominique] Washington Univ Sch Med, Div Pulm & Crit Care Med & Gen Med Sci, St Louis, MO USA, [Rosa-Salazar, Vladimir] Univ Catalic Murcia, Hosp Univ Germans Trias Pujol, Dept Internal Med, Barcelona, Spain, [Jimenez, David] Univ Catalic Murcia, Hosp Univ Germans Trias Pujol, Dept Internal Med, Barcelona, Spain, [Farge-Bancel, Dominique] Univ Catalic Murcia, Hosp Univ Germans Trias Pujol, Dept Internal Med, Barcelona, Spain, Sanofi Spain, and Bayer Pharma AG
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Outcomes ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diagnosis ,medicine ,Systole ,business.industry ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Comorbidity ,Cardiovascular physiology ,Pulmonary embolism ,Management ,Index ,Blood pressure ,030228 respiratory system ,Heart failure ,Cardiology ,Therapy ,business ,Venous thromboembolism - Abstract
There is a lack of comprehensive data on the prevalence, predictors and prognostic significance of right heart thrombi (RHT) in pulmonary embolism.In this study of patients with pulmonary embolism from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry, we assessed the prevalence and predictors of RHT, and the association between the presence of RHT and the outcomes of all-cause mortality, pulmonary embolism-related mortality, recurrences, and major bleeding through 30 days after initiation of pulmonary embolism treatment.Of 12 441 patients with pulmonary embolism and baseline echocardiographic data, 2.6% had RHT. The following increased the risk of RHT: younger age, previous bleeding, congestive heart failure, cancer, syncope, systolic blood pressure versus 0.7%; p=0.04). Major bleeding was similar in patients with and without RHT.In patients presenting with pulmonary embolism, RHT is relatively infrequent. Patients with RHT had a worse outcome when compared with those without RHT.
- Published
- 2016
3. Sex differences in the characteristics and short-term prognosis of patients presenting with acute symptomatic pulmonary embolism.
- Author
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Barrios, Deisy, Morillo, Raquel, Guerassimova, Ina, Barbero, Esther, Escobar-Morreale, Héctor, Cohen, Alexander T., Becattini, Cecilia, Tapson, Victor, Yusen, Roger, and Jimenez, David
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PULMONARY embolism , *HEALTH outcome assessment , *COHORT analysis , *PUBLIC health , *CLINICAL trials , *DIAGNOSIS , *THERAPEUTICS - Abstract
Background: We sought to examine sex-related differences in the characteristics and outcome in patients presenting with acute symptomatic pulmonary embolism (PE). Methods: We conducted a retrospective cohort study of 2,096 patients diagnosed with acute PE. The characteristics were recorded at presentation. Treatment was at the discretion of patients’ physicians. The primary study outcome, all-cause mortality, and the secondary outcomes of PE-specific mortality, recurrent venous thromboembolism, and major bleeding were assessed during the first month of follow-up after PE diagnosis. Results: Overall, the women were older than the men and had significantly higher rates of immobilization. They had significantly lower rates of chronic obstructive pulmonary disease and cancer. Women had a higher prevalence of syncope and elevated brain natriuretic peptide levels. Thirty-day all-cause mortality was similar between women and men (7.1% versus 6.2%; P = 0.38). Male gender was not independently significantly associated with PE-related death (adjusted odds ratio [OR] 1.02; 95% CI, 0.50 to 2.07; P = 0.96). Restricting the analyses to haemodynamically stable patients (n = 2,021), female gender was an independent predictor of all-cause (adjusted OR 1.56; 95% CI, 1.07 to 2.28; P = 0.02) and PE-specific mortality (adjusted OR 1.85; 95% CI, 1.02 to 3.33; P = 0.04). Compared with men, women were 2.05 times more likely to experience a major bleed. Conclusions: Women and men with PE had different clinical characteristics, presentation, and outcomes. Women receiving anticoagulation have a significantly higher risk of major bleeding, suggesting the need for careful monitoring of anticoagulant intensity in women. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
4. Feasibility of a screening algorithm for chronic thromboembolic pulmonary hypertension: The OSIRIS study.
- Author
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Otero, Remedios, Lobo, José Luis, López, Raquel, Fernández, Carmen, Jiménez, David, Muriel, Alfonso, Alfonso, María, Ballaz, Aitor, Núñez-Ares, Ana, Rodríguez-Matute, Consolación, de Miguel-Díez, Javier, Rodríguez-Chiaradía, Diego Agustín, Alcalde, Mercedes, Elías, Teresa, Jara-Palomares, Luis, Rivas, Agustina, Alonso, Ángel, García-Ortega, Alberto, Sancho, Teresa, and Morillo, Raquel
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PULMONARY hypertension , *MEDICAL screening , *THROMBOEMBOLISM , *PULMONARY embolism , *ALGORITHMS , *PATIENT preferences - Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a long-term sequel to pulmonary embolism (PE) whose incidence varies according to different published studies. We have carried out this study to determine its incidence within 2 years after index pulmonary embolism and to study limitations to an early diagnosis. OSIRIS is a multicentre, longitudinal cohort study. Patients were followed for 3, 6, 12, and 24 months after pulmonary embolism using a structured three-step algorithm. A physician-centered questionnaire at least one positive response in a screening proceeded to the second step, transthoracic echocardiography. The third step consisted of ventilation/perfusion lung scintigraphy and right heart catheterisation. A transthoracic echocardiography was performed in patients without positive response in the screening questionnaire after 2 years. CTEPH diagnosis required haemodynamic confirmation by right heart catheterisation and mismatched perfusion defects on lung scintigraphy. A total of 1191 patients were enrolled in 18 Spanish hospitals. Cumulative CTEPH incidence after 2-years PE was: 2.49 % (95 % CI: 1.68–3.56) and the incidence rate of CTEPH was 1.1 cases per 1000 person-months (95 % CI: 0.725; 1.60). The CTEPH algorithm presented a lack of adherence of 29 %; patient and physician preferences posed barriers to the triage algorithm The screening questionnaire, in patients who completed the follow-up, shows a specificity of 91.3 % (89.0–93.2 %) and negative predictive value of 99.4 % (98.4–99.8 %).. OSIRIS provides practiced clinical based data on the chronic thromboembolic pulmonary hypertension incidence and identified barriers to the implementation of a 3-step triage algorithm for its detection. clinicaltrials.gov identifier: NCT03134898. [Display omitted] • Two-year cumulative incidence of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) after pulmonary embolism (PE) was 2.49% (95% CI: 1.68-3.56) • A structured three-step diagnostic algorithm based on clinical assessment starting with a screening questionnaire showed limited feasibility, but a high negative predictive value • Observed barriers from patients and physicians to the implementation of a screening-based CTEPH diagnostic algorithm may support the planning of future studies and help to address training gaps [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
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