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1. Sustainable Estimation of Cardiovascular Risk with the Predictive Gaziano's Tables without Laboratory

Author

José Betancourt Bethencourt, Gerardo Brunet Bernal, and Moura Revueltas Agüero

Subjects
factores de riesgo de enfermedad cardiaca, predicción, valor predictivo de las pruebas, Internal medicine, RC31-1245, Special situations and conditions, RC952-1245
Abstract

Background: identifying cardiovascular risk factors is very important, because by taking actions to counteract them, the probability of presenting cardiovascular and cerebrovascular diseases can decrease significantly. Objective: to demonstrate the feasibility of using the Gaziano's tables without a laboratory to estimate cardiovascular risk. Method: 72 health workers linked to the University of Medical Sciences of Camagüey were interviewed during November 2021, in addition, their blood pressure, weight and height were measured and they were asked in the survey: age, if they were diabetic and if they smoked. These people underwent Cronbach's Alpha reliability test. They were asked if they had other modifiable habits (frequency of physical exercise, consumption of alcoholic beverages, if they have snacks between meals and if they add salt to them). Cardiovascular risk was determined with the Gaziano's tables without laboratory. Results: 21 % of the interviewees presented high and very high risk. Of the study participants, 40 % declared they were hypertensive. The mean body mass index was 29.3±4 kg/m2 and there was a correlation between this and age, with high and very high risks. Conclusions: Gaziano's predictive tables without laboratory were feasible to apply, their use could be extended to the first level of health care, as it is a sustainable, non-invasive and fast method in times of the COVID-19 pandemic. Knowledge of its use in undergraduate and postgraduate teaching should be transmitted.

Published
2022

3. Dimensión educativa de una estrategia de superación transdisciplinaria para la gestión de proyectos de investigación en salud

Author

José Aureliano Betancourt Bethencourt and Fidel Francisco Martínez Álvarez

Subjects
epistemología, educación, transdisciplinariedad, estrategia de superación, gerencia de investigaciones, Internal medicine, RC31-1245, Medicine (General), R5-920
Abstract

Se evidencian carencias epistemológicas en la gestión de proyectos de investigación en salud que provocan insuficiente introducción de resultados y producción científica. Con el objetivo de realizar una síntesis de los aspectos educativos y sociológicos subyacentes en la estrategia de superación transdisciplinaria para la actualización epistemológica de los profesionales de la salud en la gestión de proyectos de investigación, se hizo un estudio sobre aspectos educativos y sociológicos de la estrategia de superación transdisciplinaria. Para ello, se consultó la bibliografía existente en bases de datos de acceso libre además de documentos, tesis y otros. Se expone una síntesis sobre: a) epistemología del proceso de enseñanza-aprendizaje en la gestión de proyectos de investigaciones en la salud pública, b) la actividad en el proceso educativo para la formación de recursos humanos en las investigaciones, c) carácter sistémico de los componentes del proceso educativo para la gestión de proyectos de investigaciones, d) el contexto en la formación de recursos humanos para la gestión de proyectos de investigaciones, y e) formación de valores para los equipos de investigación transdisciplinarios. Se realizó una síntesis de los aspectos educativos y sociológicos subyacentes en la estrategia de superación transdisciplinaria para la actualización epistemológica de los profesionales de la salud pública en la gestión de proyectos de investigación en la provincia de Camagüey, Cuba.

Published
2017
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4. Prevalence of hypertriglyceridemia in adults and related cardiometabolic factors. SIMETAP-HTG study

Author

M.J. Frías Vargas, N. Zarzuelo Martín, Diana Fernández-Pacheco Vila, J.L. Velazco Zumarrán, M. Sánchez Herráiz, E. Revilla Pascual, M.C. Sánchez Ramos, A.P. Javierre Miranda, M. Inmaculada Hernández-Beltrán, A. Alcaraz Bethencourt, A.O. Rodríguez, Manuel J. Frías-Vargas, J.L. Quintana Gómez, C. Sanz Velasco, L. Ruiz Díaz, M.J. del Villar Redondo, R.A. Escrivá Ferrairó, R. Pleite Raposo, A.I. Macho del Barrio, Gema M. Dávila-Blázquez, M. del Carmen Antón-Sanz, P. Cabello Igual, R. Hueso Quesada, S. Redondo de Pedro, C. Zafra Urango, R.M. Hernández López, Antonio Sánchez-Calso, J.R. Iglesias Quintana, M. Redondo Sánchez, B. López Uriarte, A. Migueláñez Valero, R. Pérez Muñoz, A. Montero Costa, N. Escamilla Guijarro, Montserrat Pérez Fernández, T.F. Casaseca Calvo, D. Fernández-Pacheco Vila, Santiago Delgado Rodríguez, A.I. Martín Fernández, M.C. Vieira Pascual, M.S. Moreno Muñoz, P.L. Sanchidrián Fernández, M.R. Durán Tejada, E. Arranz Martínez, S. Delgado Rodríguez, M.T. Sarriá Sánchez, A. Rodríguez de Cossío, M.D. García Granado, M.P. Hombrados Gonzalo, S. Luna Ramírez, R. Alonso Roca, I. Tello Meco, M. Pérez Fernández, L.E. Morales Cobos, T. Pascual Val, N. de la Peña Antón, M. Rubio Villar, P. Aguilera Reija, C. Vargas-Machuca Cabañero, R. Rodríguez Cabanillas, A.M. Ibarra Sánchez, M. Rosario Morales-Chico, M.C. Hernández de Luna, E. Rodríguez de Mingo, C. Ribot Catalá, M.P. García Alcañiz, N. Caballero Ramírez, P. Simonaggio Stancampiano, M. Rivera Teijido, Rafael Alonso-Roca, M.S. Holgado Catalán, E. Gómez Díaz, Montserrat Rivera-Teijido, Raquel Pleite Raposo, Isabel Tello-Meco, E. Barrios Rueda, Beatriz López-Uriarte, José Antonio González-Posada Delgado, J.A. González-Posada Delgado, C. Abad Schilling, N. Marañón Henrich, Ana Olga Rodríguez Rodríguez, R. Álvarez Benedicto, N. Iturmendi Martínez, J. Reguillo Díaz, M.M. Zamora Gómez, M.P. Calderín Morales, R. Cabrera Vélez, Ana Pilar Javierre-Miranda, Joaquina Reguillo-Díaz, Beatriz Remón-Pérez, José Luis Quintana-Gómez, B. Sanz Pozo, M.R. Morales Chico, E. Martínez Cid de Rivera, M.P. García Villasur, J.M. Blanco Canseco, Y. Hidalgo Calleja, A. Rosillo González, M. Isabel Gutiérrez Sánchez, C. Mora Casado, M. Capitán Caldas, M.C. Martín Calle, E. Sandín de Vega, Paloma Aguilera Reija, P. González Escobar, Ignacio Íscar-Valenzuela, M.I. Hernández Beltrán, M.T. Plata Barajas, Juan Ramón Iglesias Quintana, M.E. García Fernández, J.C. Moreno Fernández, C. Ciria de Pablo, P. Arribas Álvaro, Enrique Revilla-Pascual, M.R. García Redondo, Antonio Rosillo-González, P. Magán Tapia, Antonio Ruiz-García, Rosa Ana Escrivá-Ferrairó, I. Gutiérrez Sánchez, M.C. Díez Pérez, Raúl Pérez Muñoz, I. Íscar Valenzuela, Ofelia Gómez-Fernández, B. Remón Pérez, J.E. Mariño Suárez, T. Fernández Vicente, M. Prieto Marcos, A. Ruiz García, M.S. Lorenzo Borda, M.C. Baltuille Aller, David Palacios-Martínez, Ana María Ibarra-Sánchez, R.A. García Pliego, M. Adrián Sanz, José Enrique Mariño-Suárez, O. Gómez Fernández, M. Jesús del Villar Redondo, J.A. Cique Herráinz, Norma Alejandra Doria-Carlin, M.R. Rico Pérez, P. Chao Escuer, A.M. Rey López, Ezequiel Arranz-Martínez, A. Sánchez Calso, J. Martínez Irazusta, D. Palacios Martínez, E. Benito Alonso, M.E. Minguela Puras, Rafael Rodríguez-Cabanillas, Elena Barrios-Rueda, J.C. García Álvarez, Miguel Prieto Marcos, G. Dávila Blázquez, L. de Prado Prieto, and M.L. Berbil Bautista

Subjects
medicine.medical_specialty, Multivariate analysis, Triglyceride, business.industry, Hypertriglyceridemia, General Engineering, Prevalence, medicine.disease, Obesity, chemistry.chemical_compound, chemistry, Diabetes mellitus, Internal medicine, medicine, General Earth and Planetary Sciences, Steatosis, business, General Environmental Science, Kidney disease
Abstract

Aim To determine in the adult population the crude and the sex- and age-adjusted prevalence rates of hypertriglyceridaemia (HTG) and to assess its association with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. Methods Cross-sectional observational study conducted in Primary Care, with 6,588 adult study subjects, randomly selected on base-population. Patients had HTG if the triglyceride level was ≥150 mg/dL (≥1.7 mmol/L), or were on lipid-lowering therapy to lower triglyceride. Associations were assessed by univariate and multivariate analysis, and crude and sex- and age-adjusted prevalence rates were determined. Results The arithmetic and geometric means of triglyceride levels were respectively 120.5 and 104.2 mg/dL in global population, 135.7 and 116.0 mg/dL in men, and 108.6 and 95.7 mg/dL in women. The crude HTG prevalence rates were 29.6% in global population, 36.9% in men and 23.8% in women. The sex- and age-adjusted HTG prevalence rates were 27.0% in global population, 34.6% in men and 21.4% in women. The independent variables that were most associated with HTG were hypercholesterolemia (OR: 4.6), low HDL-C (OR: 4.1), hepatic steatosis (OR: 2.8), diabetes (OR: 2.0), and obesity. (OR: 1.9). Conclusions The means of triglyceride levels and HTG prevalence rates are intermediate between those of other national and international studies. A fifth of the female adult population and more than a third of the male population had HTG. The independent factors associated with HTG were hypercholesterolemia and low HDL-C, and the cardiometabolic variables diabetes, hepatic steatosis and obesity.

Published
2020

5. The validity of salivary gland scintigraphy in Sjögren’s syndrome diagnosis: comparison of visual and excretion fraction analyses

Author

M. Ángeles Gómez Rodríguez-Bethencourt, María García-González, Iván Ferraz-Amaro, and M. Jesús González-Soto

Subjects
030203 arthritis & rheumatology, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Area under the curve, General Medicine, Scintigraphy, Gastroenterology, Rheumatology, Excretion, 03 medical and health sciences, 0302 clinical medicine, Statistical significance, Internal medicine, Salivary gland scintigraphy, medicine, Fraction (mathematics), 030212 general & internal medicine, Sjogren s, business
Abstract

Introduction. The diagnostic value of salivary gland scintigraphy (SGS) in Sjögren’s syndrome (SS) is not completely known. Whether qualitative or quantitative methods of SGS interpretation are the most appropriate remains a matter of debate. We sought to determine whether the diagnostic discrimination of quantitative excretion fraction is higher compared to SGS qualitative visual analysis in a cohort of subjects with suspected SS. Materials and methods. Cross-sectional study that encompassed 204 subjects who underwent SGS for potential SS diagnosis. Based on clinical judgement, three groups were established: SS, non-SS autoimmune diseases (AID non-SS) and neither SS nor other AID (non-AID). In addition, American-European Consensus Group -AECG- and American College of Rheumatology -ACR- criteria were applied. Qualitative diagnosis through visual analysis -normal vs. abnormal and Schall’s classification grade- and semiquantitative and quantitative excretion fraction (EF%) scores were established following SGS assessment. The diagnostic discrimination of the different SGS scores for the various SS diagnostic modalities (clinical judgement and AECG and ACR criteria) was compared through their areas under the curve (AUC). Results. Most SGS parameters were significantly associated with SS-related clinical and laboratory features. Schall’s grade ≥ III was significantly more frequent in SS than in non-SS patients. In general, EF%-derived parameters did not show significant differences between groups. AUC of Schall’s classification reached statistical significance in its diagnostic discrimination for SS clinical judgement (AUC 0.704 [95%CI 0.597–0.811], p = 0.000) and AECG criteria (AUC 0.764 [95%CI 0.641–0.886], p = 0.000). Similarly the EF% submandibular mean (AUC 0.737 [95%CI 0.546–0.931] p = 0.032) was significantly associated with SS diagnosis through ACR criteria. However, AUC comparisons between qualitative and quantitative methods did not yield significant values. Conclusion. SS diagnostic discrimination of EF% is not superior to that obtained by qualitative visual analysis.

Published
2020

6. Dyslipidemia and other cardiovascular risk factors in relation to manifest cardiovascular disease in patients with chronic obstructive pulmonary disease in the Canary Islands

Author

A. Afonso Díaz, M.A. García Bello, J.M. Figueira Gonçalves, N. Bethencourt Martín, M.D. Martín Martínez, D. Díaz Pérez, J. Mesa Fumero, I. García-Talavera, and S. García Hernández

Subjects
medicine.medical_specialty, COPD, business.industry, Vascular disease, Cardiovascular risk factors, Pulmonary disease, General Medicine, Disease, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Observational study, 030212 general & internal medicine, business, Dyslipidemia, Kidney disease
Abstract

Background Cardiovascular disease has a negative impact on the vital prognosis of patients with chronic obstructive pulmonary disease (COPD), where dyslipidaemia (DLP) and arterial hypertension (AHT) are considered the most prevalent risk factors. The objective of this study was 1) to assess the relationship between diagnosed DLP and cardiovascular disease in COPD patients and compare it with other known cardiovascular risk factors and 2) to determine the relationship between the different cardiovascular comorbidities and the severity groups according to the GOLD 2017 classification. Methods A cross-sectional, observational study was performed in 454 outpatients with COPD during their follow up. We calculated the prevalence of each of the cardiovascular comorbidities and the probability of each of the cardiovascular risk factors to occur jointly with a vascular disease (RRij). Results A total of 66.7% of the patients had DLP, whereby DLP was related to cerebrovascular accidents (CVA) (RRij 1.36, p = 0.0054), chronic kidney disease (CKD) (RRij 1.34, p = 0.00023), and peripheral arterial disease (PAD) (RRij 1.38, p = 0.00015). AHT was mostly related to CVA (RRij 1.41, p = 0.0014) and CKD (RRij 1.42, p Conclusion DLP was related to CVA, CKD, and PAD. AHT and T2DM are the conditions that mostly relate to HF and CVA.

Published
2020

7. Prevalence of diabetes mellitus in Spanish primary care setting and its association with cardiovascular risk factors and cardiovascular diseases. SIMETAP-DM study

Author

Ángela Rodríguez-de-Cossío, Amelia Alcaraz-Bethencourt, Clara Abad-Schilling, Beatriz López-Uriarte, Rosa Ana García-Pliego, Miriam Sánchez-Herráiz, D. Palacios-Martínez, María Rosario Durán-Tejada, Mercedes Rubio-Villar, Antonio Ruiz-García, María Teresa Plata-Barajas, Lidia de-Prado-Prieto, Juan Carlos García-Álvarez, María Rosa García-Redondo, María Carmen Vieira-Pascual, Nuria Escamilla-Guijarro, Juncal Martínez-Irazusta, Rosa Hueso-Quesada, Sonia Redondo-de-Pedro, María Esther Minguela-Puras, Ana María Rey-López, Concepción Zafra-Urango, Mercedes Redondo-Sánchez, Cristina Ciria-de-Pablo, Paula Chao-Escuer, María Prado García-García-Alcañiz, Alejandra Montero-Costa, Mercedes Adrián-Sanz, Ezequiel Arranz-Martínez, José Manuel Blanco-Canseco, Yolanda Hidalgo-Calleja, María Eugenia García-Fernández, Montserrat Rivera-Teijido, Eva Martínez-Cid-de-Rivera, María Luisa Berbil-Bautista, and Teresa Pascual-Val

Subjects
musculoskeletal diseases, medicine.medical_specialty, education.field_of_study, business.industry, Medical record, Population, General Engineering, Prevalence, medicine.disease, Confidence interval, Internal medicine, Diabetes mellitus, medicine, Albuminuria, General Earth and Planetary Sciences, Observational study, medicine.symptom, business, education, General Environmental Science, Kidney disease
Abstract

Introduction The aims of this study were to determine the crude age-and sex-adjusted prevalence rates of diabetes mellitus (DM), type 1 DM (DM1) and type 2 DM (DM2), and to compare the relationship with cardiovascular risk factors, cardiovascular diseases, chronic kidney disease and metabolic diseases among populations with and without DM. Methods SIMETAP-DM is a cross-sectional observational study conducted in a primary care setting, with a random population-based sample of 10,579 adults. Response rate: 66%. The diagnoses of DM, DM1 and DM2 were based on clinical and biochemical criteria and/or the checking of these diagnoses in medical records. The crude and age- and sex-adjusted prevalence rates (standardised with the Spanish population) were calculated. Results The crude prevalence rates of DM1, DM2 and DM were 0.87% (95% confidence interval [95% CI]: 0.67–1.13), 14.7% (95% CI: 13.9–15.6) and 15.6% (95% CI: 14.7–16.5), respectively. The age- and sex-adjusted prevalence rates of DM1, DM2 and DM were 1.0% (1.3% for men and 0.7% for women), 11.5% (13.6% for men and 9.7% for women) and 12.5% (14.9% for men and 10.5% for women), respectively. The prevalence of DM in the population ≥70 years was double (30.3% [95% CI: 28.0–32.7]) that of the population between 40 and 69 years old (15.3% [95% CI: 14.1–16.5%]). Hypertension, peripheral arterial disease, increased weight-to-height ratio, albuminuria, coronary heart disease, atherogenic dyslipidaemia and hypercholesterolaemia were associated with DM. Conclusions In a Spanish primary care setting, the age-adjusted prevalences of DM1, DM2 and DM in the adult population were 1.0, 11.5 and 12.5%, respectively. A third of the population over 70 years old suffered from DM.

Published
2020

8. Role of ST-Segment Resolution in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention (from the 5-Year Outcomes of the EXAMINATION [Evaluation of the Xience-V Stent in Acute Myocardial Infarction] Trial)

Author

Manel Sabaté, Andrés Iñiguez, Luis Ortega-Paz, Giancarla Scalone, Angel Cequier, Alberto Pernigotti, Vicente Mainar, Armando Bethencourt, Josep Gomez-Lara, Marco Valgimigli, Giosafat Spitaleri, Gianluca Campo, Antonio Serra, Pilar Jiménez-Quevedo, Patrick W. Serruys, Maurizio Tespili, Elisabetta Moscarella, Salvatore Brugaletta, Peter den Heijer, Nicolás Vázquez, Spitaleri, G., Brugaletta, S., Scalone, G., Moscarella, E., Ortega-Paz, L., Pernigotti, A., Gomez-Lara, J., Cequier, A., Iniguez, A., Serra, A., Jimenez-Quevedo, P., Mainar, V., Campo, G., Tespili, M., den Heijer, P., Bethencourt, A., Vazquez, N., Valgimigli, M., Serruys, P. W., and Sabate, M.

Subjects
Male, medicine.medical_treatment, Myocardial Infarction, 030204 cardiovascular system & hematology, Electrocardiography, 0302 clinical medicine, Cause of Death, Drug-Eluting Stent, Myocardial Revascularization, ST segment, 030212 general & internal medicine, Myocardial infarction, 610 Medicine & health, Drug-Eluting Stents, Middle Aged, Prognosis, humanities, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, geographic locations, Human, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Poor prognosis, Prognosi, Revascularization, Independent predictor, NO, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, In patient, cardiovascular diseases, Mortality, Aged, Proportional Hazards Models, business.industry, Percutaneous coronary intervention, Stent, Recovery of Function, social sciences, medicine.disease, eye diseases, Proportional Hazards Model, ST Elevation Myocardial Infarction, business
Abstract

In patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), lack of ST-segment resolution (STR) is associated with poor prognosis at short- and long-term follow-up. The aim of this study was to evaluate the role of STR on very long-term outcomes in patients with STEMI treated with pPCI included in the EXAMINATION (Evaluation of the Xience-V Stent in Acute Myocardial Infarction) trial. Patients were stratified according to the presence of STR 50% and STR >= 70%, respectively. In both cases, this difference was mainly driven by a significant increase in the rate of all-cause death and any revascularization. After multivariable adjustment, STR < 70%, but not STR < 50%, resulted as a 5-year independent predictor of POCE (adjusted HR 1.338, 95% CI 1.008 to 1.778, p = 0.044). In conclusion, in patients with STEM!, the evaluation of 70% STR after pPCI provides independent prognostic information at 5-year follow-up and it can be used to identify patients at high risk of very long-term cardiovascular events. (C) 2018 Elsevier Inc. All rights reserved.

Published
2018

9. Prevalence of erectile dysfunction in Spanish primary care setting and its association with cardiovascular risk factors and cardiovascular diseases. SIMETAP-ED study

Author

Antonio Ruiz-García, Ezequiel Arranz-Martínez, Roberto Cabrera-Vélez, David Palacios-Martínez, Montserrat Rivera-Teijido, Juan Carlos García-Álvarez, Luis Enrique Morales-Cobos, Juan Carlos Moreno-Fernández, María Eugenia García-Fernández, Nuria Peña-Antón, Maria Cruz Díez-Pérez, Alejandra Montero-Costa, María Soledad Lorenzo-Borda, María Dolores García-Granado, Teresa Fátima Casaseca-Calvo, Juan A. Cique-Herráinz, María Paloma García-Villasur, Nuria Marañón-Henrich, Nieves Zarzuelo-Martín, María Camino Baltuille-Aller, Pilar Arribas-Álvaro, Ana Isabel Macho-Barrio, Carlos Ribot-Catalá, Mercedes Capitán-Caldas, Cristina Ciria-de-Pablo, Carmelina Sanz-Velasco, Concepción Vargas-Machuca-Cabañero, Paula Simonaggio-Stancampiano, María Pilar Cabello-Igual, María Teresa Sarria-Sánchez, C. Abad-Schilling, M. Adrián-Sanz, P. Aguilera-Reija, A. Alcaraz-Bethencourt, R. Alonso-Roca, R. Álvarez-Benedicto, E. Arranz-Martínez, P. Arribas-Álvaro, M.C. Baltuille-Aller, E. Barrios-Rueda, E. Benito-Alonso, M.L. Berbil-Bautista, J.M. Blanco-Canseco, N. Caballero-Ramírez, P. Cabello-Igual, R. Cabrera-Vélez, M.P. Calderín-Morales, M. Capitán-Caldas, T.F. Casaseca-Calvo, J.A. Cique-Herráinz, C. Ciria-de-Pablo, P. Chao-Escuer, G. Dávila-Blázquez, N. de-la-Peña-Antón, L. de-Prado-Prieto, M.J. del-Villar-Redondo, S. Delgado-Rodríguez, M.C. Díez-Pérez, M.R. Durán-Tejada, N. Escamilla-Guijarro, R.A. Escrivá-Ferrairó, T. Fernández-Vicente, D. Fernández-Pacheco-Vila, M.J. Frías-Vargas, J.C. García-Álvarez, M.E. García-Fernández, M.P. García-García-Alcañiz, M.D. García-Granado, R.A. García-Pliego, M.R. García-Redondo, M.P. García-Villasur, E. Gómez-Díaz, O. Gómez-Fernández, P. González-Escobar, J.A. González-Posada-Delgado, I. Gutiérrez-Sánchez, M.I. Hernández-Beltrán, M.C. Hernández-de-Luna, R.M. Hernández-López, Y. Hidalgo-Calleja, M.S. Holgado-Catalán, M.P. Hombrados-Gonzalo, R. Hueso-Quesada, A.M. Ibarra-Sánchez, J.R. Iglesias-Quintana, I. Íscar-Valenzuela, N. Iturmendi-Martínez, A.P. Javierre-Miranda, B. López-Uriarte, M.S. Lorenzo-Borda, S. Luna-Ramírez, A.I. Macho-del-Barrio, N. Marañón-Henrich, J.E. Mariño-Suárez, M.C. Martín-Calle, A.I. Martín-Fernández, E. Martínez-Cid-de-Rivera, J. Martínez-Irazusta, A. Migueláñez-Valero, M.E. Minguela-Puras, A. Montero-Costa, C. Mora-Casado, L.E. Morales-Cobos, M.R. Morales-Chico, J.C. Moreno-Fernández, M.S. Moreno-Muñoz, D. Palacios-Martínez, T. Pascual-Val, M. Pérez-Fernández, R. Pérez-Muñoz, M.T. Plata-Barajas, R. Pleite-Raposo, M. Prieto-Marcos, J.L. Quintana-Gómez, S. Redondo-de-Pedro, M. Redondo-Sánchez, J. Reguillo-Díaz, B. Remón-Pérez, E. Revilla-Pascual, A.M. Rey-López, C. Ribot-Catalá, M.R. Rico-Pérez, M. Rivera-Teijido, R. Rodríguez-Cabanillas, A. Rodríguez-de-Cossío, E. Rodríguez-de-Mingo, A.O. Rodríguez-Rodríguez, A. Rosillo-González, M. Rubio-Villar, L. Ruiz-Díaz, A. Ruiz-García, A. Sánchez-Calso, M. Sánchez-Herráiz, M.C. Sánchez-Ramos, P.L. Sanchidrián-Fernández, E. Sandín-de-Vega, B. Sanz-Pozo, C. Sanz-Velasco, M.T. Sarriá-Sánchez, P. Simonaggio-Stancampiano, I. Tello-Meco, C. Vargas-Machuca-Cabañero, J.L. Velazco-Zumarrán, M.C. Vieira-Pascual, C. Zafra-Urango, M.M. Zamora-Gómez, and N. Zarzuelo-Martín

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Population, 030232 urology & nephrology, Prevalence, 030204 cardiovascular system & hematology, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Erectile Dysfunction, Metabolic Diseases, Risk Factors, Internal medicine, medicine, Humans, Pharmacology (medical), Renal Insufficiency, Chronic, education, Aged, General Environmental Science, Aged, 80 and over, Response rate (survey), education.field_of_study, Primary Health Care, business.industry, Medical record, General Engineering, Middle Aged, medicine.disease, Confidence interval, Cross-Sectional Studies, Erectile dysfunction, Cardiovascular Diseases, Spain, General Earth and Planetary Sciences, Observational study, Cardiology and Cardiovascular Medicine, business, Kidney disease
Abstract

Introduction Few studies conducted in primary care setting report about age-adjusted prevalence rates of erectile dysfunction (ED). Aims of SIMETAP-ED study were to determine crude and age-adjusted prevalence rates of ED diagnosis, to compare these rates with other similar studies, and to compare prevalence rates of cardiovascular risk factors (CVRF), cardiovascular diseases (CVD), metabolic diseases and chronic kidney disease (CKD) between populations with and without ED. Methods Cross-sectional observational study conducted in primary care setting. Population-based random sample: 2934 adult men. Response rate: 66%. A clinical interview was conducted to diagnose ED using a question derived from ED definition. The medical records of patients were reviewed to identify their CVRF and diseases associated with ED. The age-adjustments were standardized to Spanish population. Results The prevalence rates of metabolic diseases, CVD, CVRF, and CKD in population with ED were higher than population without ED, highlighting the CVD. The crude prevalence of ED was 17.2% (95% confidence interval: 15.8•18.6). The age-adjusted prevalence rates of ED were 0.71% in men under 40 years, 12.4% in men over 18 years, 10.8% in men aged 40•69 years, 18.9% in men over 40 years, and 48.6% in men over 70 years. Conclusions SIMETAP-ED study showed association of ED with metabolic diseases, CKD, CVRF, and highlighting CVD. The age-adjusted prevalence of ED was 12.4% in adult men, 19% in men over 40 years, and almost 50% in men over 70 years.

Published
2019

10. Androgen Deprivation Therapy in Patients With Prostate Cancer Increases Serum Levels of Thromboxane A

Author

Mario Álvarez-Maestro, Aritz Eguibar, Patricia Chanca, Mercedes Klett-Mingo, Juan Gómez Rivas, Antonio Buño-Soto, Fermín R. de Bethencourt, and Mercedes Ferrer

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, endothelium, medicine.drug_class, Cardiovascular Medicine, 030204 cardiovascular system & hematology, vascular function, Androgen deprivation therapy, 03 medical and health sciences, Thromboxane A2, chemistry.chemical_compound, Prostate cancer, 0302 clinical medicine, thromboxane A2 (TXA2), Internal medicine, medicine, Testosterone, Original Research, Vasomotor, business.industry, prostate cancer, Androgen, medicine.disease, androgen deprivation therapy (ADT), Endocrinology, chemistry, lcsh:RC666-701, 030220 oncology & carcinogenesis, lipids (amino acids, peptides, and proteins), Sodium nitroprusside, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Vasoconstriction, circulatory and respiratory physiology, medicine.drug
Abstract

Introduction: Androgens have been described as important players in the regulation of vascular function/structure through their action on the release and effect of vasoactive factors, such as prostanoids. Patients with prostate cancer (PCa) under androgen deprivation therapies (ADTs) present increased risk of cardiovascular mortality. Since thromboxane A2 (TXA2) is one of the most studied prostanoids and its involvement in different cardiovascular diseases has been described, the aim of this study was to investigate: (i) the effect of ADT on the serum levels of TXA2 in PCa patients and its possible link to the redox status and (ii) the effect of the non-hydrolyzable TXA2 analog U-46619 on the function of the aorta of male rats.Methods: The levels of TXA2 and total antioxidant status in 50 healthy subjects, 54 PCa patients, and 57 PCa under ADT were evaluated. These determinations were accompanied by levels of testosterone and C-reactive protein as an inflammation marker. In aortic segments from male rats, the U46619-induced effects on: (i) the vasomotor responses to acetylcholine (ACh), to the NO donor sodium nitroprusside (SNP), to the carbon monoxide-releasing molecule-3 (CORM-3), and to noradrenaline (NA) and (ii) the expression of cyclooxygenase-2 (COX-2), heme oxygenase-1 (HO-1), and phosphorylated ERK1/2 were analyzed.Results: The serum level of TXA2 in patients with PCa was increased with respect to healthy subjects, which was further increased by ADT. There was no modification in the total antioxidant status among the three experimental groups. In aortic segments from male rats, the TXA2 analog decreased the endothelium-dependent relaxation and the sensitivity of smooth muscle cells to NO, while it increased the vasoconstriction induced by NA; the expression of COX-2, HO-1, and pERK1/2 was also increased.Conclusions: ADT increased, along with other inflammatory/oxidative markers, the serum levels of TXA2. The fact that TXA2 negatively impacts the vascular function of the aorta of healthy male rats suggests that inhibition of TXA2-mediated events could be considered a potential strategy to protect the cardiovascular system.

Published
2021

11. Severe hypocalcemia and seizures after normalization of pCO2 in a patient with severe bronchopulmonary dysplasia and permissive hypercapnia

Author

Fermín García-Muñoz Rodrigo, Rocío Díaz de Bethencourt Pardo, Cristina Romero Álvarez, Lourdes Urquía Martí, and Erick J. Bordón Sardiña

Subjects
Normalization (statistics), Embryology, medicine.medical_specialty, Permissive hypercapnia, business.industry, Internal medicine, Pediatrics, Perinatology and Child Health, Cardiology, Obstetrics and Gynecology, Medicine, business, Severe Bronchopulmonary Dysplasia, pCO2
Abstract

Objectives To describe the association between the rapid normalization of pCO2 after intubation in a patient with severe bronchopulmonary dysplasia managed with permissive hypercapnia, with the risk of developing hypocalcemia and seizures, and to make health care providers aware of this risk in similar cases. Case presentation An extreme premature infant, born at 25 weeks of gestational age (GA), developed a severe bronchopulmonary dysplasia (BPD) and, after several extubation failures could be managed with non-invasive ventilation and permissive hypercapnia, with capillary pCO2 of up to 80 mmHg and pH >7.20. At 46 postmenstrual age (PMA) he was intubated because of severe hypercapnia and compensating metabolic alkalosis. About 20 h after intubation, after normalization of pH and pCO2, he developed hypocalcemia and seizures, that remitted after iCa normalization. A comparison between arterial and capillary blood gases showed a significantly greater correlation between pH and iCa in arterial than in capillary samples. Conclusions Our findings emphasize the importance of avoiding the abrupt reduction of pCO2 and the close monitoring of acute metabolic changes after its correction in chronic patients with permissive hypercapnia, as well as the potential superiority of arterial samples over capillaries to improve the precision of this control.

Published
2021

12. The androgen receptor expression and its activity have different relationships with prognosis in hepatocellular carcinoma

Author

Silvia Acosta-López, Julio Plata-Bello, F. Perez-Hernandez, A. Plata-Bello, M. C. Martin-Fernandez de Basoa, Tomás Concepción-Massip, A. Gonzalez-Rodriguez, and D. Diaz-Bethencourt

Subjects
Oncology, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.drug_class, Hepatocellular carcinoma, Science, Disease-Free Survival, Article, Downregulation and upregulation, Internal medicine, medicine, Carcinoma, Humans, Receptor, Survival rate, Aged, Regulation of gene expression, Multidisciplinary, Molecular medicine, business.industry, Liver Neoplasms, Middle Aged, Androgen, medicine.disease, Neoplasm Proteins, Androgen receptor, Gene Expression Regulation, Neoplastic, Survival Rate, Receptors, Androgen, Medicine, Female, business
Abstract

The role of the Androgen Receptor (AR) expression and its activity in the prognosis of hepatocellular carcinoma (HCC) remains inconclusive. The aim of this study is to analyze the role of the AR expression and its activity as prognostic biomarkers in HCC. Three-hundred and thirty-seven patients from The Cancer Genome Atlas (TCGA) (107 females; 59.42 years [SD = 13.0]) were included. To infer AR activity, the expression-profile of previously validated androgen responsive genes (ARGs) was included. AR activity was shown by the AR-Score-21 (21 ARGs) and AR-Score-13 (13 ARGs) that were computed based on the expression of the selected ARGs. Those ARGs whose expression was significantly different between histological grades were used for computing two new AR-Scores. HCC patients with higher AR expression showed a higher median overall survival (OS). AR-Score 21 and AR-Score-13 did not show any association with prognosis. Six of the 21 ARGs of the AR-Score-21 and 7 of the 13 ARGs of the AR-Score-13 showed a significant different expression profile among histological grades. Based on these differences, another two AR-Scores were computed (AR-Score-6 and AR-Score-7). They showed the relative increase of upregulated to downregulated ARGs in high-grade HCC. Higher AR activity inferred by these AR-Scores was associated with worse outcomes. The expression of AR is associated with a better prognosis in HCC. However, the activity of the AR seems to be qualitatively different among histological grades. The AR activity inferred by the shifted ARGs is associated with a worse prognosis in HCC patients.

Published
2020

13. Positron Emission Tomography Imaging of Long-Term Expression of the 18 kDa Translocator Protein After Sudden Cardiac Arrest in Rats

Author

Thorsten Annecke, Daniel C. Schroeder, Stefanie Vus, Bernd Neumaier, David de la Puente Bethencourt, Heike Endepols, Tim Hucho, Boris D. Zlatopolskiy, Simon R Finke, Johannes Zischler, Holger Herff, Alexander Drzezga, Erik Popp, Cathrin Rohleder, and Bernd W. Böttiger

Subjects
Male, medicine.medical_specialty, Time Factors, 030204 cardiovascular system & hematology, Hippocampal formation, Critical Care and Intensive Care Medicine, Rats, Sprague-Dawley, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Acetamides, medicine, Translocator protein, Animals, Neuroinflammation, medicine.diagnostic_test, biology, business.industry, Phenyl Ethers, 030208 emergency & critical care medicine, Magnetic resonance imaging, Sudden cardiac arrest, medicine.disease, Receptors, GABA-A, Barnes maze, Heart Arrest, Rats, Positron emission tomography, Positron-Emission Tomography, Ventricular fibrillation, Emergency Medicine, Cardiology, biology.protein, medicine.symptom, business, Carrier Proteins
Abstract

Background Knowledge about the neuroinflammatory state during months after sudden cardiac arrest is scarce. Neuroinflammation is mediated by cells that express the 18 kDa translocator protein (TSPO). We determined the time course of TSPO-expressing cells in a rat model of sudden cardiac arrest using longitudinal in vivo positron emission tomography (PET) imaging with the TSPO-specific tracer [18F]DAA1106 over a period of 6 months. Methods Five male Sprague Dawley rats were resuscitated from 6 min sudden cardiac arrest due to ventricular fibrillation, three animals served as shams. PET measurements were performed on day 5, 8, 14, 90, and 180 after intervention. Magnetic resonance imaging was performed on day 140. Imaging was preceded by Barnes Maze spatial memory testing on day 3, 13, 90, and 180. Specificity of [18F]DAA1106 binding was confirmed by Iba-1 immunohistochemistry. Results [18F]DAA1106 accumulated bilaterally in the dorsal hippocampus of all sudden cardiac arrest animals on all measured time points. Immunohistochemistry confirmed Iba-1 expressing cells in the hippocampal CA1 region. The number of Iba-1-immunoreactive objects per mm2 was significantly correlated with [18F]DAA1106 uptake. Additionally, two of the five sudden cardiac arrest rats showed bilateral TSPO-expression in the striatum that persisted until day 180. In Barnes Maze, the relative time spent in the target quadrant negatively correlates with dorsal hippocampal [18F]DAA1106 uptake on day 14 and 180. Conclusions After sudden cardiac arrest, TSPO remains expressed over the long-term. Sustainable treatment options for neuroinflammation may be considered to improve cognitive functions after sudden cardiac arrest.

Published
2020

14. Vape Arrest: A Case of E-Cigarette Induced Cardiac Arrest and ARDS

Author

Gustavo Ferrer, P. Upadhyaya, Aimee Almanzar, Arian Bethencourt, Srinivasan, and Imran Sayeedi

Subjects
medicine.medical_specialty, ARDS, business.industry, Internal medicine, Cardiology, Medicine, Pediatric critical care, business, medicine.disease, Induced cardiac arrest
Published
2020

15. Minimally Invasive Aortic Valve Replacement via Right Anterior Minithoracotomy and Central Aortic Cannulation

Author

Jennifer Le, Daniel M. Bethencourt, Gabriela Rodriguez, Robert W. Kalayjian, and Gregory S. Thomas

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Treatment outcome, 030204 cardiovascular system & hematology, Port access, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Internal medicine, medicine, Minimally invasive cardiac surgery, Humans, Minimally Invasive Surgical Procedures, Aged, Aged, 80 and over, Heart Valve Prosthesis Implantation, business.industry, General Medicine, Middle Aged, medicine.disease, Treatment Outcome, Thoracotomy, 030228 respiratory system, Cardiology, Female, Surgery, business, Cardiology and Cardiovascular Medicine, Right anterior
Abstract

Objective This study reports the evolution of a minimally invasive aortic valve replacement (mini-AVR) technique that uses a right anterior minithoracotomy approach with central cannulation, for a 13-year period. This technique has become our standard approach for isolated primary AVR in nearly all patients. Methods This observational study evaluated perioperative clinical outcomes of patients 18 years or older who underwent mini-AVR from November 2003 to June 2015. Results The mini-AVR technique was used in 202 patients during two periods of 2003 to 2009 (n = 65, “early”) and 2010 to 2015 (n = 137, “late”). The mean ± SD age was 72.5 ± 12.9 years and 60% were male. Demographic parameters were statistically similar between the study periods, except for increased body weight in the later period (75.3 ± 14.7 vs 80.9 ± 20.8 kg, P = 0.03). The mean cardiopulmonary bypass and aortic cross-clamp times were significantly different by each year and Bonferroni adjustment, with significant decreases in cardiopulmonary bypass and aortic cross-clamp times beginning 2006. Compared with the early study period, late study period patients were more often extubated intraoperatively (52% vs 12%, P < 0.001), had less frequent prolonged ventilator use postoperatively (6% vs 16%, P = 0.018), required fewer blood transfusions (mean, 2.0 ± 2.3 U vs 3.6 ± 3.0 U; P = 0.011), and had shorter postoperative stay (6.3 ± 4.5 days vs 8.0 ± 5.9 days, P = 0.026). Numerically, fewer postoperative strokes (1% vs 6%, P = 0.09) and fewer reoperations for bleeding (3% vs 6%, P = 0.3) occurred in the late period. In-hospital mortality did not differ (1/65 early vs 3/137 late). Conclusions Overall mini-AVR intraoperative and postoperative clinical outcomes improved for this 13-year experience.

Published
2017

16. Correlates of non-target vessel-related adverse events in patients with ST-segment elevation myocardial infarction: insights from five-year follow-up of the EXAMINATION trial

Author

Spitaleri G., Moscarella E., Brugaletta S., Pernigotti A., Ortega-Paz L., Gomez-Lara J., Cequier A., Iniguez A., Serra A., Jimenez-Quevedo P., Mainar V., Campo G., Tespili M., Heijer P. D., Bethencourt A., Vazquez N., Valgimigli M., Serruys P. W., Sabate M., Raber L., Vahanian A., Spitaleri, G., Moscarella, E., Brugaletta, S., Pernigotti, A., Ortega-Paz, L., Gomez-Lara, J., Cequier, A., Iniguez, A., Serra, A., Jimenez-Quevedo, P., Mainar, V., Campo, G., Tespili, M., Heijer, P. D., Bethencourt, A., Vazquez, N., Valgimigli, M., Serruys, P. W., Sabate, M., Raber, L., and Vahanian, A.

Subjects
Male, Time Factors, medicine.medical_treatment, Comorbidity, 030204 cardiovascular system & hematology, Bare metal stent, Drug-eluting stent, Multiple vessel disease, St-elevation myocardial infarction (STEMI), law.invention, 0302 clinical medicine, multiple vessel disease, Randomized controlled trial, law, Recurrence, Risk Factors, ST segment, 030212 general & internal medicine, Myocardial infarction, 610 Medicine & health, Metal, Incidence (epidemiology), Incidence, Diabetes Mellitu, Drug-Eluting Stents, Middle Aged, Treatment Outcome, Metals, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Time Factor, bare metal stent, Prosthesis Design, NO, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Diabetes mellitus, medicine, drug-eluting stent, Diabetes Mellitus, Humans, Adverse effect, Aged, business.industry, Risk Factor, Percutaneous coronary intervention, medicine.disease, ST-elevation myocardial infarction (STEMI), ST Elevation Myocardial Infarction, business
Abstract

AIMS: The aim of this substudy was to determine the five-year correlates of non-TV-related adverse events (AE) in STEMI patients included in the EXAMINATION trial. METHODS AND RESULTS: The EXAMINATION trial randomised 1,498 STEMI patients to bare metal or everolimus-eluting stent implantation. In this substudy, patients were analysed according to non-TV-related AE, defined as the composite of either non-TV revascularisation (non-TVR) or non-TV-related myocardial infarction (MI). At five-year follow-up, 125 patients (8.3%) exhibited 136 non-TV-related AE (124 [8.3%] non-TVR, 12 [0.8%] non-TV-related MI), accounting for 47.1% of 289 non-fatal cardiac events overall. These patients had a higher incidence of diabetes mellitus (p70% (p=0.042) as compared to the rest. At Cox analysis, previous MI (HR 1.872, 95% CI: 1.004-3.489; p=0.048), incomplete revascularisation (HR 1.746, 95% CI: 1.029-2.963; p=0.039) and diabetes (HR 1.942, 95% CI: 1.292-2.919; p=0.001) were independent correlates of non-TV-related AE. CONCLUSIONS: In STEMI patients undergoing primary percutaneous coronary intervention, previous MI, incomplete revascularisation and diabetes resulted in being independent correlates of five-year non-TV-related AE.

Published
2017

17. The COPD Comorbidome in the Light of the Degree of Dyspnea and Risk of Exacerbation

Author

María Dolores Martín Martínez, Sara García Hernández, Ignacio García-Talavera, Natalia Bethencourt Martín, Miguel Ángel García Bello, Juan Marco Figueira Gonçalves, David Díaz Pérez, and Lina Inmaculada Pérez Méndez

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Exacerbation, Heart Diseases, Disease, Comorbidity, Severity of Illness Index, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Prevalence, Humans, In patient, 030212 general & internal medicine, Stroke, Asthma, COPD, business.industry, medicine.disease, Degree (music), Dyspnea, 030228 respiratory system, Disease Progression, Kidney Diseases, business
Abstract

The BODE group designed a bubble chart, analogous to the solar system, which depicts the prevalence of each disease and its association with mortality and called it a "comorbidome". Although this graph was used to represent mortality and, later, the risk of needing hospital admission, it was not applied to visualize the association between a set of comorbidities and the categories of the GOLD 2017 guidelines, neither according to the degree of dyspnea nor to the risk of exacerbation. For the purpose of knowing to which extent each comorbidity associates with each of the two conditions-most symptomatic group (groups B and D) and highest risk of exacerbation (groups C and D)-we performed a analysis based on the comorbidome. 439 patients were included. Cardiovascular comorbidity (especially cardiac and renal disease) is predominantly observed in patients with a higher degree of dyspnea, whereas bronchial asthma and stroke occur more frequently in subjects at higher risk of exacerbation. This is the first time that the comorbidome is presented based on the categories of the GOLD 2017 document, which we hope will serve as a stimulus for scientific debate.

Published
2019

18. Impact of 13-valent pneumococcal conjugate polysaccharide vaccination on severe exacerbations in patients with chronic obstructive pulmonary disease and established cardiovascular disease

Author

Lina Pérez-Méndez, N. Bethencourt Martín, D. Díaz Pérez, M.A. García Bello, and J.M. Figueira Gonçalves

Subjects
Male, medicine.medical_specialty, Exacerbation, Pulmonary disease, Disease, medicine.disease_cause, Pneumococcal Infections, Pneumococcal Vaccines, Pulmonary Disease, Chronic Obstructive, Internal medicine, Forced Expiratory Volume, Streptococcus pneumoniae, Internal Medicine, medicine, Humans, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, COPD, Vaccines, Conjugate, business.industry, Vaccination, Middle Aged, medicine.disease, Hospitalization, Logistic Models, Cardiovascular Diseases, Multivariate Analysis, Disease Progression, Female, business, Conjugate
Published
2019

19. The Tryton (R) dedicated bifurcation stent: Five-year clinical outcomes

Author

Benigno Ramos López, Armando Bethencourt, Peregrine Green, Dariusz Dudek, Jo Dens, Johan Bennett, Indulis Kumsārs, Steve Ramcharitar, Robert J. van Geuns, Pieter R. Stella, Jeroen Sonck, and Cardiology

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Myocardial Infarction, Hemorrhage, Coronary Artery Disease, 030204 cardiovascular system & hematology, Prosthesis Design, Balloon, Risk Assessment, Lesion, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, 0302 clinical medicine, Risk Factors, Cause of Death, Angioplasty, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Stent thrombosis, Angioplasty, Balloon, Coronary, Aged, Retrospective Studies, Cause of death, business.industry, Coronary Thrombosis, Stent, Retrospective cohort study, General Medicine, Middle Aged, Europe, Stroke, Treatment Outcome, Cardiology, Female, Stents, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Mace
Abstract

Aims We report the first 5 year clinical follow-up data for the Tryton® bifurcation stent. Methods and results Clinical outcomes at five years were collected from 8 centres. Non-hierarchical Major Adverse Cardiovascular Events (MACE) and Major Adverse Cerebrovascular and Cardiovascular Events (MACCE) were collected. Diabetic and non-diabetic populations were compared, along with small (≤2.5 mm) vs large (>2.5 mm) side branch size. 173 patients with a follow up rate of 98% at 5 years were analysed. Non-hierarchical MACE was low at 9.8%, consisting of cardiac death of 1.2% (n = 2) and MI of 1.7% (n = 3). Target lesion revascularization (TLR) rate was 6.9% (n = 12). Non-hierarchical MACCE was also low, with major bleeding in 2.3% (n = 4) and strokes in 1.7% (n = 3) of patients. There was only 1 case (0.6%) of stent thrombosis that was definite and occurred very late (782 days). All-cause mortality was low, with 8.7% combined cardiac and non-cardiac death (n = 15). Diabetic patients had significantly higher event rates, but there was no difference in events with lesion stratification by side branch size. Conclusions The Tryton® Side-Branch Stent has a non-hierarchical MACE of 9.8% and MACCE of 13.9% at 5 years. The TLR was 6.9% with only 1 case of stent thrombosis recorded.

Published
2019

20. Health Status in Patients with COPD According to GOLD 2017 Classification: Use of the COMCOLD Score in Routine Clinical Practice

Author

Natalia Bethencourt Martín, María Dolores Martín Martínez, Lina Inmaculada Pérez Méndez, Sara García Hernández, Miguel Ángel García Bello, Juan Marco Figueira Gonçalves, Ignacio García-Talavera, and David Díaz Pérez

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Heart Diseases, Heart disease, Exacerbation, Health Status, Vital Capacity, Comorbidity, Disease, Peripheral Arterial Disease, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Forced Expiratory Volume, Internal medicine, Odds Ratio, Prevalence, medicine, Humans, In patient, 030212 general & internal medicine, Depression (differential diagnoses), Aged, COPD, Depression, business.industry, Middle Aged, medicine.disease, Cross-Sectional Studies, 030228 respiratory system, Spain, Disease Progression, Quality of Life, Female, Patient-reported outcome, business
Abstract

The COMCOLD score was developed to quantify the impact of comorbidities on health status in patients with chronic obstructive pulmonary disease (COPD). The objective of this study is to evaluate the association between health status in outpatients with COPD according to COMCOLD score and the GOLD 2017 groups according to symptoms (B and D vs. A and C) and exacerbations (C and D vs. A and B). 439 patients were included. The average score was 2.4 ± 3. 48% of cases had a COMCOLD score >0. The most symptomatic patients (B and D vs. A and C) had a higher score: 3 ± 3.3 vs. 1.3 ± 2.1 (p

Published
2019
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21. Most women with breast cancer about to initiate aromatase inhibitors already have bone loss

Author

L.M. Rodríguez Rodríguez, M.J. de la Vega Prieto, H. Roldán Delgado, J.N. Batista López, R. Hernández San Gil, M. J. Sánchez Pérez, B. Alonso Álvarez, J.M. Oramas Rodriguez, J. Cruz Jurado, E. Rodríguez Rodríguez, M.A. Gómez Rodríguez-Bethencourt, and L.S. Medina Vega

Subjects
Oncology, medicine.medical_specialty, medicine.medical_treatment, Osteoporosis, Fracturas vertebrales, Inhibidores de la aromatasa, Breast cancer, Cáncer de mama, Internal medicine, medicine, Aromatase, Bone mineral, lcsh:R5-920, Chemotherapy, biology, business.industry, Densidad mineral ósea, General Medicine, Bone fracture, medicine.disease, Osteopenia, biology.protein, lcsh:Medicine (General), business, Tamoxifen, medicine.drug
Abstract

Women with breast cancer who receive aromatase inhibitors (AI) are at risk of bone mass loss and bone fracture. Many of these women have been previously treated with chemotherapy and/or tamoxifen, also with known deleterious bone effects. We studied the bone mineral status of a group of postmenopausal women with non-advanced breast cancer about to initiate AI treatment.Between 2007 and 2010, 127 women aged 63 ± 9 years were prospectively included. Clinical, epidemiological, analytical, radiological, and densitometric data were collected.Prior to initiating AI treatment, the patients exhibited a high prevalence of bone mass loss (62.2%): 16.5% had osteoporosis and 45.7% osteopenia by OMS criteria. Besides, 7.4% of their dorso-lumbar spine x-rays revealed one or more vertebral fractures, all of which were found in patients with densitometry-defined osteoporosis or osteopenia. Surprisingly, 25-OH-vitamin D levels were normal (≥30 ng/ml) in 87.4% of the women. Obesity was prevalent (BMI 30 ± 5). Their most common tumour was infiltrating ductal carcinoma (76.4%). The women who had received adjuvant chemotherapy (50%) were younger (59.1 ± 8.3 vs. 66.2 ± 8.2, p

Published
2021

23. Impact of Body Mass Index on 5-Year Clinical Outcomes in Patients With ST–Segment Elevation Myocardial Infarction After Everolimus-Eluting or Bare-Metal Stent Implantation

Author

Andrés Iñiguez, Elisabetta Moscarella, Luis Ortega-Paz, Patrick W. Serruys, Angel Cequier, Maurizio Tespili, Vicente Mainar, Pilar Jiménez-Quevedo, Armando Bethencourt, Gianluca Campo, Marco Valgimigli, Antonio Serra, Sara Sentí Farrarons, Giosafat Spitaleri, Alberto Pernigotti, Nicolás Vázquez, Salvatore Brugaletta, Peter den Heijer, Manel Sabaté, Moscarella, E., Spitaleri, G., Brugaletta, S., Senti Farrarons, S., Pernigotti, A., Ortega-Paz, L., Cequier, A., Iniguez, A., Serra, A., Jimenez-Quevedo, P., Mainar, V., Campo, G., Tespili, M., den Heijer, P., Bethencourt, A., Vazquez, N., Valgimigli, M., Serruys, P. W., and Sabate, M.

Subjects
Bare-metal stent, Male, medicine.medical_specialty, medicine.medical_treatment, Aged, Everolimus, Female, Humans, Immunosuppressive Agents, Middle Aged, Obesity, Risk Factors, ST Elevation Myocardial Infarction, Self Expandable Metallic Stents, Treatment Outcome, Body Mass Index, Drug-Eluting Stents, Percutaneous Coronary Intervention, Cardiology and Cardiovascular Medicine, Population, 030204 cardiovascular system & hematology, Overweight, NO, 03 medical and health sciences, Immunosuppressive Agent, 0302 clinical medicine, Internal medicine, medicine, Drug-Eluting Stent, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, education, Self Expandable Metallic Stent, education.field_of_study, business.industry, Risk Factor, nutritional and metabolic diseases, Percutaneous coronary intervention, Stent, medicine.disease, Everolimu, Cardiology, medicine.symptom, business, Body mass index, Obesity paradox, Human
Abstract

Patients with high body mass index (BMI) seem to have better outcomes after percutaneous coronary intervention than normal-weight patients. However, contrasting results have been reported on the "obesity paradox" in patients presenting with ST-elevation myocardial infarction (STEMI). The aim of our study was to investigate the impact of BMI on mortality in the population enrolled in the Evaluation of the Xience-V stent in Acute Myocardial INfArcTION (EXAMINATION) trial. The EXAMINATION trial randomized 1,498 patients with STEMI to a bare-metal stent or an everolimus-eluting stent. In this substudy patients were stratified into 3 groups according to BMI values: normal (BMI < 25 kg/m(2)), overweight (BMI = 25 to 29.9 kg/m(2)), and obese (BMI 30 kg/m(2)). The coprimary end points were the all-cause and cardiac deaths among the groups at the 5-year follow-up. BMI was available in 1,421 patients, divided in 401 (28.2%) normal, 702 (49.4%) overweight, and 318 (22.4%) obese. Obese patients were younger (p = 0.012) compared with the other groups, but with a worse cardiovascular risk profile. They were more frequently female (p

Published
2017

24. Imaging Techniques in Percutaneous Cardiac Structural Interventions: Atrial Septal Defect Closure and Left Atrial Appendage Occlusion

Author

Antonio Rodríguez Fernández and Armando Bethencourt González

Subjects
Cardiac Catheterization, medicine.medical_specialty, Percutaneous, Septal Occluder Device, medicine.medical_treatment, Echocardiography, Three-Dimensional, Foramen secundum, 030204 cardiovascular system & hematology, Left atrial appendage occlusion, Heart Septal Defects, Atrial, Atrial septal defects, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Fluoroscopy, Atrial Appendage, 030212 general & internal medicine, Contraindication, medicine.diagnostic_test, business.industry, Atrial fibrillation, General Medicine, medicine.disease, Shunting, Treatment Outcome, Surgery, Computer-Assisted, Cardiology, Radiology, business, Echocardiography, Transesophageal
Abstract

Because of advances in cardiac structural interventional procedures, imaging techniques are playing an increasingly important role. Imaging studies show sufficient anatomic detail of the heart structure to achieve an excellent outcome in interventional procedures. Up to 98% of atrial septal defects at the ostium secundum can be closed successfully with a percutaneous procedure. Candidates for this type of procedure can be identified through a systematic assessment of atrial septum anatomy, locating and measuring the size and shape of all defects, their rims, and the degree and direction of shunting. Three dimensional echocardiography has significantly improved anatomic assessments and the end result itself. In the future, when combined with other imaging techniques such as cardiac computed tomography and fluoroscopy, 3-dimensional echocardiography will be particularly useful for procedure guidance. Percutaneous closure of the left atrial appendage offers an alternative for treating patients with atrial fibrillation and contraindication for oral anticoagulants. In the future, the clinical focus may well turn to stroke prevention in selected patients. Percutaneous closure is effective and safe; device implantation is successful in 94% to 99% of procedures. However, the procedure requires an experienced cardiac structural interventional team. At present, 3-dimensional echocardiography is the most appropriate imaging technique to assess anatomy suitability, select device type and size, guide the procedure alongside fluoroscopy, and to follow-up the patient afterwards.

Published
2016

25. Poster session 2THE IMAGING EXAMINATIONP536Appropriate use criteria of transthoracic echocardiography and its clinical impact: a continuous challengeP537Implementation of proprietary plug-ins in the DICOM-based computerized echo reporting system fuels the use of 3D echo and deformation imaging in the clinical routine of a multivendor laboratoryP538Exercise stress echocardiography appropriate use criteria: real-life cases classification ease and agreement among cardiologistsANATOMY AND PHYSIOLOGY OF THE HEART AND GREAT VESSELSP539Functional capacity in older people with normal ejection fraction correlates with left ventricular functional reserve and carotid-femoral pulse wave velocity but not with E/e and augmentation indexP540Survey of competency of practitioners for diagnosis of acute cardiopulmonary diseases manifest on chest x-rayASSESSMENT OF DIAMETERS, VOLUMES AND MASSP541Left atrium remodeling in dialysis patients with normal ejection fractionP542The prediction of postinfarction left ventricular remodeling and the role of of leptin and MCP-1 in regard to the presence of metabolic syndromeP543Ascending aorta and common carotid artery: diameters and stiffness in a group of 584 healthy subjectsAssessments of haemodynamicsP544Alternate echo parameters in patients without estimable RVSPAssessment of systolic functionP545Reduced contractile performance in heart failure with preserved ejection fraction: determination using novel preload-adjusted maximal left ventricular ejection forceP546Left ventricular dimensions and prognosis in acute coronary syndromesP547Time course of myocardial alterations in a murine model of high fat diet: A strain rate imaging studyP548Subclinical left ventricular systolic dysfunction in patients with premature ventricular contractionsP549Global myocardial strain by CMR-based feature tracking (FT) and tagging to predict development of severe left ventricular systolic dysfunction after acute st-elevation myocardial infarctionP550Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstructionP551The role of regional longitudinal strain assessment in predicting response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch blockP552Speckle tracking automatic border detection improves echocardiographic evaluation of right ventricular systolic function in repaired tetralogy of fallot patients: comparison with MRI findingsP553Echocardiography: a reproducible and relevant tool in pah? intermediate results of the multicentric efort echogardiographic substudy (evaluation of prognostic factors and therapeutic targets in pah)Assessment of diastolic functionP554Relationship between left ventricular filling pressures and myocardial fibrosis in patients with uncomplicated arterial hypertensionP555Cardiac rehabilitation improves echocardiographic parameters of diastolic function in patients with ischemic heart diseaseP556Diastolic parameters in the calcified mitral annulusP557Biomarkers and echocardiography - combined weapon to diagnose and prognose heart failure with and without preserved ejection fractionP558Diastolic function changes of the maternal heart in twin and singleton pregnancyIschemic heart diseaseP559Syntax score as predictor for the correlation between epicardial adipose tissue and the severity of coronary lesions in patients with significant coronary diseaseP560Impact of strain analysis in ergonovine stress echocardiography for diagnosis vasospastic anginaP561Cardiac magnetic resonance tissue tracking: a novel method to predict infarct transmurality in acute myocardial infarctionP562Infarct size is correlated to global longitudinal strain but not left ventricular ejection fraction in the early stage of acute myocardial infarctionP563Magnetic resonance myocardial deformation assessment with tissue tracking and risk stratification in acute myocardial infarction patientsP564Increase in regional end-diastolic wall thickness by transthoracic echocardiography as a biomarker of successful reperfusion in anterior ST elevation acute myocardial infarctionP565Mitral regurgitation is associated with worse long-term prognosis in ST-segment elevation myocardial infarction treated with primary percutaneous coronary interventionP566Statistical significance of 3D motion and deformation indexes for the analysis of LAD infarctionHeart valve DiseasesP567Paradoxical low gradient aortic stenosis: echocardiographic progression from moderate to severe diseaseP568The beneficial effects of TAVI in mitral insufficiencyP569Impact of thoracic aortic calcification on the left ventricular hypertrophy and its regression after aortic valve replacement in patients with severe aortic stenosisP570Additional value of exercise-stress echocardiography in asymptomatic patients with aortic valve stenosisP571Valvulo-arterial impedance in severe aortic stenosis: a dual imaging modalities studyP572Left ventricular mechanics: novel tools to evaluate left ventricular performance in patients with aortic stenosisP573Comparison of long-term outcome after percutaneous mitral valvuloplasty versus mitral valve replacement in moderate to severe mitral stenosis with left ventricular dysfunctionP574Incidence of de novo left ventricular dysfunction in patient treated with aortic valve replacement for severe aortic regurgitationP575Transforming growth factor-beta dependant progression of the mitral valve prolapseP576Quantification of mitral regurgitation with multiple jets: in vitro validation of three-dimensional PISA techniqueP577Impaired pre-systolic contraction and saddle-shape deepening of mitral annulus contributes to atrial functional regurgitation: a three-dimensional echocardiographic studyP578Incidence and determinants of left ventricular (lv) reverse remodeling after MitraClip implantation in patients with moderate-to severe or severe mitral regurgitation and reduced lv ejection fractionP579Severe functional tricuspid regurgitation in rheumatic heart valve disease. New insights from 3D transthoracic echocardiographyP58015 years of evolution of the etiologic profile for prosthetic heart valve replacement through an echocardiography laboratoryP581The role of echocardiography in the differential diagnosis of prolonged fever of unknown originP582Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacementP583The significance and advantages of echo and CT imaging & measurement at transcatherter aortic valve implantation through the left common carotid accessP584Comparison of the self-expandable Medtronic CoreValve versus the balloon-expandable Edwards SAPIEN bioprostheses in high-risk patients undergoing transfemoral aortic valve implantationP585The impact of transcatheter aortic valve implantation on mitral regurgitation severityP586Echocardiographic follow up of children with valvular lesions secondary to rheumatic heart disease: Data from a prospective registryP587Valvular heart disease and different circadian blood pressure profilesCardiomyopathiesP588Comparison of transthoracic echocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patientsP589Incidence and prognostic significance of left ventricle reverse remodeling in a cohort of patients with idiopathic dilated cardiomyopathyP590Early evaluation of diastolic function in fabry diseaseP591Echocardiographic predictors of atrial fibrillation development in hypertrophic cardiomyopathyP592Altered Torsion mechanics in patients with hypertrophic cardiomyopathy: LVOT-obstruction is the topdog?P593Prevention of sudden cardiac death in hypertrophic cardiomyopathy: what has changed in the guidelines?P594Coronary microcirculatory function as determinator of longitudinal systolic left ventricular function in hypertrophic cardiomyopathyP595Detection of subclinical myocardial dysfunction by tissue Doppler ehocardiography in patients with muscular dystrophiesP596Speckle tracking myocardial deformation analysis and three dimensional echocardiography for early detection of chemotherapy induced cardiac dysfunction in bone marrow transplantation patientsP597Left ventricular non compaction or hypertrabeculation: distinguishing between physiology and pathology in top-level athletesP598Role of multi modality imaging in familiar screening of Danon diseaseP599Early impairment of global longitudinal left ventricular systolic function independently predicts incident atrial fibrillation in type 2 diabetes mellitusP600Fetal cardiovascular programming in maternal diabetes mellitus and obesity: insights from deformation imagingP601Longitudinal strain stress echo evaluation of aged marginal donor hearts: feasibility in the Adonhers project.P602Echocardiographic evaluation of left ventricular size and function following heart transplantation - Gender mattersSystemic diseases and other conditionsP603The impact of septal kinetics on adverse ventricular-ventricular interactions in pulmonary stenosis and pulmonary arterial hypertensionP604Improvement in right ventricular mechanics after inhalation of iloprost in pulmonary hypertensionP605Does the treatment of patients with metabolic syndrome correct the right ventricular diastolic dysfunction?P606Predictors of altered cardiac function in breast cancer survivors who were treated with anthracycline-based therapyP607Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis: a prospective tissue-doppler echocardiography studyP608Diastolic and systolic left ventricle dysfunction presenting different prognostic implications in cardiac amyloidosisP609Diagnostic accuracy of Bedside Lung Ultrasonography in Emergency (BLUE) protocol for the diagnosis of pulmonary embolismP610Right ventricular systolic dysfunction and its incidence in breast cancer patients submitted to anthracycline therapyP611Right ventricular dysfunction is an independent predictor of survival among cirrhotic patients undergoing liver transplantCongenital heart diseaseP612Hypoplasia or absence of posterior leaflet: a rare congenital anomaly of the mitral valveP613ECHO screening for Barlow disease in proband's relativesDiseases of the aortaP614Aortic size distribution and prognosis in an unselected population of patients referred for standard transthoracic echocardiographyP615Abdominal aorta aneurysm ultrasonographic screening in a large cohort of asympromatic volounteers in an Italian urban settingP616Thoracic aortic aneurysm and left ventricular systolic functionStress echocardiographyP617Wall motion score index, systolic mitral annulus velocity and left ventricular mass predicted global longitudinal systolic strain in 238 patients examined by stress echocardiographyP618Prognostic parameters of exercise-induced severe mitral valve regurgitation and exercise-induced systolic pulmonary hypertensionP619Risk stratification after myocardial infarction: prognostic value of dobutamine stress echocardiographyP620relationship between LV and RV myocardial contractile reserve and metabolic parameters during incremental exercise and recovery in healthy children using 2-D strain analysisP621Increased peripheral extraction as a mechanism compensatory to reduced cardiac output in high risk heart failure patients with group 2 pulmonary hypertension and exercise oscillatory ventilationP622Can exercise induced changes in cardiac synchrony predict response to CRT?Transesophageal echocardiographyP623Fully-automated software for mitral valve assessment in chronic mitral regurgitation by three-dimensional transesophageal echocardiographyP624Real-time 3D transesophageal echocardiography provides more accurate orifice measurement in percutaneous transcatheter left atrial appendage closureP625Percutaneous closure of left atrial appendage: experience of 36 casesReal-time three-dimensional TEEP626Real-time three-dimensional transesophageal echocardiography during pulmonary vein cryoballoon ablation for atrial fibrilationP627Three dimensional ultrasound anatomy of intact mitral valve and in the case of type 2 disfunctionTissue Doppler and speckle trackingP629Left ventricle wall motion tracking from echocardiographic images by a non-rigid image registrationP630The first experience with the new prototype of a robotic system for remote echocardiographyP631Non-invasive PCWP influence on a loop diuretics regimen monitoring model in ADHF patients.P632Normal range of left ventricular strain, dimensions and ejection fraction using three-dimensional speckle-tracking echocardiography in neonatesP633Circumferential ascending aortic strain: new parameter in the assessment of arterial stiffness in systemic hypertensionP634Aortic vascular properties in pediatric osteogenesis imperfecta: a two-dimensional echocardiography derived aortic strain studyP635Assessment of cardiac functions in children with sickle cell anemia: doppler tissue imaging studyP636Assessment of left ventricular function in type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: relation to duration and control of diabetesP637A study of left ventricular torsion in l-loop ventricles using speckle-tracking echocardiographyP638Despite No-Reflow, global and regional longitudinal strains assessed by two-dimensional speckle tracking echocardiography are predictive indexes of left ventricular remodeling in patients with STEMIP639The function of reservoir of the left atrium in patients with medicaly treated arterial hypertensionP640The usefulness of speckle tracking analysis for predicting the recovery of regional systolic function after myocardial infarctionP641Two dimensional speckle tracking echocardiography in assessment of left ventricular systolic function in patients with rheumatic severe mitral regurgitation and normal ejection fractionP642The prediction of left-main and tripple vessel coronary artery disease by tissue doppler based longitudinal strain and strain rate imagingP643Role of speckle tracking in predicting arrhythmic risk and occurrence of appropriate implantable defibrillator Intervention in patients with ischemic and non-ischemic cardiomyopathyComputed Tomography & Nuclear CardiologyP644Cardiac adrenergic activity in patients with nonischemic dilated cardiomyopathy. Correlation with echocardiographyP645Different vascular territories and myocardial ischemia, there is a gradient of association?

Author

M Corneli, J C Gallego Page, C Soro, A Sharma, H Y A Girgis, K Wdowiak-Okrojek, D Djikic, F Granata, A Toscano, H A Habeeb, HA Hadeed, L Li, S Ben Kahla, G Di Salvo, I Sharka, D Szczesniak-Stanczyk, S Ranjbar, S Kadrabulatova, L Asmarats Serra, L Lanzoni, H-L Cheng, I Aquila, JJ Van Zalen, G Generati, G E Pieles, N Laredj, H Lesevic, K Wierzbowska-Drabik, E Malev, G Corrado, A Cherubini, S Kovalova, V M Parato, N Naksuk, G Portugal, A Ledakowicz-Polak, L Almeida Morais, G Cioffi, A Barac, D Radulescu, O Tufekcioglu, MMP Driessen, A Ingvarsson, M Cameli, A Kulkarni, S Bonapace, M Dantas Tavares De Melo, F D'ascenzi, G Makavos, M Gospodinova, D Trifunovic, L Reis, L Halmai, G Avegliano, L Caballero, F Macaya Ten, G Pontone, O Mozenska, A Saxena, S Guerreiro, P Kogoj, E Remsey- Semmelweiss, V Ciobotaru, J Petrovic, JA De La Chica, P Mahia, S Cimino, Z Tang, F Zuercher, M Mariani, KH Kim, E Galli, W Lam, C Goublaire, I J Cho, MF Costantino, E Fabris, N Duchateau, F Cordeiro, MC Scali, F Valente, G Joseph, SJ Ha, J D Morales Portano, S Prado Diaz, P Trzcinski, JN Codolosa, C Contaldi, M Orabona, M Chinali, A Lisowska, S Stoebe, A Shetye, SELEN Yurdakul, J Ternacle, JM Ribeiro, T T Le, VY Mo, O Vriz, BW Michalski, N Hanboly, G Mehdipoor, T Erdei, A Garcia Campos, L Badano, S Martins Fernandes, R Teixeira, I Roussin, M Lynch, D Muraru, G Romeo, D Ermacora, C Marotta, P Aruta, U Cucchini, S Iliceto, M Martin-Fernandez, JM De La Hera Galarza, C Corros-Vicente, S Colunga Blanco, E Velasco-Alonso, V Leon-Aguero, ML Rodriguez-Suarez, C Moris De La Tassa, J Edwards, D Braim, C Price, AG Fraser, F Salmani, A Arjmand Shabestari, E Szymczyk, K Kupczynska, L Peczek, B Nawrot, P Lipiec, JD Kasprzak, C Driussi, F Ferrara, G Brosolo, F Antonini-Canterin, J Magne, V Aboyans, E Bossone, BM Bellucci, JM Fisher, AA Balekian, S Idapalapati, F Huang, JI Wong, RS Tan, M Madeira, I Almeida, A Siserman, P Dinis, L Dias, AP Ramos, L Goncalves, FW Wan, DS Sawaki, JLDR Dubois-Rande, SA Adnot, GC Czibik, GD Derumeaux, G Ercan, ILKER Tekkesin, ST Sahin, B Cengiz, G Celik, S Demircan, SAIDE Aytekin, NA Razvi, SA Nazir, N Price, JN Khan, P Kanagala, A Singh, I Squire, GP Mccann, M Langel, D Pfeiffer, A Hagendorff, K Ptaszynska-Kopczynska, M Marcinkiewicz-Siemion, M Knapp, M Witkowski, WJ Musial, K Kaminski, B Natali, C D' Anna, B Leonardi, A Secinaro, G Pongiglione, G Rinelli, S Renard, N Michel, J Mancini, J Haentjens, O Sitbon, G Habib, M Imbriaco, G Alcidi, C Santoro, A Buonauro, F Lo Iudice, M Lembo, A Cuocolo, B Trimarco, M Galderisi, J Mora Robles, MA Roldan Jimenez, MA Mancisidor, MA De Mora, T Alnabelsi, I Goykhman, N Koshkelashvili, A Romero-Corral, GS Pressman, D Miskowiec, N Montoro Lopez, E Refoyo Salicio, SC Valbuena Lopez, O Gonzalez, C Alvarez, M Moreno Yanguela, JL Bartha Rasero, M De La Calle, G Guzman Martinez, JA Suarez-Cuenca, JA Merino, E B Gomez Alvarez, LG Delgado, YM Woo, WD Bang, GH Sohn, SS Cheong, SY Yoo, JF Rodriguez Palomares, L Gutierrez, G Maldonado, V Pineda, L Galian, G Teixido, MT Gonzalez Allujas, A Evangelista, D Garcia Dorado, T Zaremba, S Ekeloef, E Heiberg, H Engblom, SE Jensen, P Sogaard, G Garcia, FL Dini, F Galli, F Lattanzi, E Picano, M Marzilli, S Leao, M Moz, P Magalhaes, J Trigo, PS Mateus, A Ferreira, JI Moreira, M De Craene, D Legallois, F Labombarda, A Pellissier, M Sermesant, E Saloux, M Merlo, M Moretti, G Barbati, D Stolfo, M Gigli, B Pinamonti, G Sinagra, E Dores, A Matera, P Innelli, A Lopizzo, R Violini, R Fiorilli, G Cappabianca, G Tarsia, J Seo, HJ Chang, R Heo, IC Kim, CY Shim, GR Hong, N Chung, MM Melissopoulou, V Nguyen, E Brochet, C Cimadevilla, I Codogno, A Vahanian, D Messika-Zeitoun, F Pontana, V Vassiliou, S Prasad, C Leclercq, E Samset, E Donal, DS Lim, G Bianchi, F Rossi, J Gianetti, F Marchi, E Cerone, A Nardelli, M Terrazzi, M Solinas, S Maffei, A Pshepiy, L Vasina, E Timofeev, S Reeva, E Zemtsovsky, N Brugger, S Jahren, SF De Marchi, C Seiler, CN Jin, H Tang, K Fan, K Kam, BP Yan, CM Yu, PW Lee, M Reali, E Silvetti, T Salatino, M Mancone, M Pennacchi, A Giordano, G Sardella, L Agati, G Tirado, MT Nogales-Romo, P Marcos-Alberca, A De Agustin, C Almeria, JL Rodrigo, MA Garcia Fernandez, C Macaya, L Perez De Isla, M Mancisidor, C Lara Garcia, R Vivancos, M De Mora, M Petrovic, B Vujisic-Tesic, M Boricic-Kostic, I Petrovic, G Draganic, O Petrovic, M Tomic-Dragovic, T Furlan, J Ambrozic, PN Mohorko Pleskovic, M Bunc, R Ribeiras, J Abecasis, MJ Andrade, M Mendes, S Ramakrishnan, SK Gupta, R Juneja, SS Kothari, M Zaleska, A Segiet, S Chwesiuk, A Kroc, DA Kosior, D Andreini, A Solbiati, M Guglielmo, S Mushtaq, A Baggiano, V Beltrama, C Rota, AI Guaricci, M Pepi, J Pons Llinares, P Pericas Ramis, O Caldes Llull, A Grau Sepulveda, G Frontera, A Vaquer Segui, M Noris, A Bethencourt Gonzalez, V Climent Paya, M Martinez Moreno, D Saura, MJ Oliva, J Sanchez Quinones, A Garcia Honrubia, M Valdes, G De La Morena, M Terricabras, JP Costabel, R Ronderos, C Venturini, E Galve, A Nemes, S Neubauer, S Rahman Haley, N Banner, F Caetano, A Botelho, J Silva, J Nascimento, M Tesic, I Jovanovic, M Dragovic, J Stepanovic, M Banovic, V Guergelcheva, T Chamova, S Sarafov, I Tournev, S Denchev, I Ikonomidis, P Psarogiannakopoulos, P Tsirigotis, I Paraskevaidis, J Lekakis, A Pelliccia, BM Natali, M Focardi, M Bonifazi, S Mondillo, C Lima, L Assed, R Kalil Filho, C Mady, E A Bochi, V M C Salemi, G Targher, F Valbusa, A Rossi, P Lipari, L Zenari, G Molon, G Canali, E Barbieri, M Craft, M Nanda, JM Lorenzo, S Kutty, T Bombardini, S Sparla, C Di Tommaso, M Losito, E Incampo, M Maccherini, A Werther Evaldsson, G Radegran, M Stagmo, J Waktare, A Roijer, CJ Meurling, W Hui, FJ Meijboom, B Bijnens, A Dragulescu, L Mertens, MK Friedberg, B Sensoy, M Suleymanoglu, Y Akin, E Sahan, H Sasmaz, L Pasca, E Buzdugan, B Chis, L Stoicescu, FC Lynce, KL Smith, M Mete, C Isaacs, O Viapiana, C Di Nora, F Ognibeni, E Fracassi, A Giollo, C Mazzone, G Faganello, A Di Lenarda, M Rossini, A Galrinho, L Branco, A T Timoteo, I Rodrigues, P Daniel, S Rosa, L Ferreira, R Ferreira, L Polak, G Krauza, K Stokfisz, M Zielinska, L M Branco, M Mota Carmo, A Teresa Timoteo, S Aguiar Rosa, J Abreu, P Pinto Teixeira, A Viveiros Monteiro, R Cruz Ferreira, T Peeraphatdit, R Chaiteerakij, KW Klarich, S Masia, J Necas, S Nistri, F Negri, G Russo, C Pandullo, A Durante, E Rovelli, V Genchi, L Trabattoni, SC Zerboni, L Cattaneo, E Butti, G Ferrari, E Luneva, L Mitrofanova, V Uspensky, S Rosner, M Karl, I Ott, C Sonne, HM Ali Lahmar, L Hammou, J Forsey, L Gowing, F Miller, P Ramanujam, AG Stuart, CA Williams, F Bandera, M Pellegrino, F Carbone, V Labate, E Alfonzetti, M Guazzi, NR Patel, P Raju, L Beale, G Brickley, GW Lloyd, C Fernandez-Golfin, A Gonzalez, LM Rincon, R Hinojar, A Garcia, A Megias, JJ Jimenez-Nacher, JL Moya, JL Zamorano, A Chiampan, L Albrigi, M Noris Mora, A Rodriguez Fernandez, C Exposito Pineda, C Grande, R Gonzalez Colino, X Fernandez Vazquez, E Fortuny Frau, M Karvandi, R Blaszczyk, R Zarczuk, W Brzozowski, M Janowski, A Wysokinski, B Stanczyk, S Myftiu, D Teferici, A Quka, E Dado, J Djamandi, L Kresto, A Duka, A Kristo, I Balla, Z Issa, N Moiduddin, G Siblini, Z Bulbul, L Abid, D Abid, S Kammoun, E Rush, J Goodwin, R Kreikemeier, M Cantinotti, M A Zolaly, SQ Khoshhal, K El-Harbi, A Tarawah, Z Al-Hawsawi, I Al-Mozainy, S W G Bakhoum, M N Nabil, I N Elebrashy, S Albanese, A Carotti, R Iacobelli, C Esposito, G Moscogiuri, L Pasquini, M Malvezzi Caracciolo, RM Bianchi, P Caso, F Arenga, L Riegler, R Scarafile, A D'andrea, MG Russo, P Calabro', DS Simic, VP Peric, NM Mujovic, MM Marinkovic, NJ Jankovic, A Shim, P Wejner-Mik, N Jain, R Kharwar, RK Saran, VS Narain, SK Dwivedi, R Sethi, S Chandra, A Pradhan, S Safal, MF Marchetti, C Cacace, M Congia, V Nissardi, M Ruscazio, L Meloni, R Montisci, G Gallego Sanchez, S Calero, JJ Portero, A Tercero, JC Garcia, M Barambio, R Martinez Lazaro, AH Meretta, GO Perea, F Belcastro, E Aguirre, I De Luca, R Henquin, and O Masoli

Subjects
medicine.medical_specialty, Ejection fraction, Longitudinal strain, business.industry, General Medicine, Deformation (meteorology), medicine.disease, Infarct size, Surgery, Internal medicine, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, Myocardial infarction, Stage (cooking), Cardiology and Cardiovascular Medicine, business, Radial stress, Relevant information
Abstract

Purpose: Deformation analysis from 3D echocardiography results in a considerable amount of parameters, for which the conventional statistical approach is cumbersome. We investigate local motion and deformation patterns to determine the parameters of relevance for the study of LV myocardial deformation in the presence of LAD infarct. Methods: The study included 46 patients acquired at max. 5 days after LAD infarct (37 sequences) and at 1-year follow-up (33 sequences), and 46 controls. Patients were selected if they had a LVEF

Published
2015

26. THE EFFECT OF UNCONTROLLED DIABETES MELLITUS ON FREQUENCY OF ACUTE EXACERBATION OF COPD

Author

Vijay Srinivasan, Imran Sayeedi, Arian Bethencourt-Mirabal, Aimee Almanzar, Benjamin Sinyor, P. Upadhyaya, Wajeeha Saeed Butt, and Hector Vazquez Saad

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, COPD, Exacerbation, business.industry, Internal medicine, Diabetes mellitus, medicine, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, medicine.disease, business
Published
2020

27. Gonadal function protects against organ culture-induced vascular damage. Involvement of prostanoids

Author

Diva M. Villalpando, Daniel Flynn, Juan Gómez Rivas, Mercedes Ferrer, and Fermín R. de Bethencourt

Subjects
Male, medicine.medical_specialty, Physiology, Thromboxane, Prostaglandin, Blood Pressure, Vasodilation, Organ culture, Biochemistry, Rats, Sprague-Dawley, Thromboxane A2, chemistry.chemical_compound, Organ Culture Techniques, Internal medicine, medicine.artery, medicine, Animals, Receptor, Aorta, Pharmacology, Vasomotor, Cell Biology, Rats, Endocrinology, chemistry, Cyclooxygenase 2, Models, Animal, Androgens, Prostaglandins, lipids (amino acids, peptides, and proteins), Endothelium, Vascular, Thromboxane-A Synthase, Orchiectomy
Abstract

Androgen deprivation induces vascular dysfunction in which altered release and action of prostanoids has been extensively studied. On the other hand, the vascular organ-culture system has been reported as a valid model for phenotypic changes that occur in several cardiovascular pathologies. Since there are no studies analyzing the impact of androgenic loss on vascular vulnerability during induced vascular damage, the objective of this study was to analyze the possible preventive role of male sex hormones on the organ culture-induced vascular damage in rat aorta. The link to possible changes in gross structure was also analyzed. For this purpose, fresh and 20 h-cultured aortic arterial segments from intact and orchidectomized rats were used to analyze: (i) the release and vasomotor effect of the thromboxane A2 (TXA2), prostaglandin (PG) E2, PGF2α and PGI2; (ii) the vasodilator response induced by acetylcholine (ACh) as well as the involvement of prostanoids, in particular TXA2, in the ACh-induced response; (iii) the effect of activation of thromboxane/prostaglandin (TP) receptors on the ACh-induced response; and (iv) the vascular structure. The results showed that organ culture: i) increased production of prostanoids; ii) increased prostanoids-induced vasomotor responses; iii) decreased ACh-induced relaxation after incubation with indomethacin, a blocker of cyclooxygenases; iv) increased the ACh-induced relaxation after incubation with the TXA2 synthase inhibitor, furegrelate, more in arteries from orchidectomized rats than in those of intact rats; v) diminished ACh-induced relaxation after U-46619 incubation only in arteries from orchidectomized rats; and vi) preserved the integrity of the different vascular layers. These results showed the protective role of male sex hormones against the induced vascular damage, since a decreased deleterious effect of prostanoids, in particular that of TXA2, was observed in arteries from rats with intact gonadal function.

Published
2020

28. Persistence and adverse events of biological treatment in adult patients with juvenile idiopathic arthritis: results from BIOBADASER

Author

Bethencourt Baute, Juan José, Sanchez-Piedra, Carlos, Ruiz-Montesinos, Dolores, Medrano San Ildefonso, Marta, Rodriguez-Lozano, Carlos, Perez-Pampin, Eva, Ortiz, Ana, Manrique, Sara, Roselló, Rosa, Hernandez, Victoria, Campos, Cristina, Sellas, Agustí, Sifuentes-Giraldo, Walter Alberto, García-González, Javier, Sanchez-Alonso, Fernando, Díaz-González, Federico, Gómez-Reino, Juan Jesús, Bustabad Reyes, Sagrario, and BIOBADASER study group

Subjects
musculoskeletal diseases, Adult, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, genetic structures, Adolescent, Drug-Related Side Effects and Adverse Reactions, Population, Arthritis, Clinical practice, Persistence (computer science), 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Internal medicine, medicine, Juvenile, Humans, 030212 general & internal medicine, Prospective Studies, Registries, education, Adverse effect, skin and connective tissue diseases, Child, 030203 arthritis & rheumatology, education.field_of_study, Adult patients, business.industry, Juvenile idiopathic arthritis, Middle Aged, medicine.disease, Rheumatology, eye diseases, Arthritis, Juvenile, Biological Therapy, Treatment Outcome, Safety therapy, Spain, Antirheumatic Agents, Orthopedic surgery, lcsh:RC925-935, business, Biologic treatment, Research Article
Abstract

Background Biologic therapy has changed the prognosis of patients with juvenile idiopathic arthritis (JIA). The aim of this study was to examine the pattern of use, drug survival, and adverse events of biologics in patients with JIA during the period from diagnosis to adulthood. Methods All patients included in BIOBADASER (Spanish Registry for Adverse Events of Biological Therapy in Rheumatic Diseases), a multicenter prospective registry, diagnosed with JIA between 2000 and 2015 were analyzed. Proportions, means, and SDs were used to describe the population. Incidence rates and 95% CIs were calculated to assess adverse events. Kaplan-Meier analysis was used to compare the drug survival rates. Results A total of 469 patients (46.1% women) were included. Their mean age at diagnosis was 9.4 ± 5.3 years. Their mean age at biologic treatment initiation was 23.9 ± 13.9 years. The pattern of use of biologics during their pediatric years showed a linear increase from 24% in 2000 to 65% in 2014. Biologic withdrawal for disease remission was higher in patients who initiated use biologics prior to 16 years of age than in those who were older (25.7% vs 7.9%, p

Published
2018

29. Cost-effectiveness of everolimus-eluting versus bare-metal stents in ST-segment elevation myocardial infarction: An analysis from the EXAMINATION randomized controlled trial

Author

Salvatore Brugaletta, Matthias Schwenkglenks, Peter den Heijer, Maurizio Tespili, Andrés Iñiguez, Patrick W. Serruys, Pilar Jiménez-Quevedo, Nicolás Vázquez, Nadine Schur, Gianluca Campo, Vicente Mainar, Angel Cequier, Armando Bethencourt, Marco Valgimigli, Manel Sabaté, Antonio Serra, Zanfina Ademi, Universitat de Barcelona, Cardiology, University of Zurich, Voskuil, Michiel, and Schur, Nadine

Subjects
Genetics and Molecular Biology (all), evaluación del desenlace del paciente, Economics, Cardiovascular Procedures, modelos de riesgos proporcionales, Cost effectiveness, Cost-Benefit Analysis, humanos, Myocardial Infarction, lcsh:Medicine, Social Sciences, costos de la atención de salud, Cardiovascular Medicine, 030204 cardiovascular system & hematology, Antiplatelet Therapy, estudios de seguimiento, Vascular Medicine, Biochemistry, Geographical locations, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Medicine and Health Sciences, 030212 general & internal medicine, Myocardial infarction, 610 Medicine & health, lcsh:Science, health care economics and organizations, stents liberadores de fármacos, Coronary Artery Bypass Grafting, Multidisciplinary, Cost–benefit analysis, Pharmaceutics, Drug-Eluting Stents, General Medicine, Hematology, Health Care Costs, Cost-effectiveness analysis, Anàlisi cost-benefici, Europe, Cardiovascular Diseases, Cardiology, Stents, General Agricultural and Biological Sciences, Research Article, medicine.drug, medicine.medical_specialty, Coronary Stenting, Cost-Effectiveness Analysis, Genetics and Molecular Biology, Surgical and Invasive Medical Procedures, 1100 General Agricultural and Biological Sciences, Therapeutics, NO, 03 medical and health sciences, Drug Therapy, 1300 General Biochemistry, Genetics and Molecular Biology, Internal medicine, medicine, Humans, European Union, Everolimus, Espanya, Follow-Up Studies, Patient Outcome Assessment, Proportional Hazards Models, ST Elevation Myocardial Infarction, Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), Blood Coagulation, 1000 Multidisciplinary, Coagulation Disorders, business.industry, Proportional hazards model, Revascularization, lcsh:R, Thrombosis, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), medicine.disease, Terapèutica, Economic Analysis, Infart de miocardi, Spain, General Biochemistry, Stent Implantation, lcsh:Q, People and places, business, Decision analysis
Abstract

Background Use of everolimus-eluting stents (EES) has proven to be clinically effective and safe in patients with ST-segment elevation myocardial infarction but it remains unclear whether it is cost-effective compared to bare-metal stents (BMS) in the long-term. We sought to assess the cost-effectiveness of EES versus BMS based on the 5-year results of the EXAMINATION trial, from a Spanish health service perspective. Methods Decision analysis of the use of EES versus BMS was based on the patient-level clinical outcome data of the EXAMINATION trial. The analysis adopted a lifelong time horizon, assuming that long-term survival was independent of the initial treatment strategy after the end of follow-up. Life-expectancy, health-state utility scores and unit costs were extracted from published literature and publicly available sources. Non-parametric bootstrapping was combined with probabilistic sensitivity analysis to co-assess the impact of patient-level variation and parameter uncertainty. The main outcomes were total costs and quality-adjusted life-years. The incremental cost-effectiveness ratio was expressed as cost per quality-adjusted life-years gained. Costs and effects were discounted at 3%. Results The model predicted an average survival time in patients receiving EES and BMS of 10.52 and 10.38 undiscounted years, respectively. Over the life-long time horizon, the EES strategy was (sic)430 more costly than BMS ((sic) 8,305 vs. (sic)7,874), but went along with incremental gains of 0.10 quality-adjusted life-years. This resulted in an average incremental cost-effectiveness ratio over all simulations of (sic)3,948 per quality-adjusted life-years gained and was below a willingness-to-pay threshold of (sic)25,000 per quality-adjusted life-years gained in 86.9% of simulation runs. Conclusions Despite higher total costs relative to BMS, EES appeared to be a cost-effective therapy for ST-segment elevation myocardial infarction patients due to their incremental effectiveness. Predicted incremental cost-effectiveness ratios were below generally acceptable threshold values., The EXAMINATION trial (NCT00828087) was funded by the Spanish Heart Foundation. SB has received speakers' fees from Abbott Vascular and St Jude Medical. MV has received an honorarium as a public speaker for Terumo, the Medicines Company, Medtronic, Iroko, Merck, Abbott, Ely Lilly, AstraZeneca, Cordis, Carbostent and Implantable Devices, and Bayer. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The other authors declare no competing interests.

Published
2018

30. Atypical Presentation of Infective Endocarditis: A Case Report

Author

Joseph Reimon, Nicholas A Kerna, Daylin Rodriguez, Robert Hernandez, Tony L Brown, Dalie Ortet, and Arian Bethencourt

Subjects
medicine.medical_specialty, business.industry, General Medicine, Disease, medicine.disease, Article, Sepsis, Pneumonia, medicine.anatomical_structure, Internal medicine, Bacteremia, Infective endocarditis, medicine, Endocarditis, Heart valve, Abscess, business
Abstract

The American Heart Association defines Infective Endocarditis (IE) or bacterial endocarditis as an infection caused by bacteria that enter the bloodstream and settle in the heart lining, heart valve, or blood vessel [1]. IE is considered the fourth most common life-threatening infection syndrome after sepsis, pneumonia, and intra-abdominal abscess. In 2010, IE was associated with 1.58 million disability-adjusted life years, or years of healthy life lost, as a result of death and nonfatal illness and impairment [2,3]. The variability in clinical presentation of IE and the importance of early diagnosis require a diagnostic strategy that is prompt for disease detection and specific for its exclusion across all forms of the disease [2].

Published
2018

31. AB1147 Evolutionary study of 45 cases of undifferentiated negative hla b27 seronegative oligoarthritis

Author

L. Expósito Pérez, S. Bustabad Reyes, and J.J. Bethencourt Baute

Subjects
HLA-B27, medicine.medical_specialty, Oligoarthritis, business.industry, Spondyloarthropathy, Arthritis, medicine.disease, Connective tissue disease, Psoriasis, Rheumatoid arthritis, Internal medicine, Medicine, Reactive arthritis, business
Abstract

Background The prognosis of patients with undifferentiated arthritis may vary from self-limited to severe destructive rheumatoid arthritis. Early diagnosis is important, specially in seronegative oligoarthritis in order to start a treatment as early as possible. Objectives To describe the evolution of patients older than 16 years diagnosed with negative HLA B27 seronegative oligoarthritis without axial involvement. Methods We retrospectively studied 45 patients (23 women, 22 men) with negative HLA B27 seronegative oligoarthritis without axial involvement who debuted between 1985 and 1990 and who did not meet the criteria for any of the rheumatic diseases at the time of debut: rheumatoid arthritis (AR), psoriatic arthropathy (PsA), spondyloarthropathy, enteropathic arthritis, reactive arthritis, microcrystalline arthritis or connective tissue disease. Results The mean age at onset of oligoarthritis was 42.2 years (range 17–66). The mean follow-up time was 13.7 years (range 1–32). In its evolution, a definitive diagnosis was reached in 21 (46.6%) patients, with the mean time between debut and diagnosis being 5.47 years (range 1–25): 8 AR, 4 APs (3 with involvement) peripheral and 1 mixed), 2 undifferentiated spondyloarthritis, enteropathic arthritis, 5 gouty arthropathies and one SLE. In the case of RA, the diagnosis was made on an average of 4.8 years after the debut (range 1–16); the RF was positive in 4 patients a mean of 7.6 years (range 3–11) after the debut, and the anti-CCP were positive in 3 of the patients with positive RF. Within PsA, one developed skin psoriasis, another psoriatic onicopathy at 4 years after debut and 2 continue without skin involvement but with a family history of psoriasis, all met CASPAR criteria. From the other 24 patients (53.3%), only 3 patients (12.5%) continued to be followed up, with an average of 21.3 years (range 18–26) without meeting the criteria that allow us to define diagnosis. With the rest of the patients (40.8%), followed for an average of 4.5 years, a diagnosis was not achieved by resolution of the clinical picture or loss of follow-up. Conclusions In our series, 46.6% of the patients with a diagnosis of negative HLA B27 seronegative oligoarthritis began to meet diagnostic criteria for rheumatic disease after a mean time of 5.47 years, with RA being the most frequent diagnosis (38%) after an average of 4.8 years after the arthritis onset. Reference [1] K.N. Verpoort, H. van Dongen, C.F. Allaart, R.E.M. Toes, F.C. Breedveld, T.W.J. Huinzinga. Undifferentiated arthritis-Disease course assessed in several inception cohorts. Clin Exp Rheumatol2004;22 (Suppl.35):S12-S17. Disclosure of Interest None declared

Published
2018

32. Incidence, Predictors, and Prognostic Value of Acute Kidney Injury Among Patients Undergoing Left Atrial Appendage Closure

Author

Luis Asmarats, Pilar Jiménez-Quevedo, Juan Carlos Rama-Merchan, Jose Carlos Moreno-Samos, Hipólito Gutiérrez, Ignacio Cruz-González, Luis R. Goncalves-Ramírez, Victoria Martin-Yuste, Ignacio J. Amat-Santos, Gilles O'Hara, Tania Rodriguez-Gabella, Josep Rodés-Cabau, Luis Nombela-Franco, Armando Bethencourt, Gabriela Tirado-Conte, Xavier Freixa, Carlos Macaya, and Shweta Sahay

Subjects
Male, medicine.medical_specialty, Canada, Cardiac Catheterization, Time Factors, medicine.medical_treatment, Population, Renal function, 030204 cardiovascular system & hematology, urologic and male genital diseases, Kidney, Risk Assessment, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Internal medicine, Atrial Fibrillation, medicine, Humans, Atrial Appendage, 030212 general & internal medicine, education, Aged, Retrospective Studies, education.field_of_study, Creatinine, business.industry, Incidence (epidemiology), Incidence, Hazard ratio, Acute kidney injury, Odds ratio, Acute Kidney Injury, medicine.disease, female genital diseases and pregnancy complications, Treatment Outcome, chemistry, Spain, Cardiology, Female, Hemodialysis, Cardiology and Cardiovascular Medicine, business, Glomerular Filtration Rate
Abstract

Objectives The aims of this registry were to determine the incidence, predictors, and prognostic value of periprocedural acute kidney injury (AKI) after left atrial appendage closure (LAAC). Background No data exist on the occurrence of AKI after LAAC. Methods A total of 355 patients undergoing LAAC were included in the study. AKI was defined as an absolute or a relative increase in serum creatinine of >0.3 mg/dl or ≥50%, respectively, after the procedure or the need for hemodialysis during index hospitalization. Results The incidence of AKI was 9%, and patients with worse baseline renal function were at higher risk for developing AKI (odds ratio: 1.32; 95% confidence interval [CI]: 1.09 to 1.61; p = 0.004 for each 10 ml/min decrease in glomerular filtration rate). In-hospital bleeding events occurred more frequently in the AKI group (5.3% vs. 15.6%; p = 0.037). After a median follow-up period of 18 months, patients in the AKI group had higher mortality (hazard ratio [HR]: 2.59; 95% CI: 1.36 to 4.92; p = 0.004), more embolic events (HR: 6.14; 95% CI: 2.23 to 16.92; p = 0.001) and major bleeding events (HR: 2.36; 95% CI: 0.89 to 6.24; p = 0.083). The occurrence of AKI was an independent predictor of midterm mortality (HR: 2.00; 95% CI: 1.02 to 3.91; p = 0.044). Conclusions The occurrence of AKI was relatively frequent following LAAC, and patients with lower renal glomerular filtration rates were at high risk for developing this complication. AKI identified a group of patients with worse midterm outcomes, highlighting the importance of further preventive strategies in this population.

Published
2017

33. AB0959 Evaluate the cardiovascular risk through carotid intima-media thickness in patients with juvenile idiopathic arthritis in the young adult age

Author

L. Expόsito, J.J. Bethencourt, and Sagrario Bustabad

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Population, Arthritis, Disease, Anthropometry, medicine.disease, Blood pressure, Intima-media thickness, Internal medicine, medicine, Physical therapy, Young adult, education, business, Subclinical infection
Abstract

Background The relationship between inflammation and atherosclerosis has been demonstrated, so it is important to identify early markers of the disease. Ultrasound carotid intima-media thickness (CIMT) measurement is a non-invasive, consistent, validated technique used as a marker to identify subclinical arteriosclerotic disease, The long-term risk of cardiovascular disease in young adult patients with juvenile idiopathic arthritis (JIA) is unclear and there are no risk management guidelines for these patients. Objectives To assess whether there is an increase in CIMT in the young adult with a history of JIA and to relate CIMT with classic cardiovascular risk factors in these patients. Methods Observational and cross-sectional study. Follow-up patients from transitional care between 18 and 36 years old, with JIA diagnosis by ILAR classification. Filiations data, anthropometric variables and activity disease scores were collected. We performed, prior informed consent, CIMT measurement by radiofrequency with Esaote MyLab 70XVG. Three measurements were performed on each carotid artery, according to the protocol of the American Society of Echocardiography. Results Of the 20 patients, 17 (85%) women and 3 (15%) men. Subtype distribution was 8 (40%) oligoarticular, 1 of them ANA negative; 8 (40%) polyarticular being 4 seropositive and 4 seronegative; 1 systemic (5%); 2 (10%) psoriatic arthropathy and 1 (5%) HLA B27 positive arthritis. 66.7% are with disease modifying drugs (26.7% synthetic and 40% biological), while 33.3% do not have specific treatment. The main variables studied are described in the attached table (Table 1). In two previous independent studies conducted by Falaschi and Huang, CIMT was found to be 0.54±0.03 mm and 0.54±0.06 mm in 26 and 38 patients, respectively. From these results a mean and standard deviation of 0.54±0.05 mm were obtained. Using this last result as a control group, we compared it with the results of our series (0.466±0.068), with a significant difference (p In the statistical analysis, using the Rho Spearman, a significant correlation of the CIMT with the time of evolution of the disease in years (r =0.579) and systolic blood pressure (r =0.621) was observed at the level of 0.01 and with C Reactive Proteine (r =0.524) and BMI (r =0.471) at the 0.05 level. Conclusions The carotid intima-media thickness of patients with JIA were lower than the controls previously described in the literature, so we will complement this study with our population controls. In addition to classic cardiovascular risk factors such as systolic blood pressure and BMI, there is correlation with the evolution time in years of the disease and CRP, so that in transitional care programs we must the activity of the disease and insist on identification, control and follow-up of the classics factors associated with cardiovascular risk. Disclosure of Interest None declared

Published
2017

34. SAT0475 Recent onset psoriatic arthritis: baseline data from the reapser study

Author

J. A. Pinto Tasende, Rubén Queiro, A. Laiz Alonso, C Montilla Morales, S. Bustabad Reyes, E. Galindez Agirregoikoa, J.J. Bethencourt Baute, J Ramír, M. A. Belmonte, EA Blanco Morales, HS Park, and P Menéndez Tejόn

Subjects
medicine.medical_specialty, business.industry, Disease, medicine.disease, Rheumatology, Natural history, Psoriatic arthritis, Standard drink, Interquartile range, Internal medicine, Cohort, Medicine, Family history, business
Abstract

Background The natural history of psoriatic arthritis (PsA) is very little known and the information regarding prospective cohorts is very scarce worldwide, including our country. REAPSER (Spanish Rheumatology Society Registry of Psoriatic Arthritis) is the first registry of Spanish patients with recent onset PsA. Objectives To describe the baseline characteristics of patients included in the REAPSER cohort. Methods Observational, multicentric study (34 centers), with consecutive inclusion. We included adults of both sexes 18 years of age or older with PsA that met CASPAR criteria, and duration of less than two years since the appearance of symptoms attributed to PsA. Annual follow-up visits will be carried out for 5 years. Measurements: socio-demographic data; employment status and impact of the disease; family history of PsA and other inflammatory diseases; comorbidities and treatment; lifestyle; use of health services; clinical status at the time of diagnosis of PsA; anthropometric data; clinical evaluation of PsA manifestations; radiographic evaluation; analytical determinations; treatment of PsA. The study has been approved by the ethical committees of the participating centers. Results Two hundred and fifteen consecutive patients were included, mean age 49.8±13.9 years. Values are expressed as percentages, means with standard deviation and medians with their IQR (interquartile range). SDU: Standard Drink Units. PsAID: Psoriatic Arthritis Impact of Disease. Conclusions The baseline situation of Spanish patients with newly diagnosed PsA corresponds to that of a disease with slight cutaneous involvement and predominance of oligoarticular arthritis. Unsurprisingly, structural damage is scarce but not zero. The impact of the disease is still low in these early stages, however 18% of patients have a high Charlson9s comorbidity index (>3) and almost 5% of patients have had to change their employment status in the last year due to its PsA. Disclosure of Interest None declared

Published
2017

35. AB0788 Differences in the phenotypic expression of recent onset psoriatic arthritis among men and women: baseline data from the reapser study

Author

A. Laiz Alonso, M. A. Belmonte, J Ramír, C Montilla Morales, S. Bustabad Reyes, Rubén Queiro, E. Galindez Agirregoikoa, HS Park, E Alonso Blanco Morales, J.J. Bethencourt Baute, J. A. Pinto Tasende, and P Menéndez Tejόn

Subjects
030222 orthopedics, medicine.medical_specialty, business.industry, Arthritis, 030229 sport sciences, medicine.disease, Rheumatology, Dactylitis, 03 medical and health sciences, Psoriatic arthritis, symbols.namesake, 0302 clinical medicine, Internal medicine, Cohort, medicine, Physical therapy, symbols, Family history, business, Prospective cohort study, Fisher's exact test
Abstract

Background The natural history of psoriatic arthritis (PsA) according to gender of patients is an aspect of the disease only partially studied. In prospective PsA cohorts such information is barely known. Objectives To analyze baseline gender differences in the REAPSER cohort (Psoriatic Arthritis Registry of the Spanish Society of Rheumatology). Methods Observational, multicenter study (34 centers), with consecutive inclusion. We included adults of both sexes 18 years of age or older with PsA that met CASPAR criteria, and duration of less than two years since the appearance of symptoms attributed to PsA. Annual follow-up visits will be carried out for 5 years. Measurements: socio-demographic data; employment status and impact of the disease; family history of PsA and other inflammatory diseases; comorbidities and treatment; lifestyle; use of health services; clinical status at the time of diagnosis of PsA; anthropometric data; clinical evaluation of PsA manifestations; radiographic evaluation; analytical determinations; treatment of PsA. The study has been approved by the Ethical committees of the participating centers. Comparative statistical analysis: for qualitative variables, the χ-square or the Fisher exact statistic were used. For non-normal quantitative variables, non-parametric tests were used and for normal quantitative variables, Student9s t-test was used. Results The results are expressed in the table. Conclusions The baseline data from this prospective cohort point to significant differences in the phenotypic expression of PsA between men and women. Thus, in women, the prevalence of dactylitis and pustular psoriasis was higher, there were higher rates of depression and a perception of higher disease activity. Women scored higher on the pain linked to their arthritis and the activity of axial disease. They also had biological activity parameters (ESR) higher than that of men. It is necessary to determine if these differences are maintained or change over time. Disclosure of Interest None declared

Published
2017

36. Prognostic significance of complex karyotype and monosomal karyotype in adult patients with acute lymphoblastic leukemia treated with risk-adapted protocols

Author

Teresa Bernal, Jesús María Hernández-Rivas, Salut Brunet, Pascual Fernández-Abellán, Concepción Bethencourt, José González-Campos, Cristina Motlló, Carlos Grande, Josep-Maria Ribera, Mar Tormo, Javier Grau, Eloy del Potro, María-José Moreno, Josep Sarrá, Mireia Morgades, Pau Montesinos, Isabel Granada, Evarist Feliu, Pere Barba, and José Cervera

Subjects
Oncology, Cancer Research, Chemotherapy, Pathology, medicine.medical_specialty, business.industry, medicine.medical_treatment, Lymphoblastic Leukemia, Cancer, Karyotype, medicine.disease, Transplantation, Internal medicine, Complex Karyotype, Medicine, Stem cell, business, Monosomal karyotype
Abstract

BACKGROUND The karyotype is a predictor of outcomes in adults with acute lymphoblastic leukemia (ALL). The unfavorable prognostic significance of complex karyotype (CK) has been reported, whereas the prognostic relevance of monosomal karyotype (MK) has not been consistently evaluated. We aimed to assess the prognostic value of CK and MK in adults with ALL treated with risk-adapted protocols of the Spanish PETHEMA Group. METHODS The karyotypes of 881 adult ALL patients treated according to the protocols of the PETHEMA Group between 1993 and 2012 were centrally reviewed. CK and MK were assessed according to Moorman's criteria, and Breem's criteria, respectively. Specific analyses according to the risk groups and to the presence of t(9:22) were performed. RESULTS Of 364 evaluable patients 33 (9.2%) had CK, and 68 of 535 evaluable patients (12.8%) had MK. Complete remission rate, remission duration, and overall survival were not significantly different according to the presence of CK or MK in the whole series, according to the B or T lineage, in the high-risk group, or in patients with t(9;22), regardless of imatinib treatment, and in patients who received chemotherapy alone or chemotherapy followed by stem cell transplantation CONCLUSIONS Our study shows that CK and MK were not associated with a worse prognosis in adult patients with ALL treated with risk-adapted or subtype-oriented protocols. In patients with Ph+ ALL, MK did not have an impact on prognosis irrespective of imatinib treatment. Cancer. © 0000 American Cancer Society Cancer 2014;120:3958–3964. © 2014 American Cancer Society.

Published
2014

37. Recurrent syncope after left atrial appendage occlusion

Author

Armando Bethencourt, Jose-Angel Perez-Rivera, and Ignacio Cruz-González

Subjects
Tachycardia, medicine.medical_specialty, Surgical team, Mitral regurgitation, business.industry, medicine.medical_treatment, Atrial fibrillation, General Medicine, medicine.disease, Left atrial appendage occlusion, Surgery, medicine.anatomical_structure, Internal medicine, Mitral valve, Occlusion, cardiovascular system, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Contraindication
Abstract

We present the case of a 72-year-old woman with permanent atrial fibrillation and contraindication to long-term oral anticoagulant therapy who underwent left atrial appendage (LAA) occlusion. A 24-mm Amplatzer Cardiac Plug (St Jude Medical) device was deployed. The inferior part of the external disc of the device appeared to be over the posterior leaflet of the mitral valve but no significant mitral stenosis or mitral regurgitation was detected before deployment. After the procedure the patient suffered several syncopes when she tried to stand up. A transesophageal echocardiography (TEE) was performed and no significant differences on the device position were detected, it was not possible to perform the TEE in a stand-up position due to the patient symptoms (hypotension, tachycardia, dizziness, and loss of consciousness). After discussion with the surgical team, surgical removal of the device and surgical exclusion of LAA was performed. The symptoms disappeared and the patient was discharged. In the best of our knowledge, this is the first time that recurrent syncope has been described as a complication of LAA occlusion. © 2014 Wiley Periodicals, Inc.

Published
2014

38. Right atrial thrombosis associated with hemodialysis catheter: first description of recurrence in a poorly understood problem

Author

Juan Manuel Martínez-Riutort, Carlos Fernández-Palomeque, Luis Asmarats, and Armando Bethencourt

Subjects
Adult, Catheterization, Central Venous, medicine.medical_specialty, Heart Diseases, medicine.medical_treatment, Population, Hemodialysis Catheter, Renal Dialysis, Internal medicine, medicine, Humans, Heart Atria, education, Thrombectomy, Ultrasonography, education.field_of_study, business.industry, Anticoagulants, Thrombosis, Hematology, Thrombolysis, Middle Aged, Staphylococcal Infections, medicine.disease, Surgery, Catheter, Treatment Outcome, Catheter-Related Infections, Cardiology, Kidney Failure, Chronic, Female, Blood Coagulation Tests, Hemodialysis, Cardiology and Cardiovascular Medicine, Complication, business, Central venous catheter
Abstract

Catheter-related right atrial thrombosis (CRAT) is an underreported and potentially life-threatening complication of central venous catheter in hemodialysis patients. The accurate incidence is unknown, with reported rates ranging from 2 to 12.8 % [1] in series, up to 29 % [2] in a postmortem prospective study, and high mortality rates (18 %) [1]. The optimal treatment for CRAT is controversial and nonsystematized, including anticoagulation, thrombolysis, and surgical thrombectomy. We report two cases of CRAT in dialysis patients, who underwent surgical thrombectomy. One case required reintervention because of recurrence, a first reported case in hemodialysis population.

Published
2014

39. Comprehensive Hemodynamic Comparison and Frequency of Patient-Prosthesis Mismatch between the St. Jude Medical Trifecta and Epic Bioprosthetic Aortic Valves

Author

Ajay Yadlapati, Jimmy Diep, Daniel M. Bethencourt, Mary-Jo Barnes, Tristan Grogan, and Gabriel Vorobiof

Subjects
Adult, Male, Aortic valve, medicine.medical_specialty, medicine.medical_treatment, Aortic Valve Insufficiency, Mean pressure, Hemodynamics, EPIC, Prosthesis Design, Prosthesis, Postoperative Complications, Aortic valve replacement, Prosthesis Fitting, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Postoperative Period, Aged, Aged, 80 and over, Bioprosthesis, Heart Valve Prosthesis Implantation, Prosthetic valve, business.industry, Aortic Valve Stenosis, Middle Aged, medicine.disease, Surgery, medicine.anatomical_structure, Aortic Valve, Heart Valve Prosthesis, Aortic valve stenosis, Preoperative Period, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Patient-prosthesis mismatch (PPM) has been reported with a wide range of bioprosthetic valves after aortic valve replacement (AVR) and has been associated with multiple adverse outcomes. The aim of this study was to test the hypothesis that a novel low-profile stented pericardial tissue bioprosthesis for AVR, the Trifecta aortic valve, would have superior hemodynamics, a lower incidence of PPM, and an improvement in clinical outcomes. Its hemodynamic performance was evaluated, and a comparison was performed with a traditional stented pericardial bioprosthesis (Epic) with respect to hemodynamics, PPM, and clinical events.One hundred twenty-four patients (mean age, 73.6 ± 11.0 years) underwent AVR. Prosthetic valve types used were Trifecta (n = 75 [60.5%]) and Epic (n = 49 [39.5%]). Intraoperative transesophageal echocardiography was used to evaluate hemodynamic variables before and after AVR.Postoperative comparison of the Epic valve and the Trifecta valve revealed a lower mean pressure gradient (16.5 ± 6.7 vs 8.8 ± 3.4 mm Hg, P.001), a lower peak gradient (33.3 ± 11.8 vs 19.4 ± 8.6 mm Hg, P.001), and higher indexed effective orifice area (0.8 ± 0.2 vs 1.1 ± 0.4 cm(2)/m(2), P.001), favoring the Trifecta valve across several valve sizes. Severe PPM (6% vs 27%, P.001) and valvular-related complications at follow-up (14.3% vs 36.7%, P = .005) were less frequent in the Trifecta group.The hemodynamic performance of the Trifecta valve is superior to that of the Epic valve across many conventional prosthesis sizes, and its implantation resulted in lower rates of severe PPM. These improvements were associated with lower valvular-related adverse events.

Published
2014

40. Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent

Author

Maik J. Grundeken, Michael S. Norell, Armando Bethencourt, Robbert J. de Winter, David P. Foley, Karel T. Koch, Marije M. Vis, Maciej Lesiak, Jan G.P. Tijssen, Antonio L. Bartorelli, Pieter R. Stella, Joanna J. Wykrzykowska, Yoshinobu Onuma, Peter Damman, José P.S. Henriques, Pier Woudstra, Solomon Asgedom, Eulogio García, Cardiology, Graduate School, and Amsterdam Cardiovascular Sciences

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, Coronary Angiography, Prosthesis Design, Logistic regression, Coronary artery disease, Internal medicine, medicine, Humans, ST segment, Myocardial infarction, Angioplasty, Balloon, Coronary, Aged, Netherlands, Interventional cardiology, business.industry, Mortality rate, Percutaneous coronary intervention, Stent, Drug-Eluting Stents, medicine.disease, Surgery, Survival Rate, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Objective We evaluated differences in clinical outcomes between patients who underwent final kissing balloon inflation (FKBI) and patients who did not undergo FKBI in bifurcation treatment using the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina, USA). Methods Clinical outcomes were defined as target vessel failure (composite of cardiac death, any myocardial infarction and clinically indicated target vessel revascularisation), cardiac death, myocardial infarction (MI), clinically indicated target vessel revascularisation and stent thrombosis. Cumulative event rates were estimated using the Kaplan-Meier method. A multivariable logistic regression analysis was performed to evaluate which factors were potentially associated with FKBI performance. Results Follow-up data was available in 717 (96%) patients with a median follow-up of 190 days. Cardiac death at 1 year occurred more often in the no-FKBI group (1.7% vs 4.6%, respectively, p=0.017), although this difference was no longer observed after excluding patients presenting with ST segment elevation MI (1.6% vs 3.3%, p=0.133). No significant differences were observed concerning the other clinical outcomes. Oneyear target vessel failure rates were 10.1% in the no- FKBI group and 9.2% in the FKBI group (p=0.257). Multivariable logistic regression analysis identified renal dysfunction, ST segment elevation MI as percutaneous coronary intervention indication, narrow (

Published
2014

41. The EXAMINATION Trial (Everolimus-Eluting Stents Versus Bare-Metal Stents in ST-Segment Elevation Myocardial Infarction)

Author

Bianca Backx, Pieter den Heijer, Antonio Serra, Angel Cequier, Manel Sabaté, Patrick W. Serruys, Maurizio Tespili, Nicolás Vázquez, Salvatore Brugaletta, Andrés Iñiguez, Rosana Hernádez-Antolín, Vicente Mainar, Armando Bethencourt, and Marco Valgimigli

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, medicine.medical_treatment, Population, Percutaneous coronary intervention, Revascularization, medicine.disease, Surgery, Coronary thrombosis, Internal medicine, Cardiovascular agent, Clinical endpoint, Cardiology, Medicine, Platelet aggregation inhibitor, cardiovascular diseases, Myocardial infarction, business, education, Cardiology and Cardiovascular Medicine
Abstract

Objectives This study sought to assess the 2-year outcomes of the population included in the EXAMINATION (Everolimus-Eluting Stents Versus Bare-Metal Stents in ST-Segment Elevation Myocardial Infarction) trial beyond the 1-year prescription period of dual antiplatelet therapy. Background The EXAMINATION trial compared the performance of everolimus-eluting stents (EES) versus bare-metal stents (BMS) in an all-comer ST-segment elevation myocardial infarction (STEMI) population. Methods This was a multicenter, multinational, prospective, randomized, single-blind, controlled trial in patients with STEMI. The primary endpoint, which was the combined endpoint of all-cause death, any recurrent myocardial infarction, and any revascularization, and the endpoints target lesion revascularization and stent thrombosis were assessed at 2 years. Results Between December 31, 2008, and May 15, 2010, 1,498 patients were randomized to receive EES (n = 751) or BMS (n = 747). Compliance with dual antiplatelet regimen was reduced at 2 years to a similar degree (17.3% vs. 17.2%, p = 0.91). At 2 years, the primary endpoint occurred in 108 (14.4%) patients of the EES group and in 129 (17.3%) patients of the BMS group (p = 0.11). Rate of target lesion revascularization was significantly lower in the EES group than in the BMS group (2.9% vs. 5.6%; p = 0.009). Rates of definite and definite or probable stent thrombosis were also significantly reduced in the EES group (0.8% vs. 2.1%; p = 0.03, and 1.3% vs. 2.8%; p = 0.04, respectively). Conclusions The 2-year follow-up of the EXAMINATION trial confirms the safety and efficacy of the EES compared with BMS in the setting of STEMI. Specifically, both rates of target lesion revascularization and stent thrombosis were reduced in recipients of EES without any signs of late attrition for either of these endpoints. (A Clinical Evaluation of Everolimus Eluting Coronary Stents in the Treatment of Patients With ST-Segment Elevation Myocardial Infarction: EXAMINATION Study; NCT00828087 )

Published
2014
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42. Optimization in Stent Implantation by Manual Thrombus Aspiration in ST-Segment-Elevation Myocardial Infarction Findings From the EXAMINATION Trial

Author

Diego Fernández-Rodríguez, Salvatore Brugaletta, Maurizio Tespili, Andrés Iñíguez, Mónica Masotti, Nicolás Vázquez, Angel Cequier, Antonio Serra, Rosana Hernández-Antolín, Manel Sabaté, Victoria Martin-Yuste, Vicente Mainar, Armando Bethencourt, Marco Valgimigli, Ander Regueiro, Patrick W. Serruys, Pieter den Heijer, and Cardiology

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Kaplan-Meier Estimate, Suction, Revascularization, Coronary Angiography, Electrocardiography, Percutaneous Coronary Intervention, Internal medicine, medicine, drug-eluting stent, ST segment, Humans, Myocardial infarction, Prospective Studies, Aged, Thrombectomy, medicine.diagnostic_test, business.industry, percutaneous coronary intervention, Stent, Percutaneous coronary intervention, Drug-Eluting Stents, Thrombosis, Middle Aged, medicine.disease, Combined Modality Therapy, Surgery, Treatment Outcome, myocardial infarction, Drug-eluting stent, thrombectomy, Cardiology, Female, stent, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Background— Manual thrombus aspiration (TA) is effective to reduce the thrombus burden during primary percutaneous coronary intervention for ST-elevation myocardial infarction. The objective of this study is to assess the impact of manual TA on stent implantation during primary percutaneous coronary intervention. Methods and Results— Population of the EXAMINATION trial (n=1498) was divided into 2 groups according to the use of TA. Immediate angiographic results, primary patient-oriented end point (combination of all-cause death, myocardial infarction, and any revascularization) and secondary device-oriented end point (combination of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization), definite/probable stent thrombosis, and major/minor bleeding were evaluated at 2 years. A total of 976 (65.2%) patients were classified into TA group and 522 (34.8%) patients into nonthrombus aspiration group. Manual TA was most frequently used in patients with worse initial thrombolysis in myocardial infarction flow. The TA group received less number of stents implanted (1.35±0.62 versus 1.45±0.71, P =0.005) with bigger size (3.25±0.44 versus 3.11±0.46 mm, P P P Conclusions— Manual TA during primary percutaneous coronary intervention is associated with a higher rate of direct stenting, a lower rate of postdilatation, and larger and less stents in comparison with conventional primary percutaneous coronary intervention. Conversely, manual TA had no apparent impact on clinical outcomes at long-term follow-up. Clinical Trial Registration— http://www.clinicaltrials.gov . Unique identifier: NCT00828087.

Published
2014

44. [Untitled]

Author

Nadiuska Sanchez, Maria Marmol, Brinsley Ekinde, Ilde Lee, Carlos Guida, Arian Bethencourt Mirabal, Diego Bonilla, and Carlos Dorta

Subjects
medicine.medical_specialty, Gastrointestinal bleeding, medicine.diagnostic_test, business.industry, Internal medicine, Biopsy, Medicine, Critical Care and Intensive Care Medicine, business, GASTROINTESTINAL AMYLOIDOSIS, medicine.disease, Gastroenterology
Published
2019

45. Ezetimibe added to statin therapy after acute coronary syndromes

Author

Cannon, Christopher P., Blazing, Michael A., Giugliano, Robert P., Mccagg, Amy, White, Jennifer A., Theroux, Pierre, Darius, Harald, Lewis, Basil S., Ophuis, Ton Oude, Jukema, J. Wouter, De Ferrari, Gaetano M., Ruzyllo, Witold, De Lucca, Paul, Kyungah, Im, Bohula, Erin A., Reist, Craig, Wiviott, Stephen D., Tershakovec, Andrew M., Musliner, Thomas A., Braunwald, Eugene, Califf, Musliner T, Robert M., Tershakovec, A, Gurfinkel, E, Aylward, P, Tonkin, A, Maurer, G, Van de Werf, F, Nicolau, Jc, Theroux, P, Genest, J, Armstrong, P, Corbalan, R, Isaza, D, Spinar, J, Grande, P, Voitk, J, Kesaniemi, A, Bassand, Jp, Farnier, M, Darius, H, Keltai, M, Mathur, A, Mittal, S, Reddy, K, Lewis, B, De Ferrari GM, Ophuis, To, Jukema, J, White, H, Pedersen, T, Britto, F, Ruzyllo, W, Carrageta, M, Duris, T, Dalby, A, Seung, Kb, Lopez-Sendon, J, Dellborg, M, Mach, F, Guneri, S, Parkhomenko, A, Brady, A, Cannon, C, Blazing, M, Ballantyne, C, de Lemos, J, Kleiman, N, Mcguire, Dk, Centeno, E, Casalins, M, Cartasegna, L, Beltrano, Mc, Guerrero, R, Fanuele, M, Berra, F, Egido, J, Colombo, H, Dellatorre, M, Terns, P, Blumberg, E, Reges, P, Azize, G, Ramos, H, Fernandez, R, Carlessi, C, 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Sharma, T., Orosz, S., Shah, R., Petrino, M., Hughes, M., Hershey, J., Hudock, D., Hui, P., Von Bakonyi, A., Arnold, A., Kappel, D., Pennock, G., Cloud, B., Tucker, K., Harp, L., Hoover, C., Eisenhauer, M., Roth, J., Young, C., Thai, H., Escalante, A., Bautista, J., Gazmuri, R., Nyland, J., Cubeddu, L., DeFranco, A., Dias, D., Fielding, M., Reeves, R., Hermany, P., Meissner-Dengler, S., Evans, M., Flores, E., Tannenbaum, A., McGarr, K., Moran, J., Stout, E., Allred, S., Henderson, D., Crandall, L., Strote, J., Voyles, W., Robeson, D., Bedoya, R., Omar, B., Pettyjohn, F., Revere, C., Coy, K., Margolis, J., Sotolongo, C., Scheffel, M., Munir, A., Shirwany, A., Douglas, L., Girala, R., Humphreys, R., Agarwal, J., Bankowski, D., Watson, R., Bishop, B., Klementowicz, P., Blais, D., Cohen, B., Lobur, E., Dimenna, J., Dempsey, K., Izzo, M., Bondi, L., Carell, E., Eaton, C., Saltiel, F., Grewal, G., Connolly, T., Little, T., Wiegman, P., Gips, S., Held, J., Paraschos, A., Quesada, R., Goudreau, E., Sears, M., Istfan, P., Holt, S., McClung, J., Nguyen, N., Quintana, O., Gottlieb, D., Knutson, T., Barringhaus, K., Lester, F., Sullivan, P., Rodriguez-Ospina, L., Cannon, Cp, Blazing, Ma, Giugliano, Rp, Mccagg, A, White, Ja, Theroux, P, Darius, H, Lewis, B, Ophuis, To, Jukema, Jw, De Ferrari, Gm, Ruzyllo, W, De Lucca, P, Im, K, Bohula, Ea, Reist, C, Wiviott, Sd, Tershakovec, Am, Musliner, Ta, Braunwald, E, Califf, Rm, for the IMPROVE-IT, Investigator, Cianflone, D, Cardiovascular Division (SZG), Brigham and Women's Hospital [Boston], College of Information Science and Engineering, Ritsumeikan University, Montreal Heart Institute (MONTREAL HEART INSTITUTE), Laboratoire des Micro-algues toxiques, Institut Louis Malardé [Papeete] (ILM), Institut de Recherche pour le Développement (IRD)-Institut de Recherche pour le Développement (IRD), Interuniversity Cardiology Institute Netherlands, Institute of Cardiology (WARSAW - Cardiology), Institute of Cardiology, Merck Sharp & Dohme Corp., Merck & Co. Inc, DIPARTIMENTO DI MEDICINA SPECIALISTICA, DIAGNOSTICA E SPERIMENTALE, Facolta' di MEDICINA e CHIRURGIA, AREA MIN. 06 - Scienze mediche, Cannon, C.P., Blazing, M.A., Giugliano, R.P., Mccagg, A., White, J.A., Lewis, B.S., Jukema, J.W., De Lucca, P., Im, K., Bohula, E.A., Reist, C., Wiviott, S.D., Tershakovec, A.M., Musliner, T.A., Braunwald, E., Califf, R.M., for the IMPROVE-IT Investigators [.., C. Rapezzi, ], Other departments, Cannon, Christopher P, Blazing, Michael A., Giugliano, Robert P., Mccagg, Amy, White, Jennifer A., Theroux, Pierre, Darius, Harald, Lewis, Basil S., Ophuis, Ton Oude, Jukema, J. Wouter, De Ferrari, Gaetano M., Ruzyllo, Witold, De Lucca, Paul, Kyungah, Im, Bohula, Erin A., Reist, Craig, Wiviott, Stephen D., Tershakovec, Andrew M., Musliner, Thomas A., Braunwald, Eugene, and Califf, Robert M.

Subjects
Male, Simvastatin, acute coronary syndrome, aged, anticholesteremic agents, azetidines, cardiovascular diseases, cholesterol, ldl, double-blind method, drug therapy, combination, ezetimibe, female, humans, hydroxymethylglutaryl-coa reductase inhibitors, kaplan-meier estimate, male, middle aged, simvastatin, triglycerides, medicine (all, [SDV]Life Sciences [q-bio], Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Bococizumab, Triglyceride, chemistry.chemical_compound, 0302 clinical medicine, Azetidine, Cardiovascular Disease, Anticholesteremic Agent, Acute Coronary Syndrome, Aged, Anticholesteremic Agents, Azetidines, Cardiovascular Diseases, Cholesterol, LDL, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Middle Aged, Triglycerides, 030212 general & internal medicine, Medicine (all), Research Support, Non-U.S. Gov't, Hazard ratio, General Medicine, Acute Coronary Syndrome, Aged, Anticholesteremic Agents, Azetidines, Cardiovascular Diseases, Ezetimibe, Female, Humans, Male, Middle Aged, 3. Good health, Multicenter Study, Editorial, Cholesterol, Randomized Controlled Trial, Combination, Ezetimibe, lipids (amino acids, peptides, and proteins), Human, medicine.drug, medicine.medical_specialty, Acute Coronary Syndroms, Urology, Acute Coronary Syndrome/drug therapy, Anticholesteremic Agents/adverse effects, Anticholesteremic Agents/therapeutic use, Azetidines/adverse effects, Azetidines/therapeutic use, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/mortality, Cardiovascular Diseases/prevention & control, Cholesterol, LDL/blood, Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, Simvastatin/therapeutic use, Triglycerides/blood, NO, LDL, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Drug Therapy, Internal medicine, Journal Article, medicine, Comparative Study, Alirocumab, business.industry, PCSK9, ta3121, Lomitapide, DOENÇAS CARDIOVASCULARES, Endocrinology, chemistry, Statin Therapy, Hydroxymethylglutaryl-CoA Reductase Inhibitor, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known.METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization (≥30 days after randomization), or nonfatal stroke. The median follow-up was 6 years.RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (PCONCLUSIONS: When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below previous targets provided additional benefit. (Funded by Merck; IMPROVE-IT ClinicalTrials.gov number, NCT00202878.).

Published
2015

46. Predictors and clinical implications of stent thrombosis in patients with ST-segment elevation myocardial infarction

Author

Yoshitaka Shiratori, Andrés Iñiguez, Salvatore Brugaletta, Rosana Hernández-Antolín, Vicente Mainar, Armando Bethencourt, Pieter den Heijer, Marco Valgimigli, Bianca Backx, Angel Cequier, Manel Sabaté, Maurizio Tespili, Victoria Martin-Yuste, Nicolás Vázquez, Josep Gomez-Lara, Mónica Masotti, Patrick W. Serruys, Luis Alvarez-Contreras, and Antonio Serra

Subjects
Bare-metal stent, medicine.medical_specialty, education.field_of_study, business.industry, medicine.medical_treatment, Population, Stent, medicine.disease, Thrombosis, law.invention, surgical procedures, operative, Randomized controlled trial, law, Internal medicine, medicine, Cardiology, ST segment, cardiovascular diseases, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, education, Killip class
Abstract

Background Few data are available about safety of second generation drug eluting stents in an all-comer ST elevation myocardial infarction (STEMI) population. We sought to investigate the predictors and clinical implications of 1-year stent thrombosis (ST) in patients with STEMI, included in the EXAMINATION trial. Methods and results The EXAMINATION trial is an all-comer prospective, randomized 1:1 controlled trial, testing everolimus-eluting stent (EES) vs. cobalt chromium bare metal stent (BMS) in STEMI patients. It included 1498 patients, randomized to EES (n=751) or BMS (n=747). At 1year, definite/probable stent thrombosis, defined according to ARC criteria, occurred in 26 patients (1.73%), including 18 definite and 8 probable events. The incidence of ST was lower in patients treated with EES than in those treated with BMS (HR 0.16, 95% CI 0.03–0.29, p=0.017). Patients with ST have higher 1-year rates of cardiac death (30.8% vs. 2.5%, p Conclusions ST had low frequency in the first year after implantation of EES/BMS in STEMI patients, but it is associated with adverse events. BMS implantation, lack of ST-segment resolution and high Killip class on admission were independent predictors of 1-year ST.

Published
2013

47. Systolic Volume Index by Doppler Echocardiography Is an Useful Marker for Stratification and Prognostic Evaluation in Patients With Severe Aortic Stenosis and Preserved Ejection Fraction

Author

J. Forteza, Oriol Bonnin, Guillem Frontera, José I. Sáez-Ibarra, Guillem Caldentey, Armando Bethencourt, Carlos Fernández-Palomeque, Ana Sahuquillo, and Gaspar Melis

Subjects
Male, medicine.medical_specialty, Cardiac Volume, Doppler echocardiography, Cohort Studies, Internal medicine, Humans, Medicine, End-systolic volume, Aged, Retrospective Studies, Aged, 80 and over, Ejection fraction, medicine.diagnostic_test, business.industry, Hazard ratio, Stroke Volume, Atrial fibrillation, Aortic Valve Stenosis, General Medicine, Stroke volume, Prognosis, medicine.disease, Echocardiography, Doppler, Confidence interval, Stenosis, Cardiology, Female, business, Follow-Up Studies
Abstract

Introduction and objectives The prognosis of patients with severe aortic stenosis, low aortic gradient and preserved ejection fraction is controversial. Our study analyzed the prognosis of these patients and its relation to pressure gradient and aortic valve flow. Methods We performed a retrospective cohort study of 363 consecutive patients with severe aortic stenosis and preserved ejection fraction, divided into 4 groups, based on the presence of a systolic volume index greater or lower than 35 mL/m 2 and the presence of a mean aortic gradient greater or lower than 40 mmHg. Group I: normal flow, high gradient (n=169, 47%); group II: normal flow, low gradient (n=98, 27%); group III: low flow, high gradient (n=54, 15%), and group IV: low flow, low gradient (n=42, 12%). The primary endpoint was overall mortality. Results Independent risk factors for mortality were age (hazard ratio=1.04; 95% confidence interval, 1.01-1.08) and atrial fibrillation (hazard ratio=2.21; 95% confidence interval, 1.24-3.94). Surgical treatment was associated with longer survival in all groups (hazard ratio=0.25; 95% confidence interval: 0.13-0.49). Mortality was higher in patients with low flow than in those with with normal flow (26.6% vs 13.6%; P =.004). The most favorable mean prognosis was found in group II (hazard ratio=0.4; 95% confidence interval, 0.2-0.9). Conclusions Patients with severe aortic stenosis, normal ejection fraction and low aortic flow have a worse prognosis. Analysis of aortic flow by Doppler echocardiography is useful in risk stratification and therapeutic decision-making in patients with aortic stenosis.

Published
2013

48. Results from a prospective observational study of men with premature ejaculation treated with dapoxetine or alternative care: The PAUSE study

Author

Mirone V, ARCANIOLO, Davide, Rivas D, Bull S, Aquilina JW, Verze P, PAUSE study team Berchart G, Hass M, Ludvik G, Aalto J, Hendolin N, Lukkarinen O, Multanen M, Nurmenniemi V, Piha J, Aheimer C, Alebrahim Dehkordy A, Andreessen R, Aust C, Baer P, Bath V, Baumgrass H, Beck C, Beecken WD, Behre H, Beitzinger M, Belusa A, Bermes UR, Berning T, Bieringer La Roche D, Blasko S, Boehmer S, Borchardt A, Boerner T, Brands F, Braun PM, Braun R, Breu D, Briken P, Brueske T, Bueker R, Buse A, Carius A, Christoph F, Cuno M, Dats E, Degen N, Denil J, Dietrichs K, Domnitz R, Dorn B, Dubiel J, Eckert R, Ehrenberg W, Eichler S, El Khadra S, Engl T, Esser O, Faragallah EA, Farahmandi R, Finke G, Fleig P, Fruehauf E, Gerhardt U, Girke CG, Glauche J, Gleissner J, Gnann R, Gralla O, Grandin A, Grewe W, Gronau E, Gruber S, Grunert S, Guelbeyaz M, Guelden H, Haendel D, Haefele J, Haghighat M, Hahne D, Haschemi Schirazi R, Hecker D, Herzig J, Hettmmer R, Hitschfeld K, Hofmann J, Hohmuth H, Hoelker D, Huebner A, Hudemann B, Hung Wehmann D, Huenninghaus K, Hueter K, Igde H, Jaeger T, Javadi P, John G, Ju M, Kaisser G, Kamann L, Kastein A, Kaup F, Kellner T, Kempe T, Kempter F, Kennerknecht M, Kirschner P, Koenig M, Konert J, Kowalik S, Krieger JU, Kruppa GL, Kube U, Kuehn F, Kuefer R, Kurt T, Kwela M, Laag R, Langen L, Lehmann J, Linder C, Loeber T, Lock UC, Loebenau M, Luberg Sievers G, Luebbe R, Lutz K, Maier S, Maletz C, Mertins B, Meschede E, Meschi MR, Miersch WD, Misera A, Muehlich S, Mueller HW, Mueller D, Muench HC, Nawka P, Othman K, Paiss T, Peter K, Peters T, Petras T, Petrischenko B, Pfund A, Plate H, Ploss HJ, Pohrt U, Pooyeh S, Potempa AJ, Pusinelli WD, Rausch U, Reinhardt F, Rengel U, Rietheimer W, Rinnab L, Rohrmann K, Romahn E, Romitan Baum R, Roessler T, Rudolph R, Rueffer J, Rug M, Rueth J, Ruettgers E, Santiago RB, Schaefer A, Schaefer T, Schaetzle P, Scheunpflug K, Schlicht J, Schmidt P, Schneider J, Schnitzler M, Schonfelder R, Schreier H, Schroeder A, Schulz FM, Schulze M, Schumann M, Seidler A, Seseke S, Siebel Eggeling G, Siebels M, Sinner B, Sippel F, Soballa M, Sommer F, Spielhaupter A, Steffen H, Steinacker M, Stiersdorfer A, Stoehr C, Sturm S, Surrey HW, Swoboda A, Szymula S, Telle J, Uththoff H, Vierneisel C, Vilmar W, Wagner M, Walhoefer F, Warnack W, Weiss J, Weizert P, Wicht A, Wieland J, Willgerodt J, Wilski B, Wilson E, Wipfler G, Wohn HG, Wolf J, Zoehrlaut B, Zuerner T, Angeletti G, Avolio A, Baldassarre R, Balercia G, Balloni F, Barba G, Bartoletti R, Basile Fasolo C, Bassi PF, Beatrici V, Bertozzi MA, Bocciardi AM, Bondavalli C, Bonini F, Bonsanto M, Branchi A, Briganti A, Calabrese M, Calafiore R, Calogero AE, Cantelmo P, Caraceni E, Carbone A, Cardella A, Carini M, Carmignani L, Carmignani G, Carrino M, Caviglia C, Cecchi M, Ceruti C, Chiovato L, Cicalese V, Colpi G, Corinti M, Cormio L, Cova G, Cozzupoli P, Ottavio G, Damiano R, De Ceglie G, De Grande G, De Lisa A, DE SIO, Marco, De Stefani S, Dehò F, Delsignore A, Di Filippo A, Di Lena S, Di Trapani D, Diambrini M, Drei GN, Fabbri A, Fasolis G, Ferone D, Ferrari G, Foresta C, Francavilla S, Gadda F, Galantini A, Galì A, Gentile V, Giammusso B, Giannubilo W, Granata A, Grasso M, Iafrate M, Ilacqua N, Isidori A, Italiano E, Jallous HA, Jannini E, La Pera G, Laganà F, Lauretti S, Leonardi R, Liguori G, Loiero G, Lombardi G, Lombardo F, Lusenti C, Maffucci A, Maggi M, Maio G, Mammana G, Manieri C, Marzotto Caotorta M, Mastroeni F, Mazzilli F, Mazzone L, Minervini M, Mirone VG, Montorsi F, Morelli G, Morrone G, Nicita G, Nicola M, Palmiotto F, Paradiso M, Paulis G, Pavone C, Pescatori ES, Petterle V, Piazza N, Pittaluga P, Piubello G, Polito M, Ponchietti R, Porena M, Rago R, Risi O, Roggia A, Salzano L, Sanseverino R, SASSO, Ferdinando Carlo, Savoca G, Scarano P, Schips L, Serao A, Sforza A, Sidari V, Silvani M, Sinisi A, Sorrentino F, Spera E, Strada G, Tenaglia R, Terrone C, Titta M, Tracia A, Turchi P, Ughi G, Vecchio D, Veneziano IA, Vicini P, Vita A, Vitti P, Volpi R, Zago T, Zenico T, Zito AR, Apolinario M, Carvalho AP, Corte Real J, Matos Cabeca J, Mendes Leal A, Monteiro Pereira N, Palma dos Reis J, Patricio A, Prisco R, Rocha Mendes J, Santos A, Vieira R, Abad Gairín C, Abascal García JM, Adot Zurbano JM, Álvarez de la Red PL, Al Wattar W, Antón Saiz C, Aranda Doncel N, Arrosagaray PM, Arteaga Serrano F, Barberán Soriano J, Bataller Perello V, Beltrán Persiva J, Benejam Gual J, Blanco Díez A, Blasco Casares FJ, Blasco Villalonga M, Blázquez Izquierdo J, Boladeras Sabater J, Borrás JJ, Bouchi Bakrim AR, Bucar Terrades S, Burgués Gasión JP, Busto Castañón L, Caballero JM, Cabello Santamaría F, Cabreja López E, Carrasco Aznar JC, Casasola Chamorro J, Castellanos González L, Cimadevila García A, Closas Capdevila M, Concepción Masip T, Conde C, Conde Santos G, Cortada i. Robert J, Cos Calvet JM, Crespi Martínez F, Cruz N, De la Rosa Khermann M, Delgado Martín JA, Devesa Mújica M, Doganis Peppas C, Domínguez Freire F, Donderis Guastavino C, Duarte Vázquez JJ, El Khoury Yacob R, Escobal Tamayo V, Farré Martí JM, Fernández Fernández A, Fernández Lozano A, Fernández Viñas JA, Fiter Gómez L, Fleitas Asencio E, Frago Valls SM, Galiana Álvarez A, García Bayo I, García Contreras J, García Cruz E, García de Jalón Martín A, García Giralda L, García Marco MA, García Navas R, García Reboll L, Garrido Insúa S, Giner Santamaría C, Gómez Berjón F, Gómez Gil E, Gómez Lanza E, Gómez Pérez L, Gómez Rodríguez A, González Sala JL, González Sala MJ, Gonzalvo Ybarra A, Guerrero Martínez V, Gutiérrez González MA, Gutierrez Mínguez E, Hidalgo Arroyo J, Hmeidan M, Idígora i. Planas X, Jara Rascón J, Jiménez Verdejo J, Lledó García E, Lliteras Arañi M, López Almansa M, López Palacios MÁ, López Tello J, Lorenzo Gómez MF, Luque Gálvez P, Luque López AJ, Mallafré Sala JM, Martí Cebrián JM, Martín Clos J, Martín Huescar A, Martín Morales A, Martín Rodríguez A, Martínez Rodríguez R, Martínez Salamanca JI, Mascarós Balaguer E, Mejide Manresa R, Molero Rodríguez F, Molina Carranza A, Moncada Iribarren I, Montagud Moncho JB, Montesino Semper M, Mosteiro Ponce JA, Mouaffak Tatari N, Navarro Gil JM, Novás Castro S, Ortiz del Corral ML, Ortiz Gamiz A, Osca García JM, Padilla León M, Palomino García A, Pascual Mateo C, Peinado Ibarra F, Pérez Mestre M, Portillo Martín JA, Poyato Galán JM, Prats de Puig J, Prieto Castro R, Puigvert Martínez A, Quintana de la Rosa JL, Ramada Benlloch FJ, Reyes Martínez F, Rigabert M, Ríos Espuny AF, Robles Iniesta A, Rodrigo Aliaga M, Rodríguez Alba JL, Rodríguez Bethencourt F, Rodríguez Jiménez FJ, Rodríguez Leal DA, Rodríguez Rubio F, Rodríguez Tolrá J, Rodríguez Vallejo JM, Romero Otero J, Roselló Barbará M, Rubio Briones J, Ruíz Moriana O, Sampol Company J, San Martín Blanco C, Sánchez Encinas M, Sánchez Sánchez F, Sancho Serrano C, Santandreu Puifros J, Santisteban González M, Santos Ascarza Tabares JL, Sanz Lahoz I, Sapiña Ortola F, Sarquella Geli J, Segarra Tomás J, Soler Fernández J, Tato Rodríguez J, Tesedo Cubedo J, Traid Sender V, Valbuena Álvarez R, Valverde Rubio JM, Varela Salgado M, Vargas Rugeles M, Vilches Cocovi E, Virto Bajo FJ, Andius P, Anker Hansen O, Arver S, Bosson P, Brattberg A, Grenabo L, Hanning J, Hassler L, Paradis AÅ, Wang E., Mirone, Vincenzo, Arcaniolo, Davide, David, Riva, Scott, Bull, Joseph W., Aquilina, Verze, Paolo, Mirone, V, Arcaniolo, D, Rivas, D, Bull, S, Aquilina, JW, Verze, P, Pavone, C, Aquilina, Jw, PAUSE study team Berchart, G, Hass, M, Ludvik, G, Aalto, J, Hendolin, N, Lukkarinen, O, Multanen, M, Nurmenniemi, V, Piha, J, Aheimer, C, Alebrahim Dehkordy, A, Andreessen, R, Aust, C, Baer, P, Bath, V, Baumgrass, H, Beck, C, Beecken, Wd, Behre, H, Beitzinger, M, Belusa, A, Bermes, Ur, Berning, T, Bieringer La Roche, D, Blasko, S, Boehmer, S, Borchardt, A, Boerner, T, Brands, F, Braun, Pm, Braun, R, Breu, D, Briken, P, Brueske, T, Bueker, R, Buse, A, Carius, A, Christoph, F, Cuno, M, Dats, E, Degen, N, Denil, J, Dietrichs, K, Domnitz, R, Dorn, B, Dubiel, J, Eckert, R, Ehrenberg, W, Eichler, S, El Khadra, S, Engl, T, Esser, O, Faragallah, Ea, Farahmandi, R, Finke, G, Fleig, P, Fruehauf, E, Gerhardt, U, Girke, Cg, Glauche, J, Gleissner, J, Gnann, R, Gralla, O, Grandin, A, Grewe, W, Gronau, E, Gruber, S, Grunert, S, Guelbeyaz, M, Guelden, H, Haendel, D, Haefele, J, Haghighat, M, Hahne, D, Haschemi Schirazi, R, Hecker, D, Herzig, J, Hettmmer, R, Hitschfeld, K, Hofmann, J, Hohmuth, H, Hoelker, D, Huebner, A, Hudemann, B, Hung Wehmann, D, Huenninghaus, K, Hueter, K, Igde, H, Jaeger, T, Javadi, P, John, G, Ju, M, Kaisser, G, Kamann, L, Kastein, A, Kaup, F, Kellner, T, Kempe, T, Kempter, F, Kennerknecht, M, Kirschner, P, Koenig, M, Konert, J, Kowalik, S, Krieger, Ju, Kruppa, Gl, Kube, U, Kuehn, F, Kuefer, R, Kurt, T, Kwela, M, Laag, R, Langen, L, Lehmann, J, Linder, C, Loeber, T, Lock, Uc, Loebenau, M, Luberg Sievers, G, Luebbe, R, Lutz, K, Maier, S, Maletz, C, Mertins, B, Meschede, E, Meschi, Mr, Miersch, Wd, Misera, A, Muehlich, S, Mueller, Hw, Mueller, D, Muench, Hc, Nawka, P, Othman, K, Paiss, T, Peter, K, Peters, T, Petras, T, Petrischenko, B, Pfund, A, Plate, H, Ploss, Hj, Pohrt, U, Pooyeh, S, Potempa, Aj, Pusinelli, Wd, Rausch, U, Reinhardt, F, Rengel, U, Rietheimer, W, Rinnab, L, Rohrmann, K, Romahn, E, Romitan Baum, R, Roessler, T, Rudolph, R, Rueffer, J, Rug, M, Rueth, J, Ruettgers, E, Santiago, Rb, Schaefer, A, Schaefer, T, Schaetzle, P, Scheunpflug, K, Schlicht, J, Schmidt, P, Schneider, J, Schnitzler, M, Schonfelder, R, Schreier, H, Schroeder, A, Schulz, Fm, Schulze, M, Schumann, M, Seidler, A, Seseke, S, Siebel Eggeling, G, Siebels, M, Sinner, B, Sippel, F, Soballa, M, Sommer, F, Spielhaupter, A, Steffen, H, Steinacker, M, Stiersdorfer, A, Stoehr, C, Sturm, S, Surrey, Hw, Swoboda, A, Szymula, S, Telle, J, Uththoff, H, Vierneisel, C, Vilmar, W, Wagner, M, Walhoefer, F, Warnack, W, Weiss, J, Weizert, P, Wicht, A, Wieland, J, Willgerodt, J, Wilski, B, Wilson, E, Wipfler, G, Wohn, Hg, Wolf, J, Zoehrlaut, B, Zuerner, T, Angeletti, G, Avolio, A, Baldassarre, R, Balercia, G, Balloni, F, Barba, G, Bartoletti, R, Basile Fasolo, C, Bassi, Pf, Beatrici, V, Bertozzi, Ma, Bocciardi, Am, Bondavalli, C, Bonini, F, Bonsanto, M, Branchi, A, Briganti, A, Calabrese, M, Calafiore, R, Calogero, Ae, Cantelmo, P, Caraceni, E, Carbone, A, Cardella, A, Carini, M, Carmignani, L, Carmignani, G, Carrino, M, Caviglia, C, Cecchi, M, Ceruti, C, Chiovato, L, Cicalese, V, Colpi, G, Corinti, M, Cormio, L, Cova, G, Cozzupoli, P, Ottavio, G, Damiano, R, De Ceglie, G, De Grande, G, De Lisa, A, DE SIO, Marco, De Stefani, S, Dehò, F, Delsignore, A, Di Filippo, A, Di Lena, S, Di Trapani, D, Diambrini, M, Drei, Gn, Fabbri, A, Fasolis, G, Ferone, D, Ferrari, G, Foresta, C, Francavilla, S, Gadda, F, Galantini, A, Galì, A, Gentile, V, Giammusso, B, Giannubilo, W, Granata, A, Grasso, M, Iafrate, M, Ilacqua, N, Isidori, A, Italiano, E, Jallous, Ha, Jannini, E, La Pera, G, Laganà, F, Lauretti, S, Leonardi, R, Liguori, G, Loiero, G, Lombardi, G, Lombardo, F, Lusenti, C, Maffucci, A, Maggi, M, Maio, G, Mammana, G, Manieri, C, Marzotto Caotorta, M, Mastroeni, F, Mazzilli, F, Mazzone, L, Minervini, M, Mirone, Vg, Montorsi, F, Morelli, G, Morrone, G, Nicita, G, Nicola, M, Palmiotto, F, Paradiso, M, Paulis, G, Pescatori, E, Petterle, V, Piazza, N, Pittaluga, P, Piubello, G, Polito, M, Ponchietti, R, Porena, M, Rago, R, Risi, O, Roggia, A, Salzano, L, Sanseverino, R, Sasso, Ferdinando Carlo, Savoca, G, Scarano, P, Schips, L, Serao, A, Sforza, A, Sidari, V, Silvani, M, Sinisi, A, Sorrentino, F, Spera, E, Strada, G, Tenaglia, R, Terrone, C, Titta, M, Tracia, A, Turchi, P, Ughi, G, Vecchio, D, Veneziano, Ia, Vicini, P, Vita, A, Vitti, P, Volpi, R, Zago, T, Zenico, T, Zito, Ar, Apolinario, M, Carvalho, Ap, Corte Real, J, Matos Cabeca, J, Mendes Leal, A, Monteiro Pereira, N, Palma dos Reis, J, Patricio, A, Prisco, R, Rocha Mendes, J, Santos, A, Vieira, R, Abad Gairín, C, Abascal García, Jm, Adot Zurbano, Jm, Álvarez de la Red, Pl, Al Wattar, W, Antón Saiz, C, Aranda Doncel, N, Arrosagaray, Pm, Arteaga Serrano, F, Barberán Soriano, J, Bataller Perello, V, Beltrán Persiva, J, Benejam Gual, J, Blanco Díez, A, Blasco Casares, Fj, Blasco Villalonga, M, Blázquez Izquierdo, J, Boladeras Sabater, J, Borrás, Jj, Bouchi Bakrim, Ar, Bucar Terrades, S, Burgués Gasión, Jp, Busto Castañón, L, Caballero, Jm, Cabello Santamaría, F, Cabreja López, E, Carrasco Aznar, Jc, Casasola Chamorro, J, Castellanos González, L, Cimadevila García, A, Closas Capdevila, M, Concepción Masip, T, Conde, C, Conde Santos, G, Cortada i., Robert J, Cos Calvet, Jm, Crespi Martínez, F, Cruz, N, De la Rosa Khermann, M, Delgado Martín, Ja, Devesa Mújica, M, Doganis Peppas, C, Domínguez Freire, F, Donderis Guastavino, C, Duarte Vázquez, Jj, El Khoury Yacob, R, Escobal Tamayo, V, Farré Martí, Jm, Fernández Fernández, A, Fernández Lozano, A, Fernández Viñas, Ja, Fiter Gómez, L, Fleitas Asencio, E, Frago Valls, Sm, Galiana Álvarez, A, García Bayo, I, García Contreras, J, García Cruz, E, García de Jalón Martín, A, García Giralda, L, García Marco, Ma, García Navas, R, García Reboll, L, Garrido Insúa, S, Giner Santamaría, C, Gómez Berjón, F, Gómez Gil, E, Gómez Lanza, E, Gómez Pérez, L, Gómez Rodríguez, A, González Sala, Jl, González Sala, Mj, Gonzalvo Ybarra, A, Guerrero Martínez, V, Gutiérrez González, Ma, Gutierrez Mínguez, E, Hidalgo Arroyo, J, Hmeidan, M, Idígora i., Planas X, Jara Rascón, J, Jiménez Verdejo, J, Lledó García, E, Lliteras Arañi, M, López Almansa, M, López Palacios, Má, López Tello, J, Lorenzo Gómez, Mf, Luque Gálvez, P, Luque López, Aj, Mallafré Sala, Jm, Martí Cebrián, Jm, Martín Clos, J, Martín Huescar, A, Martín Morales, A, Martín Rodríguez, A, Martínez Rodríguez, R, Martínez Salamanca, Ji, Mascarós Balaguer, E, Mejide Manresa, R, Molero Rodríguez, F, Molina Carranza, A, Moncada Iribarren, I, Montagud Moncho, Jb, Montesino Semper, M, Mosteiro Ponce, Ja, Mouaffak Tatari, N, Navarro Gil, Jm, Novás Castro, S, Ortiz del Corral, Ml, Ortiz Gamiz, A, Osca García, Jm, Padilla León, M, Palomino García, A, Pascual Mateo, C, Peinado Ibarra, F, Pérez Mestre, M, Portillo Martín, Ja, Poyato Galán, Jm, Prats de Puig, J, Prieto Castro, R, Puigvert Martínez, A, Quintana de la Rosa, Jl, Ramada Benlloch, Fj, Reyes Martínez, F, Rigabert, M, Ríos Espuny, Af, Robles Iniesta, A, Rodrigo Aliaga, M, Rodríguez Alba, Jl, Rodríguez Bethencourt, F, Rodríguez Jiménez, Fj, Rodríguez Leal, Da, Rodríguez Rubio, F, Rodríguez Tolrá, J, Rodríguez Vallejo, Jm, Romero Otero, J, Roselló Barbará, M, Rubio Briones, J, Ruíz Moriana, O, Sampol Company, J, San Martín Blanco, C, Sánchez Encinas, M, Sánchez Sánchez, F, Sancho Serrano, C, Santandreu Puifros, J, Santisteban González, M, Santos Ascarza Tabares, Jl, Sanz Lahoz, I, Sapiña Ortola, F, Sarquella Geli, J, Segarra Tomás, J, Soler Fernández, J, Tato Rodríguez, J, Tesedo Cubedo, J, Traid Sender, V, Valbuena Álvarez, R, Valverde Rubio, Jm, Varela Salgado, M, Vargas Rugeles, M, Vilches Cocovi, E, Virto Bajo, Fj, Andius, P, Anker Hansen, O, Arver, S, Bosson, P, Brattberg, A, Grenabo, L, Hanning, J, Hassler, L, Paradis, Aå, and Wang, E.

Subjects
Adult, Complementary Therapies, Male, medicine.medical_specialty, Benzylamines, Adolescent, Nausea, Urology, Naphthalenes, Dapoxetine Safety Cardiovascular events Syncope, Syncope, Cardiovascular events, Young Adult, Internal medicine, Premature ejaculation, medicine, 80 and over, Dapoxetine, Safety, Aged, Aged, 80 and over, Humans, Middle Aged, Premature Ejaculation, Prospective Studies, Serotonin Uptake Inhibitors, Adverse effect, Prospective cohort study, Sertraline, business.industry, Settore MED/24 - UROLOGIA, Incidence (epidemiology), syncope, Anesthesia, Observational study, medicine.symptom, business, Selective Serotonin Reuptake Inhibitors, medicine.drug, Cardiovascular events, Dapoxetine, Safety, Syncope
Abstract

Background Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation (PE). Its safety was established in a thorough clinical development program. Objective To characterize the safety profile of dapoxetine in PE treatment and to report the incidence, severity, and type of adverse events. Design, setting, and participants We conducted a 12-wk, open-label, observational study with a 4-wk, postobservational contact. A total of 10 028 patients were enrolled, with 6712 patients (67.6%) treated with dapoxetine 30–60mg (group A)and 3316 (32.4%) treated with alternative care/nondapoxetine (group B). Interventions Treatment with dapoxetine or alternative care/nondapoxetine. Outcome measurements and statistical analysis Treatment-emergent adverse events (TEAEs) and concomitant therapy use during the 12-wk observational and the postobservational period were reported. Results and limitations The mean age for all patients was 40.5 yr. In group A, 93.0% of the patients were initially prescribed dapoxetine 30mg. Treatment options for group B patients included clomipramine, paroxetine, fluoxetine, sertraline, topical drugs, condoms, and behavioral counseling. Both treatment regimens were well tolerated. TEAEs were reported by 12.0% and 8.9% of group A and group B, respectively, with the highest incidence observed in patients aged >65 yr for group A (21.4%) and 30–39 yr (9.8%) for group B. The most commonly reported TEAEs were nausea, headache, and vertigo, with a higher incidence in group A (3.1%, 2.6%, and 1.0%, respectively) than in group B (oral drugs: 2.3%, 1.3%, and 0.9%, respectively). There were no cases of syncope in group A and one case in group B. A major limitation is that this was a nonrandomized, open-label, short-term study lacking efficacy data. Conclusions The results of this postmarketing observational study demonstrated that dapoxetine for treatment of PE has a good safety profile and low prevalence of TEAEs. Syncope and major cardiovascular adverse events were not reported. The high level of adherence by healthcare providers to the contraindications, special warnings, and precautions for dapoxetine minimizes the risk for its use in routine clinical practice. The current risk minimization measures for its identified and potential risks are effective.

Published
2014

49. Electrocardiographic changes of ST-elevation myocardial infarction in patients with complete occlusion of the left main trunk without collateral circulation: Differential diagnosis and clinical considerations

Author

Armando Bethencourt, Antonio Bayés de Luna, Andrés Carrillo, Miquel Fiol, Alberto Rodriguez, and Marcos Pascual

Subjects
ST depression, medicine.medical_specialty, business.industry, medicine.medical_treatment, ST elevation, Electrocardiography in myocardial infarction, Percutaneous coronary intervention, Anterior Descending Coronary Artery, medicine.disease, Collateral circulation, Surgery, Internal medicine, medicine, Cardiology, cardiovascular diseases, Myocardial infarction, Myocardial infarction diagnosis, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract

Acute coronary syndromes due to involvement of the left main trunk usually present with subtotal occlusion and electrocardiographic pattern with predominant ST depression (non-ST-elevation myocardial infarction). The cases with complete occlusion frequently present an ST-elevation myocardial infarction pattern, but these patients usually die before reaching the hospital. We present a series of 7 patients with total left main trunk occlusion without collateral circulation showing ST-elevation myocardial infarction pattern. The electrocardiographic pattern is similar to left anterior descending coronary artery proximal occlusion to first septal and first diagonal but without ST elevation in V(1) and aVR because of left circumflex coronary artery compromise. In 4 (60%) of 7 of cases, there is also advanced right bundle-branch block plus superoanterior hemiblock. Despite severe clinical state at entrance (5/7 presented cardiac arrest/cardiogenic shock), 3 patients (43%) survived after percutaneous coronary intervention.

Published
2012

50. Everolimus-eluting stent versus bare-metal stent in ST-segment elevation myocardial infarction (EXAMINATION): 1 year results of a randomised controlled trial

Author

Matteo Tebaldi, Antonio Silvestro, Rosana Hernández-Antolín, Salvatore Brugaletta, Maurizio Tespili, Victoria Martin-Yuste, Patrick W. Serruys, Manel Sabaté, Fernando Alfonso, José Antonio Baz, Robert-Jan van Geuns, Bianca Backx, Pieter den Heijer, Angel Cequier, Nicolás Vázquez, Joan Antoni Gómez-Hospital, Gerrit Anne van Es, Pascual Bordes, Mónica Masotti, Antonio Serra, Vicente Mainar, Armando Bethencourt, Marco Valgimigli, Andrés Iñiguez, Cardiology, and Radiology & Nuclear Medicine

Subjects
Target lesion, Bare-metal stent, Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Electrocardiography, Restenosis, Internal medicine, Clinical endpoint, Medicine, Humans, Single-Blind Method, Myocardial infarction, Everolimus, cardiovascular diseases, Sirolimus, Intention-to-treat analysis, business.industry, Percutaneous coronary intervention, Stent, Drug-Eluting Stents, General Medicine, Middle Aged, medicine.disease, Surgery, Cardiology, Female, Stents, Chromium Alloys, business, Immunosuppressive Agents
Abstract

Summary Background Everolimus-eluting stent (EES) reduces the risk of restenosis in elective percutaneous coronary intervention. However, the use of drug-eluting stent in patients with ST-segment elevation myocardial infarction (STEMI) is still controversial. Data regarding the performance of second-generation EES in this setting are scarce. We report the 1-year result of the EXAMINATION (clinical Evaluation of the Xience-V stent in Acute Myocardial INfArcTION) trial, comparing EES with bare-metal stents (BMS) in patients with STEMI. Methods This multicentre, prospective, randomised, all-comer controlled trial was done in 12 medical centres in three countries. Between Dec 31, 2008, and May 15, 2010, we recruited patients with STEMI up to 48 h after the onset of symptoms requiring emergent percutaneous coronary intervention. Patients were randomly assigned (ratio 1:1) to receive EES or BMS. Randomisation was in blocks of four or six patients, stratified by centre and centralised by telephone. Patients were masked to treatment. The primary endpoint was the patient-oriented combined endpoint of all-cause death, any recurrent myocardial infarction, and any revascularisation at 1 year and was analysed by intention to treat. The secondary endpoints of the study included the device-oriented combined endpoint of cardiac death, target vessel myocardial infarction or target lesion revascularisation, and rates of all cause or cardiac death, recurrent myocardial infarction, target lesion or target vessel revascularisation, stent thrombosis, device and procedure success, and major and minor bleeding. This trial is registered with ClinicalTrials.gov, number NCT00828087. Findings Of the 1504 patients randomised, 1498 patients were randomly assigned to receive EES (n=751) or BMS (n=747). The primary endpoint was similar in both groups (89 [11·9%] of 751 patients in the EES group vs 106 [14·2%] of 747 patients in the BMS group; difference −2·34 [95% CI −5·75 to 1·07]; p=0·19). Device-oriented endpoint (44 [5·9%] in the EES group vs 63 [8·4%] in the BMS group; difference −2·57 [95% CI −5·18 to 0·03]; p=0·05) did not differ between groups, although rates of target lesion and vessel revascularisation were significantly lower in the EES group (16 [2·1%] vs 37 [5·0%], p=0·003, and 28 [3·7%] vs 51 [6·8%], p=0·0077, respectively). Rates of all cause (26 [3·5%] for EES vs 26 [3·5%] for BMS, p=1·00) or cardiac death (24 [3·2%] for EES vs 21 [2·8%] for BMS, p=0·76) or myocardial infarction (10 [1·3%] vs 15 [2·0%], p=0·32) did not differ between groups. Stent thrombosis rates were significantly lower in the EES group (4 [0·5%] patients with definite stent thrombosis in the EES group vs 14 [1·9%] in the BMS group and seven [0·9%] patients with definite or probable stent thrombosis in the EES group vs 19 [2·5%] in the BMS group, both p=0·019). Although device success rate was similar between groups, procedure success rate was significantly higher in the EES group (731 [97·5%] vs 705 [94·6%]; p=0·0050). Finally, Bleeding rates at 1 year were comparable between groups (29 [3·9%] patients in the EES group vs 39 [5·2%] in the BMS group; p=0·19). Interpretation The use of EES compared with BMS in the setting of STEMI did not lower the patient-oriented endpoint. However, at the stent level both rates of target lesion revascularisation and stent thrombosis were reduced in recipients of EES. Funding Spanish Heart Foundation.

Published
2012

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