40 results on '"Guillem Caldentey"'
Search Results
2. Percutaneous coronary intervention due to chronic total occlusion in the left main coronary artery after bypass grafting: A feasible option in selected cases
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Eduardo Flores-Umanzor, Victoria Martin-Yuste, Guillem Caldentey, Sara Vazquez, Gustavo Jimenez-Britez, Rodolfo San Antonio, Pedro Cepas-Guillen, Margarida Pujol-Lopez, Marco Hernández, and Manel Sabaté
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Introduction: Chronic total occlusion (CTO) of the left main coronary artery (LMCA) is an infrequent finding. Revascularization is recommended in the presence of demonstrated viability or ischemia. Coronary artery bypass grafting (CABG) has long been considered the preferred option. Patients with previous CABG due to LMCA disease with occlusion of one graft and progression of the LMCA to CTO constitute a special population, as just one ischemic artery remains. For these patients, there is no other option for revascularization other than cardiac surgery (requiring resternotomy) or percutaneous coronary intervention (PCI) of the LMCA. Methods and Results: Out of 620 patients with CTO diagnosed in our center, we identified five with previous CABG due to LMCA disease for a retrospective case series. They had occlusion of one graft and progression of the LMCA to CTO. All five underwent PCI. Each patient received a functional classification for angina, myocardial ischemic tests, and a follow-up coronary angiogram during a median follow-up of 63 months. Coronary angiogram showed CTO of the semi-protected LMCA lesions with two CABGs previously performed in all patients, one occluded and the other patent. Three patients had occluded saphenous vein grafts to the circumflex coronary artery, and the rest had left internal mammary artery-left anterior descending artery CABG failure. Ischemia and viability were demonstrated. Surgery was ruled out due to high surgical risk. PCI due to CTO of the LMCA with drug-eluting stents was performed. In a five-year follow-up period, four patients remained asymptomatic and event free. One post-PCI death occurred from non-cardiovascular cause. Conclusions: PCI due to CTO of the LMCA following CABG can be successful and safe and can provide sustained clinical improvements in selected cases. Resumo: Introdução: A oclusão crónica total (OCT) do tronco comum (TC) coronário é um achado pouco frequente. A revascularização é recomendada na presença de viabilidade ou de isquemia comprovada. A coronary artery bypass grafting (CABG) tem sido durante muito tempo a opção preferencial. Os doentes com CABG prévia devida a doença do TC com oclusão de um enxerto e progressão para oclusão crónica total do tronco comum constituem uma população especial, uma vez que fica apenas uma artéria com isquemia. Para esses doentes não existe outra opção de revascularização além da cirurgia cardíaca – com necessidade de reesternotomia – ou a intervenção coronária percutânea do tronco comum. Métodos e resultados: Dos 620 doentes com oclusões coronárias totais diagnosticadas no nosso centro, identificamos como séries de casos retrospetivos, cinco com CABG prévia devida a doença do TC, que tinham uma oclusão de um enxerto e progressão da doença do TC para oclusão crónica total. Os cinco foram submetidos a intervenção coornária percutânea (ICP). Cada doente recebeu a classificação funcional de angina, de testes de isquemia do miocárdio e o seguimento com angiografía coronária durante o tempo médio de 63 meses de seguimento. O angiograma coronário mostrou oclusão coronária total das lesões semiprotegidas do TC com duas pontagens previamente feitas em todos os doentes, uma ocluída e a outra permeável. Três doentes tinham enxertos de veia safena para a artéria coronária circunflexa (Safena-CX) ocluídos e os restantes tinham insuficiência da pontagem com mamária interna esquerda para a artéria coronária descendente anterior (MIE-DA). Foi demonstrada isquemia ou viabilidade. A opção cirúrgica foi recusada devido ao elevado risco cirúrgico. Foi feita a ICP da oclusão coronária total do TC com stents revestidos de fármaco. Em cinco anos de seguimento, quatro doentes permaneceram assintomáticos e livres de eventos. Ocorreu uma morte após ICP devido a causa não cardiovascular. Conclusões: A ICP de oclusão crónica total do TC após CABG pode ser bem-sucedida, segura, e pode fornecer melhorias clínicas mantidas em casos selecionados. Keywords: Chronic total occlusion, Left main coronary artery, Coronary artery bypass grafting, Palavras-chave: Oclusão crónica total, Tronco comum coronário, Cirurgia coronária
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- 2018
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3. Purulent pericarditis due to Klebsiella pneumoniae pulmonary infection
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Gala Caixal Vila, Eduardo Flores, and Guillem Caldentey
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Cardiac tamponade ,Cardiology ,Complications ,Pericardium ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2017
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4. Therapeutic hypothermia after out-of-hospital cardiac arrest - Should we keep platelets in mind?
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Rodolfo San Antonio, Eduardo Josué Flores-Umanzor, Margarida Pujol-López, and Guillem Caldentey
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antiplatelet therapy ,cardiac arrest ,hypothermia ,thrombosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Therapeutic hypothermia has been associated with an increase in thrombotic events, but this point has not been fully clarified. Most patients undergoing therapeutic hypothermia in a cardiac ICU receive antithrombotic treatment, usually in the context of ischemic heart disease. But, what should we do if our patient does not need antithrombotic treatment for any reason? After this case, doubts arise on the need to use an anti-thrombotic treatment on all patients subjected to therapeutic hypothermia in the context of aborted cardiac arrest
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- 2017
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5. <scp>Sex‐gender</scp> disparities in nonagenarians with acute coronary syndrome
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Pablo Vidal, Elena Tundidor-Sanz, Manel Sabaté, Xavier Freixa, Eduardo Martinez Gomez, Andrea Fernandez-Valledor, Felipe Fernández-Vázquez, Pedro L. Cepas-Guillén, M Llagostera, Javier Borrego-Rodriguez, Eduardo Flores-Umanzor, Julio Echarte-Morales, Xavier Quiroga, Ana Viana-Tejedor, and Guillem Caldentey
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Male ,Acute coronary syndrome ,medicine.medical_specialty ,medicine.medical_treatment ,Clinical Investigations ,030204 cardiovascular system & hematology ,elderly ,acute coronary syndrome ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Sex gender ,Internal medicine ,ST‐segment elevation myocardial infarction ,medicine ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Propensity Score ,Disease burden ,Aged, 80 and over ,business.industry ,Mortality rate ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,ST-segment elevation myocardial infarction ,myocardial infarction ,Treatment Outcome ,Conventional PCI ,Cohort ,ST Elevation Myocardial Infarction ,Female ,women ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Acute coronary syndrome (ACS) remains one of the leading causes of mortality for women, increasing with age. There is an unmet need regarding this condition in a fast‐growing and predominantly female population, such as nonagenarians. Hypothesis Our aim is to compare sex‐based differences in ACS management and long‐term clinical outcomes between women and men in a cohort of nonagenarians. Methods We included consecutive nonagenarian patients with ACS admitted at four academic centers between 2005 and 2018. The study was approved by the Ethics Committee of each center. Results A total of 680 nonagenarians were included (59% females). Of them, 373 (55%) patients presented with non‐ST‐segment elevation ACS and 307 (45%) with ST‐segment elevation myocardial infarction (STEMI). Men presented a higher disease burden compared to women. Conversely, women were frailer with higher disability and severe cognitive impairment. In the STEMI group, women were less likely than men to undergo percutaneous coronary intervention (PCI) (60% vs. 45%; p = .01). Overall mortality rates were similar in both groups but PCI survival benefit at 1‐year was greater in women compared to their male counterparts (82% vs. 68%; p = .008), persisting after sensitivity analyses using propensity‐score matching (80% vs. 64%; p = .03). Conclusion Sex‐gender disparities have been observed in nonagenarians. Despite receiving less often invasive approaches, women showed better clinical outcomes. Our finding may help increase awareness and reduce the current gender gap in ACS management at any age.
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- 2021
6. Survival benefit of revascularization versus optimal medical therapy alone for chronic total occlusion management in patients with diabetes
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Ander Regueiro, Guillem Caldentey, Marc Izquierdo, Victoria Martin-Yuste, Andrea Fernandez-Valledor, Xavier Freixa, Manel Sabaté, Gustavo Jiménez-Brítez, Juan Betuel Ivey-Miranda, M. Farrero, Sara Vazquez, Ignacio Ferreira-González, Eduardo Flores-Umanzor, and Pedro L. Cepas-Guillén
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medicine.medical_specialty ,medicine.medical_treatment ,Population ,030204 cardiovascular system & hematology ,Revascularization ,Ventricular Function, Left ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,education ,education.field_of_study ,Ejection fraction ,business.industry ,Mortality rate ,Hazard ratio ,Percutaneous coronary intervention ,Stroke Volume ,General Medicine ,medicine.disease ,Treatment Outcome ,Coronary Occlusion ,Chronic Disease ,Conventional PCI ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
BACKGROUND Chronic total occlusion (CTO) is common in patients with diabetes mellitus. Data on the long-term outcomes after treatment of CTOs in this high-risk population are scarce. AIM To compare the long-term clinical outcomes of CTO revascularization either by coronary artery bypass graft (CABG) or successful percutaneous coronary intervention (PCI) versus optimal medical treatment (MT) alone in patients with diabetes. METHODS AND RESULTS A total of 538 consecutive patients with diabetes and at least one CTO were identified from 2010 to 2014 in our center. In the present analysis, patients were stratified according to the CTO treatment strategy that was selected. MT was selected in 61% of patients whereas revascularization in the remaining 39%. Patients undergoing revascularization were younger, had higher left ventricular ejection fraction (LVEF), lower ACEF score, and more positive myocardial ischemia detection results compared to the MT group (p
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- 2020
7. A rare cause of non-infectious sialadenitis: Iodide-induced sialadenitis associated with coronary angiography
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Pedro L. Cepas, Mónica Masotti, Margarida Pujol-López, M. Farrero, Xavier Freixa, Rosario J. Perea, Victoria Martin-Yuste, Guillem Caldentey, Eduardo Flores-Umanzor, and Matias Scuarcia
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chemistry.chemical_classification ,Coronary angiography ,medicine.medical_specialty ,business.industry ,Iodide ,Contrast Media ,Iodides ,medicine.disease ,Coronary Angiography ,Sialadenitis ,Text mining ,chemistry ,RC666-701 ,Diseases of the circulatory (Cardiovascular) system ,General Earth and Planetary Sciences ,Medicine ,Humans ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Non infectious ,General Environmental Science - Published
- 2021
8. Impact of revascularization versus medical therapy alone for chronic total occlusion management in older patients
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Pedro L. Cepas-Guillén, Victoria Martin-Yuste, Rut Andrea, Ander Regueiro, Sara Vazquez, Gustavo Jiménez-Brítez, Xavier Freixa, Ignacio Ferreira-González, Eduardo Flores-Umanzor, Guillem Caldentey, Manel Sabaté, and Juan Betuel Ivey-Miranda
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Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Revascularization ,Total occlusion ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Older patients ,Risk Factors ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,030212 general & internal medicine ,Coronary Artery Bypass ,Vascular Patency ,Aged ,Aged, 80 and over ,business.industry ,Hazard ratio ,Age Factors ,Percutaneous coronary intervention ,Cardiovascular Agents ,General Medicine ,Middle Aged ,Confidence interval ,Treatment Outcome ,medicine.anatomical_structure ,Coronary Occlusion ,Chronic Disease ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Chronic total occlusions (CTOs) are present in more than one third of older patients with myocardial ischemia, but controversy remains about the best therapeutic approach.To compare long-term survival after CTO revascularization (percutaneous coronary intervention [PCI] or coronary artery bypass graft [CABG]) versus medical treatment (MT) alone in patients aged 75 and older.A total of 1,252 consecutive patients with at least one CTO were identified from 2010 to 2014 in our center. Patients were stratified by age (75 years vs. ≥75 years) in the present analysis. All-cause and cardiac mortality were assessed at a median follow-up of 3.5 years. In the older subgroup (26%), patients were more likely to be treated with MT alone (71% vs. 43% of younger patients; p 0.001). Patients undergoing revascularization were younger and had higher left ventricular ejection fraction (LVEF) and lower age, creatinine, ejection fraction (ACEF) score (age/LVEF +1 if creatinine2.0 mg/dL), compared to the MT group (p 0.05). As compared to MT, revascularization predicted lower rates of cardiac mortality and all-cause mortality in older patients, both in the subgroups treated with CABG (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.17-0.71; HR 0.39, 95%CI 0.18-0.81) and PCI (HR 0.57, 95%CI 0.33-0.98; HR 0.59, 95%CI 0.28-1.2). No differences in mortality were observed according to type of revascularization procedure.Among patients aged at least 75 years with a CTO, revascularization (PCI or CABG) rather than MT alone may portend a better outcome in terms of all-cause and cardiac mortality.
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- 2019
9. Impact of Chronic Kidney Disease in Chronic Total Occlusion Management and Clinical Outcomes
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Ander Regueiro, Victoria Martin-Yuste, Mercè Roqué, Pedro L. Cepas-Guillén, Luis Alvarez-Contreras, Guillem Caldentey, Victor Arévalos, Salvatore Brugaletta, Rami Gabani, Manel Sabaté, Xavier Freixa, Leticia Castrillo-Golvano, Andrea Fernandez-Valledor, Anthony Salazar-Rodriguez, and Eduardo Flores-Umanzor
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Male ,medicine.medical_specialty ,Arterial disease ,medicine.medical_treatment ,Population ,Renal function ,Type 2 diabetes ,urologic and male genital diseases ,Revascularization ,Total occlusion ,Percutaneous Coronary Intervention ,Risk Factors ,Internal medicine ,medicine ,Humans ,Renal Insufficiency, Chronic ,education ,education.field_of_study ,business.industry ,General Medicine ,medicine.disease ,female genital diseases and pregnancy complications ,Treatment Outcome ,Coronary Occlusion ,Diabetes Mellitus, Type 2 ,Conventional PCI ,Chronic Disease ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Kidney disease ,Glomerular Filtration Rate - Abstract
BACKGROUND Data on the impact of chronic kidney disease (CKD) on clinical outcomes in chronic total occlusion (CTO) patients is scarce, and the optimal treatment strategy for this population is not well established. This study aims to compare differences in CTO management and long-term clinical outcomes, including all-cause and cardiac mortalities, according to baseline glomerular filtration rate (GFR). METHODS All patients with at least one CTO diagnosed in our center between 2010 and 2014 were included. Demographic and clinical data were registered. All-cause and cardiac mortalities were assessed during a median follow-up of 4.03 years (IQR 2.6-4.8). Clinical outcomes were compared between patients with CKD (GFR < 60 mL/min/1.73 m2) and without CKD (GFR ≥ 60 mL/min/1.73 m2). RESULTS A total of 1248 patients (67.3 ± 10.9 years; 32% CKD) were identified. CKD patients were older and had a higher prevalence of hypertension, type 2 diabetes, peripheral arterial disease, and severe left ventricular dysfunction compared to patients with normal renal function (p < 0.05). Subjects with renal dysfunction were more often treated with MT alone, compared to patients without CKD (63% vs 45%; p < 0.001), who were more likely to undergo PCI or surgery. During follow-up, 386 patients [31%] died. CKD patients had a higher rate of all-cause and cardiac mortalities compared to patients without CKD (p < 0.001). The independent predictors for all-cause mortality were age, GFR < 60 mL/min/1.73 m2, Syntax Score I, and successful revascularization of the CTO (CABG or PCI-CTO). Among patients with CKD, advanced age, eGFR
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- 2021
10. Outcomes of Nonagenarians With Acute Coronary Syndrome
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Ana Viana Tejedor, Antonio Fernández Ortiz, Francisco Noriega Sanz, Julio Echarte-Morales, Eduardo Martinez Gomez, Pedro L. Cepas-Guillén, M Llagostera, Guillem Caldentey, Armando Pérez de Prado, Xavier Freixa, Manel Sabaté, Felipe Fernández-Vázquez, Tomás Benito-González, Eduardo Flores-Umanzor, Javier Borrego-Rodriguez, Pablo Vidal, and Xavier Quiroga
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Male ,medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Population ,Myocardial Infarction ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Risk Factors ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Acute Coronary Syndrome ,education ,General Nursing ,Aged, 80 and over ,education.field_of_study ,business.industry ,Health Policy ,Mortality rate ,Hazard ratio ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Treatment Outcome ,Nonagenarians ,Conventional PCI ,ST Elevation Myocardial Infarction ,Female ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery - Abstract
Nonagenarians are a fast-growing age group among cardiovascular patients, but data about their management and prognosis after an acute coronary syndrome (ACS) is scarce. This study aimed to analyze characteristics of nonagenarian patients with ACS and to compare in-hospital and 1-year clinical outcomes between those treated with medical treatment (MT) alone and those receiving percutaneous coronary intervention (PCI).Multicenter observational study.We included consecutive nonagenarian patients with ACS admitted at 4 academic centers between 2005 and 2018. Only patients with type 1 myocardial infarction were included.Standardized definitions of all patient-related variables, clinical diagnoses, and hospital complications and outcomes were used. The primary endpoint was 1-year all-cause mortality. Long-term survival was compared between patients undergoing PCI and those managed with MT alone. Given differences in baseline characteristics could substantially interfere in outcomes, 3 sensitivity analyses were performed to adjust for confounders.A total of 680 nonagenarians were included (59% females). Of them, 373 (55%) patients presented with non-ST-segment elevation ACS (NSTE-ACS) and 307 (45%) with ST-segment elevation myocardial infarction (STEMI). A coronary angiogram was performed in 115 (31%) of NSTE-ACS and in 182 (60%) of STEMI patients with subsequent PCI in 81 (22%) and 156 (51%), respectively. Overall mortality rates were 17% in-hospital and 39% at 1-year follow-up. PCI was independently associated with a decreased risk of 1-year all-cause death [hazard ratio (HR) 0.57, 95% confidence interval (CI) 0.35, 0.95; P.05], mainly observed in those patients without disability (HR 0.59, 95% CI 0.37, 0.94; P.01) and lower Killip class (HR 0.50, 95% CI 0.28, 0.89; P.001).The prognosis of nonagenarians after an ACS was associated with comorbidities and the therapeutic approach. Although PCI appeared to be a safe and effective strategy, it is still necessary to refine the decision-making process in this high-risk population group.
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- 2021
11. Acute coronary syndromes in nonagenarians: do we have reliable risk scores?
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P.L Cepas Guillen, Felipe Fernández-Vázquez, N. Alonso Orcajo, Guillem Caldentey, A Viana Tejedor, JC Echarte Morales, Xavier Quiroga, María Isabel Castillo, Manel Sabaté, C Minguito Carazo, Javier Borrego-Rodriguez, M Llagostera, Pablo Vidal, Xavier Freixa, and E Martinez Gomez
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medicine.medical_specialty ,business.industry ,Hospital mortality ,medicine.disease ,Comorbidity ,Cardiovascular death ,Internal medicine ,Area under curve ,Cardiology ,Medicine ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,Area under the roc curve - Abstract
Introduction GRACE score is strongly validated to determine the probability of death in acute coronary syndrome (ACS), nevertheless its usefulness in nonagenarians, a population with frequently associated comorbidities, is less stablished. BARTHEL and CHARLSON scores might be useful tools to predict outcomes in this population. Objective The aim of this study was to evaluate the potential applicability of GRACE score and two comorbidity scores (CHARLSON and BARTHEL) to estimate prognosis in nonagenarians with ACS. Material and methods We retrospectively included all consecutive patients equal to or older than 90 years old admitted with non-ST (NSTEMI) or ST segment elevation myocardial infarction (STEMI) in four tertiary care centers between 2005 and 2018. Patients with type 2 myocardial infarction were excluded. We collected patients' baseline characteristics and procedural data. In-hospital and at 1-year follow-up all-cause and cardiovascular mortality were assessed. Risk score accuracy was evaluated by area under the curve ROC (AUC). Results A total of 444 patients (mean age 92.6±2.4 years, 60% females) were analyzed. Approximately half of them (n=241, 54%) with STEMI and the remainder (n=203, 46%) with NSTEMI. Global GRACE-AUC for in-hospital and 1-year all-cause mortality were moderate (0.64; 95% CI: 0.59–0.69 and 0.62; 95% CI: 0.57–0.67, respectively). Only in the NSTEMI group, the GRACE-AUC was better to predict in-hospital mortality, 0.70 (95% CI: 0.63–0.77). Neither CHARLSON nor BARTHEL showed better predictive results than GRACE score (AUC ≤0.60). Conclusion GRACE score has moderate accuracy to estimate mortality in nonagenarian patients with ACS. BARTHEL and CHARLSON scores do not improve the predictive value of GRACE score. An individualized approach is required to make therapeutic decisions in this special population. Figure 1. ROC-GRACE curves Funding Acknowledgement Type of funding source: None
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- 2020
12. Outcomes of nonagenarians with acute coronary syndrome
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Guillem Caldentey, Xavier Quiroga, A Perez De Prado, Manel Sabaté, Felipe Fernández-Vázquez, Pablo Vidal, A Viana Tejedor, Xavier Freixa, Javier Borrego-Rodriguez, P.L Cepas Guillen, E Martinez Gomez, JC Echarte Morales, M Llagostera, T Benito Gonzalez, and Eduardo Flores-Umanzor
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Acute coronary syndrome ,medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Abstract
Background Myocardial infarction (MI) in nonagenarians is associated with high morbidity and mortality. Nonetheless, this population has typically been underrepresented in cardiovascular clinical trials. Objective The aim of this study was to evaluate outcomes of nonagenarian patients presenting with MI who underwent either conservative or invasive management. Methods We retrospectively included all consecutive patients equal to or older than 90yo admitted with non-ST segment elevation (NSTEMI) or ST segment elevation MI (STEMI) in four tertiary care centers between 2005 and 2018. Patients with type 2 myocardial infarction were excluded. We collected patients' baseline characteristic and procedural data. In-hospital and at 1-year follow-up all-cause mortality and major adverse cardiovascular events were assessed. Results 523 patients (mean age 92.6±2 years; 60% females) were analyzed. Overall, 184 patients (35.2%) underwent percutaneous coronary intervention (PCI), increasing over the years, mostly in STEMI group (from 16% of patients in 2005 to 75% in 2018). PCI was preferred in those subjects with less prevalence of disability for activities of daily living (p Conclusion An invasive approach was performed in over a third of nonagenarian patients, carrying prognostic implications and with a few numbers of complications. PCI seems to be the preferred strategy for STEMI in this high-risk population in spite of age. Figure 1 Funding Acknowledgement Type of funding source: None
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- 2020
13. Sex-based differences in chronic total occlusion management and long-term clinical outcomes
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Ignacio Ferreira-González, Salvatore Brugaletta, M. Farrero, Victoria Martin-Yuste, Mercè Roqué, Pedro Perez-Fuentes, Manel Sabaté, Guillem Caldentey, Ander Regueiro, Victor Arévalos, Eduardo Flores-Umanzor, Rut Andrea, Pedro L. Cepas-Guillén, Juan Betuel Ivey-Miranda, and Xavier Freixa
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Revascularization ,Coronary Angiography ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Risk Factors ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Sex Characteristics ,Ejection fraction ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,Stroke Volume ,Middle Aged ,medicine.disease ,Confidence interval ,Treatment Outcome ,Coronary Occlusion ,Chronic Disease ,Female ,Cardiology and Cardiovascular Medicine ,business ,TIMI ,Follow-Up Studies - Abstract
Sex differences in coronary artery disease presentation and outcomes have been described. The aim of this study was to compare sex disparities in chronic total occlusion (CTO) management and long-term outcomes.All consecutive patients with at least one CTO diagnosed in our center between 2010 and 2014 were included. Demographic and clinical data were registered. All-cause and cardiac mortality were assessed during a median follow-up of 4.03 years (IQR 2.6-4.8).A total of 1248 patients (67.3 ± 10.9 years; 16% female) were identified. Women were older, had a higher prevalence of type 2 DM and a lower ventricle ejection fraction compared to men (p .05). Although women had major proportion of positive result for severe ischemia-viability test (86% vs. 74%; p = .01), they were more often treated with MT alone compared to male (57% vs 51%; p = .02). During follow-up, 386 patients (31%) died. Women presented a higher rate of all-cause and cardiac mortality, and hospitalizations for heart failure independently of treatment strategy, compared to men (p .001). In multivariable analysis female sex was associated with higher cardiac mortality [HR 1.67, 95% CI 1.10-2.57; p .001]. Among women, the independent predictors for all-cause and cardiac mortalities were age, MT of the CTO and ACEF (age, creatinin and ejection fraction) score.A significant sex gap regarding CTO treatment was observed. Female sex was an independent predictor for cardiac mortality at long-term follow-up. More data are needed to support these findings.
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- 2020
14. Serum levels of Growth Arrest-Specific 6 protein and soluble AXL in patients with ST-segment elevation myocardial infarction
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Jany Rodríguez, Rosario J. Perea, Guillem Caldentey, Antonio Berruezo, Helena Cristóbal, Eduardo Flores-Umanzor, Teresa M. de Caralt, Manel Garabito, Xavier Bosch, Rodolfo San Antonio, José T. Ortiz-Pérez, and Pablo García de Frutos
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Male ,medicine.medical_specialty ,heart failure ,Infarction ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Proto-Oncogene Proteins ,GAS6 ,Internal medicine ,Natriuretic Peptide, Brain ,Cardiac remodelling ,medicine ,Humans ,ST segment ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Aged ,Killip class ,Ventricular Remodeling ,AXL receptor tyrosine kinase ,business.industry ,Receptor Protein-Tyrosine Kinases ,General Medicine ,Middle Aged ,Brain natriuretic peptide ,medicine.disease ,Magnetic Resonance Imaging ,myocardial infarction ,Heart failure ,Cardiology ,Intercellular Signaling Peptides and Proteins ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background: Serum soluble AXL (sAXL) and its ligand, Growth Arrest-Specific 6 protein (GAS6), intervene in tissue repair processes. AXL is increased in end-stage heart failure, but the role of GAS6 and sAXL in ST-segment elevation myocardial infarction (STEMI) is unknown. Objectives: To study the association of sAXL and GAS6 acutely and six months following STEMI with heart failure and left ventricular remodelling. Methods: GAS6 and sAXL were measured by enzyme-linked immunosorbent assay at one day, seven days and six months in 227 STEMI patients and 20 controls. Contrast-enhanced magnetic resonance was performed during admission and at six months to measure infarct size and left ventricular function. Results: GAS6, but not sAXL, levels during admission were significantly lower in STEMI than in controls. AXL increased progressively over time ( p1) had higher values of sAXL at day 1 (48.9±11.9 vs. 44.0±10.7 ng/ml; pConclusion: sAXL levels increased following STEMI. Patients with heart failure and left ventricular remodelling have higher sAXL levels acutely and at six month follow-up. These findings suggest a potential role of the GAS6–AXL system in the pathophysiology of left ventricular remodelling following STEMI.
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- 2017
15. New holosystolic murmur after acute myocardial infarction
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Rodolfo San Antonio, Guillem Caldentey, and Eduardo Flores-Umanzor
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Heart Septal Defects, Ventricular ,Male ,Reoperation ,medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Coronary Angiography ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Internal medicine ,Heart Septum ,medicine ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Cardiac Surgical Procedures ,Aged, 80 and over ,Surgical repair ,Heart Murmurs ,business.industry ,Incidence (epidemiology) ,Percutaneous coronary intervention ,Electrocardiography in myocardial infarction ,General Medicine ,medicine.disease ,Echocardiography ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
In the era of primary percutaneous coronary intervention, mechanical complications after acute myocardial infarction are extremely rare, with an incidence of less than 0.5%. Rupture of the ventricular septum is the least frequent occurrence. Nevertheless, current mortality remains high and a prompt diagnosis and treatment are imperative to increase survival. Despite early surgical repair, mortality still remains high.
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- 2020
16. Severe Acute Hypertension and End-Organ Damage. Do We React Fast Enough?
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Lluís Recasens, Marc Llagostera, Beatriz Vaquerizo, Guillem Caldentey, Teresa Giralt, Quiroga Xavier, and Nuria Ribas
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medicine.medical_specialty ,End organ damage ,business.industry ,Internal medicine ,medicine ,Cardiology ,General Medicine ,medicine.disease ,business - Published
- 2019
17. Percutaneous coronary intervention due to chronic total occlusion in the left main coronary artery after bypass grafting: A feasible option in selected cases
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Victoria Martin-Yuste, Marco Hernández, Guillem Caldentey, Manel Sabaté, Margarida Pujol-López, Gustavo Jiménez-Brítez, Rodolfo San Antonio, Sara Vazquez, Eduardo Flores-Umanzor, and Pedro L. Cepas-Guillén
- Subjects
Male ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_treatment ,Ischemia ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Revascularization ,Asymptomatic ,Angina ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Internal medicine ,Occlusion ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Coronary Artery Bypass ,General Environmental Science ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Coronary Vessels ,Cardiac surgery ,surgical procedures, operative ,lcsh:RC666-701 ,Conventional PCI ,Cardiology ,General Earth and Planetary Sciences ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction: Chronic total occlusion (CTO) of the left main coronary artery (LMCA) is an infrequent finding. Revascularization is recommended in the presence of demonstrated viability or ischemia. Coronary artery bypass grafting (CABG) has long been considered the preferred option. Patients with previous CABG due to LMCA disease with occlusion of one graft and progression of the LMCA to CTO constitute a special population, as just one ischemic artery remains. For these patients, there is no other option for revascularization other than cardiac surgery (requiring resternotomy) or percutaneous coronary intervention (PCI) of the LMCA. Methods and Results: Out of 620 patients with CTO diagnosed in our center, we identified five with previous CABG due to LMCA disease for a retrospective case series. They had occlusion of one graft and progression of the LMCA to CTO. All five underwent PCI. Each patient received a functional classification for angina, myocardial ischemic tests, and a follow-up coronary angiogram during a median follow-up of 63 months. Coronary angiogram showed CTO of the semi-protected LMCA lesions with two CABGs previously performed in all patients, one occluded and the other patent. Three patients had occluded saphenous vein grafts to the circumflex coronary artery, and the rest had left internal mammary artery-left anterior descending artery CABG failure. Ischemia and viability were demonstrated. Surgery was ruled out due to high surgical risk. PCI due to CTO of the LMCA with drug-eluting stents was performed. In a five-year follow-up period, four patients remained asymptomatic and event free. One post-PCI death occurred from non-cardiovascular cause. Conclusions: PCI due to CTO of the LMCA following CABG can be successful and safe and can provide sustained clinical improvements in selected cases. Resumo: Introdução: A oclusão crónica total (OCT) do tronco comum (TC) coronário é um achado pouco frequente. A revascularização é recomendada na presença de viabilidade ou de isquemia comprovada. A coronary artery bypass grafting (CABG) tem sido durante muito tempo a opção preferencial. Os doentes com CABG prévia devida a doença do TC com oclusão de um enxerto e progressão para oclusão crónica total do tronco comum constituem uma população especial, uma vez que fica apenas uma artéria com isquemia. Para esses doentes não existe outra opção de revascularização além da cirurgia cardíaca – com necessidade de reesternotomia – ou a intervenção coronária percutânea do tronco comum. Métodos e resultados: Dos 620 doentes com oclusões coronárias totais diagnosticadas no nosso centro, identificamos como séries de casos retrospetivos, cinco com CABG prévia devida a doença do TC, que tinham uma oclusão de um enxerto e progressão da doença do TC para oclusão crónica total. Os cinco foram submetidos a intervenção coornária percutânea (ICP). Cada doente recebeu a classificação funcional de angina, de testes de isquemia do miocárdio e o seguimento com angiografía coronária durante o tempo médio de 63 meses de seguimento. O angiograma coronário mostrou oclusão coronária total das lesões semiprotegidas do TC com duas pontagens previamente feitas em todos os doentes, uma ocluída e a outra permeável. Três doentes tinham enxertos de veia safena para a artéria coronária circunflexa (Safena-CX) ocluídos e os restantes tinham insuficiência da pontagem com mamária interna esquerda para a artéria coronária descendente anterior (MIE-DA). Foi demonstrada isquemia ou viabilidade. A opção cirúrgica foi recusada devido ao elevado risco cirúrgico. Foi feita a ICP da oclusão coronária total do TC com stents revestidos de fármaco. Em cinco anos de seguimento, quatro doentes permaneceram assintomáticos e livres de eventos. Ocorreu uma morte após ICP devido a causa não cardiovascular. Conclusões: A ICP de oclusão crónica total do TC após CABG pode ser bem-sucedida, segura, e pode fornecer melhorias clínicas mantidas em casos selecionados. Keywords: Chronic total occlusion, Left main coronary artery, Coronary artery bypass grafting, Palavras-chave: Oclusão crónica total, Tronco comum coronário, Cirurgia coronária
- Published
- 2018
18. P3476Long-term survival benefit of CTO revascularisation vs. conservative treatment in elderly patients
- Author
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R San Antonio, Ander Regueiro, E Flores Umanzor, M Sabate, Sara Vazquez, J Ivey Miranda, A Fernandez Valledor, Guillem Caldentey, I Ferreira, P.L Cepas Guillen, M Pujol Lopez, G Jimenez Britez, V Martin Yuste, and Xavier Freixa
- Subjects
Conservative treatment ,medicine.medical_specialty ,Survival benefit ,business.industry ,medicine ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Term (time) - Published
- 2018
19. Racial differences in mortality in patients with advanced systolic heart failure: Potential role of right ventricular ejection fraction
- Author
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Wilbert S. Aronow, Prakash Deedwania, Stefan D. Anker, Inmaculada Aban, Michel White, Gregg C. Fonarow, Alexander X. Lo, Ali Ahmed, Ross D. Fletcher, Kanan Patel, Raya Kheirbek, and Guillem Caldentey
- Subjects
Male ,medicine.medical_specialty ,Adrenergic beta-Antagonists ,Severity of Illness Index ,Propanolamines ,chemistry.chemical_compound ,Internal medicine ,Severity of illness ,medicine ,Humans ,Intensive care medicine ,Survival rate ,Ejection fraction ,business.industry ,Incidence ,Racial Groups ,Hazard ratio ,Bucindolol ,Stroke Volume ,Stroke volume ,Middle Aged ,medicine.disease ,United States ,Confidence interval ,Survival Rate ,chemistry ,Heart failure ,Ventricular Function, Right ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Heart Failure, Systolic - Abstract
In Beta-Blocker Evaluation of Survival Trial (BEST) bucindolol significantly reduced mortality among Caucasians with systolic heart failure (HF) but not among African Americans. Whether this differential effect can be explained by racial differences in baseline characteristics has not been previously examined. Of the 2708 BEST participants, 627 were African Americans. Because African Americans were more likely to be younger and women, we used age–sex-adjusted hazard ratios (HR) and 95% confidence intervals (CI) to estimate their outcomes (vs. Caucasians). A step-wise multivariable-adjusted model using 24 baseline characteristics was used to identify variables associated with between-race outcome differences and propensity-matching was used to determine independence of associations. Age–sex-adjusted HR for all-cause mortality for African Americans during 2years of mean follow-up was 1.27. African Americans were more likely to have lower right ventricular ejection fraction. African Americans had no association with mortality among propensity-matched patients. The higher risk of death among African Americans in BEST may in part be due to their lower RVEF which may in part explain the lack of response to bucindolol among these patients. Future studies need to examine the role of low RVEF on the effect of beta-blockers in patients with systolic HF.
- Published
- 2014
20. Prognostic Value of the Physical Examination in Patients With Heart Failure and Atrial Fibrillation
- Author
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Jean L. Rouleau, Denis Roy, Marie-Claude Guertin, Hugues Leduc, Guillem Caldentey, Normand Racine, Mario Talajic, Paul Khairy, Anique Ducharme, Michel White, and Eileen O'Meara
- Subjects
medicine.medical_specialty ,Population ,Peripheral edema ,Physical examination ,030204 cardiovascular system & hematology ,Amiodarone ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,030212 general & internal medicine ,education ,Third heart sound ,education.field_of_study ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,medicine.disease ,3. Good health ,Heart failure ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Objectives This study sought to assess the prognostic value of physical examination in a modern treated heart failure population. Background The physical examination is the cornerstone of the evaluation and monitoring of patients with heart failure. Yet, the prognostic value of congestive signs (i.e., peripheral edema, jugular venous distension, a third heart sound, and pulmonary rales) has not been assessed in the current era. Methods A post-hoc analysis was conducted on all 1,376 patients, 81% male, mean age 67 ± 11 years, with symptomatic left ventricular systolic dysfunction enrolled in the AF-CHF (Atrial Fibrillation and Congestive Heart Failure) trial. The prognostic value of baseline physical examination findings was assessed in univariate and multivariate Cox regression analyses. Results Peripheral edema was observed in 425 (30.9%), jugular venous distension in 297 (21.6%), a third heart sound in 207 (15.0%), and pulmonary rales in 178 (12.9%) patients. Death from cardiovascular causes occurred in 357 (25.9%) patients over a mean follow-up of 37 ± 19 months. All 4 physical examination findings were associated with cardiovascular mortality in univariate analyses (all p values Conclusions In the modern era, congestive signs on the physical examination (i.e., peripheral edema, jugular venous distension, a third heart sound, and pulmonary rales) continue to provide important prognostic information in patients with congestive heart failure.
- Published
- 2014
21. 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
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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
22. El análisis del flujo aórtico por ecocardiografía Doppler es útil en la estratificación pronóstica de los pacientes con estenosis aórtica grave con fracción de eyección normal
- Author
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Armando Bethencourt, Oriol Bonnin, José I. Sáez-Ibarra, Ana Sahuquillo, Carlos Fernández-Palomeque, Guillem Frontera, Gaspar Melis, Guillem Caldentey, and J. Forteza
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Resumen Introduccion y objetivos El pronostico de los pacientes con estenosis aortica grave con bajo gradiente aortico y fraccion de eyeccion normal es controvertido. Nuestro estudio analiza el pronostico de estos pacientes y su relacion con el gradiente de presion y el flujo valvular aortico. Metodos Cohorte retrospectiva de 363 pacientes consecutivos con estenosis aortica grave y fraccion de eyeccion normal, dividida en cuatro grupos segun indice de volumen sistolico mayor o menor que 35 ml/m2 y gradiente aortico medio mayor o menor que 40 mmHg. Grupo I, flujo normal y gradiente elevado (n = 169; 47%); grupo II, flujo normal y bajo gradiente (n = 98; 27%); grupo III, bajo flujo y gradiente elevado (n = 54; 15%), y grupo IV, bajo flujo y bajo gradiente (n = 42; 12%). El objetivo primario es la mortalidad total. Resultados Los factores de riesgo independientes de mortalidad son la edad (hazard ratio = 1,04; intervalo de confianza del 95%, 1,01-1,08) y la fibrilacion auricular (hazard ratio = 2,21; intervalo de confianza del 95%, 1,24-3,94). El tratamiento quirurgico se asocia a mayor supervivencia en todos los grupos (hazard ratio = 0,25; intervalo de confianza del 95%, 0,13-0,49). Los pacientes con bajo flujo presentan mayor mortalidad que los pacientes con flujo normal (el 26,6 frente al 13,6%; p = 0,004). El grupo II muestra mejor pronostico (hazard ratio = 0,4; intervalo de confianza del 95%, 0,2-0,9). Conclusiones Los pacientes con estenosis aortica grave, fraccion de eyeccion normal y bajo flujo aortico presentan peor pronostico. El analisis del flujo aortico mediante ecocardiografia Doppler es util en la estratificacion de riesgo y en la toma de decisiones terapeuticas en pacientes con estenosis aortica.
- Published
- 2013
23. Staphylococcus lugdunensis: an unusual and aggressive cause of infective endocarditis
- Author
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Rodolfo San Antonio, Eduardo Josué Flores Umanzor, Gustavo Jimenez Britez, and Guillem Caldentey
- Subjects
0106 biological sciences ,Male ,medicine.medical_specialty ,Joint fluid ,030204 cardiovascular system & hematology ,Staphylococcus lugdunensis ,01 natural sciences ,Article ,03 medical and health sciences ,0302 clinical medicine ,010608 biotechnology ,medicine ,Recent trauma ,Humans ,Fluid accumulation ,Aged ,Heart Valve Prosthesis Implantation ,Arthritis, Infectious ,Hip ,Groin ,biology ,business.industry ,General Medicine ,Endocarditis, Bacterial ,Staphylococcal Infections ,medicine.disease ,biology.organism_classification ,Abscess ,Surgery ,medicine.anatomical_structure ,Infective endocarditis ,Intravenous antibiotics ,Aortic Valve ,Septic arthritis ,business - Abstract
A 68-year-old man presented with fever, right groin pain and impaired right hip motion during the last 7 days. He denied recent trauma or cutaneous infection. Initially, a diagnosis of right hip septic arthritis was assumed so, an MRI was performed that showed degenerative right coxofemoral changes with moderate fluid accumulation. The analysis of joint fluid exhibited a septic fluid. Hemocultures were taken and empirical intravenous antibiotic treatment was initiated. The patient remained clinically stable on the first few days with improvement of his clinical conditions. On day 3, …
- Published
- 2016
24. Left atrial collapse due to a giant false lumen in type B aortic dissection
- Author
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Eduardo Josué Flores Umanzor, Guillem Caldentey, Paula Sanchez Somonte, and Rodolfo San Antonio
- Subjects
Adult ,Aged, 80 and over ,Male ,medicine.medical_specialty ,Aortic Aneurysm, Thoracic ,Type B aortic dissection ,business.industry ,Pain medicine ,False lumen ,Middle Aged ,Critical Care and Intensive Care Medicine ,Aortic Dissection ,Left atrial ,Internal medicine ,Anesthesiology ,medicine ,Cardiology ,Humans ,Female ,Heart Atria ,medicine.symptom ,business ,Collapse (medical) ,Aged - Published
- 2016
25. Heart failure after acute myocardial infarction: giant pseudoaneurysm that was difficult to diagnose because of imaging techniques
- Author
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Guillem Caldentey, Mikel Martínez, Eduardo Flores, and Rodolfo San Antonio
- Subjects
Heart Failure ,Male ,medicine.medical_specialty ,business.industry ,Pain medicine ,Myocardial Infarction ,Middle Aged ,Critical Care and Intensive Care Medicine ,medicine.disease ,Diagnosis, Differential ,Pseudoaneurysm ,Echocardiography ,Heart failure ,Anesthesiology ,Medicine ,Humans ,Myocardial infarction ,business ,Intensive care medicine ,Aneurysm, False - Published
- 2015
26. Purulent pericarditis due to Klebsiella pneumoniae pulmonary infection
- Author
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Guillem Caldentey, Gala Caixal Vila, and Eduardo Flores
- Subjects
medicine.medical_specialty ,Complications ,biology ,Klebsiella pneumoniae ,business.industry ,Cardiology ,Pulmonary infection ,biology.organism_classification ,Purulent pericarditis ,Microbiology ,Internal medicine ,RC666-701 ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Cardiology and Cardiovascular Medicine ,business ,Cardiac tamponade ,Pericardium - Published
- 2017
27. Thrombocytopenia induced by giant atrial thrombus in rheumatic valve disease
- Author
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R San Antonio, Guillem Caldentey, Sara Vazquez, and Eduardo Flores-Umanzor
- Subjects
medicine.medical_specialty ,business.industry ,Heart Beat ,Atrial Thrombus ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,030220 oncology & carcinogenesis ,Internal medicine ,Cardiology ,Medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Valve disease - Published
- 2017
28. Radiation-Induced Cardiac Valve Disease
- Author
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Rodolfo San Antonio, Marco Hernández-Enríquez, Carles Paré, Guillem Caldentey, and Eduardo Flores-Umanzor
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Radiation induced ,Magnetic resonance imaging ,General Medicine ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Cardiac valve ,Medicine ,Radiology ,business - Published
- 2017
29. Giant Left Atrium as a Rare Cause of Dysphagia
- Author
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Rodolfo San Antonio, Luca Vannini, Eduardo Josué Flores Umanzor, Guillem Caldentey, and M Mimbrero
- Subjects
Cardiomegaly ,Comorbidity ,030204 cardiovascular system & hematology ,Risk Assessment ,Severity of Illness Index ,03 medical and health sciences ,Rare Diseases ,0302 clinical medicine ,medicine ,Humans ,Heart Atria ,030212 general & internal medicine ,Monitoring, Physiologic ,Aged, 80 and over ,business.industry ,General Medicine ,Anatomy ,Giant left atrium ,Dysphagia ,Dyspnea ,Echocardiography ,Disease Progression ,Female ,Radiography, Thoracic ,medicine.symptom ,Deglutition Disorders ,Tomography, X-Ray Computed ,business - Published
- 2016
30. A rare cause of intracardiac mass
- Author
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Eduardo Flores, Guillem Caldentey, Paula Sanchez, Rodolfo San Antonio, and Gala Caixal
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,medicine ,Radiology ,030204 cardiovascular system & hematology ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Intravenous leiomyomatosis ,Intracardiac injection - Published
- 2016
31. Causa inusual de taquicardia ventricular en una mujer joven
- Author
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Eduardo Flores Umanzor, Jany Rodriguez Londres, and Guillem Caldentey Adrover
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2018
32. LONG TERM SURVIVAL BENEFIT OF CHRONIC TOTAL OCCLUSION REVASCULARIZATION VERSUS CONSERVATIVE TREATMENT IN ELDERLY PATIENTS
- Author
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Rodolfo San Antonio Dharandas, Gustavo Jimenez, Guillem Caldentey, Victoria Martin-Yuste, Ander Regueiro, Eduardo Flores, Xavier Freixa, Manel Sabaté, Sara Vazquez, and Ignacio Ferreira-González
- Subjects
medicine.medical_specialty ,Myocardial ischemia ,Medical treatment ,business.industry ,medicine.medical_treatment ,Revascularization ,Total occlusion ,Conservative treatment ,Therapeutic approach ,surgical procedures, operative ,Internal medicine ,Conventional PCI ,Long term survival ,medicine ,Cardiology ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business - Abstract
Chronic total occlusions (CTO) are present in > 30% of elderly patients with myocardial ischemia. There is still controversy regarding the best therapeutic approach in this setting. To compare long term survival of CTO revascularization (PCI or CABG) versus medical treatment (MT) in the old
- Published
- 2018
33. The Reply
- Author
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Eduardo Josué, Flores-Umanzor, Marco, Hernández-Enríquez, Guillem, Caldentey, Rodolfo, San Antonio, and Carles, Paré
- Subjects
General Medicine - Published
- 2017
34. THERAPEUTIC HYPOTHERMIA IN POST-CARDIAC ARREST SYNDROME: ROLE OF NEURON-SPECIFIC ENOLASE AS EARLY PREDICTOR OF NEUROLOGICAL STATUS AT DISCHARGE
- Author
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Marco Hernandez Enriquez, Paula Sanchez Somonte, Guillem Caldentey, Eduardo Flores, Gala Caixal, Manel Sabaté, Rodolfo San Antonio Dharandas, Mónica Masotti, Gustavo Jimenez, and Xavier Freixa
- Subjects
medicine.medical_specialty ,business.industry ,Neurological status ,Enolase ,Brain damage ,Hypothermia ,nervous system ,Internal medicine ,medicine ,Cardiology ,In patient ,Post cardiac arrest ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Intensive care medicine - Abstract
Background: Several biomarkers of brain damage, particularly neuron-specific enolase (NSE), have been used to evaluate neurological outcome in out-of-hospital cardiac arrest (OHCA). In patients not undergoing therapeutic hypothermia (TH), previous studies have proposed a cutoff value of 33 ng/ml at
- Published
- 2017
35. Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure)
- Author
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Guillem, Caldentey, Paul, Khairy, Denis, Roy, Hugues, Leduc, Mario, Talajic, Normand, Racine, Michel, White, Eileen, O'Meara, Marie-Claude, Guertin, Jean L, Rouleau, and Anique, Ducharme
- Subjects
Heart Failure ,Male ,Adrenergic beta-Antagonists ,Amiodarone ,Angiotensin-Converting Enzyme Inhibitors ,Prognosis ,Angiotensin Receptor Antagonists ,Atrial Fibrillation ,Chronic Disease ,Humans ,Female ,Anti-Arrhythmia Agents ,Physical Examination ,Aged - Abstract
This study sought to assess the prognostic value of physical examination in a modern treated heart failure population.The physical examination is the cornerstone of the evaluation and monitoring of patients with heart failure. Yet, the prognostic value of congestive signs (i.e., peripheral edema, jugular venous distension, a third heart sound, and pulmonary rales) has not been assessed in the current era.A post-hoc analysis was conducted on all 1,376 patients, 81% male, mean age 67 ± 11 years, with symptomatic left ventricular systolic dysfunction enrolled in the AF-CHF (Atrial Fibrillation and Congestive Heart Failure) trial. The prognostic value of baseline physical examination findings was assessed in univariate and multivariate Cox regression analyses.Peripheral edema was observed in 425 (30.9%), jugular venous distension in 297 (21.6%), a third heart sound in 207 (15.0%), and pulmonary rales in 178 (12.9%) patients. Death from cardiovascular causes occurred in 357 (25.9%) patients over a mean follow-up of 37 ± 19 months. All 4 physical examination findings were associated with cardiovascular mortality in univariate analyses (all p values0.01). In multivariate analyses, taking all 4 signs as potential covariates, only rales (hazard ratio 1.41; 95% confidence interval: 1.07 to 1.86; p = 0.013) and peripheral edema (hazard ratio: 1.25; 95% confidence interval: 1.00 to 1.57; p = 0.048) were associated with cardiovascular mortality, independent of other variables.In the modern era, congestive signs on the physical examination (i.e., peripheral edema, jugular venous distension, a third heart sound, and pulmonary rales) continue to provide important prognostic information in patients with congestive heart failure.
- Published
- 2013
36. Lesiones de Janeway, nódulos de Osler y hemorragias en astilla
- Author
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Guillem Caldentey Adrover, Eduardo Flores Umanzor, Luca Vannini, and Rodolfo San Antonio
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,business ,Dermatology - Published
- 2016
37. Janeway lesions, Osler nodes and splinter hemorrhages
- Author
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Eduardo Flores Umanzor, Luca Vannini, Rodolfo San Antonio, and Guillem Caldentey Adrover
- Subjects
Male ,medicine.medical_specialty ,Foot ,business.industry ,General surgery ,Hemorrhage ,Endocarditis, Bacterial ,Middle Aged ,Staphylococcal Infections ,Subarachnoid Hemorrhage ,Hand ,Magnetic Resonance Imaging ,Skin Diseases ,medicine ,Humans ,Mouth Diseases ,business ,Mouth Floor - Published
- 2016
38. Prognostic Value of the Physical Examination in Patients with Heart Failure and Atrial Fibrillation: Insights from the AF-CHF Trial
- Author
-
Guillem Caldentey, Michel White, Normand Racine, Jean L. Rouleau, Mario Talajic, Eileen O'Meara, Hugues Leduc, Denis Roy, Paul Khairy, and Anique Ducharme
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,Physical examination ,medicine.disease ,Internal medicine ,Heart failure ,medicine ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Value (mathematics) - Published
- 2013
39. LOW RIGHT VENTRICULAR EJECTION FRACTION: A POTENTIAL EXPLANATION FOR RACIAL DIFFERENCES IN MORTALITY IN ADVANCED SYSTOLIC HEART FAILURE IN THE BETA-BLOCKER EVALUATION OF SURVIVAL TRIAL
- Author
-
Guillem Caldentey, Alexander Lo, Ali Ahmed, Michel White, Kanan Patel, Prakash Deedwania, Inmaculada Aban, and Stefan D. Anker
- Subjects
medicine.medical_specialty ,medicine.drug_class ,business.industry ,Internal medicine ,Heart failure ,medicine ,Cardiology ,Racial differences ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Beta blocker ,Right ventricular ejection fraction - Published
- 2013
40. Lymphoma with massive cardiac involvement.
- Author
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UMANZOR, Eduardo Josué FLORES, ADROVER, Guillem CALDENTEY, LONDRES, Jany RODRIGUEZ, ANTONIO, Rodolfo SAN, and MEJÍA, Nely Mercy DIAZ
- Published
- 2016
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