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  1. Article: Do coronary stents suffer long-term deterioration after repeated intracoronary lithotripsy for rebel underexpansion treatment?

    Valencia, Jose / Herrero-Brocal, Marta / Torres-Mezcua, Fernando / Pineda, Javier / Ruiz-Nodar, Juan Miguel

    Clinical case reports

    2022  Volume 10, Issue 11, Page(s) e6547

    Abstract: Coronary intravascular lithotripsy (IVL) is the latest developed technique available for stent underexpansion treatment, although it is unclear if this therapy causes stent structure damage. We present the case of a patient with severe, refractory stent ... ...

    Abstract Coronary intravascular lithotripsy (IVL) is the latest developed technique available for stent underexpansion treatment, although it is unclear if this therapy causes stent structure damage. We present the case of a patient with severe, refractory stent underexpansion after primary angioplasty, which was resolved with a double session of IVL. Elective angiographic and optical coherence tomography (OCT) follow-up was performed 1 year after the procedure, which demonstrated the absence of any damage in the stent platform. Paradoxically, the study revealed a critical restenotic lesion in an area distant from the one of interest. Review of the first OCT after the primary procedure revealed 78% underexpansion in that area, which went by unnoticed and could be the cause of restenosis. Repeated IVL therapy may be helpful in cases of rebel stent underexpansion, and it conveys the impression of being safe in the long term in relation to the integrity and effectiveness of the drug-eluting coronary stents.
    Language English
    Publishing date 2022-11-15
    Publishing country England
    Document type Case Reports
    ZDB-ID 2740234-4
    ISSN 2050-0904
    ISSN 2050-0904
    DOI 10.1002/ccr3.6547
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: High medium-term incidence of major cardiovascular events in discharged patients with unstable angina.

    Herrero-Brocal, Marta / Marín, Francisco / Valverde, Laura / García-Barrios, Ana M / Fuertes, Laura / Cambra, Cristina / Torres-Mezcua, Fernando / Hortelano, Ignacio / Villamia, Beatriz / Esteve-Pastor, María Asunción / Orenes-Piñero, Esteban / Martínez, Juan Gabriel Martínez / Rivera-Caravaca, José Miguel / Ruiz-Nodar, Juan M

    International journal of cardiology. Heart & vasculature

    2023  Volume 46, Page(s) 101209

    Abstract: The introduction of high-sensitivity troponin (hsTn) assays has reduced the diagnosis of unstable angina (UA) in favor of non-ST elevation myocardial infarction (NSTEMI) in the context of non-ST elevation acute coronary syndrome (NSTEACS). It is unclear ... ...

    Abstract The introduction of high-sensitivity troponin (hsTn) assays has reduced the diagnosis of unstable angina (UA) in favor of non-ST elevation myocardial infarction (NSTEMI) in the context of non-ST elevation acute coronary syndrome (NSTEACS). It is unclear whether the detection of these hsTn levels affects the prognosis and therefore whether a different therapeutic approach is warranted. This study aims to determine whether using hsTn results in medium-term prognostic differences in patients with UA and NSTEMI.
    Methods: This multicenter, prospective registry study included consecutive patients who underwent hsTn assays and were discharged with a diagnosis of NSTEACS. Patients were followed for two years. Outcomes were the occurrence of major adverse cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, and non-fatal ischemic stroke), major bleeding, and all-cause mortality.
    Results: Patients with UA and NSTEMI did not show differences in terms of the invasive interventions received, the coronary artery disease diagnosed, the type of revascularization performed, or the proportion presenting MACE (UA 18.1% vs. NSTEMI 18.9%; p = 0.79). However, patients with NSTEMI had higher cardiovascular mortality at two years (UA 4% vs. NSTEMI 9.2%; p = 0.012), as well as, all-cause mortality (UA vs. 7.9% vs. NSTEMI 16.4%; p = 0.002).
    Conclusions: Medium-term incidence of MACE was similar in patients with UA and NSTEMI, but cardiovascular and all-cause mortality in NSTEMI patients was over twice that of patients with UA.
    Language English
    Publishing date 2023-04-26
    Publishing country Ireland
    Document type Journal Article ; Review
    ZDB-ID 2818464-6
    ISSN 2352-9067
    ISSN 2352-9067
    DOI 10.1016/j.ijcha.2023.101209
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Influence of sex on the timing of coronary angiography and the prescription of antiplatelet therapy in patients with nonST-segment elevation myocardial infarction.

    Martínez-Guisado, Antonio / Cepas-Guillén, Pedro / Díez-Villanueva, Pablo / López Lluva, María Thiscal / Jurado-Román, Alfonso / Bazal-Chacón, Pablo / Negreira-Caamaño, Martín / Olavarri-Miguel, Iván / Elorriaga, Ane / Rivera-López, Ricardo / Escribano, David / Salinas, Pablo / Vaquero-Luna, Jessica / Prieto, Alicia / Pérez-Cebey, Lucía / Carrasquer, Anna / Llaó, Isaac / Torres Mezcúa, Fernando José / Giralt-Borrell, Teresa /
    Matute-Blanco, Lucía / Fernández-Cordón, Clara / González, Clea / Arbas-Redondo, Emilio / Aritza-Conty, David / Díez-Delhoyo, Felipe

    Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

    2024  Volume 36, Issue 2, Page(s) 123–130

    Abstract: Objectives: To assess differences in the clinical management of nonST-segment elevation myocardial infarction (NSTEMI), including in-hospital events, according to biological sex.: Material and methods: Prospective observational multicenter study of ... ...

    Title translation Impacto del sexo en los tiempos de cateterismo y en el uso de pretratamiento antiagregante plaquetario en pacientes con síndrome coronario agudo sin elevación del segmento ST (SCASEST).
    Abstract Objectives: To assess differences in the clinical management of nonST-segment elevation myocardial infarction (NSTEMI), including in-hospital events, according to biological sex.
    Material and methods: Prospective observational multicenter study of patients diagnosed with NSTEMI and atherosclerosis who underwent coronary angiography.
    Results: We enrolled 1020 patients in April and May 2022; 240 (23.5%) were women. Women were older than men on average (72.6 vs 66.5 years, P .001), and more women were frail (17.1% vs 5.6%, P .001). No difference was observed in pretreatment with any P2Y12 inhibitor (prescribed in 68.8% of women vs 70.2% of men, P = .67); however, more women than men were prescribed clopidogrel (56% vs 44%, P = .009). Women prescribed clopidogrel were more often under the age of 75 years and not frail. Coronary angiography was performed within 24 hours less corooften in women (29.8% vs 36.9%, P = .03) even when high risk was recognized. Frailty was independently associated with deferring coronary angiography in the adjusted analysis; biological sex by itself was not related. The frequency and type of revascularization were the same in both sexes, and there were no differences in in-hospital cardiovascular events.
    Conclusion: Women were more often prescribed less potent antithrombotic therapy than men. Frailty, but not sex, correlated independently with deferral of coronary angiography. However, we detected no differences in the frequency of coronary revascularization or in-hospital events according to sex.
    MeSH term(s) Male ; Humans ; Female ; Aged ; Platelet Aggregation Inhibitors/therapeutic use ; Clopidogrel/therapeutic use ; Coronary Angiography ; Non-ST Elevated Myocardial Infarction/diagnostic imaging ; Non-ST Elevated Myocardial Infarction/drug therapy ; Frailty ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/drug therapy ; Prescriptions
    Chemical Substances Platelet Aggregation Inhibitors ; Clopidogrel (A74586SNO7)
    Language English
    Publishing date 2024-04-08
    Publishing country Spain
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2127173-2
    ISSN 2386-5857 ; 2386-5857
    ISSN (online) 2386-5857
    ISSN 2386-5857
    DOI 10.55633/s3me/016.2024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Timing of coronary angiography and use of antiplatelet pretreatment in patients with NSTEACS in Spain.

    Díez-Delhoyo, Felipe / López Lluva, María T / Cepas-Guillén, Pedro / Jurado-Román, Alfonso / Bazal-Chacón, Pablo / Negreira-Caamaño, Martín / Olavarri-Miguel, Iván / Elorriaga, Ane / Fernández-Sánchez, Jose A / Escribano, David / Salinas, Pablo / Vaquero-Luna, Jessica / Prieto-Lobato, Alicia / Pérez-Cebey, Lucía / Carrasquer, Anna / Llaóo, Isaac / Torres Mezcúa, Fernando J / Giralt-Borrell, Teresa / Abellas, María /
    García-Blas, Sergio / Matute-Blanco, Lucía / Robles-Gamboa, Carolina / Martínez-Guisado, Antonio / Fernández-Cordón, Clara / González-Maniega, Clea / Díez-Villanueva, Pablo

    Revista espanola de cardiologia (English ed.)

    2023  Volume 77, Issue 3, Page(s) 234–242

    Abstract: Introduction and objectives: The optimal timing of coronary angiography in patients admitted with non-ST-segment elevation acute coronary syndrome (NSTEACS) as well as the need for pretreatment are controversial. The main objective of the IMPACT-TIMING- ... ...

    Abstract Introduction and objectives: The optimal timing of coronary angiography in patients admitted with non-ST-segment elevation acute coronary syndrome (NSTEACS) as well as the need for pretreatment are controversial. The main objective of the IMPACT-TIMING-GO registry was to assess the proportion of patients undergoing an early invasive strategy (0-24hours) without dual antiplatelet therapy (no pretreatment strategy) in Spain.
    Methods: This observational, prospective, and multicenter study included consecutive patients with NSTEACS who underwent coronary angiography that identified a culprit lesion.
    Results: Between April and May 2022, we included 1021 patients diagnosed with NSTEACS, with a mean age of 67±12 years (23.6% women). A total of 87% of the patients were deemed at high risk (elevated troponin; electrocardiogram changes; GRACE score>140) but only 37.8% underwent an early invasive strategy, and 30.3% did not receive pretreatment. Overall, 13.6% of the patients underwent an early invasive strategy without pretreatment, while the most frequent strategy was a deferred angiography under antiplatelet pretreatment (46%). During admission, 9 patients (0.9%) died, while major bleeding occurred in 34 (3.3%).
    Conclusions: In Spain, only 13.6% of patients with NSTEACS undergoing coronary angiography received an early invasive strategy without pretreatment. The incidence of cardiovascular and severe bleeding events during admission was low.
    MeSH term(s) Aged ; Female ; Humans ; Male ; Middle Aged ; Acute Coronary Syndrome/therapy ; Coronary Angiography/adverse effects ; Prospective Studies ; Spain/epidemiology ; Platelet Aggregation Inhibitors/adverse effects ; Time Factors
    Chemical Substances Platelet Aggregation Inhibitors
    Language Spanish
    Publishing date 2023-10-29
    Publishing country Spain
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2592481-3
    ISSN 1885-5857 ; 1885-5857
    ISSN (online) 1885-5857
    ISSN 1885-5857
    DOI 10.1016/j.rec.2023.07.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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