Publications by authors named "Alex Castro Mejia"
Background: In Ecuador, there are few data about the clinical behaviour of heart failure (HF). This study aims to analyse the clinical characteristics, treatment and prognosis according to the current classification based on left ventricular ejection fraction (EF).
Methods: A retrospective observational study was carried out in patients with chronic HF from the 'Los Ceibos' registry during the period January 2017-December 2022.
Article Synopsis
- * Researchers analyzed data from the HOPE-2 registry, examining 2382 patients discharged alive and tracking their mortality and long-term COVID-19 symptoms.
- * Findings reveal that patients with elevated troponin levels face higher mortality rates and are more likely to experience lasting cardiovascular issues, such as fatigue and dyspnea, after discharge.
Background: Concern has risen about the effects of COVID-19 in interstitial lung disease (ILD) patients. The aim of our study was to determine clinical characteristics and prognostic factors of ILD patients admitted for COVID-19.
Methods: Ancillary analysis of an international, multicenter COVID-19 registry (HOPE: Health Outcome Predictive Evaluation) was performed.
Article Synopsis
- Patients with diabetes mellitus (DM) experience a higher long-term mortality rate post-COVID-19 compared to those without DM.
- Among the studied symptoms, diabetics showed fewer cardiovascular complaints but a higher incidence of psychiatric issues like paranoia, and more respiratory complications as evidenced by abnormal spirometry.
- Rates of readmission and reinfection after COVID-19 were similar for both diabetic and non-diabetic patients, indicating that the presence of diabetes does not significantly impact these outcomes.
Article Synopsis
- Heart disease significantly worsens outcomes for COVID-19 survivors, leading to higher rates of post-COVID complications and increased mortality.
- In a study involving over 7,000 patients, those with heart disease were generally older with more health issues compared to those without, showing a 2.63 times higher risk of death.
- The research highlights that vaccination against COVID-19 offers substantial protection, drastically lowering the risk of mortality for patients with pre-existing heart conditions.
Background COVID-19 is an infectious illness, featured by an increased risk of thromboembolism. However, no standard antithrombotic therapy is currently recommended for patients hospitalized with COVID-19. The aim of this study was to evaluate safety and efficacy of additional therapy with aspirin over prophylactic anticoagulation (PAC) in patients hospitalized with COVID-19 and its impact on survival.
View Article and Find Full Text PDFArticle Synopsis
- Most COVID-19 research focuses on hospitalized patients, leaving the impact of prior oral anticoagulation (OAC) therapy before admission understudied.
- Analyzing data from the HOPE COVID-19 Registry, the study compared outcomes between hospitalized patients who had or hadn’t used OAC prior to their admission.
- Results indicated that patients on prior OAC faced a higher risk of mortality and adverse outcomes than those without OAC, with no significant differences between types of OAC used (VKAs vs. DOACs).
Background: High degree cardiac conduction disturbances (HDCD) remain a major complication after transcatheter aortic valve replacement (TAVR), especially with self-expandable valves (SEV). Our aim was to investigate peri-procedural and in-hospital modification of atrioventricular and intracardiac conduction associated to new generation SEV implantation, and the development of new HDCD resulting in permanent pacemaker implantation (PPM) in patients undergoing TAVR.
Methods And Results: Three-hundred forty-four consecutive patients with severe aortic stenosis who underwent TAVR with a new generation SEV [Evolut-R/Pro (n = 130), Acurate-neo (n = 79), Portico (n = 75) and Allegra (n = 60)] were included.
Background: Several studies have compared surface electrocardiographic changes following different self-expandable (SE) (Evolut (Medtronic, USA); Acurate (Boston Scientific, USA); Portico (Abbott, USA); and Allegra (NVT, Germany)) and balloon-expandable (BE) Sapien-3 (Edwards Lifesciences, USA) transcatheter heart valves. We aimed to compare these prosthesis with the novel Myval BE prosthesis (Meril Life, India).
Methods: Academic European registry of consecutive patients with severe aortic stenosis who received any of the 6 aforementioned valves.
Background: A systematic analysis of concomitant arterial hypertension in COVID-19 patients and the impact of angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs) have not been studied in a large multicentre cohort yet. We conducted a subanalysis from the international HOPE Registry (https://hopeprojectmd.com, NCT04334291) comparing COVID-19 in presence and absence of arterial hypertension.
View Article and Find Full Text PDFObjectives: To investigate the outcomes of deferred coronary revascularization in patients with non-significant in-stent restenosis (ISR) by physiological assessment.
Background: The pathophysiology and natural history of ISR is markedly different from de-novo stenoses. There is a paucity of data on the safety of deferral of revascularization of ISR using physiological assessment.
Gender-related differences in COVID-19 clinical presentation, disease progression, and mortality have not been adequately explored. We analyzed the clinical profile, presentation, treatments, and outcomes of patients according to gender in the HOPE-COVID-19 International Registry. Among 2,798 enrolled patients, 1,111 were women (39.
View Article and Find Full Text PDFObjectives: No standard therapy, including anticoagulation regimens, is currently recommended for coronavirus disease 2019. Aim of this study was to evaluate the efficacy of anticoagulation in coronavirus disease 2019 hospitalized patients and its impact on survival.
Design: Multicenter international prospective registry (Health Outcome Predictive Evaluation for Corona Virus Disease 2019).
Background: The use of Renin-Angiotensin system inhibitors (RASi) in patients with coronavirus disease 2019 (COVID-19) has been questioned because both share a target receptor site.
Methods: HOPE-COVID-19 (NCT04334291) is an international investigator-initiated registry. Patients are eligible when discharged after an in-hospital stay with COVID-19, dead or alive.
Background: The safety of revascularization deferral according to pressure wire examination in patients with chronic kidney disease (CKD) has not been fully established.
Methods: From a retrospective cohort of 439 patients in whom revascularization was deferred after physiological assessment, we examined the incidence of patient-oriented composite endpoint (POCE: all-cause death, myocardial infarction [MI] and unplanned revascularization) in patients with CKD (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m²) and without it.
Background: The success rate of coronary angiography (CA) after transcatheter aortic valve implantation (TAVI) is variable. Our aim was to investigate CA difficulty, outcomes, and predictors of difficult CA after TAVI.
Method: This was an international multicentric retrospective cohort study that included patients with TAVI and subsequent CA between January 2010 and December 2019.
Introduction And Objectives: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2. Atrial fibrillation (AF) is common in acute situations, where it is associated with more complications and higher mortality.
Methods: Analysis of the international HOPE registry (NCT04334291).
Introduction And Objectives: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2. Atrial fibrillation (AF) is common in acute situations, where it is associated with more complications and higher mortality.
Methods: Analysis of the international HOPE registry (NCT04334291).
There is limited information on the presenting characteristics, prognosis, and therapeutic approaches of young patients hospitalized for coronavirus disease 2019 (COVID-19). We sought to investigate the baseline characteristics, in-hospital treatment, and outcomes of a wide cohort < 65 years admitted for COVID-19. Using the international multicenter HOPE-COVID-19 registry, we evaluated the baseline characteristics, clinical presentation, therapeutic approach, and prognosis of patients < 65 years discharged (deceased or alive) after hospital admission for COVID-19, also compared with the elderly counterpart.
View Article and Find Full Text PDFBackground: The presence of any underlying heart condition could influence outcomes during the coronavirus disease 2019 (COVID-19).
Methods: The registry HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19, NCT04334291) is an international ambispective study, enrolling COVID-19 patients discharged from hospital, dead or alive.
Results: HOPE enrolled 2798 patients from 35 centers in 7 countries.
Unlabelled: Dysnatremia is associated with increased mortality in patients with community-acquired pneumonia. SARS-COV2 (Severe-acute-respiratory syndrome caused by Coronavirus-type 2) pneumonia can be fatal. The aim of this study was to ascertain whether admittance dysnatremia is associated with mortality, sepsis, or intensive therapy (IT) in patients hospitalized with SARS-COV2 pneumonia.
View Article and Find Full Text PDFRecently the coronavirus disease (COVID-19) outbreak has been declared a pandemic. Despite its aggressive extension and significant morbidity and mortality, risk factors are poorly characterized outside China. We designed a registry, HOPE COVID-19 (NCT04334291), assessing data of 1021 patients discharged (dead or alive) after COVID-19, from 23 hospitals in 4 countries, between 8 February and 1 April.
View Article and Find Full Text PDFIntroduction And Objectives: Aortic self-expandable (SE) transcatheter aortic valve implantation (TAVI) devices are particularly useful for patients with aortic stenosis and small/tortuous vessels, small aortic annuli, or low coronary ostia. However, it is unclear whether the growing range of SE devices shows comparable hemodynamic and clinical outcomes. We aimed to determine the differential hemodynamic (residual valve area and regurgitation) and clinical outcomes of these devices in comparable scenarios.
View Article and Find Full Text PDFBackground: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite its international aggressive extension, with a significant morbidity and mortality, the impact of renal function on its prognosis is uncertain.
Methods: Analysis from the international HOPE-Registry (NCT04334291).