Publications by authors named "Belen Cid Alvarez"
Background: Coronary heart disease is the leading cause of heart failure (HF), and tools are needed to identify patients with a higher probability of developing HF after an acute coronary syndrome (ACS). Artificial intelligence (AI) has proven to be useful in identifying variables related to the development of cardiovascular complications.
Methods: We included all consecutive patients discharged after ACS in two Spanish centers between 2006 and 2017.
Article Synopsis
- Current evidence shows that patients with high ischemic risk benefit from extended dual antiplatelet treatment (DAPT), while those with high bleeding risk are better suited for shorter durations of DAPT.
- A study evaluated over 8,200 patients post-acute coronary syndrome (ACS) and categorized them into three DAPT groups based on their bleeding and ischemic risk.
- Results indicated that a significant portion of patients face higher risks of major adverse cardiovascular events (MACE) and mortality, particularly those recommended for short DAPT.
Background: Remnant cholesterol has been identified as one of leading lipid values associated with the incidence of coronary heart disease. There is scarce evidence on its distribution and prognostic value in acute coronary syndrome (ACS) patients.
Methods And Results: We included all consecutive patients admitted for ACS in two different centres.
Article Synopsis
- The Zwolle risk score aims to better predict in-hospital mortality for patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) compared to the GRACE score.
- In a study of 4,446 STEMI patients across three university hospitals, the Zwolle score identified only 25% as high-risk, while the GRACE score identified 60%.
- The Zwolle score showed higher specificity for identifying high-risk patients, suggesting it could be more effective for clinical use in decision-making regarding STEMI treatment.
Article Synopsis
- The PANDEMIC study analyzed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients with ST-Elevation Myocardial Infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI), finding concerning outcomes compared to SARS-CoV-2 negative patients.
- Results showed SARS-CoV-2-positive patients had significantly higher in-hospital mortality and poorer postprocedural blood flow (assessed by TIMI flow), with male patients at greater risk.
- Key factors predicting higher mortality in these patients included being aged 75 or older, having impaired postprocedural TIMI flow, and presenting with cardiogenic shock.
Background: Severe tricuspid regurgitation (TR) is frequently associated with significant morbidity and mortality; such patients are often deemed to be at high surgical risk. Heterotopic bicaval stenting is an emerging, attractive transcatheter solution for these patients.
Objectives: The aim of this study was to evaluate the 30-day safety and 6-month efficacy outcomes of specifically designed bioprosthetic valves for the superior and inferior vena cava.
Background: In elderly patients with non-ST elevation acute coronary syndrome (NSTEACS), while routine invasive management is established in high-risk NSTEACS patients, there is still uncertainty regarding the optimal timing of the procedure.
Methods: This study analyzes the association of early coronary angiography with all-cause mortality, cardiovascular mortality, heart failure (HF) hospitalization, and major adverse cardiovascular events (MACE) in patients older than 75 years old with NSTEACS. This retrospective observational study included 7811 consecutive NSTEACS patients who were examined between the years 2003 and 2017 at two Spanish university hospitals.
Few studies have addressed to date the interaction between sex and diabetes mellitus (DM) in the prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Our aim was to address the role of DM in the prognosis of non-selected elderly patients with NSTEACS according to sex. A retrospective analysis from 11 Spanish NSTEACS registries was conducted, including patients aged ≥70 years.
View Article and Find Full Text PDFArticle Synopsis
- The study analyzes cardiovascular outcomes in patients with diabetes mellitus who are experiencing non-ST elevation acute coronary syndrome (NSTEACS) and evaluates the effectiveness of two risk assessment scores: GRACE and PRECISE-DAPT.
- A total of 7,415 patients were included, with 28% having diabetes; findings revealed diabetic patients were generally older and had higher initial risk scores, with differences in treatment approaches observed.
- The PRECISE-DAPT score effectively predicted mortality and adverse cardiovascular events in diabetic patients, while the GRACE score performed worse over the long term for these individuals.
The benefit of complete revascularization in elderly patients with non-ST elevation myocardial infarction (NSTEMI), and multivessel disease remains debated (MVD). The aim of our study was to determine the current long-term prognostic benefit of complete revascularization in this population. A retrospective cohort study of 1722 consecutive elderly NSTEMI patients was performed.
View Article and Find Full Text PDFBackground: Routine manual thrombectomy (MT) is not recommended in primary percutaneous coronary intervention (P-PCI) but it is performed in many procedures. The objective of our study was validating the DDTA score, designed for selecting patients who benefit most from MT.
Methods: Observational and multicenter study of all consecutive patients undergoing P-PCI in five institutions.
Background: Transcatheter mitral valve repair (TMVR) is an effective therapy for high-risk patients with severe mitral regurgitation (MR) but heart failure (HF) readmissions and death remain substantial on mid-term follow-up. Recently, right ventricular (RV) to pulmonary arterial (PA) coupling has emerged as a relevant prognostic predictor in HF. In this study, we aimed to assess the prognostic value of tricuspid annular plane systolic excursion (TAPSE) to PA systolic pressure (PASP) ratio as a non-invasive measure of RV-to-PA coupling in patients undergoing TMVR with MitraClip (Abbott, CA, USA).
View Article and Find Full Text PDFPrognostic benefit from an early invasive strategy in patients with non-ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines.
Clin Res Cardiol
September 2021
Objectives: The objective of our work is to evaluate the prognostic benefit of an early invasive strategy in patients with high-risk NSTACS according to the recommendations of the 2020 clinical practice guidelines during long-term follow-up.
Methods: This retrospective observational study included 6454 consecutive NSTEACS patients. We analyze the effects of early coronary angiography (< 24 h) in patients with: (a) GRACE risk score > 140 and (b) patients with "established NSTEMI" (non ST-segment elevation myocardial infarction defined by an increase in troponins) or dynamic ST-T-segment changes with a GRACE risk score < 140.
Article Synopsis
- The study examines how the COVID-19 outbreak affected the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI) in Spain, focusing on changes in patient care before and after the pandemic.
- Results showed a 27.6% decrease in STEMI patient treatments and a significant rise in in-hospital mortality during COVID-19 (7.5% vs 5.1%) despite consistent use of primary percutaneous coronary intervention as a treatment strategy.
- The findings indicate that COVID-19 led to longer ischemic times for patients and a notable incidence of confirmed SARS-CoV-2 infections during hospitalization, highlighting the challenges faced in managing STEMI cases during the pandemic.
Article Synopsis
- The study evaluated the impact of the COVID-19 outbreak on the treatment and outcomes of patients with STEMI in Spain, comparing cohorts treated before and after the pandemic began.
- It found a significant decrease in both suspected and confirmed STEMI patients, along with a longer ischemic time for those treated during COVID-19; however, the reperfusion strategy remained largely unchanged.
- In-hospital mortality increased during the COVID-19 period, with a reported rate rising from 5.1% to 7.5%, highlighting a concerning trend in patient outcomes despite consistent treatment methods.
Introduction And Objectives: The purpose of this analysis was to assess the incidence, predictors and prognostic impact of acute heart failure (AHF) after transcatheter aortic valve implantation (TAVI) using a self-expanding prosthesis.
Methods: From November 2008 to June 2017, all consecutive patients undergoing TAVI in our center were prospectively included in our TAVI registry. The predictive effect of AHF on all-cause mortality following the TAVI procedure was analyzed using Cox regression models.
Percutaneous coronary intervention (PCI) is establishing as the last remaining revascularization option in an increasing number of patients affected by complex coronary artery disease not suitable for surgery. Over the past decade, percutaneous left ventricular assist device (pLVAD) has increasingly replaced intra-aortic balloon pump to provide hemodynamic support during such non-emergent complex high-risk indicated procedures (CHIP) averting the risk of circulatory collapse and of adverse events in long lasting and/or complicated procedures. This review article aims to report the key factors to define CHIP, to summarize the available pLVAD which have CE mark for temporary mechanical LV support and to discuss the rationale of their use in this subset of patients.
View Article and Find Full Text PDFCoronary artery disease (CAD) is a common co-morbidity in transcatheter aortic valve implantation (TAVI) patients, but the prognostic value of coronary revascularization before TAVI is currently unknown. The aim of the present study was to assess the impact of coronary revascularization in patients who underwent TAVI. Patients underwent TAVI from 2008 to 2016 were included in the study.
View Article and Find Full Text PDFClinical impact of mineralocorticoid receptor antagonists treatment after acute coronary syndrome in the real world: A propensity score matching analysis.
Eur Heart J Acute Cardiovasc Care
October 2019
Article Synopsis
- - Recent research questions the benefits of mineralocorticoid receptor antagonists for patients experiencing acute coronary syndrome, prompting a study to assess their long-term prognostic value.
- - A retrospective analysis involving 8,318 patients was conducted, with only 6.3% discharged on these antagonists, revealing no significant differences in cardiovascular mortality or heart failure readmissions after accounting for patient similarities.
- - The study found that while mineralocorticoid receptor antagonists did not enhance overall survival, they were linked to fewer major cardiovascular events, indicating a potential benefit in reducing specific complications rather than improving long-term outcomes.