Publications by authors named "Cosme Garcia-Garcia"

Article Synopsis
  • The Shock-CAT study aimed to assess in-hospital mortality and prognosis in cardiogenic shock (CS) patients, comparing those with acute myocardial infarction (AMI) to those without it.
  • Out of 382 patients studied, AMI-CS exhibited higher in-hospital mortality rates (37.1%) compared to non-AMI-CS (26.7%), with AMI-CS patients requiring more mechanical circulatory support.
  • The IABP-SHOCK II score was found to be more accurate than the CardShock score in predicting 90-day mortality for AMI-CS patients, while both scores performed similarly for non-AMI-CS patients.
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Article Synopsis
  • The study evaluates the effectiveness of STEMI networks, focusing on out-of-hospital triage, in improving patient outcomes for ST elevation myocardial infarction (STEMI).
  • It found that implementing these networks led to significant reductions in case-fatality (35%) and long-term mortality (27%), along with improvements in various patient conditions and treatment times.
  • The positive effects were more pronounced in urban areas and high-income countries, emphasizing the importance of emergency transport systems in enhancing patient care.
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  • Atrial fibrillation (AF) commonly complicates ST elevation myocardial infarction (STEMI), increasing the risks of heart failure and mortality, making treatment strategies controversial.
  • A study analyzed 4,184 STEMI patients, finding that 6.4% developed AF in the first 48 hours, leading to a comparison between AF-STEMI patients and a matched control group.
  • Results showed that AF-STEMI patients had worse outcomes, including higher in-hospital mortality (11.9% vs 7.2%) and greater 10-year mortality (50.5% vs 36.2%), alongside a higher recurrence of AF, but no significant difference in stroke rates.
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  • Meteorin-like protein (Metrnl) is a cytokine that plays a role in reducing inflammation and its high levels are linked to poorer outcomes in heart failure patients.
  • This study focused on patients with ST-segment elevation myocardial infarction (STEMI) and measured Metrnl levels to evaluate its predictive power for health outcomes over three years.
  • Results showed that higher Metrnl levels correlated with greater risks of death or nonfatal heart attacks, indicating it could be a significant prognostic biomarker for complications in STEMI patients.
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  • The study examines the impact of different types of first medical contact (FMC), such as EMS, community hospital, PCI hospital, and primary care center, on mortality rates in STEMI patients undergoing primary coronary intervention between 2010-2020.
  • Out of 18,332 patients, those who received care at PCI hospitals and community hospitals showed higher 1-year mortality rates, while patients at primary care centers had better outcomes despite longer delays in treatment.
  • The findings suggest that receiving first medical assistance from PCI and community hospitals may lead to worse survival rates compared to emergency medical services, while primary care centers presented a lower risk and better results overall.
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  • The study investigates the use of Venoarterial extracorporeal membrane oxygenation (VA-ECMO) in patients with refractory cardiogenic shock, focusing on determining optimal flow rates and identifying risk factors for high ECMO flow.
  • Out of 209 patients analyzed over seven years, 50% were classified as 'high-flow', exhibiting more severe conditions at admission compared to the 'low-flow' group.
  • The findings revealed that while high-flow patients experienced more complications and a higher incidence of ventilator-associated pneumonia, there was no significant difference in overall lengths of stay or survival rates between the two groups.
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Article Synopsis
  • - The study aimed to investigate the prevalence and mortality trends of mechanical complications in STEMI (ST-elevation myocardial infarction) over two decades, specifically comparing a pre-pPCI (primary percutaneous coronary intervention) period to a post-pPCI period.
  • - Among 6,033 STEMI patients analyzed, mechanical complications occurred in 135 patients, with free wall rupture (FWR) showing a significant reduction of 60% in the pPCI era compared to the pre-pPCI era.
  • - Despite the reduction in FWR, overall mortality rates for mechanical complications did not show significant changes between the two periods, indicating improvements in treatment may not have drastically altered outcomes.
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  • The study explored the effectiveness of emergency coronary angiography (CAG) and percutaneous coronary intervention (PCI) in improving survival and neurological outcomes for patients who experienced out-of-hospital cardiac arrest (OHCA) without STEMI.
  • Researchers conducted a randomized trial with 69 OHCA survivors, assigning them to either immediate CAG or deferred CAG, focusing on in-hospital survival and major adverse cardiac events as primary endpoints.
  • Results showed no significant difference in survival rates between the immediate and delayed CAG groups, concluding that immediate intervention did not offer benefits in terms of survival without neurological impairment.
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Article Synopsis
  • Cardiogenic shock (CS) is a serious complication that can occur after an acute myocardial infarction (AMI), and its prognosis may differ based on whether the ST segment on an ECG is elevated (STEMI-CS) or not (NSTEMI-CS).
  • In a study involving 4,647 AMI patients, 239 developed CS, with STEMI-CS patients having larger heart damage and higher 30-day mortality (59.5%) compared to NSTEMI-CS patients (36.7%).
  • However, after three years, both groups showed similar long-term outcomes despite the initial differences in short-term mortality rates.
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Primary ventricular fibrillation (PVF) is a life-threatening complication of ST-segment elevation myocardial infarction (STEMI). It is unclear what roles viral infection and/or systemic inflammation may play as underlying triggers of PVF, as a second hit in the context of acute ischaemia. Here we aimed to evaluate whether the circulating virome and inflammatory proteome were associated with PVF development in patients with STEMI.

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Article Synopsis
  • Sudden cardiac death (SCD) significantly affects healthcare due to its cardiological and neurological complications, especially among the elderly, leading to more admissions in intensive care.
  • A study analyzing SCD patients from five hospitals found that patients aged 80 and older received less aggressive treatments, like new antiplatelet agents and coronary angiography, compared to younger patients.
  • While older age was linked to worse survival rates, it did not correlate with poorer neurological outcomes; instead, factors like rhythm type and time to CPR were more predictive of outcomes regardless of age.
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Fulminant myocarditis (FM) is an uncommon syndrome characterized by sudden and severe hemodynamic compromise secondary to acute myocardial inflammation, often presenting as profound cardiogenic shock, life-threatening ventricular arrhythmias and/or electrical storm. FM may be refractory to conventional therapies and require mechanical circulatory support (MCS). The immune system has been recognized as playing a pivotal role in the pathophysiology of myocarditis, leading to an increased focus on immunosuppressive treatment strategies.

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Article Synopsis
  • Primary ventricular fibrillation (PVF) is a significant cause of cardiac arrest in patients experiencing STEMI (a type of heart attack).
  • This study compared levels of linoleic acid (LA) in serum phospholipids between 58 patients with STEMI-related PVF and 116 matched control patients, finding significantly lower levels of LA in those with PVF.
  • Higher consumption of LA-rich foods (like nuts and seed oils) is suggested to reduce the risk of developing PVF, as each increase in LA was linked to a 42% decrease in prevalence.
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Article Synopsis
  • VA-ECMO is a key treatment for severe cardiogenic shock, but its use is complicated by risks associated with mechanical ventilation.
  • A study analyzed data from 231 patients to compare outcomes between those kept awake during VA-ECMO (awake ECMO) and those who required more sedation (non-awake ECMO).
  • The results showed that awake ECMO resulted in lower rates of pneumonia, fewer complications, and reduced mortality at both 60 days and one year compared to non-awake ECMO patients.
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  • Dietary omega-3 eicosapentaenoic acid (EPA) is linked to heart health, and higher levels in serum phosphatidylcholine (PC) reflect recent intake, potentially impacting recovery from STEMI (a type of heart attack).
  • A study of 944 STEMI patients found that higher serum-PC EPA levels were associated with lower rates of major cardiovascular events and readmissions over three years.
  • Additionally, increased levels of alpha-linolenic acid (ALA) were linked to reduced all-cause mortality, suggesting that diets rich in these omega-3 fatty acids may enhance recovery and improve outcomes after a heart attack.
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Background Coronary artery disease remains a major cause of death despite better outcomes of ST-segment-elevation myocardial infarction (STEMI). We aimed to analyze data from the Ruti-STEMI registry of in-hospital, 28-day, and 1-year events in patients with STEMI over the past 3 decades in Catalonia, Spain, to assess trends in STEMI prognosis. Methods and Results Between February 1989 and December 2017, a total of 7589 patients with STEMI were admitted consecutively.

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Aims: Cardiogenic shock (CS) is an ominous complication of ST-elevation myocardial infarction (STEMI), despite the recent widespread use of reperfusion and invasive management. The Ruti-STEMI-Shock registry analysed the prevalence of and 30-day and 1-year mortality rates in ST-elevation myocardial infarction (STEMI) complicated by CS (STEMI-CS) over the last three decades.

Methods And Results: From February 1989 to December 2018, 493 STEMI-CS patients were consecutively admitted in a well-defined geographical area of ~850,000 inhabitants.

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Background: Coronary care units were established in the 1960s to reduce acute-phase mortality in acute coronary syndrome. In the 21st century, the original coronary care unit concept has evolved into an intensive cardiovascular care unit. The aim of this study was to analyse trend changes in characteristics and mortality of patients admitted to a coronary care unit over the past three decades.

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For almost half a century, cardiac transplant has been the only long-term treatment for patients with end-stage heart failure. Implantable left ventricular assist devices (LVADs) have emerged as a new treatment option for advanced heart failure as destination therapy for patients either too old or not suitable for transplant. A meta-analysis presenting head-to-head comparisons of cardiac transplant versus LVAD as destination therapy (LVAD-DT) found no difference in 1-year mortality rates between LVAD-DT and cardiac transplant (OR 1.

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The incidence of cardiogenic shock (CS) has increased remarkably over the past decade and remains a challenging condition with mortality rates of ∼50%. Cardiogenic shock encompasses cardiac contractile dysfunction; however, it is also a multiorgan dysfunction syndrome, often complicated by a systemic inflammatory response with severe cellular and metabolic dysregulations. Here, we review the evidence on the biochemical manifestations of CS, elaborating on current gold standard biomarkers and novel candidates from molecular signatures of CS.

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Background: Growth differentiation factor 15 (GDF-15) is an inflammatory cytokine released in response to tissue injury. It has prognostic value in cardiovascular diseases and other acute and chronic conditions. Here, we explored the value of GDF-15 as an early predictor of neurologic outcome after an out-of-hospital cardiac arrest (OHCA).

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Introduction: Despite the use of the new generation P2Y12 inhibitors (Ticagrelor and Prasugrel) with aspirin is the recommended therapy in acute NSTE-ACS patients, their current use in clinical practice remains quite low and might be related, among several variables, with increased comorbidity burden. We aimed to assess the prevalence of these treatments and whether their use could be associated with comorbidity.

Method: A multicentric prospective registry was conducted at 8 Cardiac Intensive Care Units (October 2017-April 2018) in patients admitted with non ST elevation myocardial infarction.

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