Publications by authors named "Eduardo Pinar"
Introduction And Objectives: Impact of gender on long-term outcomes after transcatheter aortic valve implantation (TAVI) remains uncertain. We aimed to investigate gender-specific differences in TAVI and its impact on outcomes.
Methods: This analysis used data from the prospective Spanish TAVI registry, which included consecutive TAVI patients treated in 46 Spanish centers from 2009 to 2021.
Coronary physiology: an essential diagnostic tool beyond obtaining a cutoff point.
Rev Esp Cardiol (Engl Ed)
November 2024
Article Synopsis
- Intravascular lithotripsy (IVL) is a new technique aimed at improving stenting in patients with coronary calcification, which can hinder optimal results.
- A multicenter study analyzed 90 patients with both concentric and eccentric calcium morphologies to determine IVL's efficacy, focusing on outcomes such as angiographic success and fracture presence post-procedure.
- Results showed that while concentric lesions had more fractures, overall effectiveness in terms of stent expansion and lumen area was not significantly different between the two types of calcium morphology.
Article Synopsis
- The study aimed to evaluate the prevalence of high bleeding risk (HBR) characteristics in patients who underwent percutaneous coronary intervention (PCI) and assess the representativeness of the MASTER DAPT trial data.
- Out of 2,847 patients screened, 38.6% were identified as HBR, but only 9.9% consented to participate in the trial, revealing differences in HBR characteristics between consenting and non-consenting patients.
- The findings highlight significant selection biases, as the characteristics of HBR patients in the trial differed notably from those in the overall patient population, indicating that trial results may not fully reflect real-world scenarios.
Background: Complete revascularization of the culprit and all significant nonculprit lesions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD) reduces major adverse cardiac events, but optimal timing of revascularization remains unclear.
Objectives: This study aims to compare immediate complete revascularization (ICR) and staged complete revascularization (SCR) in patients presenting with NSTE-ACS and MVD.
Methods: This prespecified substudy of the BIOVASC (Percutaneous Complete Revascularization Strategies Using Sirolimus Eluting Biodegradable Polymer Coated Stents in Patients Presenting With Acute Coronary Syndrome and Multivessel Disease) trial included patients with NSTE-ACS and MVD.
Background: Drug-eluting stents (DES) are considered the therapy of choice in ST-segment elevation myocardial infarction (STEMI); however, a low persistent rate of revascularizations and stent thrombosis exist over the time. We have previously shown that a paclitaxel (PTX)-drug-coated balloon (DCB) after a bare-metal stent (BMS) implantation (DCB-combined strategy) yields superior angiographic and clinical results compared to BMS in the short term. However, the long-term safety and efficacy of this approach remain uncertain.
View Article and Find Full Text PDFArticle Synopsis
- Clinical events can occur after percutaneous coronary intervention (PCI), especially in complex cases, and using advanced intracoronary imaging and pressure guidewires may help reduce these risks.
- The OPTI-XIENCE study is an international, multicenter prospective observational study involving 1,064 patients with specific high-risk characteristics undergoing stent implantation, monitoring them for 12 months.
- The study aims to evaluate the effectiveness of using these intracoronary tools, with the primary focus on the rate of target lesion failure after one year, while also assessing additional cardiovascular outcomes.
Objective: To assess the efficiency of Dyevert™ Power XT compared to the standard clinical practice when used for percutaneous coronary interventions (PCI).
Methods: A Markov model was developed to estimate, over 3-month cycles and a lifetime time horizon, the cumulative costs and health outcomes (life years gained [LYG] and quality-adjusted life years [QALY]) in a hypothetical cohort of 1,000 patients with chronic kidney disease (CKD) 3b-4 and an average age of 72 years. The incidence of contrast-induced acute kidney injury for these patients is 18.
Background: Revascularization of left main coronary artery (LMCA) stenosis is mostly based on angiography. Indices based on angiography might increase accuracy of the decision, although they have been scarcely used in LMCA. The objective of this study is to study the diagnostic agreement of QFR (quantitative flow ratio) with wire-based fractional flow reserve (FFR) in LMCA lesions and to compare with visual severity assessment.
View Article and Find Full Text PDFInstantaneous Wave-Free Ratio for the Assessment of Intermediate Left Main Coronary Artery Stenosis: Correlations With Fractional Flow Reserve/Intravascular Ultrasound and Prognostic Implications: The iLITRO-EPIC07 Study.
Circ Cardiovasc Interv
November 2022
Article Synopsis
- This study investigates the agreement between fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) in patients with intermediate stenosis in the left main coronary artery (LMCA), finding an 80% concordance between the two methods.
- The research involved 300 patients and emphasized the role of intravascular ultrasound (IVUS) for assessing cases where FFR and iFR results disagreed, identifying minimal lumen areas as a factor in decision-making.
- Over a 20-month follow-up, deferral of revascularization based on iFR and IVUS showed a lower incidence of major adverse cardiac events compared to those who underwent revascularization, suggesting that deferring treatment
Background: Aortic valve replacement is the gold standard treatment for severe symptomatic aortic stenosis, but thrombosis of bioprosthetic valves (PVT) remains a concern.
Objective: To analyze the factors involved in the contact pathway during aortic valve replacement and to assess their impact on the development of thromboembolic complications.
Methods: The study was conducted in 232 consecutive patients who underwent: transcatheter aortic valve replacement (TAVR, = 155), and surgical valve replacement (SAVR, = 77) (MUVITAVI project).
Prospective application of a bleeding and ischemic risks-adjusted antithrombotic protocol in elderly patients revascularized with everolimus-eluting stents: EPIC05-Sierra75 study.
J Geriatr Cardiol
May 2022
Article Synopsis
- The study aimed to evaluate the outcomes of elderly patients (over 75 years) undergoing percutaneous transluminal coronary intervention (PCI) using an antithrombotic strategy that considers their individual risks for bleeding and ischemic events.
- The research included 1,064 patients and found that the incidence of major adverse cardiovascular events and bleeding was lower in this tailored treatment group compared to a control group, with no cases of stent thrombosis in those receiving shorter dual antiplatelet therapy.
- The conclusion indicates that a risk-adjusted antithrombotic protocol for elderly patients after revascularization with the latest stent technology may lead to better health outcomes regarding both bleeding and ischemic events.
The amphilimus-eluting stent (AES) is a thin-strut polymer-free stent that releases sirolimus formulated with a carrier from abluminal grooves. The RESERVOIR trial compared AES vs everolimus-eluting stents (EES) in patients with diabetes mellitus (DM) and showed non-inferior neointimal hyperplasia suppression at 9 months follow-up. The aim of this study was to assess comparative clinical outcomes at 5 years.
View Article and Find Full Text PDFBackground: Resolute Onyx polymer-based zotarolimus-eluting stents (ZES) were noninferior in safety and effectiveness to BioFreedom polymer-free biolimus A9-coated stents (DCS) in high-bleeding-risk (HBR) patients treated with 1-month dual antiplatelet therapy (DAPT) followed by single antiplatelet therapy (SAPT) at 1 year.
Objectives: This study reports the final 2-year results of the randomized Onyx ONE trial.
Methods: The Onyx ONE (A Randomized Controlled Trial With Resolute Onyx in One Month Dual Antiplatelet Therapy (DAPT) for High-Bleeding Risk Patients) trial randomly assigned HBR patients to treatment with ZES or DCS.
Donation after circulatory death (DCD) represents a promising opportunity to overcome the relative shortage of donors for heart transplantation. However, the necessary period of warm ischemia is a concern. This study aims to determine the critical warm ischemia time based on in vivo biochemical changes.
View Article and Find Full Text PDFAim: Patients with diabetes mellitus are at high risk of adverse events after percutaneous revascularization, with no differences in outcomes between most contemporary drug-eluting stents. The Cre8 EVO stent releases a formulation of sirolimus with an amphiphilic carrier from laser-dug wells, and has shown clinical benefits in diabetes. We aimed to compare Cre8 EVO stents to Resolute Onyx stents (a contemporary polymer-based zotarolimus-eluting stent) in patients with diabetes.
View Article and Find Full Text PDFBackground: We sought to investigate the antithrombotic regimens applied and their prognostic effects in patients over 75 years old with atrial fibrillation (AF) after revascularization with drug-eluting stents (DES).
Methods: Retrospective registry in 20 centers including patients over 75 years with AF treated with DES. A primary endpoint of MACCE and a co-primary endpoint of major bleeding by ISTH criteria were considered at 12 months.
Introduction And Objectives: Transcatheter aortic valve implant has become a widely accepted treatment for inoperable patients with aortic stenosis and patients at high surgical risk. Its indications have recently been expanded to include patients at intermediate and low surgical risk. Our aim was to evaluate the efficiency of SAPIEN 3 vs conservative medical treatment (CMT) or surgical aortic valve replacement (SAVR) in symptomatic inoperable patients at high or intermediate risk.
View Article and Find Full Text PDFBackground: During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes.
Objectives: The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome.
Background: During COVID-19 pandemic in Spain, elective procedures were canceled or postponed, mainly due to health care systems overwhelming.
Objective: The objective of this study was to evaluate the consequences of interrupting invasive procedures in patients with chronic cardiac diseases due to the COVID-19 outbreak in Spain.
Methods: The study population is comprised of 2,158 patients that were pending on elective cardiac invasive procedures in 37 hospitals in Spain on the 14th of March 2020, when a state of alarm and subsequent lockdown was declared in Spain due to the COVID-19 pandemic.
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.
Background: Polymer-free drug-coated stents provide superior clinical outcomes to bare-metal stents in patients at high bleeding risk who undergo percutaneous coronary intervention (PCI) and are treated with 1 month of dual antiplatelet therapy. Data on the use of polymer-based drug-eluting stents, as compared with polymer-free drug-coated stents, in such patients are limited.
Methods: In an international, randomized, single-blind trial, we compared polymer-based zotarolimus-eluting stents with polymer-free umirolimus-coated stents in patients at high bleeding risk.
The aim of this study is to propose national diagnostic reference levels (DRL) for updating in the field of interventional cardiology and to include technical details to help plan optimization. Medical physics experts and interventional cardiologists from 14 hospitals provided patient dose indicators from coronary angiography and percutaneous coronary interventions. Information about X-ray system dose settings and image quality was also provided.
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