Publications by authors named "Esteban Lopez-De-Sa"
Background: To assess long-term effectiveness and safety of edoxaban in Europe.
Methods And Results: ETNA-AF-Europe, a prospective, multinational, multi-centre, post-authorisation, observational study was conducted in agreement with the European Medicines Agency. The primary and secondary objectives assessed real-world safety (including bleeding and deaths) and effectiveness (including stroke, systemic embolic events and clinical edoxaban use), respectively.
Article Synopsis
- The PRINCESS2-study aims to evaluate the effectiveness of ultrafast hypothermia (cooling initiated during or immediately after cardiac arrest) on neurologic recovery in patients who have suffered out-of-hospital cardiac arrest with shockable rhythms, compared to standard care without early cooling.
- The trial will involve randomly assigning 1022 patients to either receive trans-nasal cooling shortly after arrival of emergency medical services, followed by in-hospital hypothermia, or to receive standard care without cooling.
- The primary outcome measured will be survival with complete neurologic recovery at 90 days, with secondary outcomes including overall survival rates at hospital discharge and 90 days, and neurologic recovery scores.*
Article Synopsis
- * Data was collected from 115 intensive care and cardiology units across Spain, focusing on patient outcomes and cost factors related to out-of-hospital cardiac arrest cases.
- * Findings reveal that using servo-control for temperature management significantly improves neurological outcomes and can lead to better cost-effectiveness, with patients treated this way showing minimal increased costs compared to the benefits gained.
Aims: Many historical and recent reports showed that post-infarction ventricular septal rupture (VSR) represents a life-threatening condition and the strategy to optimally manage it remains undefined. Therefore, disparate treatment policies among different centres with variable results are often described. We analysed data from European centres to capture the current clinical practice in VSR management.
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- A study conducted from 2017-2020 at five cardiac intensive care units (C-ICUs) found that influenza was detected in 5.5% of patients admitted during flu season, highlighting the potential for underdiagnosis.
- Patients with influenza often had conditions like heart failure and required mechanical ventilation, with higher instances of myocarditis and pericarditis compared to those without influenza.
- Despite a significant vaccination uptake (43% of patients), the findings suggest that routine screening for influenza is necessary at C-ICU admissions during influenza epidemics.
Article Synopsis
- Despite advances in mechanical circulatory support, patients with cardiogenic shock still have a poor prognosis, prompting the need for improved rapid care initiatives.
- This document emphasizes the importance of a structured "SC code" to enhance the organization, activation, and care flow for cardiogenic shock patients.
- The authors aim to outline the unique aspects of cardiogenic shock, team logistics, management strategies, and the challenges of implementing an SC code in both adult and pediatric cases.
What is the role of coronary angiography in the management of postarrest syndrome?
Rev Esp Cardiol (Engl Ed)
February 2023
Objectives: The aim of this study was to describe the procedural and early outcomes of patients with mechanical mitral valve prosthesis (MVP) undergoing transcatheter aortic valve replacement (TAVR) with a novel self-expandable retrievable device.
Background: TAVR in patients with prior MVP may have an increased risk of complications related to device positioning and interference between both prosthetic valves.
Methods: An observational study was conducted, including eight patients with severe symptomatic aortic stenosis and prior mechanical MVP who underwent TAVR with the novel device Allegra (Biosensors).
Aims: Patients with atrial fibrillation (AF) treated with oral anticoagulation still suffer from cardiovascular complications including cardiovascular death, stroke, and major bleeding. To identify risk factors for predicting stroke and bleeding outcomes in anticoagulated patients, we assessed 2-year outcomes in patients with AF treated with edoxaban in routine care. We also report the age-adjusted risk predictors of clinical outcomes.
View Article and Find Full Text PDFBackground: Chronic use of Angiotensin-converting enzyme (ACE) inhibitors (ACEi) and aldosterone-receptor blockers (ARB) is not associated with worse outcomes in patients with COVID-19. However, evidence on the impact of their discontinuation during hospital admission is scarce. Our aim was to determine whether withdrawal of ACEi, ARB and mineralocorticoid receptor antagonists (MRA) is associated with all-cause mortality in a real-life large cohort of patients with SARS-CoV-2 infection.
View Article and Find Full Text PDFAims And Objectives: Statins have been proposed as potentially useful agents for modulating the host response in COVID-19. However, solid evidence-based recommendations are still lacking. Our aim was to study the association between statin use and clinical outcomes in a large cohort of hospitalized patients with SARS-CoV-2 infection, as well as the specific consequences of chronic treatment withdrawal during hospital admission.
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- Ventricular septal rupture (VSR) after a heart attack is a severe condition that requires surgery, and there is debate about the best time for this surgery and how to support patients leading up to it.
- A study analyzed 141 patients over a decade, finding that delaying surgery until at least 4 days after diagnosis significantly reduced mortality rates compared to surgery within the first 24 hours.
- The research also indicated that mechanical circulatory support (like IABP and VA-ECMO) was more commonly used in surgical patients, and overall, surgical intervention had a lower mortality rate (52.3%) compared to conservative treatment (91.5%).
Introduction And Objectives: Myocardial dysfunction contributes to early mortality (24-72 hours) among survivors of a cardiac arrest (CA). The benefits of mechanical support in refractory shock should be balanced against the patient's potential for neurological recovery. To date, these early treatment decisions have been taken based on limited information leading mainly to undertreatment.
View Article and Find Full Text PDFRisk factors associated with in-hospital mortality in young patients with ST-segment elevation myocardial infarction are poorly described. In addition, it is increasingly recognized that these risk factors might differ from those of older patients. The dataset herein presented describes the association between different variables and in-hospital mortality in patients <55 years old with ST-segment elevation myocardial infarction.
View Article and Find Full Text PDFGender-related differences after ST-segment elevation myocardial infarction (STEMI) have been reported, but studies have generally focused on high-risk groups and results are inconsistent. This study aims to determine gender-related differences in the treatment of STEMI and in-hospital mortality in a contemporary cohort of young patients. We included patients aged <55 years admitted to the Acute Cardiac Care Unit with STEMI during an 11-year period.
View Article and Find Full Text PDFBackground: Myocardial injury has been identified as a common complication in patients with COVID-19. However, recent research has serious limitations, such as non-guideline definition of myocardial injury, heterogenicity of troponin sampling or very short-term follow-up. Using data from a large European cohort, we aimed to overcome these pitfalls and adequately characterize myocardial damage in COVID-19.
View Article and Find Full Text PDFAims And Objectives: Statins have been proposed as potentially useful agents for modulating the host response in COVID-19. However, solid evidence-based recommendations are still lacking. Our aim was to study the association between statin use and clinical outcomes in a large cohort of hospitalized patients with SARS-CoV-2 infection, as well as the specific consequences of chronic treatment withdrawal during hospital admission.
View Article and Find Full Text PDFHeavily calcified coronary lesions increase the complexity of percutaneous coronary interventions (PCI) and represent a challenge for interventional cardiologists. They are an important cause of stent underexpansion and poor clinical outcome. Nowadays, there are different dedicated devices which enhance the chances of success.
View Article and Find Full Text PDFBackground: Myocardial injury has been identified as a common complication in patients with COVID-19. However, recent research has serious limitations, such as non-guideline definition of myocardial injury, heterogenicity of troponin sampling or very short-term follow-up. Using data from a large European cohort, we aimed to overcome these pitfalls and adequately characterize myocardial damage in COVID-19.
View Article and Find Full Text PDFAims: Age, sex, and cardiovascular disease have been linked to thromboembolic complications and poorer outcomes in COVID-19. We hypothesize that CHADS2 and CHA2DS2-VASc scores may predict thromboembolic events and mortality in COVID-19.
Methods And Results: COVID-19 hospitalized patients with confirmed SARS-CoV-2 infection from 1 March to 20 April 2020 who completed at least 1-month follow-up or died were studied.