Publications by authors named "Isabel Munoz Pousa"
Guideline-directed medical therapy for heart failure in arrhythmia-induced cardiomyopathy with improved left ventricular ejection fraction.
Eur J Heart Fail
December 2024
Aims: No study has analyzed the impact of guideline-directed medical therapy in preventing heart failure (HF) relapse in patients with arrhythmia-induced cardiomyopathy (AiCM) following left ventricular ejection fraction (LVEF) improvement.
Methods And Results: We analyzed data from a single-center cohort of 200 patients admitted for HF, LVEF <50% and cardiac arrhythmia considered by cardiologists to be the precipitating cause of the episode. The primary endpoint was time-to-HF relapse, defined as the composite of readmission for HF, Emergency Department (ED) visit for HF, or significant decline in LVEF.
Article Synopsis
- Long-term right ventricular pacing (VP) can lead to negative outcomes like heart failure and cardiovascular mortality in patients who have undergone transcatheter aortic valve replacement (TAVR).
- The PACE-TAVI registry studied 377 TAVR patients with pacemakers, comparing those with VP below 40% to those at or above 40% to see how this affects their health outcomes.
- Results showed that patients with VP ≥40% had a significantly higher risk of cardiovascular death and heart failure hospitalization, emphasizing the need for closer monitoring of these patients after TAVR.
Article Synopsis
- The study aimed to determine how cancer affects the risks of embolic (blood clots) and bleeding events in patients with atrial fibrillation (AF).
- In a cohort of over 16,000 AF patients, only those with active cancer or a history of radiotherapy showed a higher risk of bleeding, but there was no increased risk of embolic events due to cancer.
- The widely used CHADS-VASc and HAS-BLED scores were found to be less effective at predicting risks in nonanticoagulated patients with active cancer.
Little is known about the prediction of atrial fibrillation (AF) risk scores in patients with cancer. The aim of this study was to assess the predictive ability of the CHADS-VASc and HAS-BLED scores in patients with AF and cancer. Overall, 16,056 patients with AF diagnosed between 2014 and 2018 from a Spanish health area, including 1,137 patients with cancer, were observed during a median follow-up of 4.
View Article and Find Full Text PDFDespite patients with cancer having a higher incidence of atrial fibrillation (AF), little is known about the predictors of outcomes in this population. This study aimed to assess the incidence and predictors of bleeding in patients with AF and cancer. The study population comprised 16,056 patients from a Spanish health area diagnosed with AF between 2014 and 2018 (1,137 with cancer).
View Article and Find Full Text PDFArticle Synopsis
- Intracoronary imaging techniques are effective in identifying atherosclerotic plaques, particularly in patients with acute coronary syndrome (ACS), highlighting that plaque erosion is a common issue alongside plaque rupture.
- A case study of a 45-year-old man with a history of smoking and cocaine use showed ST-segment elevation myocardial infarction (STEMI) due to thrombotic occlusion, but optical coherence tomography revealed an eroded plaque treatable through conservative management.
- Young patients with risk factors like smoking and drug use often experience STEMI from eroded plaques, and using imaging technology can lead to accurate diagnoses and tailored treatments without the need for stents.
Article Synopsis
- Patients with atrial fibrillation (AF) on anticoagulants often experience bleeding, which may indicate hidden cancers; this study analyzed 8,753 patients aged 75+ from 2014 to 2017.
- Out of those, 24.8% had clinically significant bleeding, and 5.5% were diagnosed with cancer within three years; 9.1% of bleeding patients were later found to have cancer.
- Specific types of bleeding (gastrointestinal, genitourinary, bronchopulmonary) significantly increased the likelihood of cancer diagnosis, highlighting the need for further cancer investigations in these cases.
Article Synopsis
- ACE inhibitors (ACEi) and angiotensin II receptor blockers (ARB) show similar survival rates in heart failure patients with low ejection fraction, but their effectiveness in those with preserved ejection fraction post-acute coronary syndrome (ACS) is unclear.
- A study of 3,006 patients with preserved LVEF (≥40%) after an ACS found no significant differences in outcome measures like mortality and heart failure when comparing ACEi and ARB treatments over an average follow-up of 3.6 years.
- The results suggest that there is no prognostic advantage of using ACEi over ARB or vice versa in this patient population, highlighting the need for further studies to validate these findings.
Article Synopsis
- * A study involving 3,644 ACS patients found that those who experienced postdischarge bleeding had a significantly higher risk of being diagnosed with cancer, especially spontaneous bleeding, with adjusted hazard ratios indicating a strong link.
- * The association between bleeding severity and cancer risk was notable, with a median interval of 4.6 months from bleeding to cancer diagnosis, suggesting that monitoring postdischarge bleeding could aid in early cancer detection.
Aims: Nutrition is an important determinant of health above the age of 80 years. Malnutrition in the elderly is often underdiagnosed. The aim of this study was to report the prevalence and prognostic value of malnutrition in patients ≥80 years old with atrial fibrillation (AF) with and without anticoagulant therapy.
View Article and Find Full Text PDFArticle Synopsis
- * Conducted on patients aged 85 and older from 2013 to 2018, the study found that while anticoagulation reduced the risk of embolisms, it also increased the risk of bleeding in both dementia and non-dementia groups.
- * Importantly, anticoagulation was linked to lower mortality rates only in patients without dementia, suggesting the need for tailored treatments in this vulnerable population.
Article Synopsis
- The study analyzed the risks of recurring ischemia and bleeding in patients treated for acute coronary syndrome (ACS) with percutaneous coronary intervention (PCI) over the first year after the procedure.
- Two large registries, BleeMACS and RENAMI, were used to compare the average daily ischemic risk (ADIR) and average daily bleeding risk (ADBR) among nearly 20,000 patients receiving different antiplatelet therapies.
- Results showed that while ADIR was generally greater than ADBR in the initial weeks post-PCI (especially for severe cases), this trend shifted, with higher bleeding risks found in specific groups like non-ST-segment elevation ACS patients and those on ticagrelor after three months
Article Synopsis
- The PRECISE-DAPT and PARIS risk scores were created to help doctors decide on the best duration for dual antiplatelet therapy (DAPT) after heart procedures, but these scores were not tested in patients with acute coronary syndrome (ACS) using recent medications like prasugrel or ticagrelor.
- A study involving 4,424 ACS patients who had percutaneous coronary interventions was conducted, measuring how well these risk scores predicted major bleeding and ischemic events during an average follow-up of 14 months.
- The findings showed that PRECISE-DAPT was more effective in predicting major bleeding incidents, while the PARIS ischemic risk score was better at predicting ischemic
Article Synopsis
- A study examined the effects of oral anticoagulation on patients aged 90 and older with atrial fibrillation, finding that this group is often underrepresented in clinical trials.
- Out of 1,750 nonagenarians analyzed over an average follow-up of nearly 24 months, DOACs showed a lower risk of death and embolic events compared to no anticoagulation, while VKAs did not demonstrate a significant difference.
- Both DOACs and VKAs were linked to a higher risk of major bleeding, with VKAs also associated with an increased risk of intracranial hemorrhage, highlighting the need for careful management of anticoagulation in this age group.
Efficacy and Safety of Clopidogrel, Prasugrel and Ticagrelor in ACS Patients Treated with PCI: A Propensity Score Analysis of the RENAMI and BleeMACS Registries.
Am J Cardiovasc Drugs
June 2020
Article Synopsis
- This study compares the effectiveness and safety of clopidogrel, prasugrel, and ticagrelor in over 19,000 patients with acute coronary syndrome undergoing PCI and looks at the risks of ischemic events and bleeding over time.
- Results show prasugrel leads to significantly lower rates of net adverse clinical events and major adverse cardiovascular events compared to clopidogrel, while ticagrelor also reduces major adverse cardiovascular events but has a higher bleeding risk.
- The analysis indicates that clopidogrel’s risk profile peaks at 3 months for ischemic events while prasugrel maintains a balance between ischemia and bleeding, and ticagrelor consistently reduces heart attacks over
Article Synopsis
- - The study evaluates the safety and effectiveness of prasugrel and ticagrelor in real-life patients with acute coronary syndrome (ACS) who also have chronic kidney disease (CKD).
- - Out of 19,255 patients, those with CKD showed higher mortality and reinfarction rates, but the use of potent P2Y12 inhibitors like prasugrel and ticagrelor significantly reduced these risks without increasing major bleeding complications.
- - The findings suggest that for ACS patients with CKD, using prasugrel and ticagrelor can improve outcomes compared to clopidogrel, making them a safer option for this high-risk group.
Article Synopsis
- The text discusses the significance of the first author's name in scholarly works.
- It highlights how the first author typically represents the main contributor to the research or study.
- The importance of proper citation and recognition in academic settings is emphasized throughout.
Article Synopsis
- The study aimed to evaluate the relationship between ACE inhibitors (ACEI) or angiotensin receptor blockers (ARB) and mortality rates in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), focusing on those with different levels of left ventricular ejection fraction (LVEF).
- Data from the BleeMACS registry showed that 75.2% of the 15,401 patients were prescribed ACEI/ARB, resulting in a 3.7% mortality rate within the first year.
- Results indicated that ACEI/ARB significantly reduced 1-year mortality—by 46.1% in patients with LVEF ≤ 40% and by 15.7% in those
Incidence, predictors and prognostic impact of intracranial bleeding within the first year after an acute coronary syndrome in patients treated with percutaneous coronary intervention.
Eur Heart J Acute Cardiovasc Care
October 2020
Background: The rate of intracranial haemorrhage after an acute coronary syndrome has been studied in detail in the era of thrombolysis; however, in the contemporary era of percutaneous coronary intervention, most of the data have been derived from clinical trials. With this background, we aim to analyse the incidence, timing, predictors and prognostic impact of post-discharge intracranial haemorrhage in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
Methods: We analysed data from the BleeMACS registry (patients discharged for acute coronary syndrome and undergoing percutaneous coronary intervention from Europe, Asia and America, 2003-2014).
Background: Limited data are available concerning differences in clinical outcomes for real-life patients treated with ticagrelor versus prasugrel after percutaneous coronary intervention (PCI).
Objective: Our objective was to determine and compare the efficacy and safety of ticagrelor and prasugrel in a real-world population.
Methods: RENAMI was a retrospective, observational registry including the data and outcomes of consecutive patients with acute coronary syndrome (ACS) who underwent primary PCI and were discharged with dual antiplatelet therapy (DAPT) between January 2012 and January 2016.
Renin-Angiotensin System Blockade and Risk of Heart Failure After Myocardial Infarction Based on Left Ventricular Ejection Fraction: A Retrospective Cohort Study.
Am J Cardiovasc Drugs
October 2019
Article Synopsis
- This study aimed to explore how angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) impact the occurrence of heart failure (HF) following an acute myocardial infarction (AMI), considering patients' left ventricular ejection fraction (LVEF).
- Researchers analyzed data from 8,169 AMI patients discharged from two Spanish hospitals between 2010 and 2016, employing various statistical methods to assess the relationship between ACEI/ARB use and heart failure admissions.
- Findings indicated that while ACEIs/ARBs showed no significant benefit for patients with LVEF over 40%, they significantly reduced HF admissions in patients with LVEF 40% or lower, suggesting
Long versus short dual antiplatelet therapy in acute coronary syndrome patients treated with prasugrel or ticagrelor and coronary revascularization: Insights from the RENAMI registry.
Eur J Prev Cardiol
May 2020
Article Synopsis
- The study investigates the effectiveness of different durations of dual antiplatelet therapy (DAPT) using prasugrel or ticagrelor in patients with acute coronary syndromes who underwent percutaneous coronary intervention, as previous research primarily focused on clopidogrel.
- Researchers analyzed data from 4424 patients, categorizing them into three groups based on DAPT duration: less than 12 months, exactly 12 months, and more than 12 months, to assess net adverse clinical events (NACEs) and major adverse cardiac events (MACEs).
- Findings showed that patients on 12 months or longer of DAPT had a significantly lower risk of NACEs and MACEs compared to those receiving less than 12
Introduction: There are conflicting clinical and laboratory data about the effect of dual antiplatelet therapy (DAPT) on cancer incidence, including analysis suggesting an increased cancer risk. This study aims to analyze if there are differences in the incidence of cancer according to the type of P2Y12 inhibitor prescribed (clopidogrel, prasugrel, or ticagrelor), among a population of acute coronary syndrome (ACS) survivors treated with DAPT.
Material And Methods: A retrospective study was conducted among 4229 consecutive ACS patients discharged from a tertiary hospital with DAPT from 2010 to 2016.
Introduction: The safety and efficacy of prasugrel and ticagrelor in patients with diabetes mellitus presenting with acute coronary syndrome and treated with percutaneous coronary intervention remain to be assessed.
Methods: All diabetes patients admitted for acute coronary syndrome and enrolled in the REgistry of New Antiplatelets in patients with Myocardial Infarction (RENAMI) were compared before and after propensity score matching. Net adverse cardiovascular events (composite of death, stroke, myocardial infarction and BARC 3-5 bleedings) and major adverse cardiovascular events (composite of death, stroke and myocardial infarction) were the co-primary endpoints.
Article Synopsis
- - The study assessed the occurrence and predictors of major bleeding in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) and were treated with prasugrel or ticagrelor.
- - Out of 4424 patients, 1.8% experienced significant bleeding after about 14 months, which was linked to higher rates of major adverse cardiovascular events (MACE) and death.
- - Older adults (over 75 years) and women were identified as independent risk factors for major bleeding, suggesting a need for personalized antiplatelet therapy strategies in these groups.