Publications by authors named "Jose A Barrabes"
Objective: To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the MOSCA-FRAIL clinical trial.
Methods: The MOSCA-FRAIL trial randomized 167 frail patients, defined by a Clinical Frailty Scale (CFS) ≥ 4, with NSTEMI to an invasive or conservative strategy. The primary endpoint was the number of days alive and out of hospital (DAOH) one year after discharge.
Background: Left atrial deformation analysis may identify patients at higher risk of adverse events in the setting of non-ischemic dilated cardiomyopathy (NIDCM). The purpose was to determine the association between peak longitudinal (PALS) and contraction (PACS) LA strain in NIDCM, accounting for left ventricular global longitudinal strain (LV-GLS).
Methods: Consecutive patients with NIDCM, sinus rhythm and LV ejection fraction (LVEF)<50 % were included.
Cysteine proteases calpains contribute to heart failure (HF), but it remains unknown whether their inhibition provides any benefit compared to standard pharmacological treatment for HF. Here, we characterize the pharmacological properties of NPO-2270 (NPO) as a potent inhibitor of cysteine proteases. Then, we describe that acute administration of NPO in rodent models of transient ischemia at the time of reperfusion reduces myocardial infarction, while its chronic oral administration attenuates adverse remodeling and cardiac dysfunction induced by ischemic and non-ischemic pathological stimuli more effectively than enalapril when given at the same dose.
View Article and Find Full Text PDFNonischemic dilated cardiomyopathy (NIDCM) is associated with an increased risk of atrial fibrillation (AF) and stroke, especially in patients with high CHADS-VASc. We aimed to identify variables associated with incident AF or stroke using left atrial deformation analysis and its prognostic value added to CHADS-VASc score. Patients with NIDCM and left ventricular ejection fraction <50% in sinus rhythm were included between January 2015 and December 2019.
View Article and Find Full Text PDFArticle Synopsis
- The MOSCA-FRAIL trial examined the effects of invasive versus conservative treatment strategies in frail patients aged 70 and older with non-ST-segment elevation myocardial infarction (NSTEMI).
- The study included 167 participants and focused on various geriatric conditions, finding that invasive management had a notable survival benefit primarily for those with lower frailty levels (CFS=4).
- Results suggested that frailty, as indicated by the Clinical Frailty Scale (CFS), is an important factor in determining the risks and benefits of treatment, with a CFS score greater than 4 potentially signaling a need for more cautious decision-making.
Aims: Atrial fibrillation (AF) is a common comorbidity in non-ischaemic dilated cardiomyopathy (NIDCM) affecting conventional measures of left atrial (LA) function. We aimed to determine whether LA function analysis could identify patients at higher risk of major cardiovascular events (MACEs).
Methods And Results: A retrospective study of patients with NIDCM in AF referred to a single centre for transthoracic echocardiography (TTE) between 2015 and 2019.
Article Synopsis
- The study aimed to evaluate the feasibility and survival outcomes of a multidisciplinary extracorporeal cardiopulmonary resuscitation (ECPR) program at a university hospital in Spain over a four-year period.
- The research analyzed data from 54 adult patients who received ECPR, noting that 16 patients (29.6%) were alive after 180 days, with 15 showing good neurological outcomes.
- The results suggest that implementing an ECPR program is practical and can result in favorable survival rates and potential organ donation opportunities in a specialized medical center.
Article Synopsis
- The MOSCA-FRAIL trial investigated treatment approaches for frail patients (aged ≥70) with non-ST-segment elevation myocardial infarction (NSTEMI) and found no significant difference in health outcomes after one year between invasive and conservative strategies.
- Following extended follow-up until January 2023, the analysis of 167 patients indicated similar survival times and readmission rates, revealing that neither treatment significantly outperformed the other.
- Overall, while initial outcomes suggested that invasive treatment might lead to shorter survival in the first year, the long-term results demonstrated inconclusive differences, highlighting the need for personalized treatment decisions in frail older adults.
Background: The measurement of aortic dimensions and their evolution are key in the management of patients with aortic diseases. Manual assessment, the current guideline-recommended method and clinical standard, is subjective, poorly reproducible, and time-consuming, limiting the capacity to track aortic growth in everyday practice. Aortic geometry mapping (AGM) via image registration of serial computed tomography angiograms outperforms manual assessment, providing accurate and reproducible 3D maps of aortic diameter and growth rate.
View Article and Find Full Text PDFQuestion: Shock with electrocardiogram deterioration.
Eur Heart J Acute Cardiovasc Care
February 2024
Article Synopsis
- Percutaneous mitral paravalvular leak (PVL) closure is a safe and effective alternative to surgery, but its long-term outcomes are not well-studied. The study focused on how successful closure impacts long-term patient outcomes.* -
- Researchers analyzed data from 90 patients undergoing their first mitral PVL closure attempt between 2010 and 2021, finding that while 91.1% had a reduction in leak severity, only 52.2% achieved successful closure.* -
- After a median follow-up of 3.2 years, those with procedural failure faced significantly higher mortality rates, particularly from cardiovascular causes, indicating that successful PVL closure greatly benefits long-term health.*
Succinate is enhanced during initial reperfusion in blood from the coronary sinus in ST-segment elevation myocardial infarction (STEMI) patients and in pigs submitted to transient coronary occlusion. Succinate levels might have a prognostic value, as they may correlate with edema volume or myocardial infarct size. However, blood from the coronary sinus is not routinely obtained in the CathLab.
View Article and Find Full Text PDFIntroduction: Cases of myocarditis after COVID-19 messenger RNA (mRNA) vaccines administration have been reported. Although the majority follow a mild course, fulminant presentations may occur. In these cases, cardiopulmonary support with venoarterial extracorporeal membrane oxygenation (V-A ECMO) may be needed.
View Article and Find Full Text PDFArticle Synopsis
- This study is the first randomized clinical trial to compare invasive versus conservative treatment strategies for frail, older patients (≥70 years) with non-ST-segment elevation acute myocardial infarction (NSTEMI).
- Conducted across 13 hospitals in Spain from 2017 to 2021, it included 167 patients and measured primary outcomes like days alive and out of the hospital (DAOH) and the rates of cardiac-related complications.
- Results showed that while conservatively managed patients had slightly more DAOH (312 days) compared to those managed invasively (284 days), the difference was not statistically significant, and no major differences in mortality were found between the two groups. *
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.
Impact of revascularization guided by functional testing in ischaemic cardiomyopathy.
Eur Heart J Cardiovasc Imaging
September 2022
Aims: The burden of ischaemia is a risk factor for adverse outcomes in ischaemic cardiomyopathy (ICM) but is not systematically tested when deciding on revascularization. Limited data exists in patients with ICM regarding the interaction between ischaemia and early coronary revascularization (ECR). This study sought to determine if the burden of ischaemia modifies the outcomes of ECR in ICM.
View Article and Find Full Text PDF[2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA)].
G Ital Cardiol (Rome)
July 2022
2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA).
Rev Esp Cardiol (Engl Ed)
May 2022
Despite advances in its treatment, heart failure remains a major cause of morbidity and mortality, evidencing an urgent need for novel mechanism-based targets and strategies. Myocardial hypertrophy, caused by a wide variety of chronic stress stimuli, represents an independent risk factor for the development of heart failure, and its prevention constitutes a clinical objective. Recent studies performed in preclinical animal models support the contribution of the Ca-dependent cysteine proteases calpains in regulating the hypertrophic process and highlight the feasibility of their long-term inhibition as a pharmacological strategy.
View Article and Find Full Text PDFBackground: The effect of renin-angiotensin system (RAS) blockade either by angiotensin-converting enzyme inhibitors (ACEis) or angiotensin-receptor blockers (ARBs) on coronavirus disease 2019 (COVID-19) susceptibility, mortality and severity is inadequately described. We examined the association between RAS blockade and COVID-19 diagnosis and prognosis in a large population-based cohort of patients with hypertension (HTN).
Methods: This is a cohort study using regional health records.