Publications by authors named "Jose M Garcia-Acuna"
Background: Coronary heart disease is the leading cause of heart failure (HF), and tools are needed to identify patients with a higher probability of developing HF after an acute coronary syndrome (ACS). Artificial intelligence (AI) has proven to be useful in identifying variables related to the development of cardiovascular complications.
Methods: We included all consecutive patients discharged after ACS in two Spanish centers between 2006 and 2017.
Background: Cardiogenic shock (CS) is a significant complication of Takotsubo syndrome (TTS), contributing to heightened mortality and morbidity. Despite this, the Society for Cardiovascular Angiography and Interventions (SCAI) staging system for CS severity lacks validation in patients with TTS and CS. This study aimed to characterize a patient cohort with TTS using the SCAI staging system and assess its utility in cases of TTS complicated by CS.
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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
- Current evidence shows that patients with high ischemic risk benefit from extended dual antiplatelet treatment (DAPT), while those with high bleeding risk are better suited for shorter durations of DAPT.
- A study evaluated over 8,200 patients post-acute coronary syndrome (ACS) and categorized them into three DAPT groups based on their bleeding and ischemic risk.
- Results indicated that a significant portion of patients face higher risks of major adverse cardiovascular events (MACE) and mortality, particularly those recommended for short DAPT.
Background: Remnant cholesterol has been identified as one of leading lipid values associated with the incidence of coronary heart disease. There is scarce evidence on its distribution and prognostic value in acute coronary syndrome (ACS) patients.
Methods And Results: We included all consecutive patients admitted for ACS in two different centres.
Article Synopsis
- The Zwolle risk score aims to better predict in-hospital mortality for patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) compared to the GRACE score.
- In a study of 4,446 STEMI patients across three university hospitals, the Zwolle score identified only 25% as high-risk, while the GRACE score identified 60%.
- The Zwolle score showed higher specificity for identifying high-risk patients, suggesting it could be more effective for clinical use in decision-making regarding STEMI treatment.
Article Synopsis
- 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.
Article Synopsis
- * Out of 2004 patients studied, those with improved or stable kidney function after one year experienced significantly lower rates of major adverse cardiovascular events and all-cause mortality.
- * The findings suggest that monitoring and improving renal function in these patients is crucial for better long-term health outcomes following STEMI.
Aim: Whether Takotsubo syndrome (TTS) should be classified within myocardial infarction with non-obstructive coronary arteries (MINOCAs) is still controversial. The aim of this work was to evaluate the main differences between TTS and non-TTS MINOCAs.
Methods And Results: A cohort study based on two prospective registries: TTS from the RETAKO registry (:1,015) and patients with non-TTS MINOCAs from contemporary records of acute myocardial infarction from five 5 national centers (:1,080).
Background: In elderly patients with non-ST elevation acute coronary syndrome (NSTEACS), while routine invasive management is established in high-risk NSTEACS patients, there is still uncertainty regarding the optimal timing of the procedure.
Methods: This study analyzes the association of early coronary angiography with all-cause mortality, cardiovascular mortality, heart failure (HF) hospitalization, and major adverse cardiovascular events (MACE) in patients older than 75 years old with NSTEACS. This retrospective observational study included 7811 consecutive NSTEACS patients who were examined between the years 2003 and 2017 at two Spanish university hospitals.
Few studies have addressed to date the interaction between sex and diabetes mellitus (DM) in the prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Our aim was to address the role of DM in the prognosis of non-selected elderly patients with NSTEACS according to sex. A retrospective analysis from 11 Spanish NSTEACS registries was conducted, including patients aged ≥70 years.
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- The study aimed to compare soluble angiotensin-converting enzyme-2 (sACE2) plasma level variations and their impact on the prognosis of two groups: heart failure (HF) and acute coronary syndrome (ACS).
- In a clinical study involving 102 patients from each cohort, higher levels of sACE2 were found in the HF group, and these levels were linked to long-term cardiac outcomes and various health parameters, depending on the cohort.
- Treatment with angiotensin receptor blockers and β-blockers was associated with increased sACE2 levels, indicating that certain cardiovascular drugs influence ACE enzymes, with implications for patient management in HF and ACS.
Article Synopsis
- The study analyzes cardiovascular outcomes in patients with diabetes mellitus who are experiencing non-ST elevation acute coronary syndrome (NSTEACS) and evaluates the effectiveness of two risk assessment scores: GRACE and PRECISE-DAPT.
- A total of 7,415 patients were included, with 28% having diabetes; findings revealed diabetic patients were generally older and had higher initial risk scores, with differences in treatment approaches observed.
- The PRECISE-DAPT score effectively predicted mortality and adverse cardiovascular events in diabetic patients, while the GRACE score performed worse over the long term for these individuals.
Aims: Left ventricular ejection fraction (LVEF) recovery after an ST-segment elevation myocardial infarction (STEMI) identifies a group of patients with a better prognosis. However, the association between long-term outcomes and LVEF recovery among patients with STEMI undergoing primary percutaneous coronary intervention (PCI) has not yet been well investigated. Our study aims to detect differences in long-term all-cause and cardiovascular mortality between patients who recover LVEF at 1-year post-PCI and those who do not, and search for predictors of LVEF recovery.
View Article and Find Full Text PDFThe benefit of complete revascularization in elderly patients with non-ST elevation myocardial infarction (NSTEMI), and multivessel disease remains debated (MVD). The aim of our study was to determine the current long-term prognostic benefit of complete revascularization in this population. A retrospective cohort study of 1722 consecutive elderly NSTEMI patients was performed.
View Article and Find Full Text PDFPrognostic benefit from an early invasive strategy in patients with non-ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines.
Clin Res Cardiol
September 2021
Objectives: The objective of our work is to evaluate the prognostic benefit of an early invasive strategy in patients with high-risk NSTACS according to the recommendations of the 2020 clinical practice guidelines during long-term follow-up.
Methods: This retrospective observational study included 6454 consecutive NSTEACS patients. We analyze the effects of early coronary angiography (< 24 h) in patients with: (a) GRACE risk score > 140 and (b) patients with "established NSTEMI" (non ST-segment elevation myocardial infarction defined by an increase in troponins) or dynamic ST-T-segment changes with a GRACE risk score < 140.
Recently the coronavirus disease (COVID-19) outbreak has been declared a pandemic. Despite its aggressive extension and significant morbidity and mortality, risk factors are poorly characterized outside China. We designed a registry, HOPE COVID-19 (NCT04334291), assessing data of 1021 patients discharged (dead or alive) after COVID-19, from 23 hospitals in 4 countries, between 8 February and 1 April.
View Article and Find Full Text PDFComorbidity burden and revascularization benefit in elderly patients with acute coronary syndrome.
Rev Esp Cardiol (Engl Ed)
September 2021
Article Synopsis
- The study aimed to assess how comorbidities impact the effectiveness of in-hospital revascularization in older patients with non-ST-segment elevation acute coronary syndrome (NSTEACS).
- Researchers analyzed data from 7211 patients aged 70 and older, finding that revascularization significantly reduced 1-year mortality rates, although this benefit diminished as comorbidities increased.
- Specifically, patients with renal failure, peripheral artery disease, and chronic pulmonary disease experienced fewer benefits from revascularization compared to those with fewer comorbidities, while diabetes and previous strokes did not significantly alter the results.
Introduction And Objectives: There is insufficient data regarding sex-related prognostic differences in patients with a non-ST elevation acute coronary syndrome (NSTEACS). We performed a sex-specific analysis of cardiovascular outcomes after NSTEACS using a large contemporary cohort of patients from two tertiary hospitals.
Methods: This work is a retrospective analysis from a prospective registry, that included 5,686 consecutive NSTEACS patients from two Spanish University hospitals between the years 2005 and 2017.
Article Synopsis
- Coronary heart disease is a major contributor to heart failure (HF), and this study focused on patients with acute coronary syndrome who had no prior HF or left ventricular issues to evaluate their risk of readmission for HF.
- In a study involving 5962 patients, 9.5% faced at least one HF readmission within an average follow-up period of 63 months, highlighting a greater risk of HF readmission compared to mortality in the first seven years post-discharge.
- Key risk factors for HF readmission included age, diabetes, history of coronary heart disease, and several other health issues, while optimal medical treatment lowered this risk; a straightforward HF risk score was developed to help predict readmission likelihood.