Publications by authors named "Jose Maria Garcia Acuna"
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
- The study investigates the effects of beta-blocker therapy on long-term outcomes for patients who have recovered from Takotsubo syndrome (TTS), a condition that can be triggered by stress and involves temporary heart dysfunction.
- Researchers analyzed data from 970 TTS survivors in Spain, assessing whether those treated with beta-blockers had different rates of mortality and TTS recurrence compared to those who were not treated.
- Results showed no significant differences in survival or recurrence rates between patients on beta-blockers and those not on them, suggesting that beta-blockers may not be beneficial for improving long-term outcomes in TTS patients.
Article Synopsis
- Cardiogenic shock (CS) is a serious condition with significant mortality, prompting a study to create a risk score to predict in-hospital death in affected patients.
- A retrospective analysis of 135 patients identified key factors—like age, mitral regurgitation, and certain biomarkers—that contributed to the development of the Santiago Shock Score (S3), which showed a high accuracy for predicting mortality (AUC 0.85).
- The S3 score categorizes patients into low, intermediate, and high-risk groups with respective mortality rates of 12.9%, 49.1%, and 87.5%, providing a tool for better risk assessment and treatment decisions for patients with CS.
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 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 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.
Comorbidity 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
- Acute coronary syndromes include a specific type called MINOCA, which involves myocardial infarction without significant blockage in coronary arteries and affects younger, predominantly female patients with fewer risk factors.
- * MINOCA has different causes, including issues with epicardial arteries (like plaque disruption) and microvascular problems (like spasms or takotsubo syndrome), making it crucial to identify the underlying mechanism for proper treatment and prognosis.
- * The diagnosis of MINOCA involves various tests, including coronary angiography and cardiac imaging, and standardizing care through future clinical trials could improve outcomes for these patients.
Background Takotsubo syndrome (TTS) is an acute reversible heart condition initially believed to represent a benign pathology attributable to its self-limiting clinical course; however, little is known about its prognosis based on different triggers. This study compared short- and long-term outcomes between TTS based on different triggers, focusing on various physical triggering events. Methods and Results We analyzed patients with a definitive TTS diagnosis recruited for the Spanish National Registry on TTS (RETAKO [Registry on Takotsubo Syndrome]).
View Article and Find Full Text PDFThe association between prior stroke/transient ischemic attack (TIA) and clinical outcomes in patients with acute coronary syndrome (ACS) has not been well explored. We evaluated the impact of prior stroke/TIA on this specific patient population. We conducted an international multicenter study including 15 401 patients with ACS from the Bleeding Complications in a Multicenter Registry of Patients Discharged With Diagnosis of Acute Coronary Syndrome registry.
View Article and Find Full Text PDFIntroduction And Objectives: This study sought to analyze the association of early coronary angiography with all-cause mortality and cardiovascular mortality in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) using a large contemporary cohort of patients with NSTEACS from 2 Spanish tertiary hospitals.
Methods: This retrospective observational study included 5673 consecutive NSTEACS patients from 2 Spanish hospitals between 2005 and 2016. We performed propensity score matching to obtain a well-balanced subset of patients with the same probability of undergoing an early strategy, resulting in 3780 patients.
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: Patients with COPD are at higher risk of presenting with atrial fibrillation (AF). Information about clinical outcomes and optimal medical treatment of AF in the setting of COPD remains missing. We aimed to describe the prevalence of COPD in a sizeable cohort of real-world AF patients belonging to the same healthcare area and to examine the relationship between comorbid COPD and AF prognosis.
View Article and Find Full Text PDFIntroduction: Today's healthcare policies rely heavily on data that has been gathered from multiple small studies in intrinsically varied populations. We sought to describe the prevalence, comorbidities and outcomes of atrial fibrillation (AF) in the population of a specific region where all healthcare centers have implemented a common information technology (IT) structure.
Methods: The total number of inhabitants was obtained from the healthcare area's IT system.
Article Synopsis
- - This study aimed to analyze the frequency, causes, and effects of cardiogenic shock (CS) in patients with takotsubo syndrome (TTS), which is linked to serious heart instability.
- - Out of 711 patients, 11.4% experienced CS, with higher mortality rates and other complications associated with factors like male gender and severe heart function issues at admission.
- - CS was identified as a major predictor of long-term mortality, emphasizing its seriousness in TTS cases; however, beta-blocker treatment improved survival rates in those with CS at discharge.
Introduction: Bleeding is an independent risk factor of mortality in patients with acute coronary syndromes (ACS). BleeMACS project focuses on long-term bleeding events after hospital discharge, thus we evaluated gender-related differences in post-discharge bleeding among patients with ACS.
Materials And Methods: We investigated 13,727 ACS patients treated with percutaneous coronary intervention and discharged on dual antiplatelet therapy (either with clopidogrel or prasugrel/ticagrelor).
Introduction: Atrial fibrillation might increase the risk of dementia. We aim to test the hypothesis that dementia could reclassify the actual risk of stroke and death predicted by the CHA2DS2-VASc in patients with atrial fibrillation (AF).
Methods: A prospective study performed in a specific health care area.