Publications by authors named "Josep Gomez Lara"

Background: Longitudinal changes in gut microbiome and inflammation may be involved in the evolution of atherosclerosis after an acute coronary syndrome (ACS). We aimed to characterize repeated profiles of gut microbiota and peripheral CD4+ T lymphocytes during the first year after an ACS, and to address their relationship with atherosclerotic plaque changes.

Methods: Over one year we measured the microbiome, peripheral counts of CD4+ T populations and cytokines in 67 patients shortly after a first ACS.

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  • Intravascular lithotripsy (IVL) is effective for treating calcified coronary lesions in patients with stable coronary disease, as shown in a study involving 426 patients across 26 centers in Spain.
  • The study found that IVL was successfully delivered in 99% of cases, achieving procedural success in 66% of patients and similar outcomes for both acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) groups.
  • The safety analysis showed a relatively low rate of major adverse cardiovascular events (MACE) at 30 days, with 3% overall (1% for CCS and 5% for ACS), indicating that IVL is both safe and effective in real-life clinical settings.
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  • The study investigates long-term outcomes after ST-segment myocardial infarction (STEMI), focusing on how different adverse events affect patient prognosis over a 10-year period.
  • Patients were randomized to receive either an everolimus-eluting stent or a bare-metal stent, and various predictors of composite adverse events (like death or revascularization) were analyzed.
  • Results showed that about one-third of patients experienced adverse events, with factors like age and diabetes being significant predictors, but the type of first event (target vessel failure vs. non-target vessel failure) did not significantly impact subsequent outcomes.
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Background ST-segment-elevation myocardial infarction complicated with no reflow after primary percutaneous coronary intervention is associated with adverse outcomes. Although several hyperemic drugs have been shown to improve the Thrombolysis in Myocardial Infarction flow, optimal treatment of no reflow remains unsettled. Saline infusion at 20 mL/min via a dedicated microcatheter causes (flow-mediated) hyperemia.

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Background: Little data exist on the relationship between total stent length (TSL) and cardiovascular outcomes at very-long follow-up in patients with ST-elevation myocardial infarction (STEMI) in the 2nd generation drug-eluting stents (DES) era.

Aim: To analyze the relationship between TSL and 10-year target-lesion failure (TLF) in STEMI patients treated with percutaneous coronary intervention enrolled in the EXAMINATION-EXTEND.

Methods: The EXAMINATION-EXTEND was an extended-follow-up study of the EXAMINATION trial, which randomized 1:1 STEMI patients to receive DES or bare metal stent (BMS).

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Background: The long-term cardiovascular (CV) outcomes of COVID-19 have not been fully explored.

Methods: This was an international, multicenter, retrospective cohort study conducted between February and December 2020. Consecutive patients ≥18 years who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 were included.

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The aim of this substudy of the EXAMINATION-EXTEND was to analyze 10-year outcomes according to the patient's age at the time of the first ST-elevation myocardial infarction (STEMI). Of 1,498 patients with STEMI included in the EXAMINATION-EXTEND study, those with a previous history of coronary ischemic even or ischemic stroke were excluded from this analysis. The remaining 1,375 patients were divided into 4 age groups: <55, 55 to 65, 65 to 75, and >75 years.

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Introduction: Patients with diabetes mellitus (DM) have augmented platelet reactivity and diminished responsiveness to clopidogrel. Ticagrelor, a more potent P2Y inhibitor, is clinically superior to clopidogrel in acute coronary syndromes, although its role in chronic coronary syndromes (CCS) is still the subject of debate. The aim of this investigation was to compare the pharmacodynamic effectiveness of ticagrelor and clopidogrel in Mediterranean DM patients with CCS.

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Background Long-term outcomes of ST-segment-elevation myocardial infarction in patients with diabetes have been barely investigated. The objective of this analysis from the EXAMINATION-EXTEND (10-Years Follow-Up of the EXAMINATION trial) trial was to compare 10-year outcomes of patients with ST-segment-elevation myocardial infarction with and without diabetes. Methods and Results Of the study population, 258 patients had diabetes and 1240 did not.

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  • This study investigated the incidence and predictors of not recovering left ventricular function in patients experiencing cardiogenic shock due to myocardial infarction related to unprotected left main coronary artery (ULMCA).
  • Conducted at two tertiary care centers from 2012 to 2020, the study included 70 patients, finding that 58.6% faced death or required heart transplantation (HT) or left ventricular assist devices (LVAD) during admission, especially among those with severe shock and occluded LMCA.
  • Successful percutaneous coronary intervention (PCI) lowered overall risk but didn't significantly impact outcomes in the most complex cases; a predictive model identified key factors like left ventricular ejection fraction and severity of shock with a strong ability to forecast
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  • This study investigates the agreement between fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) in patients with intermediate stenosis in the left main coronary artery (LMCA), finding an 80% concordance between the two methods.
  • The research involved 300 patients and emphasized the role of intravascular ultrasound (IVUS) for assessing cases where FFR and iFR results disagreed, identifying minimal lumen areas as a factor in decision-making.
  • Over a 20-month follow-up, deferral of revascularization based on iFR and IVUS showed a lower incidence of major adverse cardiac events compared to those who underwent revascularization, suggesting that deferring treatment
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Objectives: Coronary lithotripsy (CL) works by fracturing the calcified plaque, allowing mean area gain, enhancing vessel compliance, and facilitating stent deployment. This study reports the safety, effectiveness, and durability of the clinical benefit of CL at long-term follow-up of a real-world multicenter registry.

Methods: This was a prospective, multicenter, single-arm study that included consecutive patients with calcified lesions undergoing CL from August, 2018 to October, 2020 with a clinical follow-up of 20 months (interquartile range, 14.

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Background: Short-term outcomes following ST-segment elevation myocardial infarction (STEMI) in women are worse than in men, with a higher mortality rate. It is unknown whether sex plays a role in very long term outcomes.

Objectives: The aim of this study was to assess whether very long term outcomes following STEMI treatment are influenced by sex.

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The amphilimus-eluting stent (AES) is a thin-strut polymer-free stent that releases sirolimus formulated with a carrier from abluminal grooves. The RESERVOIR trial compared AES vs everolimus-eluting stents (EES) in patients with diabetes mellitus (DM) and showed non-inferior neointimal hyperplasia suppression at 9 months follow-up. The aim of this study was to assess comparative clinical outcomes at 5 years.

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Background: The Impella pump has emerged as a promising tool in patients with cardiogenic shock (CS). Despite its attractive properties, there are scarce data on the specific clinical setting and the potential role of Impella devices in CS patients from routine clinical practice.

Methods: This is an observational, retrospective, single center, cohort study.

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Background: The long-term safety and performance of magnesium-based bioresorbable scaffolds (MgBRS) in ST-segment-elevation myocardial infarction (STEMI) patients are uncertain.

Aims: The aim of this study was to report the 3-year clinical outcomes of the MAGSTEMI trial.

Methods: This investigator-driven, multicentre, randomised, single-blind, controlled trial randomised STEMI patients 1:1 to MgBRS or to permanent metallic sirolimus-eluting stents (SES) at 11 academic centres.

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Aim: Patients with diabetes mellitus are at high risk of adverse events after percutaneous revascularization, with no differences in outcomes between most contemporary drug-eluting stents. The Cre8 EVO stent releases a formulation of sirolimus with an amphiphilic carrier from laser-dug wells, and has shown clinical benefits in diabetes. We aimed to compare Cre8 EVO stents to Resolute Onyx stents (a contemporary polymer-based zotarolimus-eluting stent) in patients with diabetes.

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Background Early generation drug-eluting stents (DESs) showed a high grade of coronary endothelial dysfunction that was attributed to lack of stent reendothelialization. Endothelium-dependent vasomotor response of current DESs and bioresorbable scaffolds (BRSs) remains unknown. This study sought to assess the device-related endothelial function of current devices and to correlate neointima healing with endothelial function.

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Background: Patients presenting with the coronavirus-2019 disease (COVID-19) may have a high risk of cardiovascular adverse events, including death from cardiovascular causes. The long-term cardiovascular outcomes of these patients are entirely unknown. We aim to perform a registry of patients who have undergone a diagnostic nasopharyngeal swab for SARS-CoV-2 and to determine their long-term cardiovascular outcomes.

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