Publications by authors named "Laura Dominguez-Perez"
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.
Article 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.
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.
Article 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
- * In SOT patients, there were notable findings such as a lower average age, more comorbidities, a higher incidence of healthcare-related IE, and a significant prevalence of Staphylococcus infections.
- * Despite the increased complications, including kidney issues and septic shock, mortality rates for SOT patients were similar to those without SOT, suggesting that while SOT recipients have different challenges, the overall survival outcome is comparable.
Delirium is a frequent complication in patients admitted to intensive cardiac care units (ICCU) with potentially severe consequences including increased risks of mortality, cognitive impairment and dependence at discharge, and longer times on mechanical ventilation and hospital stay. Delirium has been widely documented and studied in general intensive care units and in patients after cardiac surgery, but it has barely been studied in acute nonsurgical cardiac patients. Moreover, delirium (especially in its hypoactive form) is commonly misdiagnosed.
View Article and Find Full Text PDFBackground: Targeted temperature management (TTM) has been associated with an improvement in neurological function and survival in patients with cardiac arrest (CA) and an initially shockable rhythm. We report the Montreal Heart Institute (MHI) experience using TTM to evaluate mortality and neurological outcome in patients remaining in coma after CA, regardless of the initial rhythm.
Methods: We performed a retrospective review of all patients receiving TTM at the MHI between 2008 and 2015.
Article Synopsis
- Reperfusion therapy significantly reduced overall mortality rates after ST-segment elevation myocardial infarction (STEMI), leading researchers to investigate changes in mechanical complications (MCs) that still contribute to mortality.
- The study analyzed data from 1988 to 2008 involving patients aged 75 and older, finding that in-hospital mortality dropped from 34.3% to 13.4%, while mortality from MCs also decreased but remained a consistent proportion of overall deaths.
- Although the incidence of MCs in elderly patients declined significantly, the fatality rates for these complications did not improve, indicating that while MCs are less frequent, they still pose serious risks in the context of STEMI.
Introduction And Objectives: In recent years, implantation of cardiac resynchronization therapy devices has significantly increased. The benefits of this therapy are directly related to the maintenance of continuous biventricular pacing. This study analyzed the incidence, causes, and outcomes of loss of continuous biventricular pacing, and the approach adopted.
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- Current guidelines don't recommend assessing right atrial volume routinely due to insufficient standardized data, but a new method called three-dimensional wall-motion tracking (3D-WMT) could change that.
- This study aimed to establish reference values for right atrial volume using both two-dimensional echocardiography (2D-echo) and 3D-WMT in a healthy adult population while evaluating the consistency of these methods.
- Results showed that while indexed volumes from 2D-echo and 3D-WMT were not strongly correlated, 3D-WMT provided better intra- and interobserver agreement, suggesting it could be a reliable method for measuring right atrial volume.
Introduction And Objectives: Sprint Fidelis defibrillation leads are prone to early failure. Most of the reported series come from a single institution. This paper describes the clinical experience in nine Spanish hospitals.
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