Publications by authors named "Pablo Antunez-Muinos"
Article Synopsis
- Antithrombotic treatment (ATT) after left atrial appendage occlusion (LAAO) is debated, especially for patients at high bleeding risk.
- This study compared simplified ATT, which involves single antiplatelet or no treatment, to conventional ATT, including dual antiplatelet or anticoagulation therapy, in very high bleeding risk patients.
- Results showed no significant differences in major adverse outcomes between the two treatment groups; however, patients with a history of major bleeding had a lower incidence of major bleeding with the simplified ATT.
Article Synopsis
- The study aimed to determine the effectiveness and safety of low-dose direct oral anticoagulation (DOAC) compared to dual antiplatelet therapy (DAPT) in patients who underwent left atrial appendage occlusion (LAAO) for three months post-procedure.
- Conducted across three European sites, the ADALA trial faced challenges with participant recruitment due to the COVID-19 pandemic and was halted prematurely, involving only 90 patients.
- The main outcomes assessed included the rates of major bleeding and thromboembolic events, with the study analyzing patients who had a history of bleeding and various health profiles.
Article Synopsis
- - A new technique for aligning the valves during transcatheter aortic valve replacement with the Allegra valve is introduced, ensuring consistency in the procedure.
- - Slight rotation of the valve system is required before insertion, which helps in achieving proper alignment.
- - The Allegra valve features a permaflow system and radiopaque markings, allowing for small adjustments to be made before deploying the valve, enhancing accuracy.
Introduction And Objectives: Advanced chronic kidney disease (A-CKD) combined with atrial fibrillation increases the risk of both thrombogenic and bleeding events. Left atrial appendage occlusion (LAAO) may be an alternative to oral anticoagulation to prevent thromboembolic events. We aimed to evaluate the outcomes of LAAO in patients with A-CKD.
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- Left atrial appendage occlusion (LAAO) is a successful alternative to oral anticoagulants for patients with nonvalvular atrial fibrillation, and advancements in technology have made the procedure safer and more efficient.* -
- This study aimed to compare the safety and efficacy of an outpatient LAAO program versus a conventional hospital stay approach by analyzing 262 patients and measuring their outcomes after 30 days.* -
- Results showed a 99.6% success rate and similar safety profiles between the outpatient and conventional groups, with the outpatient group benefiting from a shorter hospital stay, indicating potential clinical and economic advantages.*
Article Synopsis
- 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
- This study examines the safety and effectiveness of percutaneous closure for paravalvular leaks (PVL) after transcatheter aortic valve implantation (TAVI) across 14 hospitals from January 2018 to October 2022.
- A total of 45 patients, primarily elderly males, experienced a high success rate (94%) in closing severe and moderate leaks, leading to significant clinical improvements post-procedure.
- The findings suggest that percutaneous PVL closure is a safe and effective treatment, with positive long-term outcomes, including reduced heart failure hospitalizations and survival rates after intervention.
Article Synopsis
- Device-related thrombus (DRT) is rare after left atrial appendage (LAA) closure but poses a greater risk for blood clots, making the search for reliable predictors critical.
- A study involving 1150 patients compared traditional multivariable methods with machine learning techniques to determine which can better predict DRT.
- While machine learning showed higher predictive power without resampling (ROC curve of 0.7974), the results indicated no significant advantage over multivariable analysis when resampling was used, highlighting inconsistencies in previous research on DRT predictors.
Article Synopsis
- Paravalvular leaks (PVL) occur in 5-17% of patients after surgical valve replacement, especially in the mitral position, and if untreated, can lead to poor outcomes.
- This study assessed the effectiveness and safety of percutaneous closure for mitral PVLs over a median follow-up of about 42 months, analyzing 128 procedures from 2010 to 2020.
- Results showed a high success rate (89.8%) for the procedure, with significant improvements in patient outcomes and long-term survival, especially for those without complications like chronic kidney disease.
Article Synopsis
- The study investigated the effects of long-term use of RAAS inhibitors on hypertensive patients hospitalized with COVID-19, finding that nearly 74% of these patients were using such medications prior to hospitalization.
- Results showed that hypertensive patients had a higher mortality rate; however, those on RAAS inhibitors had a lower risk of death, and the use of these medications appeared to provide a protective benefit.
- The overall conclusion is that RAAS inhibitors may be beneficial for hypertensive COVID-19 patients, and continued use during hospitalization likely does not worsen outcomes, supported by a separate meta-analysis.
Paravalvular leak incidence after mitral surgical replacement ranges from 7% to 17%. Between 1% and 5% of these are clinically significant. Large PVLs can cause important clinical manifestations such as heart failure or haemolysis.
View Article and Find Full Text PDFBackground: 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.
Article Synopsis
- * Out of 849 patients, nearly half were hypertensive; those on RAAS inhibitors before and during hospitalization had lower mortality rates than those not on these medications.
- * The analysis suggests that RAAS inhibitors may provide protective benefits for hypertensive COVID-19 patients, indicating that continuing these medications during treatment may not worsen outcomes.
Deterioration is sometimes unexpected in SARS-CoV2 infection. The aim of our study is to establish laboratory predictors of mortality in COVID-19 disease which can help to identify high risk patients. All patients admitted to hospital due to Covid-19 disease were included.
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- - The study evaluated the impact of heart disease (HD) and cardiovascular medications on COVID-19 hospitalized patients, revealing that those with HD had higher mortality rates compared to those without (35.4% vs. 18.2%).
- - Among 859 patients, diabetes was particularly linked to increased risk of death, while common cardiovascular medications did not worsen patient outcomes; however, statins were associated with lower mortality rates.
- - The occurrence of cardiovascular events during hospitalization was linked to worse overall outcomes, with a mortality rate of 31.8% in patients who experienced such events compared to 19.3% in those who did not.
Background: Limited data are available regarding change in the nutritional status after transcatheter aortic valve replacement (TAVR). This study evaluated the prognostic impact of the change in the geriatric nutritional risk index following TAVR.
Methods: TAVR patients were analyzed in a prospective and observational study.
Objective: The aim of this work is to assess the relationship between significant paravalvular leak (SPL) after transcatheter aortic valve implantation (TAVI) on anaemia and their impact on prognosis.
Methods: Observational analytic study developed at two university hospitals, including all consecutive patients who underwent TAVI during a 10-year period (2009 to 2018). A logistic regression model was created to determine independent predictors of anaemia at 3 months.
Article Synopsis
- COVID-19 is a global pandemic, and researchers aimed to understand if prior use of ACE inhibitors (ACEI) or angiotensin receptor blockers (ARB) affects the outcomes for patients diagnosed with the virus.
- A retrospective study of nearly 1,000 COVID-19 patients found that those on ACEI/ARB drugs showed no significant differences in mortality, hospitalization, or severe cardiovascular events.
- The study concludes that continuing ACEI/ARB treatment in COVID-19 patients is supported by existing guidelines, as it doesn't negatively impact their health outcomes.