Publications by authors named "Roberto Martin-Asenjo"
Catheter-directed interventions in acute pulmonary embolism. Position statement of SEC-Interventional Cardiology Association/SEC-Ischemic Heart Disease and Acute Cardiovascular Care Association/SEC-Working Group on Pulmonary Hypertension.
Rev Esp Cardiol (Engl Ed)
November 2024
Article Synopsis
- Pulmonary embolism (PE) is a major cause of hospital deaths and cardiovascular issues, with traditional treatments like anticoagulation and surgery being standard options.
- Recent advancements include catheter-directed interventions (CDI), such as thrombolysis, which may quickly enhance patient outcomes, despite limited supporting evidence from clinical trials.
- A joint report highlights the need for rapid response teams, thorough patient evaluation, and collaborative methods to optimize treatment and outcomes for those dealing with PE.
Article Synopsis
- Cardiogenic shock (AMI-CS) is a severe condition following acute myocardial infarction, showing high rates of morbidity and mortality, especially highlighting ongoing gender disparities in treatment.* -
- A study analyzing data from 151,560 AMI-CS patients found that women were significantly less likely to receive mechanical circulatory support (MCS) and had higher in-hospital mortality rates than men, despite no major differences in bleeding or other complications.* -
- Racial disparities were noted, with female patients from all racial backgrounds receiving less MCS than their male counterparts, while Black and Hispanic patients had lower MCS utilization compared to White patients, emphasizing the complexities of gender, race, and healthcare access.*
Introduction And Objectives: The aim of this study was to analyze the clinical profile, management, and prognosis of ST segment elevation myocardial infarction-related cardiogenic shock (STEMI-CS) requiring interhospital transfer, as well as the prognostic impact of structural variables of the treating centers in this setting.
Methods: This study included patients with STEMI-CS treated at revascularization-capable centers from 2016 to 2020. The patients were divided into the following groups: group A: patients attended throughout their admission at hospitals with interventional cardiology without cardiac surgery; group B: patients treated at hospitals with interventional cardiology and cardiac surgery; and group C: patients transferred to centers with interventional cardiology and cardiac surgery.
Aims: Many historical and recent reports showed that post-infarction ventricular septal rupture (VSR) represents a life-threatening condition and the strategy to optimally manage it remains undefined. Therefore, disparate treatment policies among different centres with variable results are often described. We analysed data from European centres to capture the current clinical practice in VSR management.
View Article and Find Full Text PDFIntroduction: Hyperlipidemia is the main underlying cause of atherosclerotic cardiovascular disease. Reducing low-density lipoprotein (LDL) cholesterol to recommended targets after an acute coronary syndrome (ACS) is of utmost importance as it is associated with a reduction of mortality and further cardiovascular events. Unfortunately, there are considerable gaps between guideline recommendations and clinical practice.
View Article and Find Full Text PDFPrasugrel and ticagrelor, new P2Y12-ADP receptor antagonists, are associated with greater pharmacodynamic inhibition and reduction of cardiovascular events in patients with an acute coronary syndrome. However, evidence is lacked about the effects of achieving faster and stronger cyclooxygenase inhibition with intravenous lysine acetylsalicylate (LA) compared to oral aspirin. Recently, we demonstrated in healthy volunteers that the administration of intravenous LA resulted in a significantly reduction of platelet reactivity compared to oral aspirin.
View Article and Find Full Text PDFArticle Synopsis
- 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
Article Synopsis
- - The study investigates how the right ventricle (RV) responds to veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and whether pre-existing heart issues and cannulation methods impact this response.
- - A review of echocardiographic data from 87 patients showed that RV performance remained stable during VA-ECMO, regardless of cannulation type or presence of heart failure.
- - Successful weaning from VA-ECMO is linked to prior RV function and improvement during treatment; specifically, better outcomes were seen if RV dysfunction wasn't present before starting support and if any RV recovery occurred during treatment.
Aims: To evaluate echocardiographic and biomarker changes during chemotherapy, assess their ability to early detect and predict cardiotoxicity and to define the best time for their evaluation.
Methods And Results: Seventy-two women with breast cancer (52 ± 9.8 years) treated with anthracyclines (26 also with trastuzumab), were evaluated for 14 months (6 echocardiograms/12 laboratory tests).
Article Synopsis
- - A new microRNA, hsa-miR-Chr8:96, was discovered as a potential diagnostic marker for acute myocarditis, showing promise in differentiating it from other heart conditions like myocardial infarction.
- - The research involved analyzing specific immune cells in mice and then validating the findings in human patients, revealing that this microRNA is present in those with myocarditis but not in those with myocardial infarction.
- - This microRNA demonstrated a high diagnostic accuracy with an area under the curve of 0.927, making it a valuable tool for diagnosing acute myocarditis and potentially reducing reliance on invasive procedures.
Antithrombotic drug use for acute coronary syndromes (ACS) varies considerably. The number of antithrombotic drugs (excluding oral anticoagulants) used pre- and in-hospital was recorded in ACS survivors enrolled at hospital discharge in the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) registry ( NCT01171404 ), a prospective cohort study. Among 10,568 patients, the number of antithrombotic drugs used early/patient ranged from 0 to 8 (interquartile range = 3-4).
View Article and Find Full Text PDFDelirium 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.
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- - 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.
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.
Background: Myocardial infarction (MI) patients are increasingly older, and common risk scores include chronological age, but do not consider chronic comorbidity or biological age. Frailty status reflects these variables and may be independently correlated with prognosis in this setting.
Objective: This study investigated the impact of frailty on the prognosis of elderly patients admitted due to MI.