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1.
Cardiovasc Diabetol ; 20(1): 69, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33757510

RESUMO

BACKGROUND: During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. OBJECTIVES: The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. METHODS: We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. RESULTS: Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p < 0.001] and cardiovascular mortality 4.9% vs 0.9% [p = 0.002] in patients with and without diabetes, respectively). In the multivariable analysis, diabetes remained as an independent risk factor both for overall and cardiovascular mortality. No significant interaction was found with other clinical variables. CONCLUSION: Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.


Assuntos
Angiografia Coronária , Diabetes Mellitus , Cardiopatias/diagnóstico por imagem , Cardiopatias/terapia , Intervenção Coronária Percutânea , Tempo para o Tratamento , Listas de Espera , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Bases de Dados Factuais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidade , Feminino , Cardiopatias/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Fatores de Risco , Espanha/epidemiologia , Fatores de Tempo , Listas de Espera/mortalidade
4.
Ann Intern Med ; 174(2): JC21, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33524286

RESUMO

SOURCE CITATION: Brouwer J, Nijenhuis VJ, Delewi R, et al. Aspirin with or without clopidogrel after transcatheter aortic-valve implantation. N Engl J Med. 2020;383:1447-57. 32865376.


Assuntos
Aspirina , Substituição da Valva Aórtica Transcateter , Aspirina/efeitos adversos , Clopidogrel/efeitos adversos , Quimioterapia Combinada , Humanos , Inibidores da Agregação de Plaquetas/efeitos adversos , Substituição da Valva Aórtica Transcateter/efeitos adversos
5.
Heart Fail Rev ; 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33404999

RESUMO

The angiotensin-converting enzyme 2 (ACE2) is a type I integral membrane that was discovered two decades ago. The ACE2 exists as a transmembrane protein and as a soluble catalytic ectodomain of ACE2, also known as the soluble ACE2 that can be found in plasma and other body fluids. ACE2 regulates the local actions of the renin-angiotensin system in cardiovascular tissues, and the ACE2/Angiotensin 1-7 axis exerts protective actions in cardiovascular disease. Increasing soluble ACE2 has been associated with heart failure, cardiovascular disease, and cardiac remodelling. This is a review of the molecular structure and biochemical functions of the ACE2, as well we provided an updated on the evidence, clinical applications, and emerging potential therapies with the ACE2 in heart failure, cardiovascular disease, lung injury, and COVID-19 infection.

7.
EuroIntervention ; 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33433389

RESUMO

AIMS: To evaluate the efficacy of the new BioFreedom Ultra™ drug-coated stent with a thin-strut cobalt-chromium platform (BF-CoCr) compared to the BioFreedom™ drug-coated stent with a stainless-steel platform (BF-SS) in an all-comers population undergoing percutaneous coronary interventions (PCI). METHODS AND RESULTS: This was a prospective, multi-center, non-inferiority trial. The primary endpoint was in-stent late lumen loss (LLL) as determined by quantitative coronary angiographic at 9-month follow-up. Clinical evaluation was performed at 1 year. A total of 200 patients were randomized (1:1) to either the BF-CoCr or the BF-SS stent at 8 centers in Spain and Denmark. Baseline clinical and lesion characteristics were similar among the groups. Mean age was 66 years and 23% were females. The mean number of stents implanted per patient was 1.5. At 9-month follow-up, mean in-stent LLL was 0.34±0.49mm in BF-CoCr versus 0.29±0.37mm in the BF-SS, p=0.005 for non-inferiority. At 1-year, target lesion failure was similar between groups (7.3% in Bf-CoCr vs 9.3% in the BF-SS group; p=0.60). CONCLUSIONS: The BF-CoCr was non-inferior to the BF-SS in terms of in-stent LLL at 9 months. Larger studies powered for clinical endpoints are warranted to compare the efficacy of this new platform with currently available DES.

9.
EuroIntervention ; 16(14): 1177-1186, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33416050

RESUMO

The rearrangement of healthcare services required to face the coronavirus disease 2019 (COVID-19) pandemic led to a drastic reduction in elective cardiac invasive procedures. We are already facing a "second wave" of infections and we might be dealing during the next months with a "third wave" and subsequently new waves. Therefore, during the different waves of the COVID-19 pandemic we have to face the problems of how to perform elective cardiac invasive procedures in non-COVID patients and which patients/procedures should be prioritised. In this context, the interplay between the pandemic stage, the availability of healthcare resources and the priority of specific cardiac disorders is crucial. Clear pathways for "hot" or presumed "hot" patients and "cold" patients are mandatory in each hospital. Depending on the local testing capacity and intensity of transmission in the area, healthcare facilities may test patients for SARS-CoV-2 infection before the interventional procedure, regardless of risk assessment for COVID-19. Pre-hospital testing should always be conducted in the presence of symptoms suggestive of SARS-CoV-2 infection. In cases of confirmed or suspected COVID-19 positive patients, full personal protective equipment using FFP 2/N95 masks, eye protection, gowning and gloves is indicated during cardiac interventions for healthcare workers. When patients have tested negative for COVID-19, medical masks may be sufficient. Indeed, individual patients should themselves wear medical masks during cardiac interventions and outpatient visits.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares , Procedimentos Cirúrgicos Eletivos , Pandemias , Humanos , Máscaras , Equipamento de Proteção Individual
10.
Rev. esp. cardiol. (Ed. impr.) ; 73(12): 994-1002, dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192957

RESUMO

INTRODUCCIÓN Y OBJETIVOS: El impacto del brote de COVID-19 en el tratamiento del infarto agudo de miocardio con elevación del segmento ST (IAMCEST) no está claro. El objetivo de este estudio es evaluar los cambios en el tratamiento del IAMCEST durante el brote de COVID-19. MÉTODOS: Se utilizó un registro multicéntrico, nacional, retrospectivo y observacional de pacientes consecutivos atendidos en 75 centros, se compararon las características de los pacientes y de los procedimientos y los resultados hospitalarios en 2 cohortes según se los hubiera tratado antes o durante la COVID-19. RESULTADOS: Los casos con sospecha de IAMCEST disminuyeron el 27,6% y los pacientes con IAMCEST confirmado se redujeron de 1.305 a 1.009 (22,7%). No hubo diferencias en la estrategia de reperfusión (más del 94% tratados con angioplastia primaria). El tiempo de isquemia fue más largo durante la COVID-19 (233 [150-375] frente a 200 [140-332] min; p <0,001), sin diferencias en el tiempo primer contacto médico-reperfusión. La mortalidad hospitalaria fue mayor durante la COVID-19 (el 7,5 frente al 5,1%; OR bruta=1,50; IC95%, 1,07-2,11; p <0,001); esta asociación se mantuvo tras ajustar por factores de confusión (OR ajustada=1,88; IC95%, 1,12-3,14; p = 0,017). La incidencia de infección confirmada por SARS-CoV-2 fue del 6,3%. CONCLUSIONES: El brote de COVID-19ha implicado una disminución en el número de pacientes con IAMCEST, un aumento del tiempo entre el inicio de los síntomas y la reperfusión y un aumento en la mortalidad hospitalaria. No se han detectado cambios en la estrategia de reperfusión. La combinación de infección por SARS-CoV-2 e IAMCEST fue relativamente infrecuente


INTRODUCTION AND OBJECTIVES: The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. METHODS: Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. RESULTS: Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P<.001) but showed no differences in the time from first medical contact to reperfusion. In-hospital mortality was higher during COVID-19 (7.5% vs 5.1%; unadjusted OR, 1.50; 95%CI, 1.07-2.11; P <.001); this association remained after adjustment for confounders (risk-adjusted OR, 1.88; 95%CI, 1.12-3.14; P=.017). In the 2020 cohort, there was a 6.3% incidence of confirmed SARS-CoV-2 infection during hospitalization. CONCLUSIONS: The number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Vírus da SARS/patogenicidade , Infecções por Coronavirus/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Angioplastia Coronária com Balão/métodos , Estudos Retrospectivos , Surtos de Doenças/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Tratamento de Emergência/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Registros de Doenças/estatística & dados numéricos
11.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(6): 338-342, nov.-dic. 2020. tab
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-FGT-6057

RESUMO

ANTECEDENTES Y OBJETIVOS: La prevalencia de fibrilación auricular (FA) y cardiopatía isquémica (CI) aumenta con la edad. Coexisten en hasta un 20% de los pacientes octogenarios, situación que supone un desafío terapéutico. Los ensayos que han abordado este escenario, que incluyeron un porcentaje bajo de octogenarios, demostraron que la doble terapia (antiagregación simple + anticoagulación) en comparación con la triple terapia (doble antiagregación + anticoagulación) se asocia menos eventos hemorrágicos, especialmente con anticoagulantes orales de acción directa. Estos estudios no tenían potencia suficiente para detectar diferencias en eventos isquémicos. Por otro lado, aspectos prevalentes en la población mayor, como los síndromes geriátricos, no se valoraron en estos estudios, y tampoco en la práctica clínica habitual, desconociéndose su impacto pronóstico en este contexto clínico. MATERIAL Y MÉTODOS: Estudio observacional, prospectivo y multicéntrico, que incluirá pacientes ≥ 80 años con FA y CI en España. Se valorarán las características basales y los síndromes geriátricos, así como la elección del tratamiento antitrombótico. El objetivo primario es conocer la mortalidad cardiovascular y por todas las causas a uno y tres años. RESULTADOS: Este estudio permitirá conocer las características y el pronóstico de pacientes octogenarios con FA y CI en nuestro medio, los factores implicados en la elección del tratamiento antitrombótico y la incidencia de eventos isquémicos y hemorrágicos durante el seguimiento a corto y largo plazo. CONCLUSIONES: Nuestro trabajo contribuirá a mejorar el conocimiento en términos de seguridad y eficacia de las distintas opciones terapéuticas en pacientes mayores con FA y CI y su impacto pronóstico


BACKGROUND AND OBJECTIVES: The prevalence of atrial fibrillation (AF) and ischaemic heart disease (IHC) increases with age. They coexist in up to 20% of octogenarian patients, a situation that poses a therapeutic challenge. Trials that have addressed this scenario, which included a low percentage of octogenarians, showed that double therapy (single antiplatelet + anticoagulation) compared to triple therapy (double antiplatelet + anticoagulation) was associated with less bleeding events, especially with direct oral anticoagulants. These studies did not have sufficient power to detect differences in ischaemic events. On the other hand, prevalent characteristics in the elderly, such as geriatric syndromes, were not assessed in these studies, and are not usually evaluated in clinical practice. Accordingly, their prognostic impact remains unknown in this clinical context. METHODS: Observational, prospective, and multicentre study that will include patients ≥ 80 years with AF and IHC in Spain. Baseline characteristics and geriatric syndromes will be assessed, as well as the choice of antithrombotic treatment. The primary endpoint is cardiovascular and overall mortality at one and three years follow-up. RESULTS: This study will assess both characteristics and prognosis of octogenarian patients with AF and IHC in Spain, the factors involved in the choice of antithrombotic treatment, and the incidence of ischaemic and haemorrhagic events during the short- and long-term follow-up. CONCLUSION: This study will contribute to improve the knowledge in terms of safety and efficacy of the different therapeutic options in older patients with AF and IHC, as well as their prognostic impact

12.
Artigo em Inglês | MEDLINE | ID: mdl-33336506

RESUMO

BACKGROUND: During COVID-19 pandemic in Spain, elective procedures were canceled or postponed, mainly due to health care systems overwhelming. OBJECTIVE: The objective of this study was to evaluate the consequences of interrupting invasive procedures in patients with chronic cardiac diseases due to the COVID-19 outbreak in Spain. METHODS: The study population is comprised of 2,158 patients that were pending on elective cardiac invasive procedures in 37 hospitals in Spain on the 14th of March 2020, when a state of alarm and subsequent lockdown was declared in Spain due to the COVID-19 pandemic. These patients were followed-up until April 31th. RESULTS: Out of the 2,158 patients, 36 (1.7%) died. Mortality was significantly higher in patients pending on structural procedures (4.5% vs. 0.8%, respectively; p < .001), in those >80 year-old (5.1% vs. 0.7%, p < .001), and in presence of diabetes (2.7% vs. 0.9%, p = .001), hypertension (2.0% vs. 0.6%, p = .014), hypercholesterolemia (2.0% vs. 0.9%, p = .026) [Correction added on December 23, 2020, after first online publication: as per Dr. Moreno's request changes in p-values were made after original publication in Abstract.], chronic renal failure (6.0% vs. 1.2%, p < .001), NYHA > II (3.8% vs. 1.2%, p = .001), and CCS > II (4.2% vs. 1.4%, p = .013), whereas was it was significantly lower in smokers (0.5% vs. 1.9%, p = .013). Multivariable analysis identified age > 80, diabetes, renal failure and CCS > II as independent predictors for mortality. CONCLUSION: Mortality at 45 days during COVID-19 outbreak in patients with chronic cardiovascular diseases included in a waiting list due to cancellation of invasive elective procedures was 1.7%. Some clinical characteristics may be of help in patient selection for being promptly treated when similar situations happen in the future.

13.
Artigo em Inglês | MEDLINE | ID: mdl-33232583

RESUMO

OBJECTIVES: To assess the efficacy and safety of excimer laser coronary atherectomy (ELCA), as well as, the long-term outcomes and the factors associated with ELCA failure in uncrossable lesions. BACKGROUND: Uncrossable lesions constitute a challenge for percutaneous coronary intervention. METHODS: This multicenter registry included 126 patients with 126 uncrossable lesions. Study endpoints were ELCA success, technical success and a composite of cardiac death, myocardial infarction (MI), and target-lesion revascularization (TLR) on follow-up. Predictors of ELCA failure were analyzed. RESULTS: Moderate or severe calcification was present in 79 (62.7%) of the lesions and 58 (46%) were a chronic total occlusion. ELCA success was obtained in 103 (81.8%) patients. Rotational atherectomy was attempted as bailout in 21 out of 23 ELCA failure (91.3%), being successful in 14 (66.7%) of them. Finally, technical and procedural success were achieved in 114 (90.5%) and 110 (87.3%) of the patients. Severe calcification was independently associated with ELCA failure (OR: 3.73, 95% CI: 1.35-10.32; p = .011). Two (1.6%) patients died (one after a stroke and another patient because of heart failure), 4 (3.2%) developed a non-Q MI without clinical consequences and 1 (0.8%) patient had a Q-MI. Other complications were ventricular tachycardia/fibrillation (n = 2; 1.6%) and flow-limiting dissection (n = 1, 0.8%). At follow-up (median 424 days), 3 (2.4%) patients died (1 (0.8%) from cardiovascular cause) and 15 (11.9%) required TLR. CONCLUSIONS: In our multicenter experience, ELCA use demonstrated to be safe and reasonably effective with a rate of events on follow-up relatively low. Severe calcification was associated with ELCA failure.

14.
Sci Rep ; 10(1): 20741, 2020 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-33244093

RESUMO

Agricultural weeds can adapt rapidly to human activities as exemplified by the evolution of resistance to herbicides. Despite its multi-faceted nature, herbicide resistance has rarely been researched in a holistic manner. A novel approach combining timely resistance confirmation, investigation of resistance mechanisms, alternative control solutions and population modelling was adopted for the sustainable management of the Amaranthus palmeri weed in soybean production systems in Argentina. Here, we show that resistance to glyphosate in the studied population from Cordoba province was mainly due to a P106S target-site mutation in the 5-enolpyruvylshikimate 3-phosphate synthase (EPSPS) gene, with minor contributions from EPSPS gene duplication/overexpression. Alternative herbicides, such as fomesafen, effectively controlled the glyphosate-resistant plants. Model simulations revealed the tendency of a solo herbicidal input to primarily select for a single resistance mechanism and suggested that residual herbicides, alongside chemical diversity, were important for the sustainable use of these herbicides. We also discuss the value of an interdisciplinary approach for improved understanding of evolving weeds.

15.
EuroIntervention ; 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33164893

RESUMO

AIMS: To assess clinical and prognosis differences in patients with Covid-19 and STEMI. METHODS AND RESULTS: Using a nationwide registry of consecutive patients managed within 42 specific STEMI-care networks, we compared patient and procedure characteristics and in-hospital outcomes in 2 different cohorts, according to whether they had Covid-19. Among 1010 consecutive STEMI patients, 91 were identified as Covid-19 (10.9%). With the exception of smoking status (more frequent in non-Covid-19) and previous coronary artery disease (more frequent in Covid-19), clinical characteristics were similar between groups, but Covid-19 patients had more heart failure on arrival (31.9% vs 18.4%, p=0.002). Mechanical thrombectomy (44% vs 33.5%, p=0.046) and IIbIIIa inhibitors administration (20.9% vs 11.2%, p=0.007) were more frequent in Covid-19 patients, who had an increased in-hospital mortality (23.1% vs 5.7%, p<0.0001), that remained consistent after adjustment for age, sex, Killip class and ischemic time: OR (95% CI) = 4.85 (2.04-11.51); p<0.001. Covid-19 patients had an increase of stent thrombosis (3.3% vs 0.8%, p=0.020) and cardiogenic shock development after PCI (9.9 % vs 3.8%, p=0.007). CONCLUSIONS: Our study revealed a significant increase in in-hospital, stent thrombosis and cardiogenic shock development after PCI in patients with STEMI and Covid-19 in comparison with contemporaneous non-Covid-19 STEMI patients.

16.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33158760

RESUMO

INTRODUCTION AND OBJECTIVES: Aortic self-expandable (SE) transcatheter aortic valve implantation (TAVI) devices are particularly useful for patients with aortic stenosis and small/tortuous vessels, small aortic annuli, or low coronary ostia. However, it is unclear whether the growing range of SE devices shows comparable hemodynamic and clinical outcomes. We aimed to determine the differential hemodynamic (residual valve area and regurgitation) and clinical outcomes of these devices in comparable scenarios. METHODS: All patients were enrolled from 4 institutions and were managed with 4 different SE TAVI devices. Baseline and follow-up clinical data were collected and echocardiographic tests blindly and centrally analyzed. Patients were compared according to valve type and a 1:1 matched comparison was performed according to degree of calcification, aortic annulus dimensions, left ventricular ejection fraction, and body surface area. RESULTS: In total, 514 patients were included (Evolut R/PRO, 217; ACURATE neo, 107; ALLEGRA, 102; Portico, 88). Surgical risk scores were comparable in the unmatched population. No differences were observed in the post-TAVI regurgitation rate and in in-hospital mortality (2.7%). The rate of pacemaker implantation at discharge was significantly different among devices (P=.049), with Portico showing the highest rate (23%) and ACURATE neo the lowest (9.5%); Evolut R/PRO and ALLEGRA had rates of 15.9% and 21.2%, respectively. The adjusted comparison showed worse residual TAVI gradients and aortic valve area with ACURATE neo vs ALLEGRA (P=.001) but the latter had higher risk of valve embolization and a tendency for more cerebrovascular events. CONCLUSIONS: A matched comparison of 4 SE TAVI devices showed no differences regarding residual aortic regurgitation and in-hospital mortality.

17.
J Invasive Cardiol ; 32(11): E295-E297, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33130596

RESUMO

Percutaneous MitraClip intervention for treatment of severe mitral regurgitation in high surgical risk patients requires large-diameter transseptal sheaths that can result in iatrogenic atrial septal defect (iASD), and its prevalence is higher compared with non-MitraClip procedures. This iASD is not routinely closed because the possible consequences are still not fully understood. However, we believe it is important to identify patients who may benefit from its closure immediately after the procedure to prevent hemodynamic deterioration and long-term negative clinical outcomes. We describe our experience with 2 patients who required iASD closure after MitraClip procedure due to right-to-left shunt resulting from increase in right heart pressures.

18.
Rev. esp. cardiol. (Ed. impr.) ; 73(11): 927-936, nov. 2020. tab, graf
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET1-6957

RESUMO

INTRODUCCIÓN Y OBJETIVOS: La Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (ACI-SEC) presenta su informe anual de actividad de 2019. MÉTODOS: Se invitó a participar a todos los centros españoles con laboratorio de hemodinámica. La recogida de datos se realizó telemáticamente y una empresa externa, junto con los miembros de la ACI-SEC, llevó a cabo su análisis. RESULTADOS: Participaron 119 centros (83 públicos y 36 privados). Se realizaron 165.124 estudios diagnósticos (el 4,7% más que en 2018). La guía de presión y la ecografía intracoronaria crecieron un 20% y la tomografía de coherencia óptica, un 8,4%. El intervencionismo coronario aumentó un 4,5%, con 75.819 procedimientos. De ellos, 22.529 en el infarto agudo de miocardio, con el 91,8% de angioplastias primarias (el 6,3% más que en 2018). La media de angioplastias primarias por millón de habitantes creció a 439. El acceso fue radial en el 88,3% de los procedimientos intervencionistas. Se practicaron 4.281 implantes percutáneos de válvula aórtica (el 21,0% más que en 2018), con una media de 90,9 por millón de habitantes. La reparación percutánea mitral también creció un 17,4% (385 procedimientos); el cierre de orejuela, un 43,0% (n=921) y el foramen oval permeable, un 38,1% (n=710). CONCLUSIONES: En 2019 se produjo un incremento del uso de técnicas de diagnóstico intracoronarias y prodecimientos diagnósticos y terapéuticos coronarios, fundamentalmente en la angioplastia primaria. En intervencionismo estructural, destaca el fuerte ascenso del número de implantes percutáneos de válvula aórtica, así como de procedimientos de reparación mitral, cierre de orejuela y foramen oval permeable


INTRODUCTION AND OBJECTIVES: The Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) presents its annual report on the activity for 2019. METHODS: All Spanish centers with a catheterization laboratory were invited to participate. Data were introduced online and analyzed by an external company together with the Steering Committee of the ACI-SEC. RESULTS: A total of 119 centers participated (83 public, 36 private). In all, there were 165124 diagnostic studies (4.7% more than in 2018). The use of pressure wire and intravascular ultrasound increased by 20% and that of optical coherence tomography by 8.4%. The number of percutaneous coronary interventions (PCI) rose by 4.5% (75 819 procedures). Of these, 22529 were performed in the acute myocardial infarction setting, with 91.8% being primary PCI (6.3% increase). The mean number of primary PCIs per million inhabitants increased to 439. Among PCIs, access was radial in 88.3%. There were 4281 transcatheter aortic valve implantations (21.0% increase), with an average of 90.9 per million inhabitants. Mitral valve repair also rose by 17.4% (n=385), left atrial appendage closure by 43.0% (n=921) and patent foramen ovale closure by 38.1% (n=710). CONCLUSIONS: In 2019, the use of intracoronary diagnostic techniques increased, as did that of diagnostic and therapeutic coronary procedures, mainly in primary PCI. Of particular note was the marked increase in the number of transcatheter aortic valve implantations, as well as in the number of mitral valve repairs and left atrial appendage and patent foramen ovale closure procedures

19.
Rev Esp Cardiol ; 73(11): 927-936, 2020 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-33012949

RESUMO

Introduction and objectives: The Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) presents its annual report on the activity for 2019. Methods: All Spanish centers with a catheterization laboratory were invited to participate. Data were introduced online and analyzed by an external company together with the Steering Committee of the ACI-SEC. Results: A total of 119 centers participated (83 public, 36 private). In all, there were 165 124 diagnostic studies (4.7% more than in 2018). The use of pressure wire and intravascular ultrasound increased by 20% and that of optical coherence tomography by 8.4%. The number of percutaneous coronary interventions (PCI) rose by 4.5% (75 819 procedures). Of these, 22 529 were performed in the acute myocardial infarction setting, with 91.8% being primary PCI (6.3% increase). The mean number of primary PCIs per million inhabitants increased to 439. Among PCIs, access was radial in 88.3%. There were 4281 transcatheter aortic valve implantations (21.0% increase), with an average of 90.9 per million inhabitants. Mitral valve repair also rose by 17.4% (n = 385), left atrial appendage closure by 43.0% (n = 921) and patent foramen ovale closure by 38.1% (n = 710). Conclusions: In 2019, the use of intracoronary diagnostic techniques increased, as did that of diagnostic and therapeutic coronary procedures, mainly in primary PCI. Of particular note was the marked increase in the number of transcatheter aortic valve implantations, as well as in the number of mitral valve repairs and left atrial appendage and patent foramen ovale closure procedures.

20.
J Invasive Cardiol ; 32(10): E266, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32999102

RESUMO

We present a case in which optical coherence tomography was useful to characterize in vivo superficial calcific sheet and exclude other causes of acute coronary syndromes.

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