Papers by Guillem Caldentey
European heart journal. Acute cardiovascular care, Aug 1, 2020
In the era of primary percutaneous coronary intervention, mechanical complications after acute my... more In the era of primary percutaneous coronary intervention, mechanical complications after acute myocardial infarction are extremely rare, with an incidence of less than 0.5%. Rupture of the ventricular septum is the least frequent occurrence. Nevertheless, current mortality remains high and a prompt diagnosis and treatment are imperative to increase survival. Despite early surgical repair, mortality still remains high.
Supplementary material : Radiation-Induced Cardiac Valve Disease
Medicina Clínica (english Edition), Jul 1, 2016
International Journal of Cardiology, Nov 1, 2014
< 0.005) and between MRI-1 and MRI-3 (p < 0.002) was statistically significant. Conclusions: In t... more < 0.005) and between MRI-1 and MRI-3 (p < 0.002) was statistically significant. Conclusions: In this study, there is minimal resection cavity shrinkage, and the cavity volume change is not statistically significant even over an extended follow-up period of a median 80 days. This analysis has additionally demonstrated a statistically significant reduction in edema volume between the first post-operative MRI and subsequent MRI scans. Based upon this prospective analysis, there is significant reduction in edema following Cs-131 implantation that is evident at a median 41 days after surgery and maintained throughout the median 80-day follow-up period.
International Journal of Cardiology, Feb 1, 2021
Background: Optimal timing of antithrombotic therapy for patients with ST-segment elevation myoca... more Background: Optimal timing of antithrombotic therapy for patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) is unclear. We analyzed the impact of pre-angioplasty administration of unfractionated heparin (UFH) on infarct-related artery (IRA) patency and mortality. Method: Multicenter prospective observational study of 3520 STEMI patients treated with PPCI from 2016 to 2018. Subjects were divided into four groups according to the elapsed time from heparin administration to PPCI: Group 1: Upon arrival at catheterization laboratory or ≤ 30 min (n = 800; 22.7%); Group 2: 31 to 60 min (n = 994; 28.2%); Group 3: 61 to 90 min (n = 1091; 31%); Group 4: >90 min (n = 635; 18%). IRA patency was defined as thrombolysis in myocardial infarction (TIMI) flow grade 2-3. Multivariate analyses assessed factors associated with IRA patency and both 30-day and 1-year mortality. Results: UFH administration at STEMI diagnosis was an independent predictor of IRA patency especially when administered more than 60 min before the PPCI (OR 1.43; 95% CI 1.14-1.81), either an independent predictor of 30day (HR 0.63; 95% CI 0.42-0.94) and 1-year (HR 0.57; 95% CI 0.41-0.80) mortality. The effect of UFH on IRA patency was higher when administered earlier from the symptom onset. Conclusion: UFH administration at STEMI diagnosis improves coronary reperfusion prior to PPCI and this benefit seems associated with superior clinical outcomes. The presented results highlight a time-dependent effectiveness of UFH, since its reported effect is greater the sooner UFH is administered after symptom onset.
Case Reports, Aug 23, 2016
Jacc-Heart Failure, Feb 1, 2014
(Table). Absence of congestion was defined as the absence of jugular venous distension, dyspnea, ... more (Table). Absence of congestion was defined as the absence of jugular venous distension, dyspnea, rales, and pedal or sacral edema on hospital day 7 or discharge. The associations between Loop Dose, discharge congestion status, and all-cause mortality and worsening HF events (HF hospitalization; unscheduled outpatient or emergency department visit associated with IV therapy for HF; or death from HF) within 90 days of randomization were assessed. Results: Median Loop Dose for all subjects was 93 mg and did not differ in 2558 subjects with discharge congestion (89 mg) vs. 600 subjects without discharge congestion (107 mg), p50.36. At 90 days, mortality and worsening HF events occurred in 7.5% and 15.4% of subjects respectively. Higher Loop Dose was associated with clinical markers of more severe disease (Table) and increased risk of mortality (HR 1.37, p!0.001 for one unit increase in natural-log-transformed dose) and worsening HF (HR 1.68/2.35 as compared to Medium/Low Doses, p!0.001). The association between Loop Dose and outcome events did not differ in patients with or without persistent congestion at the time of hospital discharge (for all-cause mortality, with congestion HR 1.44 vs. without congestion HR 0.94, p50.10 for interaction term; and for worsening HF, with congestion HR 1.57 vs. without congestion HR 1.28, p50.18 for interaction term). Conclusion: Higher Loop Dose during hospitalization was associated with worse clinical status, increased short-term all-cause mortality, and increased risk of worsening HF events. The association between in-hospital diuretic dose and clinical outcomes did not differ in patients with or without clinical signs and symptoms of congestion at hospital discharge.
Intensive Care Medicine, Jul 25, 2016
Medicina Clinica, Jul 1, 2016
Sex-based differences in chronic total occlusion management and long-term clinical outcomes
International Journal of Cardiology, Nov 1, 2020
AbstractᅟChronic total occlusions (CTOs) are an important and increasingly recognized subgroup of... more AbstractᅟChronic total occlusions (CTOs) are an important and increasingly recognized subgroup of coronary lesions, documented in at least 30%, but up to 52% of patients with coronary artery disease (CAD) undergoing coronary angiography. Percutaneous coronary intervention (PCI) of these lesions is increasingly pursued, with excellent success rates.Purpose of ReviewIt is known that gender differences exist in the presentation of CAD, as well as in clinical outcomes after routine PCI; however, it is not well described how these differences pertain to management of CTOs. This review summarizes the available data regarding sex-based differences in CTO management and outcomes.Recent FindingsWomen comprise approximately 20% of CTO registry and trial participants.SummaryAs has been demonstrated in PCI studies, women comprise a minority of patients in CTO PCI registries and trials. Sex-based differences exist in complication rates, collateral formation, and outcomes and need further evaluation in future studies.
Journal of the American College of Cardiology, Mar 1, 2017
Acta Cardiologica, Oct 1, 2016
Intensive Care Medicine, Dec 21, 2015
Journal of Cardiac Failure, Aug 1, 2013
(Table). Absence of congestion was defined as the absence of jugular venous distension, dyspnea, ... more (Table). Absence of congestion was defined as the absence of jugular venous distension, dyspnea, rales, and pedal or sacral edema on hospital day 7 or discharge. The associations between Loop Dose, discharge congestion status, and all-cause mortality and worsening HF events (HF hospitalization; unscheduled outpatient or emergency department visit associated with IV therapy for HF; or death from HF) within 90 days of randomization were assessed. Results: Median Loop Dose for all subjects was 93 mg and did not differ in 2558 subjects with discharge congestion (89 mg) vs. 600 subjects without discharge congestion (107 mg), p50.36. At 90 days, mortality and worsening HF events occurred in 7.5% and 15.4% of subjects respectively. Higher Loop Dose was associated with clinical markers of more severe disease (Table) and increased risk of mortality (HR 1.37, p!0.001 for one unit increase in natural-log-transformed dose) and worsening HF (HR 1.68/2.35 as compared to Medium/Low Doses, p!0.001). The association between Loop Dose and outcome events did not differ in patients with or without persistent congestion at the time of hospital discharge (for all-cause mortality, with congestion HR 1.44 vs. without congestion HR 0.94, p50.10 for interaction term; and for worsening HF, with congestion HR 1.57 vs. without congestion HR 1.28, p50.18 for interaction term). Conclusion: Higher Loop Dose during hospitalization was associated with worse clinical status, increased short-term all-cause mortality, and increased risk of worsening HF events. The association between in-hospital diuretic dose and clinical outcomes did not differ in patients with or without clinical signs and symptoms of congestion at hospital discharge.
The American Journal of Medicine, Mar 1, 2017
Catheterization and Cardiovascular Interventions, Feb 25, 2020
Background: Chronic total occlusion (CTO) is common in patients with diabetes mellitus. Data on t... more Background: Chronic total occlusion (CTO) is common in patients with diabetes mellitus. Data on the long-term outcomes after treatment of CTOs in this high-risk population are scarce. Aim: To compare the long-term clinical outcomes of CTO revascularization either by coronary artery bypass graft (CABG) or successful percutaneous coronary intervention (PCI) versus optimal medical treatment (MT) alone in patients with diabetes. Methods and Results: A total of 538 consecutive patients with diabetes and at least one CTO were identified from 2010 to 2014 in our center. In the present analysis, patients were stratified according to the CTO treatment strategy that was selected. MT was selected in 61% of patients whereas revascularization in the remaining 39%. Patients undergoing revascularization were younger, had higher left ventricular ejection fraction (LVEF), lower ACEF score, and more positive myocardial ischemia detection results compared to the MT group (p < .001).Patients referred for CABG had higher rates of left main disease compared to the PCI and MT groups (32% vs. 3% and 11%, respectively; p < .001). Complete revascularization was more often achieved in the CABG group, compared to the PCI group (62% vs. 32% p < .001).
Revista Colombiana de Cardiología, Jul 1, 2017
European Heart Journal, Nov 1, 2020
The American Journal of Medicine, Dec 1, 2016
European Heart Journal, 2018
Background: Chronic total occlusions (CTO) are present in >30% of elderly patients with myocardia... more Background: Chronic total occlusions (CTO) are present in >30% of elderly patients with myocardial ischemia. There is still controversy regarding the best therapeutic approach in this setting. Aims: To compare long term survival of CTO revascularization (PCI or CABG) versus medical treatment (MT) in the old population. Methods and results: From 2010 to 2014, 1.252 patients with at least one CTO were identified (26% ≥75 years). The received treatment (PCI, CABG or MT) and clinical variables were analyzed according to age (≥ or <75 years). Global and cardiovascular (CV) mortality and rates of MACE were assessed during a median follow-up of 3.5 years. Older patients were more commonly treated with MT (71 vs 43%; p<0.001). Among patients ≥75 years, 29% underwent revascularization. These subjects were younger, had higher LVEF and lower ACEF scores compared to the MT group (p<0.05). Global mortality was lower with CABG or PCI compared to MT (HR 0.35, IC 0.17-0.71 and HR 0.57, IC 0.33-0.98, respectively). No differences in mortality were observed according to type of procedure. The intervention group had lower rates of MACE (HR 0.39, IC 0.22-0.68 for CABG and HR 0.48, IC 0.26-0.91 for PCI). CV mortality was lower in the CABG group (HR 0.39; IC 0.18-0.81) compared to MT. A non-significant reduction of CV mortality was also observed in the PCI group (HR 0.59, IC 0.28-1.2).
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Papers by Guillem Caldentey