Bruno García Del Blanco

Autonomous University of Barcelona, Cerdanyola del Vallès, Catalonia, Spain

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Publications (47)261.86 Total impact

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    ABSTRACT: -This study aimed to evaluate the prevalence of previously undiagnosed arrhythmias in candidates for TAVR and to determine its impact on therapy changes and arrhythmic events following the procedure. -A total of 435 candidates for TAVR underwent 24-hour continuous electrocardiographic (ECG) monitoring the day before the procedure. Newly diagnosed arrhythmias were observed in 70 patients (16.1%) before TAVR: paroxysmal atrial fibrillation (AF)/atrial tachycardia (AT) in 28, advanced atrio-ventricular block (AVB) or severe bradycardia in 24, non-sustained ventricular tachycardia in 26, and intermittent left bundle branch block (LBBB) in 3 patients. All arrhythmic events but one were asymptomatic, and led to a therapy change in 43% of patients. In patients without known AF/AT, the occurrence of AF/AT during 24-hour ECG recording was associated with a higher rate of 30-day cerebrovascular events (7.1% vs 0.4%, P=0.030). Among the 53 patients with new-onset AF/AT after TAVR, 30.2% had newly diagnosed paroxysmal AF/AT before the procedure. In patients who needed permanent pacemaker implantation following the procedure (n=35), 31.4% had newly diagnosed advanced AVB or severe bradycardia before TAVR. New-onset persistent LBBB following TAVR occurred in 37 patients, 8.1% of whom had intermittent LBBB before the procedure. -Newly diagnosed arrhythmias were observed in about a fifth of TAVR candidates, led to a higher rate of cerebrovascular events and accounted for a third of arrhythmic events following the procedure. This high arrhythmia burden highlights the importance of an early diagnosis of arrhythmic events in such patients in order to implement the appropriate therapeutic measures earlier on.
    Circulation 12/2014; · 15.20 Impact Factor
  • JACC: Cardiovascular Interventions. 11/2014;
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    ABSTRACT: The Working Group on Cardiac Catheterization and Interventional Cardiology presents its yearly report on the data from the registry of the activity in Spain corresponding to 2013.Methods The centers introduce their data online voluntarily and the information is analyzed by the Steering Committee of the Working Group on Cardiac Catheterization.ResultsIn 2013, 104 hospitals sent their data (72 public centers and 32 private). In all, 136 715 diagnostic studies were performed (120 358 coronary angiograms), with a slight decrease with respect to 2012, a reduction that was also observed in the rate, which was 2944 diagnostic studies per million population. A total of 65 912 interventional procedures were carried out during a phase of stability, for a rate of 1419 interventions per million population. Other techniques included the implantation of 99 417 stents and 1384 biodegradable intracoronary devices (64% of them drug-eluting devices). There were 18 337 procedures in acute myocardial infarction, for an increase of 7% with respect to 2012 and representing 27.8% of all the percutaneous coronary interventions. Radial access was the approach used in 71% of the diagnostic procedures and in 65% of the interventional procedures. The performance of renal denervation has nearly doubled with respect to 2012. For the first time, more than 1000 transcatheter aortic valve implantation procedures were carried out in 1 year, although the frequency increased only slightly (23%).Conclusions There continued to be a slight increase in the activity in cardiac catheterization in association with ST-segment elevation myocardial infarction, whereas, with the exception of recently introduced, highly specific procedures, the use of the remainder of the procedures, among them transcatheter aortic valve implantation, leveled off.Full English text available from: www.revespcardiol.org/en
    Revista Española de Cardiología. 11/2014;
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    ABSTRACT: Background:It is unknown if lack of polymer can provoke a different edge response in drug-eluting stents. The aim of this study was to compare edge vascular response between polymer-free paclitaxel-eluting stent (PF-PES) and polymer-based paclitaxel-eluting stents (PB-PES).Methods and Results:A total of 165 eligible patients undergoing percutaneous coronary intervention were prospectively randomized 1:1 to receive either PF-PES or PB-PES. Those patients with paired intravascular ultrasound (IVUS) after procedure and at 9-month follow-up were included in this analysis.Seventy-six patients with 84 lesions, divided into PB-PES (38 patients, 41 lesions) and PF-PES groups (38 patients, 43 lesions) had paired post-procedure and 9-month follow-up IVUS and were therefore included in this substudy. There was a significant lumen decrease at the proximal edge of PF-PES (from 9.02±3.06 mm(2)to 8.47±3.05 mm(2); P=0.040), and a significant plaque increase at the distal edges of PF-PES (from 4.39±2.73 mm(2)to 4.78±2.63 mm(2); P=0.004). At the distal edge there was a significant plaque increase in the PF-PES compared to PB-PES (+8.0% vs. -0.6%, respectively; P=0.015) with subsequent lumen reduction (-5.2% vs. +6.0%, respectively; P=0.024).Conclusions:PF-PES had significant plaque increase and lumen reduction at the distal edge as compared to PB-PES, probably due to difference in polymer-based drug-release kinetics between the 2 platforms.
    Circulation journal : official journal of the Japanese Circulation Society. 09/2014;
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    ABSTRACT: Aims: This study will compare the efficacy of drug-eluting balloons (DEB) and everolimus-eluting stents (EES) in patients with drug-eluting stent (DES) in-stent restenosis (ISR). Methods and results: This is a prospective, multicentre, randomised clinical trial comparing DEB and EES in patients with DES-ISR. The study is an investigator-driven initiative generated within the RIBS study programme. A total of 310 patients with DES-ISR will be included and randomised (1:1) to DEB or EES. Angiographic follow-up has been scheduled at six to nine months. Quantitative coronary analyses will be performed in a centralised core lab by blinded personnel. The primary endpoint of the study is minimal lumen diameter at angiographic follow-up. Other secondary angiographic endpoints include % diameter stenosis, late loss, net gain and binary restenosis rate. An independent clinical events committee will adjudicate clinical events after reviewing source documents. The main clinical outcome measure is a combined endpoint of cardiac death, myocardial infarction and target vessel revascularisation at one year. Individual components of the combined clinical endpoint and rates of target lesion revascularisation and stent thrombosis will also be compared. Conclusions: This randomised clinical trial will determine the relative efficacy of EES versus DEB in patients presenting with DES-ISR. (ClinicalTrials.gov Identifier: NCT01239940).
    09/2014;
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    ABSTRACT: Objectives The aim of this study was to determine the impact of the degree of residual aortic regurgitation (AR) and acuteness of presentation of AR after transcatheter aortic valve replacement (TAVR) on outcomes. Background The degree of residual AR after TAVR leading to excess mortality remains controversial, and little evidence exists on the impact of the acuteness of presentation of AR. Methods A total of 1,735 patients undergoing TAVR with balloon-expandable or self-expanding valves were included. The presence and degree of AR were evaluated by transthoracic echocardiography; acute AR was defined as an increase in AR severity of ≥1 degree compared with pre-procedural echocardiography. Results Residual AR was classified as mild in 761 patients (43.9%) and moderate to severe in 247 patients (14.2%). The presence of moderate to severe AR was an independent predictor of mortality at a mean follow-up of 21 ± 17 months compared with none to trace (adjusted hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.32 to 2.48; p < 0.001) and mild AR (adjusted HR: 1.68, 95% CI: 1.27 to 2.24; p < 0.001) groups. There was no increased risk in patients with mild AR compared with those with none to trace AR (p = 0.393). In patients with moderate to severe AR, acute AR was observed in 161 patients (65%) and chronic AR in 86 patients (35%). Acute moderate to severe AR was independently associated with increased risk of mortality compared with none/trace/mild AR (adjusted HR: 2.37, 95% CI: 1.53 to 3.66; p < 0.001) and chronic moderate to severe AR (adjusted HR: 2.24, 95% CI: 1.17 to 4.30; p = 0.015). No differences in survival rate were observed between patients with chronic moderate to severe and none/trace/mild AR (p > 0.50). Conclusions AR occurred very frequently after TAVR, but an increased risk of mortality at ∼2-year follow-up was observed only in patients with acute moderate to severe AR.
    JACC: Cardiovascular Interventions. 09/2014; 7(9):1022–1032.
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    ABSTRACT: Introducción y objetivos El gen PLAU, que codifica para el activador del plasminógeno tipo urocinasa, desempeña un papel destacado en el crecimiento colateral. Se ha investigado si el polimorfismo PLAU P141L (C > T), que causa una mutación en el dominio kringle de la proteína, se asocia con la circulación colateral coronaria en una cohorte de 676 pacientes con enfermedad arterial coronaria. Métodos Se genotipificó el polimorfismo de muestras de sangre mediante prueba basada en TaqMan, y la circulación colateral se evaluó por el método Rentrop. Las asociaciones de las variantes alélicas y los genotipos con la circulación colateral se examinaron mediante modelos de regresión logística multivariable ajustados por las variables clínicamente relevantes. Resultados Los pacientes con circulación colateral deficiente (Rentrop 0-1; n = 547) presentaron mayor frecuencia del genotipo TT que aquellos con buena circulación colateral (Rentrop 2-3; n = 129; p = 0,020). Por otra parte, el alelo T fue más frecuente en los pacientes con circulación deficiente (p = 0,006). La odds ratio de los portadores del alelo T de presentar una circulación colateral deficiente (ajustada por variables clínicamente relevantes) fue estadísticamente significativa en el modelo dominante (odds ratio = 1,83 [intervalo de confianza del 95%, 1,16-2,90]; p = 0,010) o el aditivo (odds ratio = 1,73 [intervalo de confianza del 95%, 1,14-2,62]; p = 0,009). Conclusiones Se demuestra una asociación entre la circulación colateral coronaria y el polimorfismo PLAU P141L. Los pacientes con la variante 141L tienen mayor riesgo de sufrir una circulación colateral deficiente.
    Revista Espanola de Cardiologia 07/2014; · 3.20 Impact Factor
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    ABSTRACT: We sought to compare the long-term clinical outcome of patients with ST-segment elevation myocardial infarction treated with paclitaxel-eluting stents or everolimus-eluting stents and the influence of thrombectomy on outcomes.
    Revista Espanola de Cardiologia 06/2014; · 3.20 Impact Factor
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    ABSTRACT: Most drug-eluting stents currently in use are coated with a polymer carrying the drug that is released for several weeks. However, a durable polymer may provoke hypersensitive reaction, delayed artery healing, and eventually stent thrombosis. The aim of this study was to investigate the safety and efficacy of a polymer-free paclitaxel-eluting stent (PF-PES) versus a polymer-based PES (PB-PES). Eligible patients undergoing percutaneous coronary intervention were randomized 1:1 to receive either PF-PES or PB-PES. The primary end point was late loss at 9 months. Intravascular ultrasound analysis at 9 months and final 2-year clinical follow-up were also performed. From October 2007 to April 2009, 164 patients were enrolled and randomized into 2 groups (PF-PES: n=84; PB-PES: n=80). Mean in-stent lumen loss was 0.90±0.59 mm for PF-PES and 0.49±0.52 mm for PB-PES (P<0.001). Mean neointimal area by intravascular ultrasound was higher in PF-PES than in PB-PES (1.42±1.09 versus 0.51±0.61 mm(2); P<0.001). At 2 years, a composite end point of all-cause death, any myocardial infarction, and target vessel revascularization occurred in 36.9% for PF-PES and 16.3% for PB-PES (P=0.004), mainly driven by a higher rate of target vessel revascularization (PF-PES: 35.7%; PB-PES: 13.8%; P=0.001). One late stent thrombosis was observed in PF-PES. Compared with PB-PES, PF-PES was associated with increased neointimal proliferation and subsequent clinical restenosis. Polymer plays an essential role in the performance of drug-eluting stents. http://www.clinicaltrials.gov. Unique identifier: NCT01375855.
    Circulation Cardiovascular Interventions 05/2014; · 6.54 Impact Factor
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    ABSTRACT: The aim of this study was to determine the effects of advanced chronic kidney disease (CKD) on early and late outcomes after transcatheter aortic valve implantation (TAVI), and to evaluate the predictive factors of poorer outcomes in such patients. This was a multicentre study including a total of 2075 consecutive patients who had undergone TAVI. Patients were grouped according the estimated glomerular filtration rate as follows: CKD stage 1-2 (≥60 mL/min/1.73 m(2); n = 950), stage 3 (30-59 mL/min/1.73 m(2); n = 924), stage 4 (15-29 mL/min/1.73 m(2); n = 134) and stage 5 (<15 mL/min/1.73 m&sup2; or dialysis; n = 67). Clinical outcomes were evaluated at 30-days and at follow-up (median of 15 [6-29] months) and defined according to the VARC criteria. Advanced CKD (stage 4-5) was an independent predictor of 30-day major/life-threatening bleeding (P = 0.001) and mortality (P = 0.027), and late overall, cardiovascular and non-cardiovascular mortality (P < 0.01 for all). Pre-existing atrial fibrillation (HR: 2.29, 95% CI: 1.47-3.58, P = 0.001) and dialysis therapy (HR: 1.86, 95% CI: 1.17-2.97, P = 0.009) were the predictors of mortality in advanced CKD patients, with a mortality rate as high as 71% at 1-year follow-up in those patients with these 2 factors. Advanced CKD patients who had survived at 1-year follow-up exhibited both a significant improvement in NYHA class (P < 0.001) and no deterioration in valve hemodynamics (P = NS for changes in mean gradient and valve area over time). Advanced CKD was associated with a higher rate of early and late mortality and bleeding events following TAVI, with AF and dialysis therapy determining a higher risk in these patients. The mortality rate of patients with both factors was unacceptably high and this should be taken into account in the clinical decision-making process in this challenging group of patients.
    European Heart Journal 05/2014; · 14.72 Impact Factor
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    European heart journal cardiovascular Imaging. 05/2014; 15(suppl 1):i1-i7.
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    ABSTRACT: Urokinase-type plasminogen activator, which is encoded by the PLAU gene, plays a prominent role during collateral arterial growth. We investigated whether the PLAU P141L (C > T) polymorphism, which causes a mutation in the kringle domain of the protein, is associated with coronary collateral circulation in a cohort of 676 patients with coronary artery disease. The polymorphism was genotyped in blood samples using a TaqMan-based genotyping assay, and collateral circulation was assessed by the Rentrop method. Multivariate logistic regression models adjusted by clinically relevant variables to estimate odds ratios were used to examine associations of PLAU P141L allelic variants and genotypes with collateral circulation. Patients with poor collateral circulation (Rentrop 0-1; n = 547) showed a higher frequency of the TT genotype than those with good collateral circulation (Rentrop 2-3; n = 129; P = .020). The T allele variant was also more common in patients with poor collateral circulation (P = .006). The odds ratio of having poorly developed collaterals in patients bearing the T allele (adjusted for clinically relevant variables) was statistically significant under the dominant model (odds ratio =1.83 [95% confidence interval, 1.16-2.90]; P = .010) and the additive model (odds ratio =1.73 [95% confidence interval, 1.14-2.62]; P = .009). An association was found between coronary collateral circulation and the PLAU P141L polymorphism. Patients with the 141L variant are at greater risk of developing poor coronary collateral circulation. Full English text available from: www.revespcardiol.org/en.
    Revista Espa de Cardiologia 04/2014; · 3.20 Impact Factor
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    ABSTRACT: En este artículo se presenta una revisión de las publicaciones y los estudios más relevantes en el ámbito de la cardiología intervencionista en 2013. El intervencionismo coronario en el contexto del infarto de miocardio con elevación del segmento ST ocupa un lugar destacado, con estudios que evalúan diferentes dispositivos y estrategias farmacológicas y mecánicas en la angioplastia primaria. Grupos de pacientes cada vez más numerosos (diabéticos, ancianos) y su mejor estrategia de revascularización coronaria son también objeto de exhaustiva investigación. El intervencionismo percutáneo sobre el tronco izquierdo sigue generando un significativo número de publicaciones, tanto por los resultados del uso de diferentes stents como por las técnicas de imagen intravascular para guiar el procedimiento y su resultado. Los nuevos stents farmacoactivos con polímeros bioabsorbibles o con estructura totalmente reabsorbible se están comparando con los stents farmacoactivos de segunda generación con el objetivo de demostrar su eficacia para prevenir la reestenosis y disminuir las trombosis tardías. El intervencionismo cardiaco estructural continúa generando muchas publicaciones, especialmente las prótesis aórticas percutáneas, pero también los cierres de foramen oval y de orejuela izquierda. Finalmente, la denervación renal continúa suscitando gran atención en la literatura médica.
    Revista Espa de Cardiologia 04/2014; · 3.20 Impact Factor
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    ABSTRACT: Electrocardiography is an excellent tool for decision making in patients with ST elevation myocardial infarction (STEMI). However, little is known on the correlation between its dynamic changes during primary percutaneous coronary intervention (PCI) and the anatomic information provided by cardiovascular magnetic resonance. The study aimed to assess the predictive value of dynamic ST-segment changes before and after PCI on myocardial area at risk (AAR), infarct size, and left ventricular function in patients with STEMI. Eighty-five consecutive patients with a first STEMI were included. An electrocardiogram was recorded before and after PCI at 1, 24, 48, 72, and 120 hours. Sum of ST elevation (sumSTE), the number of STE, and STE resolution (resSTE) were determined. Complete resSTE was defined as ≥70% resolution, and patients were classified into 3 groups: group 1 (resSTE 1 hour after PCI) n = 39; group 2 (resSTE 120 hour after PCI) n = 27; and group 3, without resSTE (n = 19). Cardiovascular magnetic resonance was performed during hospitalization and at 6 months. Left ventricular volumes, ejection fraction, AAR, infarct size, myocardial salvage index, and microvascular obstruction were determined. Before PCI, the number of STE and sumSTE were best associated with AAR (p <0.001). After PCI, lack of resSTE (group 3) was associated with larger infarct size, MVO, and lower myocardial salvage index. However, sumSTE at 120 hours after PCI best discriminated patients with larger infarct size, ventricular volumes, and lower ejection fraction during hospitalization and at follow-up. In conclusion, admission sumSTE best correlates with AAR, whereas sumSTE at 120 hours rather than early resSTE best correlates with infarct size and left ventricular volumes during hospitalization and at 6 months.
    The American journal of cardiology 02/2014; 113(4):593-600. · 3.58 Impact Factor
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    ABSTRACT: The aim of this study was to determine the impact of new-onset persistent left bundle branch block (NOP-LBBB) on late outcomes after transcatheter aortic valve implantation (TAVI). The impact of NOP-LBBB after TAVI remains controversial. A total of 668 consecutive patients who underwent TAVI with a balloon-expandable valve without pre-existing LBBB or permanent pacemaker implantation (PPI) were included. Electrocardiograms were obtained at baseline, immediately after the procedure, and daily until hospital discharge. Patients were followed at 1, 6, and 12 months and yearly thereafter. New-onset LBBB occurred in 128 patients (19.2%) immediately after TAVI and persisted at hospital discharge in 79 patients (11.8%). At a median follow-up of 13 months (range 3 to 27 months), there were no differences in mortality rate between the NOP-LBBB and no NOP-LBBB groups (27.8% vs. 28.4%; adjusted-hazard ratio: 0.87 [95% confidence interval: 0.55 to 1.37]; p = 0.54). There were no differences between groups regarding cardiovascular mortality (p = 0.82), sudden death (p = 0.87), rehospitalizations for all causes (p = 0.11), or heart failure (p = 0.55). NOP-LBBB was the only factor associated with an increased rate of PPI during the follow-up period (13.9% vs. 3.0%; hazard ratio: 4.29 [95% CI: 2.03-9.07], p<0.001. NOP-LBBB was also associated with a lack of left ventricular ejection fraction improvement and poorer New York Heart Association functional class at follow-up (p < 0.02 for both). NOP-LBBB occurred in ∼1 of 10 patients who had undergone TAVI with a balloon-expandable valve. NOP-LBBB was associated with a higher rate of PPI, a lack of improvement in left ventricular ejection fraction, and a poorer functional status, but did not increase the risk of global or cardiovascular mortality or rehospitalizations at 1-year follow-up.
    JACC. Cardiovascular Interventions 01/2014; · 1.07 Impact Factor
  • David Garcia-Dorado, Bruno Garcia Del Blanco
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    ABSTRACT: To the Editor: On the basis of registry data from July 2005 through June 2009, Menees et al. (Sept. 5 issue)(1) report no reduction in mortality among patients with ST-segment elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PCI), despite a decrease in door-to-balloon time of 16 minutes. There was a nonsignificant reduction in risk-adjusted mortality from 5.0% to 4.7% (P=0.34), an absolute 0.3-percentage-point effect size that is consistent with a previous report from the same registry.(2) Although we are unable to calculate the exact 95% confidence interval for the study by Menees et al., a . . .
    New England Journal of Medicine 01/2014; 370(2):178-182. · 54.42 Impact Factor
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    ABSTRACT: The present article reviews the most important publications and studies in the field of interventional cardiology in 2013. Coronary interventions for ST-segment elevation myocardial infarction are among the most important, with studies that assess different devices and pharmacologic and mechanical strategies in primary angioplasty. Increasingly large groups of patients (with diabetes, of advanced age) and the best coronary revascularization strategy are also the focus of exhaustive research. Percutaneous procedures in the left main coronary artery continue to give rise to a significant number of publications, both because of the results of using different types of stent and because of the intravascular imaging techniques used to guide procedures and the results of their use. New bioabsorbable polymer-coated drug-eluting stents or bioresorbable drug-eluting scaffolds are being compared with second-generation drug-eluting stents to show their efficacy in preventing restenosis and reducing incidence of late thrombosis. Percutaneous treatment of structural heart disease continues to produce many publications, especially regarding percutaneous aortic prostheses, but also on closure of foramen ovale and of left atrial appendage. Finally, renal denervation continues to arouse much interest in the medical literature. Full English text available from: www.revespcardiol.org/en
    Revista Española de Cardiología. 01/2014;
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    ABSTRACT: Introduction and objectives Urokinase-type plasminogen activator, which is encoded by the PLAU gene, plays a prominent role during collateral arterial growth. We investigated whether the PLAU P141L (C > T) polymorphism, which causes a mutation in the kringle domain of the protein, is associated with coronary collateral circulation in a cohort of 676 patients with coronary artery disease. Methods The polymorphism was genotyped in blood samples using a TaqMan-based genotyping assay, and collateral circulation was assessed by the Rentrop method. Multivariate logistic regression models adjusted by clinically relevant variables to estimate odds ratios were used to examine associations of PLAU P141L allelic variants and genotypes with collateral circulation. Results Patients with poor collateral circulation (Rentrop 0-1; n = 547) showed a higher frequency of the TT genotype than those with good collateral circulation (Rentrop 2-3; n = 129; P = .020). The T allele variant was also more common in patients with poor collateral circulation (P = .006). The odds ratio of having poorly developed collaterals in patients bearing the T allele (adjusted for clinically relevant variables) was statistically significant under the dominant model (odds ratio =1.83 [95% confidence interval, 1.16-2.90]; P = .010) and the additive model (odds ratio =1.73 [95% confidence interval, 1.14-2.62]; P = .009). Conclusions An association was found between coronary collateral circulation and the PLAU P141L polymorphism. Patients with the 141L variant are at greater risk of developing poor coronary collateral circulation. Full English text available from: www.revespcardiol.org/en
    Revista Española de Cardiología. 01/2014;
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    ABSTRACT: Small and large preclinical animal models have shown that antagomir-92a-based therapy reduces early postischemic loss of function, but its effect on postinfarction remodeling is not known. In addition, the reported remote miR-92a inhibition in noncardiac organs prevents the translation of nonvectorized miR-targeted therapy to the clinical setting. We investigated whether a single intracoronary administration of antagomir-92a encapsulated in microspheres could prevent deleterious remodeling of myocardium 1 month after acute myocardial infarction AUTHOR: Should "acute" be added before "myocardial infarction" (since abbreviation is AMI)? Also check at first mention in main text (AMI) without adverse effects.
    Journal of the American Heart Association. 01/2014; 3(5).
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    ABSTRACT: Very few data exist on the clinical impact of permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI). The objective of this study was to assess the impact of PPI following TAVI on late outcomes in a large cohort of patients. A total of 1,556 consecutive patients without prior PPI undergoing TAVI were included. 239 patients (15.4%) required a PPI within the first 30 days following TAVI. At a mean follow-up of 22±17 months, no association was observed between the need for 30-day PPI and all-cause mortality (HR: 0.98, 95% CI:0.74-1.30, P=0.871), cardiovascular mortality (HR: 0.81, 95% CI: 0.56-1.17, P=0.270), and all-cause mortality or rehospitalization due to heart failure (HR: 1.00, 95% CI:0.77-1.30, P=0.980). A lower rate of sudden or unknown death was observed in patients with PPI (HR: 0.31, 95% CI: 0.11-0.85, P=0.023). Patients with new PPI showed a poorer evolution of left ventricular ejection fraction (LVEF) over time (P=0.017), and new PPI was an independent predictor of LVEF decrease at 6- to 12-month follow-up (estimated coefficient: -2.26, 95% CI:-4.07 to -0.44, P= 0.013, R(2): 0.121). The need for PPI was a frequent complication of TAVI, but it was not associated with any increase in overall or cardiovascular death or rehospitalization due to heart failure after a mean follow-up of ~ 2 years. Indeed, 30-day PPI was a protective factor for the occurrence of unexpected (sudden or unknown) death. However, new PPI did have a negative effect on left ventricular function over time.
    Circulation 12/2013; · 15.20 Impact Factor

Publication Stats

108 Citations
261.86 Total Impact Points

Institutions

  • 2011–2014
    • Autonomous University of Barcelona
      Cerdanyola del Vallès, Catalonia, Spain
  • 2010–2014
    • Vall d’Hebron Institute of Oncology
      Barcino, Catalonia, Spain
  • 2009–2014
    • University Hospital Vall d'Hebron
      • • Department of Cardiology
      • • Laboratorio de Cardiología Experimental
      Barcino, Catalonia, Spain
  • 2013
    • Sociedad Española de Cardiología
      Madrid, Madrid, Spain
  • 2012
    • Laval University
      • Department of Surgery
      Québec, Quebec, Canada