12 results on '"Kristian Rivera"'
Search Results
2. Diagnóstico postmortem de la trombosis subaguda de un stent coronario
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Tania Ramírez-Martínez, Pablo Pastor-Pueyo, Jara Gayán-Ordas, Carlos Tomás-Querol, Michelle Cossette-Merheb, and Kristian Rivera
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2024
- Full Text
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3. Litotricia intracoronaria como rescate de un stent infraexpandido
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Kristian Rivera, Diego Fernández-Rodríguez, Marta Zielonka, Ignacio Barriuso, Núria Pueyo, and Juan Casanova-Sandoval
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2022
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- View/download PDF
4. Reply to the Letter to the Editor: Takotsubo syndrome in the setting of COVID-19: Pathogenetic and diagnostic implications
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Kristian Rivera, Diego Fernández-Rodríguez, Marta Zielonka, and Juan Casanova-Sandoval
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2022
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- View/download PDF
5. Ajustando a RFR por Preditores de Discordância, 'A RFR Ajustada': Uma Metodologia Alternativa para Melhorar a Capacidade Diagnóstica dos Índices Coronarianos
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Diego Fernández-Rodríguez, Juan Casanova-Sandoval, Ignacio Barriuso, Kristian Rivera, Imanol Otaegui, Bruno García del Blanco, Teresa Gil Jiménez, Manuel López-Pérez, Marcos Rodríguez-Esteban, Francisco Torres-Saura, Víctor Jiménez Díaz, Raymundo Ocaranza-Sánchez, Vicente Peral Disdier, Guillermo Sánchez Elvira, and Fernando Worner
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Angina ,Reserva de Fluxo Fracionado ,Relação do Ciclo Completo de Repouso ,Sensibilidade ,Especificidade ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo Fundamento Os limiares de corte para a “relação do ciclo completo de repouso” (RFR) oscilam em diferentes séries, sugerindo que as características da população podem influenciá-los. Da mesma forma, foram documentados preditores de discordância entre a RFR e a reserva de fluxo fracionado (FFR). O Estudo RECOPA, mostrou que a capacidade diagnóstica está reduzida na “zona cinzenta” da RFR, tornando necessária a realização de FFR para descartar ou confirmar isquemia. Objetivos Determinar os preditores de discordância, integrar as informações que eles fornecem em um índice clínico-fisiológico: a “RFR Ajustada”, e comparar sua concordância com o FFR. Métodos Usando dados do Estudo RECOPA, os preditores de discordância em relação à FFR foram determinados na “zona cinzenta” da RFR (0,86 a 0,92) para construir um índice (“RFR Ajustada”) que pesaria a RFR juntamente com os preditores de discordância e avaliar sua concordância com a FFR. Resultados Foram avaliadas 156 lesões em 141 pacientes. Os preditores de discordância foram: doença renal crônica, cardiopatia isquêmica prévia, lesões não envolvendo a artéria descendente anterior esquerda e síndrome coronariana aguda. Embora limitada, a “RFR Ajustada” melhorou a capacidade diagnóstica em comparação com a RFR na “zona cinzenta” (AUC-RFR = 0,651 versus AUC-“RFR Ajustada” = 0,749), mostrando também uma melhora em todos os índices diagnósticos quando foram estabelecidos limiares de corte otimizados (sensibilidade: 59% a 68%; especificidade: 62% a 75%; acurácia diagnóstica: 60% a 71%; razão de verossimilhança positiva: 1,51 a 2,34; razão de verossimilhança negativa: 0,64 a 0,37). Conclusões Ajustar a RFR integrando as informações fornecidas pelos preditores de discordância para obter a “RFR Ajustada” melhorou a capacidade diagnóstica em nossa população. Mais estudos são necessários para avaliar se os índices clínico-fisiológicos melhoram a capacidade diagnóstica da RFR ou de outros índices coronarianos.
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- 2022
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6. Diagnosis of Takotsubo syndrome in the COVID-19 era
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Kristian Rivera, Diego Fernández-Rodríguez, Marta Zielonka, and Juan Casanova-Sandoval
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
- Full Text
- View/download PDF
7. Comparison between the Right and Left Distal Radial Access for Patients Undergoing Coronary Procedures: A Propensity Score Matching Analysis
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Kristian Rivera, Diego Fernández-Rodríguez, Juan Casanova-Sandoval, Ignacio Barriuso, Marta Zielonka, Nuria Pueyo-Balsells, Immaculada Calaf Valls, and Fernando Worner
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Introduction. Distal radial access for coronary procedures decreases hemostasis time, prevents radial occlusion, and improves patient comfort compared to conventional transradial access. Initially described for left distal radial access (lDRA), the right distal radial access (rDRA) is feasible. However, there are no comparative studies to date. This study aimed to evaluate the impact of the access site on vascular access and procedural performance. Methods. From August 2020 to October 2021, coronary procedures performed through distal radial access were prospectively recorded. After propensity score matching, the rDRA and lDRA were compared. The primary endpoint was the proportion of approach success. The secondary endpoints included access time, coronary procedural success, radial spasm, exposition to ionizing radiation, patient comfort, and vascular access-related complications. Results. From a total of 385 procedures in 382 patients, after a propensity score matching, 182 procedures were compared between the rDRA and lDRA. There were no differences in the baseline characteristics between the groups. Compared to the lDRA, the rDRA presented similar approach success (96.7% vs. 96.7%, p=1.0), less access time (39 (25–60) sec vs. 50 (29–90) sec, p=0.018), comparable coronary procedural success after sheath placement (100% vs. 100%, p=1.000), and not statistically significant radial spasm (2.19% vs. 6.59%, p=0.148). No differences in dose-area product (32 (20–56.2) Gy.m2 vs. 32.3 (19.4–46.3) Gy.m2; p=0.472) and fluoroscopy time (4.4 (2.5–9.1) min vs. 4.3 (2.4–7.5) min, p=0.251) were detected between the groups. No vascular access-related complications were observed in any group. Conclusions. The rDRA, compared to the lDRA, had the same proportion of approach success and procedural performance, with a slight reduction in access time for patients undergoing coronary procedures.
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- 2022
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8. Usefulness of the Hybrid RFR-FFR Approach: Results of a Prospective and Multicenter Analysis of Diagnostic Agreement between RFR and FFR—The RECOPA (REsting Full-Cycle Ratio Comparation versus Fractional Flow Reserve (A Prospective Validation)) Study
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Juan Casanova-Sandoval, Diego Fernández-Rodríguez, Imanol Otaegui, Teresa Gil Jiménez, Marcos Rodríguez-Esteban, Kristian Rivera, Francisco Torres-Saura, Víctor Jiménez Díaz, Raymundo Ocaranza-Sánchez, Vicente Peral Disdier, Guillermo Sánchez-Elvira, and Fernando Worner
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background. The resting full‐cycle ratio (RFR) is a novel resting index which in contrast to the gold standard (fractional flow reserve (FFR)) does not require maximum hyperemia induction. The objectives of this study were to evaluate the agreement between RFR and FFR with the currently recommended thresholds and to design a hybrid RFR-FFR ischemia detection strategy, allowing a reduction of coronary vasodilator use. Materials and Methods. Patients subjected to invasive physiological study in 9 Spanish centers were prospectively recruited between April 2019 and March 2020. Sensitivity and specificity studies were made to assess diagnostic accuracy between the recommended levels of RFR ≤0.89 and FFR ≤0.80 (primary objective) and to determine the RFR “grey zone” in order to define a hybrid strategy with FFR affording 95% global agreement compared with FFR alone (secondary objective). Results. A total of 380 lesions were evaluated in 311 patients. Significant correlation was observed (R2 = 0.81; P
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- 2021
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9. Impact of One-Catheter Strategy with TIG I Catheter on Coronary Catheterization Performance and Economic Costs
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Joan Costa-Mateu, Diego Fernández-Rodríguez, Kristian Rivera, Juan Casanova, Patricia Irigaray, Marta Zielonka, Eduardo Pereyra-Acha, Albina Aldomá, and Fernando Worner
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Cineagiography/methods ,Cardiac Catheterization/economic ,Radiation, Ionizing ,Fluoroscopy ,Cost Savings/economic ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background: Coronary angiography with two catheters is the traditional strategy for diagnostic coronary procedures. TIG I catheter permits to cannulate both coronary arteries, avoiding exchanging catheters during coronary angiography by transradial access. Objective: The aim of this study is to evaluate the impact of one-catheter strategy, by avoiding catheter exchange, on coronary catheterization performance and economic costs. Methods: Transradial coronary diagnostic procedures conducted from January 2013 to June 2017 were collected. One-catheter strategy (TIG I catheter) and two-catheter strategy (left and right Judkins catheters) were compared. The volume of iodinated contrast administered was the primary endpoint. Secondary endpoints included radial spasm, procedural duration (fluoroscopy time) and exposure to ionizing radiation (dose-area product and air kerma). Direct economic costs were also evaluated. For statistical analyses, two-tailed p-values < 0.05 were considered statistically significant. Results: From a total of 1,953 procedures in 1,829 patients, 252 procedures were assigned to one-catheter strategy and 1,701 procedures to two-catheter strategy. There were no differences in baseline characteristics between the groups. One-catheter strategy required less iodinated contrast [primary endpoint; (60-105)-mL vs. 92 (64-120)-mL; p < 0.001] than the two-catheter strategy. Also, the one-catheter group presented less radial spasm (5.2% vs. 9.3%, p = 0.022) and shorter fluoroscopy time [3.9 (2.2-8.0)-min vs. 4.8 (2.9-8.3)-min, p = 0.001] and saved costs [149 (140-160)-€/procedure vs. 171 (160-183)-€/procedure; p < 0.001]. No differences in dose-area product and air kerma were detected between the groups. Conclusions: One-catheter strategy, with TIG I catheter, improves coronary catheterization performance and reduces economic costs compared to traditional two-catheter strategy in patients referred for coronary angiography.
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10. Usefulness of the Hybrid RFR-FFR Approach: Results of a Prospective and Multicenter Analysis of Diagnostic Agreement between RFR and FFR-The RECOPA (REsting Full-Cycle Ratio Comparation versus Fractional Flow Reserve (A Prospective Validation)) Study
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Diego Fernández-Rodríguez, Juan Casanova-Sandoval, Marcos Rodríguez-Esteban, Francisco Torres-Saura, Raymundo Ocaranza-Sánchez, Victor Alfonso Jimenez Diaz, Teresa Gil Jiménez, Kristian Rivera, Fernando Worner, Vicente Peral Disdier, Imanol Otaegui, Guillermo Sánchez-Elvira, [Casanova-Sandoval, Juan] Hosp Arnau Vilanova, Lleida, Spain, [Fernandez-Rodriguez, Diego] Hosp Arnau Vilanova, Lleida, Spain, [Rivera, Kristian] Hosp Arnau Vilanova, Lleida, Spain, [Worner, Fernando] Hosp Arnau Vilanova, Lleida, Spain, [Casanova-Sandoval, Juan] Inst Recerca Biomed Lleida IRBLleida, Lleida, Spain, [Fernandez-Rodriguez, Diego] Inst Recerca Biomed Lleida IRBLleida, Lleida, Spain, [Rivera, Kristian] Inst Recerca Biomed Lleida IRBLleida, Lleida, Spain, [Worner, Fernando] Inst Recerca Biomed Lleida IRBLleida, Lleida, Spain, [Otaegui, Imanol] Hosp Univ Vall dHebron, Barcelona, Spain, [Gil Jimenez, Teresa] Hosp Univ Clin San Cecilio Granada, Granada, Spain, [Rodriguez-Esteban, Marcos] Hosp Univ Nuestra Senora Candelaria, Tenerife, Spain, [Torres-Saura, Francisco] Hosp Univ Vinalopo, Elche, Spain, [Jimenez Diaz, Victor] Hosp Univ Alvaro Cunqueiro, Vigo, Spain, [Ocaranza-Sanchez, Raymundo] Hosp Univ Lucus Augusti, Lugo, Spain, [Peral Disdier, Vicente] Hosp Son Espases, Palma de Mallorca, Spain, [Sanchez-Elvira, Guillermo] Complejo Hosp Navarra, Pamplona, Spain, Institut Català de la Salut, [Casanova-Sandoval J, Fernández-Rodríguez D, Rivera K] Hospital Universitari Arnau de Vilanova, Lleida, Spain. Institut de Recerca Biomédica de Lleida (IRBLleida), Lleida, Spain. [Otaegui I] Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Gil Jiménez T] Hospital Universitario Clínico San Cecilio de Granada, Granada, Spain. [Rodríguez-Esteban M] Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Male ,Adenosine ,Vasodilator Agents ,Myocardial Ischemia ,Coronary ,Diagnostic accuracy ,Fractional flow reserve ,Coronary Angiography ,Malalties coronàries - Diagnòstic ,Severity of Illness Index ,Wave-free ratio ,Other subheadings::/diagnosis [Other subheadings] ,Medicine ,Correlation of Data ,técnicas de investigación::métodos epidemiológicos::diseño de la investigación epidemiológica::sensibilidad y especificidad::valor predictivo de las pruebas [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Artery stenosis severity ,Predictive value ,Fractional Flow Reserve, Myocardial ,Grey zone ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Malalties coronàries - Fisiologia patològica ,Investigative Techniques::Epidemiologic Methods::Epide miologic Research Design::Sensitivity and Specificity::Predictive Value of Tests [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Research Article ,Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia [DISEASES] ,Validation study ,medicine.medical_specialty ,Article Subject ,Blood-flow ,Invasive physiological indexes ,Otros calificadores::/diagnóstico [Otros calificadores] ,enfermedades cardiovasculares::enfermedades cardíacas::isquemia miocárdica [ENFERMEDADES] ,Hyperemia ,Sensitivity and Specificity ,Predictive Value of Tests ,Pressure measurements ,Internal medicine ,Coronary Circulation ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Dose-Response Relationship, Drug ,business.industry ,Coronary Stenosis ,Gold standard (test) ,Spain ,RC666-701 ,Coronary vasodilator ,business - Abstract
Background. The resting full‐cycle ratio (RFR) is a novel resting index which in contrast to the gold standard (fractional flow reserve (FFR)) does not require maximum hyperemia induction. The objectives of this study were to evaluate the agreement between RFR and FFR with the currently recommended thresholds and to design a hybrid RFR-FFR ischemia detection strategy, allowing a reduction of coronary vasodilator use. Materials and Methods. Patients subjected to invasive physiological study in 9 Spanish centers were prospectively recruited between April 2019 and March 2020. Sensitivity and specificity studies were made to assess diagnostic accuracy between the recommended levels of RFR ≤0.89 and FFR ≤0.80 (primary objective) and to determine the RFR “grey zone” in order to define a hybrid strategy with FFR affording 95% global agreement compared with FFR alone (secondary objective). Results. A total of 380 lesions were evaluated in 311 patients. Significant correlation was observed (R2 = 0.81; P < 0.001 ) between the two techniques, with 79% agreement between RFR ≤ 0.89 and FFR ≤ 0.80 (positive predictive value, 68%, and negative predictive value, 80%). The hybrid RFR-FFR strategy, administering only adenosine in the “grey zone” (RFR: 0.86 to 0.92), exhibited an agreement of over 95% with FFR, with high predictive values (positive predictive value, 91%, and negative predictive value, 92%), reducing the need for vasodilators by 58%. Conclusions. Dichotomous agreement between RFR and FFR with the recommended thresholds is significant but limited. The adoption of a hybrid RFR-FFR strategy affords very high agreement, with minimization of vasodilator use.
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- 2021
11. Massive thrombus over an aneurysmatic left main coronary artery: Non-interventional therapy?
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Marta Zielonka, Kristian Rivera, Diego Fernández-Rodríguez, and Juan Casanova-Sandoval
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medicine.medical_specialty ,business.industry ,Coronary Thrombosis ,Coronary Aneurysm ,medicine.disease ,Coronary Vessels ,medicine.anatomical_structure ,RC666-701 ,Internal medicine ,Non interventional ,medicine ,Cardiology ,Diseases of the circulatory (Cardiovascular) system ,General Earth and Planetary Sciences ,Humans ,Thrombus ,business ,Cardiology and Cardiovascular Medicine ,General Environmental Science ,Artery - Published
- 2021
12. Diagnosis of Takotsubo syndrome in the COVID-19 era
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Marta Zielonka, Kristian Rivera, Diego Fernández-Rodríguez, and Juan Casanova-Sandoval
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Takotsubo syndrome ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,COVID-19 ,Virology ,Article ,Image in Cardiology ,Takotsubo Cardiomyopathy ,RC666-701 ,Diseases of the circulatory (Cardiovascular) system ,General Earth and Planetary Sciences ,Medicine ,Humans ,Cardiology and Cardiovascular Medicine ,business ,General Environmental Science - Published
- 2020
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