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481 results on '"Alvarez, Paulino A."'

103. Additional file 1 of Characteristics and outcomes in patients with atrial fibrillation receiving direct oral anticoagulants in off-label doses

Author

Briasoulis, Alexandros, Yubo Gao, Chakradhari Inampudi, Alvarez, Paulino, Asleh, Rabea, Chrischilles, Elizabeth, Leira, Enrique, and Vaughan-Sarrazin, Mary

Abstract

Additional file 1: Table S1. ICD 9 and 10 codes of comorbidities and outcomes included in the analysis and list of medications used for dose adjustments of dabigatran and rivaroxaban. Description of Data: All ICD 9 and 10 codes included in the analysis.

Published
2020
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108. Enoxaparin Use and Adverse Events in Outpatients With a Continuous Flow Left Ventricular Assist Device at a Single Institution.

Author

Bernard, Allison M., Alvarez, Paulino A., Bream-Rouwenhorst, Heather R., Horner, Kathleen E., Briasoulis, Alexandros, and Czerniak, Laura C.

Subjects
*ENOXAPARIN, *DRUG efficacy, *THROMBOSIS, *HEART assist devices, *RETROSPECTIVE studies, *ACQUISITION of data, *HEART ventricles, *LOW-molecular-weight heparin, *MEDICAL records, *DRUG side effects, *INTERNATIONAL normalized ratio, *OUTPATIENT services in hospitals, *HEART failure, *PATIENT safety, *HEMORRHAGE
Abstract

Background: Patients with left ventricular assist devices (LVADs) are anticoagulated with warfarin and may receive enoxaparin bridging for a subtherapeutic international normalized ratio (INR). There is no guideline regarding enoxaparin bridging in LVAD patients and a dosing strategy to ensure efficacy and safety is uncertain. Objective: The objective was to characterize the use of enoxaparin bridging for subtherapeutic INRs and its impact on thrombotic or major bleeding events (MBE) in patients with an LVAD. Methods: A retrospective review from 6/1/17 to 6/30/18 was performed. Patients with an LVAD were excluded if they had less than 60 days of outpatient anticoagulation or age <18 years old. Patients were divided into 2 cohorts based on enoxaparin exposure. MBE and thrombotic events were classified as related to enoxaparin if events occurred while receiving enoxaparin and up to 7 days or 30 days, respectively, after discontinuation. Results: Seventy-one LVAD patients met inclusion criteria and 50 patients received enoxaparin bridging. Therapeutic-dose enoxaparin was initiated at a mean INR of 1.8 for a mean duration of 2.8 days. In the enoxaparin exposure group, one MBE occurred 6 days after enoxaparin discontinuation, coinciding with an INR increase from 1.8 to 4.7. One thrombotic event occurred 2 days after enoxaparin discontinuation at an INR of 5.0. Conclusion: This institution's bridging strategy of therapeutic-dose enoxaparin with a short duration has a low rate of bleeding and thrombotic events. Additional prospective studies of anticoagulation bridging based on characteristics such as type of LVAD device are warranted. [ABSTRACT FROM AUTHOR]

Published
2022
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109. Outflow graft foreign body reaction and thrombosis in HeartMate 3 left ventricular assist device.

Author

Alvarez, Paulino, Humble, Robert, Firchau, Dennis, and Briasoulis, Alexandros

Abstract

Outflow cannula occlusion is an infrequent complication occurring among recipients of continuous flow left ventricular assist devices. Hereby, we present a case of a 66-year-old man with a HeartMate 3 left ventricular assist device that presented 18 months after implantation and during his admission, evidence of poor left ventricular unloading and forward flow uncovered intrinsic and extrinsic outflow cannula obstruction. The patient's course was complicated by cardiogenic shock, diffuse alveolar hemorrhage and multiorgan failure. Post-mortem examination suggested foreign body reaction as a potential contributor of outflow graft obstruction at the level of the bend relief. [ABSTRACT FROM AUTHOR]

Published
2022
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118. Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): a randomised, double-blind, placebo-controlled, phase 3 trial

Author

Olivotto, Iacopo, primary, Oreziak, Artur, additional, Barriales-Villa, Roberto, additional, Abraham, Theodore P, additional, Masri, Ahmad, additional, Garcia-Pavia, Pablo, additional, Saberi, Sara, additional, Lakdawala, Neal K, additional, Wheeler, Matthew T, additional, Owens, Anjali, additional, Kubanek, Milos, additional, Wojakowski, Wojciech, additional, Jensen, Morten K, additional, Gimeno-Blanes, Juan, additional, Afshar, Kia, additional, Myers, Jonathan, additional, Hegde, Sheila M, additional, Solomon, Scott D, additional, Sehnert, Amy J, additional, Zhang, David, additional, Li, Wanying, additional, Bhattacharya, Mondira, additional, Edelberg, Jay M, additional, Waldman, Cynthia Burstein, additional, Lester, Steven J, additional, Wang, Andrew, additional, Ho, Carolyn Y, additional, Jacoby, Daniel, additional, Bartunek, Jozef, additional, Bondue, Antoine, additional, Van Craenenbroeck, Emeline, additional, Zemanek, David, additional, Jensen, Morten, additional, Mogensen, Jens, additional, Thune, Jens Jakob, additional, Charron, Philippe, additional, Hagege, Albert, additional, Lairez, Olivier, additional, Trochu, Jean-Noël, additional, Axthelm, Christoph, additional, Duengen, Hans-Dirk, additional, Frey, Norbert, additional, Mitrovic, Veselin, additional, Preusch, Michael, additional, Schulz-Menger, Jeanette, additional, Seidler, Tim, additional, Arad, Michael, additional, Halabi, Majdi, additional, Katz, Amos, additional, Monakier, Daniel, additional, Paz, Offir, additional, Viskin, Samuel, additional, Zwas, Donna, additional, Olivotto, Iacopo, additional, Brunner-La Rocca, Hans Peter, additional, Michels, Michelle, additional, Dudek, Dariusz, additional, Oko-Sarnowska, Zofia, additional, Cardim, Nuno, additional, Pereira, Helder, additional, García Pavia, Pablo, additional, Gimeno Blanes, Juan, additional, Hidalgo Urbano, Rafael, additional, Rincón Diaz, Luis Miguel, additional, Elliott, Perry, additional, Yousef, Zaheer, additional, Abraham, Theodore, additional, Alvarez, Paulino, additional, Bach, Richard, additional, Becker, Richard, additional, Choudhury, Lubna, additional, Fermin, David, additional, Jefferies, John, additional, Kramer, Christopher, additional, Lakdawala, Neal, additional, Lester, Steven, additional, Marian, Ali, additional, Maurer, Mathew, additional, Nagueh, Sherif, additional, Owens, David, additional, Rader, Florian, additional, Sherrid, Mark, additional, Shirani, Jamshid, additional, Symanski, John, additional, Turer, Aslan, additional, Wever-Pinzon, Omar, additional, Wheeler, Matthew, additional, Wong, Timothy, additional, and Yamani, Mohamad, additional

Published
2020
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132. INCIDENCE OF NOSOCOMIAL INFECTIONS AND ITS CLINICAL IMPLICATION IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION AND CARDIOGENIC SHOCK WITH PERCUTANEOUS MECHANICAL CIRCULATORY SUPPORT DEVICES

Author

Chehab, Omar, primary, Rachwan, Rayan Jo, additional, Pahuja, Mohit, additional, Mansoor, Shareef, additional, Tabaja, Hussam, additional, Kanj, Amjad, additional, Ajam, Mustafa, additional, Alvarez, Paulino, additional, and Briasoulis, Alexandros, additional

Published
2020
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145. Gender Differences in Outcomes After Implantation of Left Ventricular Assist Devices.

Author

Ahmed, Abdelrahman, Adegbala, Oluwole, Akintoye, Emmanuel, Inampudi, Chakradhari, Ajam, Mustafa, Yassin, Ahmed S., Olawusi, Emmanuel, Shokr, Mohamed, Alvarez, Paulino, and Briasoulis, Alexandros

Abstract

Left ventricular assist device (LVAD) implantation has historically been underutilized in women compared with men. It was hypothesized that the introduction of continuous-flow LVADs would lead to more LVAD implantations in women and possibly narrow the gender gap. Patients who underwent LVAD implantation between 2009 and 2014 were identified using the national inpatient sample. A total of 3511 patients (17,251 when weighted) underwent LVAD implantation in the United States between 2009 and 2014. Mean age was 56 years and there were 817 women in the study sample (23.32%). LVAD implantations in women doubled from 2009 to 2014, but men continued to receive LVAD 3 times more than women. Inpatient mortality after LVAD placement was similar between men and women (13.42% women vs 12.85% men; odds ratio, 1.05; P =.16). Most common complications after LVAD implantation in both genders included acute kidney injury, bleeding requiring blood transfusion, and postoperative sepsis. There were no gender-specific differences in the incidence of periprocedural complications, including postoperative cardiac tamponade, postoperative thromboembolism, or sepsis. In addition, no significant difference was found in length of stay and median hospitalization cost. The use of extracorporeal membrane oxygenation did not differ between men and women. Subgroup analysis in patients older than 65 years of age showed higher in-hospital mortality but no differences between genders. The number of women undergoing LVAD implantation has increased with the introduction of continuous-flow LVADs, but a gender gap still exists. Most major in-hospital outcomes after LVAD implantation are similar between genders. [ABSTRACT FROM AUTHOR]

Published
2020
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