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2. Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome.

Author

Raquel Pimienta González, Patricia Couto Comba, Marcos Rodríguez Esteban, José Juan Alemán Sánchez, Julio Hernández Afonso, María Del Cristo Rodríguez Pérez, Itahisa Marcelino Rodríguez, Buenaventura Brito Díaz, Roberto Elosua, and Antonio Cabrera de León

Subjects
Medicine, Science
Abstract

To determine whether the risk of cardiovascular mortality associated with cardiorenal syndrome subtype 1 (CRS1) in patients who were hospitalized for acute coronary syndrome (ACS) was greater than the expected risk based on the sum of its components, to estimate the predictive value of CRS1, and to determine whether the severity of CRS1 worsens the prognosis.Follow-up study of 1912 incident cases of ACS for 1 year after discharge. Cox regression models were estimated with time to event (in-hospital death, and readmission or death during the first year after discharge) as the dependent variable.The incidence of CRS1 was 9.2/1000 person-days of hospitalization (95% CI = 8.1-10.5), but these patients accounted for 56.6% (95% CI = 47.4-65.) of all mortality. The positive predictive value of CRS1 was 29.6% (95% CI = 23.9-36.0) for in-hospital death, and 51.4% (95% CI = 44.8-58.0) for readmission or death after discharge. The risk of in-hospital death from CRS1 (RR = 18.3; 95% CI = 6.3-53.2) was greater than the sum of risks associated with either acute heart failure (RR = 7.6; 95% CI = 1.8-31.8) or acute kidney injury (RR = 2.8; 95% CI = 0.9-8.8). The risk of events associated with CRS1 also increased with syndrome severity, reaching a RR of 10.6 (95% CI = 6.2-18.1) for in-hospital death at the highest severity level.The effect of CRS1 on in-hospital mortality is greater than the sum of the effects associated with each of its components, and it increases with the severity of the syndrome. CRS1 accounted for more than half of all mortality, and its positive predictive value approached 30% in-hospital and 50% after discharge.

Published
2016
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3. One sinus, three arteries: An unexpected coronary anomaly

Author

Alejandro Quijada Fumero, Luis Álvarez Acosta, Raquel Pimienta González, Marcos Farrais Villalba, and Marcos Rodríguez Esteban

Subjects
coronary artery, anomaly, angiogram, ct scan, Medicine, Internal medicine, RC31-1245, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2015
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7. Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies

Author

L. Parra, Luis V. García, Cinta Valls-Pedret, Patricia Guillem-Saiz, Josep A. Tur, María P. Portillo, J. Vila, Estefanía Toledo, R. Martí Massó, E. de la Cruz, José I. González, J. de Irala, L. Garcia-Pérez, Simona Giardina, J.A. Cabeza-Beunza, I. Bautista Castaño, R. Osma, Alejandro Diaz, Ana Jover, M. Mata, Laura Quiles, Elena Martinez, T. Macua-Martínez, T. Elcarte-Lopez, Daniel Muñoz-Aguayo, Andrés Díaz-López, I. Duaso, Christopher Papandreou, L. Mellado, Manuel Leal, Carlos Ferreira, M.L. Garcés Ducar, M.J. Férnandez Rodríguez, I. Falcón Sanabria, P. Pascual-Pascual, L. Mengual, M.T. Martín, V. Velasco García, C. Simón García, G. Mestres, R. Benítez Pont, M. Ginard, Manuel Ortega-Calvo, L. Fernández Urzainqui, Susana Munuera, A. Fernandez Montero, James R. Hébert, E. Maestre, J. Amat, Miquel Fiol, Antonio García-Rodríguez, M. Vivó, Ernest Vinyoles, A. Ramos, B. Macías Gutiérrez, A. Casi, F. Artal-Moneva, M.A. Rodríguez, I. González-Monje, I. Maldonado Díaz, José V. Sorlí, Miguel-Angel Muñoz, Josep Basora-Gallisà, Dolores Corella, J. Gil Zarzosa, J. Alvarez-Pérez, M.A. Rovira, Mònica Bulló, Maira Bes-Rastrollo, P. Iglesias, N. Tort, Adriano Marçal Pimenta, S. Sánchez-Navarro, J. San Vicente, Pilar Buil-Cosiales, José Alfredo Martínez, E. Gutierrez, A. Proenza, Cristina Razquin, Paola Quifer-Rada, J. Marrugat, A.J. Santana Santana, Olga Castañer, Javier Rekondo, F. Trias, Magí Farré, J.M. Lozano-Rodriguez, Carlos Muñoz-Bravo, Marta Evelia Aparicio García, G. Mena, Leticia Miró-Moriano, Anna Tresserra-Rimbau, Z. Vazquez Ruiz, S. Tello, P. Baby, M.J. Ariz-Arnedo, J. García, M. Donazar, Emili Corbella, Jordi Salas-Salvadó, J. Fernandez-Crehuet, C. Simón, J.M. Baena, C. Murillo, Amelia Marti, A. Brau, H. Schröder, Rafael Balanza, C. Iglesias, R. Pedret, C. Oreja-Arrayago, J. Clos, R. Villanueva Moreno, V. Pascual, C. Lopez del Burgo, Raquel Pimienta González, Mercè Serra-Mir, Luis Forga, Helmut Schröder, Alex Medina-Remón, Javier Díez-Espino, C. de Juan, M. Amorós, M.D. Martínez-Mazo, D. Godoy, Olga Portolés, L. Quinzavos, Nancy Babio, Nerea Becerra-Tomás, J. Altirriba, P. Martínez, Carolina Donat-Vargas, N. Rosique Esteban, P. Villanueva, Ramon Estruch, Albert Goday, M. Tafalla, Alfredo Gea, R. de la Torre, F. Martin, B. Sanjulián, Ana García-Arellano, Y. García, Alvaro Alonso, P. Román, M. García-Valdueza, M.T. Barrio Lopez, N. Ibarrola, Marisa Guillén, Francisco Javier Basterra-Gortari, M. Liroz, Joan Fernández-Ballart, I. Bobe, F. Paris, P. Pascual Pascual, E. Manzano, Ricardo Gómez-Huelgas, F. Sarmiendo de la Fe, José Lapetra, R. Navajas, J. García Roselló, E. Sanz, F. Fiol, A. Baca Osorio, A.I. Castellote-Bargalló, J.V. Extremera-Urabayen, Carmen Sayón-Orea, I. Montull, Xavier Corbella, Sebastián Cervantes, T. del Hierro, Nitin Shivappa, E. Solis, Jorge M. Núñez-Córdoba, I. Zazpe Garcıa, A. Parra-Osés, Rosa Casas, Francisco Guillén-Grima, A. Altés, F.J. Giménez, Itziar Salaverria, M.C. Yuste, Carolina Ortega-Azorín, A. Carratalá-Calvo, E. Vargas López, F. Bestard, Eva M. Asensio, Paula Carrasco, T. Cervello, J.J. Sánchez Luque, Raul Ramallal, A. Isach, Ariadna Rovira, Juan Carlos Martínez-González, M. Oller, Francesc Francés, Lluis Serra-Majem, Montse Cofán, J.M. Santos-Lozano, Julia Wärnberg, C. Arroyo-Azpa, I. Sarasa, E. Díez Benítez, Guiem Frontera, J. Rekondo, Manuel Serrano-Martínez, Ana Pérez-Heras, Emilio Ros, I. Felipe, C. Domínguez-Espinaco, Carmen Saiz, M.I. Santamaría, Francisca Lahortiga, E. Figuerido-Garmendia, I. Pla, J. Benavent, Marta Guasch-Ferré, J.A. Tabar-Sarrias, P. Hernandez, X. Pintó-Salas, Rafel M. Prieto, C. Valero-Barceló, Albert Salas-Huetos, A. Loma-Osorio, M.T. Bonet, E. Arina-Vergara, P.A. de la Rosa, C. de la Fuente, J. Basells, Jaime Algorta, R. Segarra, A. Guarner, Rocío Barragán, S. Vaquero Diaz, Roberto Elosua, A. Sánchez Tainta, M. Bianchi Alba, Pilar Roura, Casandra Riera, Ana Galera, N. Molina, P. Cia-Lecumberri, J.A. Munar, Jesús Vizcaíno, J. de Diego Salas, J.M. Esparza-López, R. M. Lamuela-Raventos, A. Ruiz Zambrana, Aleix Sala-Vila, Amelia Marí-Sanchis, L. Coll, A.F. Barcena, Miguel Ángel Martínez-González, J.J. Beunza, Y. Corchado, M.S. Sánchez, Mónica Doménech, J. Toledo-Atucha, E. Goni-Ochandorena, Silvia Canudas, Raquel de Deus Mendonça, M. Cabre, O. Coltell, Miguel Ruiz-Canela, Javier Llorca, M.A. Pages, M.C. López Sabater, Guillermo T. Sáez, S. Francisco, M. Araque, Almudena Sánchez-Villegas, Silvia Carlos, Carmen Cabezas, Dora Romaguera, M. Llauradó, S. Benito Corchon, A. Rico, M.J. Lasanta-Sáez, C. Molina, C. Viñas, Rebeca Fernández-Carrión, M.A. Fernandez, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (España), Centro Nacional de Investigaciones Cardiovasculares (España), European Commission, Ministerio de Ciencia e Innovación (España), Fundación Mapfre, Junta de Andalucía, Generalitat de Catalunya, Generalitat Valenciana, and Diputación Foral de Navarra

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Mediterranean diet, 030209 endocrinology & metabolism, Context (language use), Type 2 diabetes, Diet, Mediterranean, Critical Care and Intensive Care Medicine, Dietary inflammatory index, Body Mass Index, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Humans, Medicine, Obesity, Prospective Studies, Mortality, Prospective cohort study, Randomized Controlled Trials as Topic, Inflammation, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Smoking, Hazard ratio, Middle Aged, medicine.disease, Diet, C-Reactive Protein, Diabetes Mellitus, Type 2, Cohort, Patient Compliance, Cohort studies, Female, business, CRP, Cohort study
Abstract

[Background]: Inflammation is known to be related to the leading causes of death including cardiovascular disease, several types of cancer, obesity, type 2 diabetes, depression-suicide and other chronic diseases. In the context of whole dietary patterns, the Dietary Inflammatory Index (DII®) was developed to appraise the inflammatory potential of the diet. [Objective]: We prospectively assessed the association between DII scores and all-cause mortality in two large Spanish cohorts and valuated the consistency of findings across these two cohorts and results published based on other cohorts., [Design]: We assessed 18,566 participants in the “Seguimiento Universidad de Navarra” (SUN) cohort followed-up during 188,891 person-years and 6790 participants in the “PREvencion con DIeta MEDiterránea” (PREDIMED) randomized trial representing 30,233 person-years of follow-up. DII scores were calculated in both cohorts from validated FFQs. Higher DII scores corresponded to more proinflammatory diets. A total of 230 and 302 deaths occurred in SUN and PREDIMED, respectively. In a random-effect meta-analysis we included 12 prospective studies (SUN, PREDIMED and 10 additional studies) that assessed the association between DII scores and all-cause mortality., [Results]: After adjusting for a wide array of potential confounders, the comparison between extreme quartiles of the DII showed a positive and significant association with all-cause mortality in both the SUN (hazard ratio [HR] = 1.85; 95% CI: 1.15, 2.98; P-trend = 0.004) and the PREDIMED cohort (HR = 1.42; 95% CI: 1.00, 2.02; P-trend = 0.009). In the meta-analysis of 12 cohorts, the DII was significantly associated with an increase of 23% in all-cause mortality (95% CI: 16%–32%, for the highest vs lowest category of DII)., [Conclusion]: Our results provide strong and consistent support for the hypothesis that a pro-inflammatory diet is associated with increased all-cause mortality. The SUN cohort and PREDIMED trial were registered at clinicaltrials.gov as NCT02669602 and at isrctn.com as ISRCTN35739639, respectively., Supported by the official funding agency for biomedical research of the Spanish Government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial (RTIC G03/140, to R.E.; RTIC RD 06/0045, to Miguel A. Martínez-González) and through Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional (Proyecto de Investigación (PI) 04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, P11/02505, PI13/00462, PI13/00615, PI13/01090, PI14/01668, PI14/01798, PI14/01764), Ministerio de Ciencia e Innovación (Recursos y teconologia agroalimentarias(AGL)-2009-13906-C02 and AGL2010-22319-C03 and AGL2013-49083-C3-1- R), Fundación Mapfre 2010, the Consejería de Salud de la Junta de Andalucía (PI0105/2007), the Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (Generalitat Valenciana Ayuda Complementaria (GVACOMP) 06109, GVACOMP2010-181, GVACOMP2011-151), Conselleria de Sanitat y, PI14/01764 AP; Atención Primaria (CS) 2010-AP-111, and CS2011-AP-042), and Regional Government of Navarra (P27/2011).). Drs. Shivappa and Hébert were supported by grant number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases.

Published
2019

9. Iatrogenic Radial Artery Psedoaneurysm After Cardiac Catheterisation

Author

Leydimar Anmad Shihadeh Musa, Raquel Pimienta- González, Carlos Rubio- Iglesias, Marcos Rodriguez- Esteban, and Julio Hernández- Afonso

Subjects
lcsh:Internal medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, business.industry, iatrogenic, lcsh:R, lcsh:Medicine, psedoaneurysm, Cardiac catheterisation, radial, lcsh:RC666-701, medicine.artery, Internal medicine, Cardiology, Medicine, Radial artery, lcsh:RC31-1245, Cardiology and Cardiovascular Medicine, business
Published
2018

10. Esophageal ulcers secondary to cryoenergy after pulmonary vein ablation using the second-generation balloon

Author

Alejandro Quijada-Fumero, Raquel Pimienta-González, Luis Álvarez-Acosta, and Julio Hernández-Afonso

Subjects
Adult, lcsh:Internal medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, Peptic Ulcer, medicine.medical_specialty, medicine.medical_treatment, lcsh:Medicine, Catheter ablation, 030204 cardiovascular system & hematology, Esophageal Diseases, Balloon, Cryosurgery, Pulmonary vein, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, atrial fibrillation, 030212 general & internal medicine, lcsh:RC31-1245, Stroke, business.industry, Esophageal disease, lcsh:R, Cryoablation, medicine.disease, Esophageal Ulcer, Surgery, lcsh:RC666-701, Pulmonary Veins, cryoablation, esophageal, ulcers, Catheter Ablation, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Pulmonary vein isolation is an effective treatment for patients with symptomatic paroxysmal atrial fibrillation. Cryoablation balloon therapy has been developed as an alternative. Cryoablation complications have primarily been related to phrenic nerve palsy, vascular complications, stroke, and others of lesser incidence. Esophageal lesions are rare and they are not yet completely understood.

Published
2017

11. Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome

Author

Antonio Cabrera de León, Itahisa Marcelino Rodríguez, Roberto Elosua, Patricia Couto Comba, Marcos Rodríguez Esteban, Buenaventura Brito Díaz, María del Cristo Rodríguez Pérez, José Juan Alemán Sánchez, Raquel Pimienta González, and Julio Salvador Hernández Afonso

Subjects
Male, Pulmonology, Cardiovascular Procedures, Infart de miocardi -- Mortalitat, 030232 urology & nephrology, lcsh:Medicine, Comorbidity, 030204 cardiovascular system & hematology, Kidney Function Tests, Vascular Medicine, Biochemistry, 0302 clinical medicine, Risk Factors, Cardio-Renal Syndrome, Cause of Death, Medicine and Health Sciences, Coronary Heart Disease, Hospital Mortality, lcsh:Science, Cause of death, Aged, 80 and over, Multidisciplinary, Incidence, Incidence (epidemiology), Acute kidney injury, Middle Aged, Hospitals, Hospitalization, Creatinine, Predictive value of tests, Female, Anatomy, Research Article, Acute coronary syndrome, medicine.medical_specialty, Chronic Obstructive Pulmonary Disease, Cardiology, Surgical and Invasive Medical Procedures, Cardiorenal syndrome, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Humans, Vascular Diseases, Acute Coronary Syndrome, Mortality, Aged, Proportional Hazards Models, Coronary Revascularization, Heart Failure, business.industry, Proportional hazards model, Revascularization, lcsh:R, Biology and Life Sciences, Kidneys, Renal System, medicine.disease, Health Care, Peripheral Vascular Disease, Health Care Facilities, lcsh:Q, business, Biomarkers, Follow-Up Studies
Abstract

Objectives To determine whether the risk of cardiovascular mortality associated with cardiorenal syndrome subtype 1 (CRS1) in patients who were hospitalized for acute coronary syndrome (ACS) was greater than the expected risk based on the sum of its components, to estimate the predictive value of CRS1, and to determine whether the severity of CRS1 worsens the prognosis. Methods Follow-up study of 1912 incident cases of ACS for 1 year after discharge. Cox regression models were estimated with time to event (in-hospital death, and readmission or death during the first year after discharge) as the dependent variable. Results The incidence of CRS1 was 9.2/1000 person-days of hospitalization (95% CI = 8.1-10.5), but these patients accounted for 56.6% (95% CI = 47.4-65.) of all mortality. The positive predictive value of CRS1 was 29.6% (95% CI = 23.9-36.0) for in-hospital death, and 51.4% (95% CI = 44.8-58.0) for readmission or death after discharge. The risk of in-hospital death from CRS1 (RR = 18.3; 95% CI = 6.3-53.2) was greater than the sum of risks associated with either acute heart failure (RR = 7.6; 95% CI = 1.8-31.8) or acute kidney injury (RR = 2.8; 95% CI = 0.9-8.8). The risk of events associated with CRS1 also increased with syndrome severity, reaching a RR of 10.6 (95% CI = 6.2-18.1) for in-hospital death at the highest severity level. Conclusions The effect of CRS1 on in-hospital mortality is greater than the sum of the effects associated with each of its components, and it increases with the severity of the syndrome. CRS1 accounted for more than half of all mortality, and its positive predictive value approached 30% in-hospital and 50% after discharge.

Published
2016

12. Multiple fibroelastomas: A rare find

Author

Javier Poncela-Mireles, Alejandro Quijada-Fumero, and Raquel Pimienta-González

Subjects
medicine.medical_specialty, business.industry, medicine, Cardiology and Cardiovascular Medicine, business, Dermatology
Published
2018

13. Absence of left circumflex with superdominant right coronary artery

Author

Alejandro Quijada-Fumero, Raquel Pimienta-González, and Marcos Rodríguez-Esteban

Subjects
Male, medicine.medical_specialty, Cardiac Catheterization, medicine.medical_treatment, Coronary Vessel Anomalies, Anterior Descending Coronary Artery, Coronary Angiography, Asymptomatic, Article, Coronary circulation, Internal medicine, medicine.artery, Coronary Circulation, medicine, Humans, Circumflex, Cardiac catheterization, Incidental Findings, business.industry, General Medicine, Middle Aged, Coronary Vessels, Coronary arteries, medicine.anatomical_structure, Right coronary artery, Cardiology, medicine.symptom, business, Rare disease
Abstract

Congenital anomalies of coronary arteries are a group of diseases that are infrequently found. Their prevalence has been reported from 0.6% to 1.3%. Most clinical manifestations are benign and asymptomatic. Congenital absence of the left circumflex artery is a very rare congenital anomaly of the coronary circulation, and only a few cases have been reported in the literature. We report a case of a 51-year-old man who underwent a cardiac catheterisation. Coronary angiography showed a left anterior descending coronary artery with no circumflex and a dominant right coronary artery.

Published
2014

14. Una arteria coronaria derecha inusual

Author

Marcos Rodríguez-Esteban, Raquel Pimienta-González, and Alejandro Quijada-Fumero

Subjects
business.industry, Medicine, Anatomy, Cardiology and Cardiovascular Medicine, business
Published
2017

15. One sinus, three arteries: An unexpected coronary anomaly

Author

Marcos Rodríguez Esteban, Raquel Pimienta González, Alejandro Quijada Fumero, Luis Álvarez Acosta, and Marcos Farráis Villalba

Subjects
Coronary angiography, Male, medicine.medical_specialty, Chest Pain, lcsh:Internal medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, coronary artery, Coronary Vessel Anomalies, Coronary Vessel Anomaly, anomaly, lcsh:Medicine, Computed tomography, Coronary Anomaly, Chest pain, Coronary Angiography, Diagnosis, Differential, angiogram, Internal medicine, medicine, Humans, lcsh:RC31-1245, Sinus (anatomy), medicine.diagnostic_test, business.industry, ct scan, lcsh:R, Middle Aged, Sinus of Valsalva, medicine.anatomical_structure, lcsh:RC666-701, Cardiology, Stents, Radiology, Anomaly (physics), medicine.symptom, Differential diagnosis, Cardiology and Cardiovascular Medicine, business
Published
2015

16. Esophageal ulcers secondary to cryoenergy after pulmonary vein ablation using the second-generation balloon

Author

Luis Álvarez- Acosta, Alejandro Quijada- Fumero, Raquel Pimienta- González, and Julio S. Hernández- Afonso

Subjects
atrial fibrillation, cryoablation, esophageal, ulcers., Medicine, Internal medicine, RC31-1245, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Pulmonary vein isolation is an effective treatment for patients with symptomatic paroxysmal atrial fibrillation. Cryoablation balloon therapy has been developed as an alternative. Cryoablation complications have primarily been related to phrenic nerve palsy, vascular complications, stroke, and others of lesser incidence. Esophageal lesions are rare and they are not yet completely understood.

Published
2018
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