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1. Diseño del estudio ROLLERCOASTR: aterectomía rotacional, litotricia o láser para el tratamiento de estenosis coronarias calcificadas

Author

Alfonso Jurado-Román, Antonio Gómez-Menchero, Ignacio J. Amat-Santos, Juan Caballero-Borrego, Soledad Ojeda, Raymundo Ocaranza-Sánchez, Santiago Jiménez-Valero, Guillermo Galeote, and Raúl Moreno

Subjects
Intervencionismo coronario percutáneo, Placas calcificadas, Láser, Litotricia, Aterectomía rotacional, Tomografía de coherencia óptica, Internal medicine, RC31-1245
Abstract

RESUMEN Introducción y objetivos: La calcificación coronaria es uno de los principales factores que inciden negativamente en la seguridad y la eficacia del intervencionismo coronario percutáneo. Existen varias técnicas de modificación del calcio, pero falta evidencia de estudios aleatorizados sobre la terapia de elección en este escenario. Métodos: El ROLLERCOASTR es un estudio prospectivo, multicéntrico y aleatorizado, diseñado para comparar la seguridad y la eficacia de 3 técnicas de modificación de la placa en el contexto de calcificación coronaria moderada o grave: aterectomía rotacional (AR), aterectomía coronaria con láser láser excimer (ACLE) y litotricia intracoronaria (LIC). El objetivo primario es la expansión del stent evaluada mediante tomografía de coherencia óptica. Su análisis se hará por intención de tratar, con un α de 0,05 entre el grupo de referencia (AR) y cada uno de los otros grupos (ACLE y LIC). Se realizará también un análisis del objetivo primario por protocolo para mantener la coherencia. Si se confirma la hipótesis de no inferioridad, se realizará un análisis bilateral de superioridad. El comité de eventos clínicos y el laboratorio central independiente no conocerán la rama de tratamiento. Asumiendo un error α de 0,05, un error β de 0,2 (80% de potencia), un margen de irrelevancia (ε) del 7% y un 10% de pérdidas por dificultad de medición o imposibilidad de completar la intervención, se estima un tamaño de muestra de 56 casos en cada grupo. Los objetivos secundarios son el éxito del dispositivo, el éxito del procedimiento, la tasa de cruce entre técnicas y la presentación de eventos cardiovasculares adversos importantes al año de seguimiento. Conclusiones: El estudio ROLLERCOASTR evaluará y comparará la seguridad y la eficacia, en pacientes con estenosis coronaria calcificada, de 3 técnicas de modificación de placa: AR, ACLE y LIC. Este ensayo se ha registrado en Clinicaltrials.gov: NCT04181268.

Published
2023
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2. Design of the ROLLERCOASTR trial: rotational atherectomy, lithotripsy or laser for the management of calcified coronary stenosis

Author

Alfonso Jurado-Román, Antonio Gómez-Menchero, Ignacio J. Amat-Santos, Juan Caballero-Borrego, Soledad Ojeda, Raymundo Ocaranza-Sánchez, Santiago Jiménez-Valero, Guillermo Galeote, and Raúl Moreno

Subjects
Percutaneous coronary intervention, Calcified plaques, Laser, Lithotripsy, Rotational atherectomy, Optical coherence tomography, Medicine
Abstract

ABSTRACT Introduction and objectives: Coronary calcification is one of the leading factors that affect negatively the safety and effectiveness of percutaneous coronary intervention. Several calcium modification techniques exist. However, there is a lack of randomized evidence on the therapy of choice in this scenario. Methods: The ROLLERCOASTR is a prospective, multicenter, randomized clinical trial designed to compare the safety and efficacy profile of 3 plaque modification techniques in the moderate-to-severe coronary calcification setting: rotational atherectomy (RA), excimer laser coronary angioplasty (ELCA), and intravascular lithotripsy (IVL). The study primary endpoint is stent expansion evaluated by optical coherence tomography. An intention-to-treat analysis will be conducted with an alpha coefficient of 0.05 between the reference group (RA) and the remaining 2 groups (ELCA and IVL). An analysis of the study primary endpoint per protocol will be conducted for consistency purposes. If the non-inferiority hypothesis is confirmed, a superiority 2-sided analysis will be conducted. Both the clinical events committee and the independent core laboratory will be blinded to the treatment arm. Assuming an α error of 0.05, an β error of 0.2 (80% power), a margin of irrelevance (ε) of 7, and losses of 10% due to measurement difficulty or impossibility to complete the intervention, we estimate a sample size of 56 cases per group. The study secondary endpoints are device success, procedural success, crossover rate among the different techniques used, and the occurrence of major adverse cardiovascular events at 1-year follow-up. Conclusions: The ROLLERCOASTR trial will evaluate and compare the safety and effectiveness of 3 plaque modification techniques: RA, ELCA, and IVL in patients with calcified coronary stenosis. This trial was registered at clinicaltrials.gov with identifier NCT04181268.

Published
2023
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3. Documento de posicionamiento de la ACI-SEC sobre la modificación de la placa en el tratamiento de las lesiones calcificadas

Author

Alfonso Jurado-Román, Antonio Gómez-Menchero, Nieves Gonzalo, Javier Martín-Moreiras, Raymundo Ocaranza, Soledad Ojeda, Jorge Palazuelos, Oriol Rodríguez-Leor, Pablo Salinas, Beatriz Vaquerizo, Xavier Freixa, and Ana Belén Cid-Álvarez

Subjects
Lesiones coronarias calcificadas, Técnicas de modificación de la placa, Imagen intracoronaria, Internal medicine, RC31-1245
Abstract

RESUMEN La calcificación coronaria es probablemente el mayor determinante de un mal resultado de la angioplastia y se asocia a mayores tasas de eventos adversos. En la actualidad existen distintas técnicas de modificación de la placa basadas en balones o en dispositivos específicos. El conocimiento de sus características y su uso adecuado son aspectos clave para el tratamiento óptimo de las lesiones calcificadas. Este artículo de posicionamiento, promovido desde la Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (ACI-SEC), describe las técnicas de modificación de la placa existentes en la actualidad y propone un algoritmo para el tratamiento de la lesión calcificada.

Published
2023
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4. Plaque modification techniques to treat calcified coronary lesions. Position paper from the ACI-SEC

Author

Alfonso Jurado-Román, Antonio Gómez-Menchero, Nieves Gonzalo, Javier Martín-Moreiras, Raymundo Ocaranza, Soledad Ojeda, Jorge Palazuelos, Oriol Rodríguez-Leor, Pablo Salinas, Beatriz Vaquerizo, Xavier Freixa, and Ana Belén Cid-Álvarez

Subjects
Calcified coronary lesions, Plaque modification techniques, Intracoronary imaging modalities, Medicine
Abstract

ABSTRACT Coronary artery calcification is probably the main determinant of the poor outcome of percutaneous coronary interventions and is associated with higher rates of adverse events. There are currently different balloon or specific device-based plaque modification techniques available. Knowing their characteristics and proper use is key for the optimal treatment of calcified lesions. This position paper—promoted by the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC)—describes existing plaque modification techniques currently available and proposes an algorithm for the management of calcified lesions.

Published
2023
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5. Association of cyclophilins and cardiovascular risk factors in coronary artery disease

Author

Sandra Gegunde, Amparo Alfonso, Rebeca Alvariño, Nadia Pérez-Fuentes, Jeremías Bayón-Lorenzo, Eva Alonso, Raymundo Ocaranza-Sánchez, Rosa Alba Abellás-Sequeiros, Melisa Santás-Álvarez, Mercedes R. Vieytes, Carlos Juanatey-González, and Luis M. Botana

Subjects
cyclophilins, cardiovascular disease, inflammation, cardiovascular risk factors, type 2 diabetes, dyslipidemia, Physiology, QP1-981
Abstract

Cyclophilins are chaperone proteins that play important roles in signal transduction. Among them, cyclophilins A, B, C, and D were widely associated with inflammation and cardiovascular diseases. Cyclophilins A and C have been proposed as coronary artery disease biomarkers. However, less is known about their relationship with cardiovascular risk factors. Therefore, this study aimed to determine the association between cyclophilin A, B, C, and D and cardiovascular risk factors in coronary artery disease. Serum levels of cyclophilins were measured in 167 subjects (subdivided according to cardiovascular risk factors presence). This study reveals that cyclophilin A and C are elevated in patients regardless of the risk factors presence. Moreover, cyclophilin B is elevated in male patients with hypertension, type 2 diabetes, or high glucose levels. In addition, cyclophilins A, B, and C were significantly correlated with cardiovascular risk factors, but only cyclophilin B was associated with type 2 diabetes. The multivariate analysis strengthens the predictive value for coronary artery disease presence of cyclophilin A (>8.2 ng/mL) and cyclophilin C (>17.5 pg/mL) along with the cardiovascular risk factors tobacco, hypertension, dyslipidemia, and high glucose and cholesterol levels. Moreover, the risk of coronary artery disease is increased in presence of cyclophilin B levels above 63.26 pg/mL and with hypertension or dyslipidemia in male patients. Consequently, cyclophilins A and C serum levels are reinforced as useful coronary artery disease biomarkers, meanwhile, cyclophilin B is a valuable biomarker in the male population when patients are also suffering from hypertension or dyslipidemia.

Published
2023
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6. Seguimiento clínico del stent coronario largo no cónico de sirolimus en el mundo real en lesiones de novo. Registro Billar

Author

Enric Domingo Ribas, Josep Guindo, Ramón Calviño Santos, Imanol Otaegui, Joan Antoni Gómez, Xavier Carrillo Suárez, Juan Sánchez, Leire Andraka, Alfonso Torres, Juan Casanova-Sandoval, Raymundo Ocaranza Sánchez, Javier León Jiménez, Juan Francisco Muñoz, Ramiro Trillo Nouche, Mónica Fuertes, and Bruno García del Blanco

Subjects
Angioplastia coronaria, Stents farmacoactivos, Stents largos no cónicos, Internal medicine, RC31-1245
Abstract

RESUMEN Introducción y objetivos: Las lesiones coronarias largas y difusas, cuando se tratan percutáneamente, requieren a menudo superposición de los stents, que se asocia a una mayor tasa de reestenosis. Por otro lado, el adelgazamiento progresivo de las arterias dificulta el tratamiento de las lesiones largas. En este estudio se analizan la seguridad y la eficacia clínica de los stents liberadores de sirolimus largos no cónicos (> 36 mm) para el tratamiento de lesiones largas de novo en un escenario real. Métodos: Estudio prospectivo, no aleatorizado, multicéntrico, con 696 pacientes consecutivos con implantación de stent BioMime largo no cónico para el tratamiento de lesiones coronarias de novo largas y difusas. El criterio de valoración de seguridad fueron los eventos adversos cardiovasculares mayores en el seguimiento, definidos como la combinación de muerte cardiaca, infarto de miocardio, necesidad de nueva revascularización en la misma lesión guiada por la clínica, trombosis del stent o hemorragia mayor a los 12 meses. Resultados: De los 696 pacientes incluidos, el 38,79% eran diabéticos. La edad media fue de 64,6 ± 14 años y el 80% eran varones. La indicación de revascularización fue un síndrome coronario agudo en el 63,1%. Se identificaron 899 lesiones, de las que 742 se trataron con éxito con stents BioMime (37-40-44-48 mm). La incidencia acumulada de eventos adversos cardiovasculares mayores fue del 8,1% a los 12 meses, con un 2,09% de muertes de causa cardiaca, un 1,34% de infartos de miocardio y un 0,5% de trombosis del stent. Conclusiones: El presente estudio confirma la seguridad y el buen perfil clínico a 12 meses del stent BioMime largo no cónico para el tratamiento de lesiones coronarias de novo largas y difusas, por lo que debe considerarse un tratamiento seguro y eficaz para este tipo de lesiones en la práctica clínica habitual.

Published
2022
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7. Clinical follow-up of long nontapered sirolimus-eluting coronary stent in real-world patients with de novo lesions. The Billar registry

Author

Enric Domingo Ribas, Josep Guindo, Ramón Calviño Santos, Imanol Otaegui, Joan Antoni Gómez, Xavier Carrillo Suárez, Juan Sánchez, Leire Andraka, Alfonso Torres, Juan Casanova-Sandoval, Raymundo Ocaranza Sánchez, Javier León Jiménez, Juan Francisco Muñoz, Ramiro Trillo Nouche, Mónica Fuertes, and Bruno García del Blanco

Subjects
Coronary angioplasty, Drug-eluting stent, Nontapered stents, Medicine
Abstract

ABSTRACT Introduction and objectives: Coronary lesions with stent overlapping are associated with higher neointimal proliferation that leads to more restenosis. Furthermore, the tapering of coronary arteries is a major challenge when treating long coronary lesions. This study attempted to assess the safety and clinical level of performance of long nontapered sirolimus-eluting coronary stent systems (> 36 mm) to treat long and diffused de novo coronary lesions in real-world scenarios. Methods: This was a prospective, non-randomized, multicentre study that included 696 consecutive patients treated with the long nontapered BioMime sirolimus-eluting coronary stent system in long and diffused de novo coronary lesions. The safety endpoint was major adverse cardiovascular events defined as a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, and major bleeding at the 12-month follow-up. Results: Of a total of 696 patients, 38.79% were diabetic. The mean age of all the patients was 64.6 ± 14 years, and 80% were males. The indication for revascularization was acute coronary syndrome in 63.1%. A total of 899 lesions were identified out of which 742 were successfully treated with long BioMime stents (37 mm, 40 mm, 44 mm, and 48 mm). The cumulative incidence of major adverse cardiovascular events was 8.1% at the 12-month follow-up including cardiac death (2.09%), myocardial infarction (1.34%), and total stent thrombosis (0.5%). Conclusions: This study confirms the safety and good performance of long nontapered BioMime coronary stents to treat de novo coronary stenosis. Therefore, it can be considered a safe and effective treatment for long and diffused de novo coronary lesions in the routine clinical practice.

Published
2022
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8. The role of invasive coronary physiology in Takotsubo Syndrome

Author

Jeremías Bayón, Miguel-Ángel Reyes, Melisa Santás-Álvarez, Rosa-Alba Abellás-Sequeiros, Raymundo Ocaranza-Sánchez, and Carlos Gonzalez-Juanatey

Subjects
takotsubo syndrome, invasive coronary physiology, coronary microvascular dysfunction, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

The pathophysiology of Takotsubo Syndrome has not yet been precisely defined. Different hypotheses have been proposed, including cardiotoxicity due to catecholaminergic hormone release, metabolic disorders, coronary microvascular dysfunction and epicardial coronary artery spasm. Invasive coronary physiology is considered the cornerstone to understand physiological assessment of coronary blood flow in this setting. We have reviewed most important studies in coronary invasive physiology in this field to update the state of the art in TakoTsubo Syndrome.

Published
2021
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9. Ajustando a RFR por Preditores de Discordância, 'A RFR Ajustada': Uma Metodologia Alternativa para Melhorar a Capacidade Diagnóstica dos Índices Coronarianos

Author

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

Subjects
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.

Published
2022
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10. Registro unicéntrico a largo plazo (>12 meses) del implante de Magmaris en el síndrome coronario agudo

Author

Jeremías Bayón, Verónica Gordo, Melisa Santás-Álvarez, Rosa-Alba Abellás-Sequeiros, Raymundo Ocaranza-Sánchez, and Carlos González-Juanatey

Subjects
Magmaris, Síndrome coronario agudo, Trombosis armazón bioabsorbible, Internal medicine, RC31-1245
Abstract

RESUMEN Introducción y objetivos: Los resultados del Magmaris en el síndrome coronario agudo son controvertidos y se necesitan más estudios para evaluar su seguridad a largo plazo. El objetivo del trabajo fue analizar mediante un estudio observacional la seguridad clínica más allá de 12 meses de los Magmaris implantados en un único centro hospitalario en pacientes con síndrome coronario agudo. Métodos: Se registraron de manera consecutiva 36 pacientes con Magmaris implantados entre noviembre de 2016 y noviembre de 2018 con diagnóstico de síndrome coronario agudo. Para el objetivo primario se consideró el combinado orientado al dispositivo de infarto de miocardio del vaso diana, fracaso de la lesión diana y muerte de causa cardiovascular. Como objetivo secundario se incluyó la trombosis del dispositivo. Resultados: En cuanto al combinado orientado al dispositivo no se observó infarto de miocardio del vaso diana (0%), en 2 casos (5,6%) se observó fracaso de la lesión diana y se constató 1 caso de muerte cardiaca (2,8%) a los 36 meses del implante del Magmaris, sin poder conocer la causa por no disponer de autopsia. Con respecto a los objetivos secundarios, no hubo casos de trombosis del Magmaris durante el seguimiento. Conclusiones: Nuestros resultados, con un seguimiento a largo plazo, apoyan...

Published
2021
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11. Long-term (> 12 months) single-center registry of Magmaris implantation in the acute coronary syndrome setting

Author

Jeremías Bayón, Verónica Gordo, Melisa Santás-Álvarez, Rosa-Alba Abellás-Sequeiros, Raymundo Ocaranza-Sánchez, and Carlos González-Juanatey

Subjects
Magmaris, Acute coronary syndrome, Bioresorbable scaffold thrombosis, Medicine
Abstract

ABSTRACT Introduction and objectives: The results of Magmaris implantation in the acute coronary syndrome setting is uncertain and more studies will be needed to assess the long-term safety profile of these devices. The objective of this work was to conduct an observational study to analyze the clinical safety profile of Magmaris implanted in a single hospital center in the acute coronary syndrome setting beyond 12 months. Methods: Registry of 36 patients with Magmaris devices implanted between November 2016 through November 2018 with a diagnosis of acute coronary syndrome included consecutively. The primary endpoint was considered the device-oriented composite endpoint of target vessel myocardial infarction, target lesion failure, and cardiac death. Secondary endpoints included Magmaris related thrombosis. Results: Regarding the device-oriented combination, no target vessel myocardial infarction was observed, 0 cases (0%), while target lesion failure was seen in 2 cases (5.6%). There were no cases of Magmaris thrombosis at the follow-up and only 1 case of cardiac death (2.8%) was found 36 months after Magmaris implantation. The cause of death could not be determined since no autopsy was performed. Conclusions: Our results with long-term follow-up confirm that Magmaris has a favorable clinical profile in the acute coronary syndrome complex setting.

Published
2021
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12. Real-world registry of the durable Angiolite fluoroacrylate polymer-based sirolimus-eluting stent: the EPIC02 – RANGO study

Author

Armando Pérez de Prado, Raymundo Ocaranza-Sánchez, Fernando Lozano Ruiz-Poveda, José Moreu Burgos, Raquel Álvarez Ramos, Alberto Rodrigues, Pablo Aguar, Eduardo Pinar, Vicente Peral, Fermín Sainz Laso, José Ramón Rumoroso, Alfonso Torres, Manel Sabaté, and Ramiro Trillo Nouche

Subjects
Sirolimus-eluting-stent, Durable fluoropolymer, Observational study, Efficacy, Safety, Stent thrombosis, Medicine
Abstract

ABSTRACT Introduction and objectives: After the positive pre-clinical and clinical results with Angiolite, a cobalt-chromium sirolimus-eluting stent, we decided to analyze its performance in a non-selected, real-world population: the RANGO registry. Methods: We conducted an observational, prospective, multicenter registry of patients with different clinical indications. All consecutive patients treated with percutaneous coronary intervention with, at least, 1 Angiolite stent and who gave their informed consent were included. The registry primary endpoint was the occurrence of target lesion failure (TLF) at 6, 12, and 24 months defined as cardiovascular death, myocardial infarction (MI) related to target vessel, and clinically driven target lesion revascularization. The secondary endpoints were the individual components of the primary endpoint, major adverse cardiovascular events (MACE: all-cause mortality, any MI, or any revascularization), and stent thrombosis. We describe the 2-year clinical results of the RANGO study in the entire population, in those who only received Angiolite stents, and in 2 predefined subgroups: diabetics and patients with small-vessels (≤ 2.5mm). Results: 646 patients (426 of them only received Angiolite stents) with a high-risk profile were recruited: prevalence of previous MI (18.4%), previous coronary revascularization (23.4%), clinical presentation as ST-segment elevation MI (23.1%), and multivessel disease (47.8%). At the 2-year follow-up, the rates of TLF, MACE, and stent thrombosis were 3.4%, 9.6%, and 0.9%, respectively. Similar results were observed among patients treated with Angiolite stents only: TLF, 3.1%; MACE, 8.0%; thrombosis, 0.7%. The rates were not significantly different for the diabetic (TLF, 3.0%; MACE, 14.1%; thrombosis, 1.0%), and small-vessel subgroups (TLF, 4.3%; MACE, 12.1%; thrombosis, 0%). Conclusions: In conclusion, the results of this observational registry on the use of Angiolite in a real-world population, including a high-risk population, corroborate the excellent results observed in previous studies, up to a 2-year follow-up. An extended 5-year follow-up is planned to discard the occurrence of late events.

Published
2021
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13. Aumento de niveles séricos de Ciclofilina C en el seguimiento de la enfermedad arterial coronaria: un biomarcador y posible predictor clínico

Author

Jeremías Bayón, Amparo Alfonso, Melisa Santás-Álvarez, Eva Alonso, Ana Testa-Fernández, Ramón Ríos-Vázquez, Raymundo Ocaranza-Sánchez, Rosa A. Abellás-Sequeiros, Juliana Elices-Teja, Luis Botana, and Carlos González-Juanatey

Subjects
Coronary artery disease. Inflammation. Cyclophilin. Biomarkers., Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objetivo: Este estudio tiene como objetivo investigar los cambios en los niveles séricos de CypC y su relación con eventos cardiovasculares a los 12 meses de seguimiento en pacientes con EAC. Método: El estudio incluyó un total de 125 sujetos (40 pacientes con EAC aguda, 40 pacientes con EAC crónica y 45 voluntarios de control) y se analizaron los niveles plasmáticos de CypC desde el inicio hasta los 6 y 12 meses para comprender mejor su comportamiento en la aterosclerosis. Resultados: Se demostró que los niveles séricos de CypC aumentaron gradualmente en pacientes con CAD [(30.63 pg/ml ± 3.77 al inicio del estudio, 38.70 pg/ml ± 6.41 a los 6 meses (p = 0.25) y 47.27 pg/ml ± 5.65 a los 12 meses (p = 0,007)]. Además, los niveles séricos de CypC durante el seguimiento fueron un predictor significativo de EAC (estadístico c 0.76 a los 6 meses y 0.89 a los 12 meses; p < 0.001). A pesar de ello, no hubo asociación significativa entre CypC y eventos cardiovasculares, pero los niveles séricos de CypC tendieron a ser más altos en los pacientes que sufrieron eventos cardiovasculares durante el seguimiento (29.02 pg/mL ± 6.39 vs. 79.96 pg/mL ± 22.18; p = 0.029). En este sentido, los niveles plasmáticos de hsCRP > 2.3 mg/L más NT-proBNP> 300 pg/ml juntos fueron predictores significativos de eventos cardiovasculares durante el seguimiento en pacientes con EAC con niveles de CypC > 17.5 pg/ml (p = 0.048). Conclusiones: Tomados en conjunto, nuestros resultados sugieren que los niveles séricos de CypC aumentan durante el seguimiento en pacientes con EAC y podría ser un nuevo biomarcador con un posible valor pronóstico en combinación con hsCRP y NT-proBNP.

Published
2022
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15. 12-month clinical outcomes after Magmaris percutaneous coronary intervention in a real-world cohort of patients: Results from the CardioHULA registry

Author

Rosa A. Abellas-Sequeiros, Raymundo Ocaranza-Sanchez, Jeremias Bayon-Lorenzo, Melisa Santas-Alvarez, and Carlos Gonzalez-Juanatey

Subjects
Suportes vasculares restaurativos transitórios biorreabsorbíveis, Magnésio, ICP, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Introduction and objectives: Clinical evidence on the bioresorbable magnesium scaffolds (BRS) is still scarce. We aim to assess clinical outcomes after magnesium BRS deployment in a real-world cohort of patients. Methods: We included in a non-randomized, prospective, single-center registry of all patients treated with at least one Magmaris device in our cath lab. Pre and postdilatation with optical coherence tomography guidance, as part of the 4Ps strategy, were performed in all cases. The primary endpoint was target lesion failure (TLF) at 12 months. Results: 42 patients (with 42 lesions) underwent Magmaris percutaneous coronary intervention (PCI) between June 2016 to April 2017. PCI was performed in an acute setting in 54.76% cases; the most treated vessel was the anterior descending artery, with a mean diameter of 3.30±0.25 mm. All lesions underwent predilatation and postdilatation, with a mean postdilatation pressure of 19.2 atm. Procedural success rate was 100%. TLF rate was 4.7% at 12 months. None of our patients died or suffered myocardial infarction. Two patients (4.7%) underwent clinically-driven target lesion revascularization due to in-stent restenosis. No stent thrombosis was detected. Conclusion: 12-months clinical outcomes after Magmaris PCI demonstrate its safety and feasibility when deployed in a 4Ps strategy. Resumo: Introdução e objetivos: A evidência clínica dos suportes vasculares restaurativos biorreabsorbíveis de magnésio é ainda escassa. O objetivo deste estudo consistiu na avaliação dos resultados clínicos após a implantação dos SVR (suportes vasculares restaurativos) de magnésio numa coorte de doentes do mundo real. Métodos: Incluímos num registo não aleatório, prospetivo e unicêntrico todos os doentes tratados com pelo menos um dispositivo Magmaris, no nosso laboratório de hemodinâmica. A pré e a pós-dilatação, sob a orientação de TCO como parte da estratégia dos 4 Ps, foram efetuadas em todos os casos. O objetivo primário foi a falência da lesão alvo (FLA) aos 12 meses. Resultados: Foram submetidos 42 doentes (com 42 lesões) a ICP com Magmaris entre junho de 2016 e abril de 2017. A ICP foi efetuada num contexto agudo em 54,76% dos casos, sendo a artéria descendente anterior alvo do maior número de tratamentos, com um diâmetro médio de vaso de 3,30±0,25 mm. Todas as lesões foram submetidas a pré e pós-dilatação, com uma pressão média de pós-dilatação de 19,2 atm. A taxa de sucesso do procedimento foi de 100%. A taxa da FLA foi de 4,7% aos 12 meses. Nenhum dos doentes faleceu ou sofreu enfarte do miocárdio. Dois doentes (4,7%) foram submetidos a revascularização da lesão alvo devido a restenose intra stent. Não foi detetada trombose de stent. Conclusão: Os resultados clínicos a 12 meses após a ICP com Magmaris demonstraram segurança e viabilidade quando desenvolvidos sob uma estratégia de 4 Ps.

Published
2020
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16. Telescoping catheter technique in percutaneous coronary intervention. How would I approach it?

Author

Raymundo Ocaranza Sánchez

Subjects
Medicine
Abstract

HOW WOULD I APPROACH IT? The authors present an interesting and challenging case regarding percutaneous treatment, and with a very complex resolution. This is the case of a patient already surgically revascularized with significant ischemia whose revascularization option is through the bypass on which the entire territory of the left circumflex artery depends on. At this point right now of the angioplasty where the stent cannot be crossed despite the use of the buddy-wire technique, and even though the stent was very short and had good navigability, I would try the following staged maneuvers: 1) Try to advance a high-support guidewire a little more distal inside the native vessel taking advantage of the native artery good distal bed so that the guidewire section with the highest support of all is placed on the curve zone. If possible, I would even bend the tip to avoid damaging the artery aware that the push forward maneuvers we’ll be performing can uncontrollably displace the guidewire at any time. 2) Benefit from the balloon already crossed and the lesion already dilated to redilate the lesion with the balloon using the anchorage technique with the balloon to move the guide extension catheter forward, cross the curve, and eventually reach...

Published
2022
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17. Técnica de catéteres telescopados en intervencionismo coronario percutáneo. ¿Cómo lo haría?

Author

Raymundo Ocaranza Sánchez

Subjects
Internal medicine, RC31-1245
Abstract

¿CÓMO LO HARÍA? Los autores presentan un interesante caso que supone un reto para el tratamiento percutáneo, y de muy compleja resolución, en un paciente ya revascularizado quirúrgicamente, con isquemia importante, cuya opción de revascularización es a través del puente del que depende por completo todo el territorio de la arteria circunfleja. Partiendo del punto en que nos encontramos en la angioplastia en este momento, al no cruzar el stent a pesar de haber intentado la técnica de buddy-wire y de ser un stent con buena navegabilidad y muy corto, intentaría la siguiente maniobra en estos pasos: 1) Tratar de avanzar la guía de alto soporte un poco más distal en el vaso nativo aprovechando el buen lecho distal de la arteria nativa para que la porción de más soporte de la guía quede colocada en la zona de curvas. Incluso, si fuera posible, se podría doblar la punta para evitar lesionar la arteria, sabiendo que en las maniobras de empuje que vamos a realizar la guía puede desplazarse sin que se pueda controlar en todo momento. 2) Aprovechar que ya ha cruzado un balón y se ha conseguido dilatar la lesión para nuevamente dilatar con el balón la lesión y realizar una técnica...

Published
2022
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18. 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

Author

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

Subjects
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

Published
2021
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19. Assessment with intracoronary pressure and flow guidewire, at baseline and after intracoronary adenosine infusion, in a patient with Takotsubo syndrome

Author

Jeremias Bayon, Melisa Santás-Älvarez, Raymundo Ocaranza-Sánchez, and Carlos González-Juanatey

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

We present the case of a patient with Takotsubo syndrome assessed by intracoronary flow and pressure guidewire, showing elevation of intracoronary pressures at the level of the anterior descending artery, and thus demonstrating a new therapeutic target in a still little understood etiopathogenic entity. The results of this test have never been previously reported in Takotsubo patients. Resumo: Apresentamos um caso dum paciente com síndrome de Takotsubo e a avaliação por fluxo intracoronário/fio de pressão, mostrando elevação das pressões intracoronárias ao nível da artéria descendente anterior, podendo demonstrar um novo alvo terapêutico numa entidade etiopatogénica ainda desconhecida. Os resultados deste teste nunca foram relatados previamente em pacientes de Takotsubo. Keywords: Coronary disease, Intracoronary pressure and flow guidewire, Takotsubo syndrome, Palavras-chave: Doença coronária, Guia de pressão/fluxo intracoronária, Síndrome de Takotsubo

Published
2019
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20. Feasibility of use of magnesium reabsorbable scaffolds in complex coronary artery disease: True bifurcation, multiple overlapping scaffolds and chronic total occlusion treatment

Author

Jeremías Bayón, Melisa Santá-Álvarez, Raymundo Ocaranza-Sánchez, and Carlos González-Juanatey

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

We present first-in-human treatment with bioabsorbable magnesium scaffolds for percutaneous coronary intervention in a patient with nickel allergy. We present images from angiography and optical coherence tomography at three months. We also review the current status of these novel devices. Resumo: Apresentamos pela primeira vez o tratamento com suportes bioabsorbíveis de magnésio na intervenção coronária percutânea complexa de doentes com alergia ao níquel. Incluímos a angiografia e as imagens da tomografia de coerência óptica efetuadas durante um período de três meses. Analisamos também o estado atual deste equipamento inovador. Keywords: Bioabsorbable magnesium scaffolds, Nickel allergy, Complex percutaneous coronary intervention, Palavras-chave: Suportes bioabsorbíveis de magnésio, Alergia ao níquel, Intervenção coronária percutânea complexa

Published
2018
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21. Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial

Author

Reynolds, Harmony R., primary, Cyr, Derek D., additional, Merz, C. Noel Bairey, additional, Shaw, Leslee J., additional, Chaitman, Bernard R., additional, Boden, William E., additional, Alexander, Karen P., additional, Rosenberg, Yves D., additional, Bangalore, Sripal, additional, Stone, Gregg W., additional, Held, Claes, additional, Spertus, John, additional, Goetschalckx, Kaatje, additional, Bockeria, Olga, additional, Newman, Jonathan D., additional, Berger, Jeffrey S., additional, Elghamaz, Ahmed, additional, Lopes, Renato D., additional, Min, James K., additional, Berman, Daniel S., additional, Picard, Michael H., additional, Kwong, Raymond Y., additional, Harrington, Robert A., additional, Thomas, Boban, additional, O'Brien, Sean M., additional, Maron, David J., additional, Hochman, Judith S., additional, Mavromatis, Kreton, additional, Linefsky, Jason, additional, Miller, Todd, additional, Banerjee, Subhash, additional, Reynolds, Harmony R., additional, Donnino, Robert M., additional, Phillips, Lawrence M., additional, Saric, Muhamed, additional, Abdul‐Nour, Khaled, additional, Stone, Peter H., additional, Jang, James J., additional, Yee, Gennie, additional, Weitz, Steven, additional, Arnold, Suzanne, additional, O’Keefe, James Henry, additional, Shapiro, Michael D., additional, El‐Hajjar, Mohammad, additional, Sidhu, Mandeep S., additional, Fein, Steven A., additional, Torosoff, Mikhail T., additional, Lyubarova, Radmila, additional, Mookherjee, Sulagna, additional, Drzymalski, Krzysztof, additional, McFalls, Edward O., additional, Garcia, Santiago A., additional, Bertog, Stefan C., additional, Siddiqui, Rizwan A., additional, Ishani, Areef, additional, Hansen, Ronnell A., additional, Khouri, Michel Georges, additional, Goldberg, Jonathan L., additional, Goldweit, Richard, additional, Cohen, Ronny A., additional, Mirrer, Brooks, additional, Navarro, Victor, additional, Winchester, David E., additional, Kronenberg, Marvin, additional, Rogal, Philip, additional, McFarren, Christopher, additional, Heitner, John F., additional, Dauber, Ira M., additional, Cannan, Charles, additional, Sudarshan, Sriram, additional, Mehta, Puja K., additional, McDaniel, Michael, additional, Lerakis, Stamatios, additional, Quyyumi, Arshed, additional, Wenger, Nanette K., additional, Hedgepeth, Chester M., additional, Hurlburt, Heather, additional, Rosen, Alan, additional, Sahul, Zakir, additional, Booth, David, additional, Leung, Steve, additional, Abdel‐Latif, Ahmed, additional, Reda, Hassan, additional, Ziada, Khaled, additional, Setty, Sampoornima, additional, Barua, Rajat S., additional, Hage, Fadi, additional, Caldeira, Christiano, additional, Davies, James E., additional, Leesar, Massoud, additional, Heo, Jaekyeong, additional, Iskandrian, Amy, additional, Al Solaiman, Firas, additional, Singh, Satinder, additional, Dajani, Khaled, additional, Der Mesropian, Paul, additional, Sacco, Joseph, additional, McCandless, Brian, additional, Orgera, Marisa, additional, Arif, Imran, additional, Kerr, Hanan, additional, Trejo (Gutierrez), Jorge F., additional, Fletcher, Gerald, additional, Lane, Gary E., additional, Neeson, Lynn M., additional, Parikh, Pragnesh P., additional, Pollak, Peter M., additional, Shapiro, Brian P., additional, Landolfo, Kevin, additional, Gemignani, Anthony, additional, O’Rourke, Daniel, additional, Meadows, Judith L., additional, Call, Jason T., additional, Hannan, Joseph, additional, Bojar, Robert, additional, Kumar, Deepti, additional, Mukai, John, additional, Martin, Edward T., additional, Vorobiof, Gabriel, additional, Moorman, Alec, additional, Kinlay, Scott, additional, Hamburger, Robert J., additional, Rocco, Thomas P., additional, Bhatt, Deepak L., additional, Croce, Kevin, additional, Quin, Jacquelyn A., additional, Anumpa, Jati, additional, Zenati, Marco, additional, Faxon, David P., additional, Rayos, Glenn, additional, Seedhom, Ashraf, additional, Sullenberger, Lance, additional, Kumkumian, Gregory, additional, Sedlis, Steven P., additional, Donnino, Robert M., additional, Lorin, Jeffrey, additional, Tamis‐Holland, Jacqueline E., additional, Kornberg, Robert, additional, Leber, Robert, additional, Saba, Souheil, additional, Lee, Michael W., additional, Small, Delano R., additional, Nona, Wassim, additional, Alexander, Patrick B., additional, Rehman, Iram, additional, Badami, Umesh, additional, Marzo, Kevin, additional, Robbins, Inga H., additional, Levite, Howard A., additional, Shetty, Sanjay, additional, Patel, Mayuri, additional, Hamroff, Glenn S., additional, Little, Raymond W., additional, Zimbelman, Brandi D., additional, Lui, Charles Y., additional, Smith, Brigham R., additional, Vezina, Daniel P., additional, Khor, Lillian L., additional, Abraham, Josephine D., additional, Bull, David A., additional, McKellar, Stephen H., additional, Kotter, John, additional, Hu, Bob, additional, Labovitz, Arthur J., additional, Berlowitz, Michael, additional, Matar, Fadi, additional, Rodriguez, Fatima, additional, Schnittger, Ingela, additional, Fearon, William F., additional, Deedwania, Prakash, additional, Reddy, Kiran, additional, Sweeny, Joseph, additional, Spizzieri, Christopher, additional, Hochberg, Claudia P., additional, Salerno, William D., additional, Wyman, Ray, additional, Zarka, Amer, additional, Shah, Anil V., additional, Haldis, Thomas, additional, Kohn, Jeffrey A., additional, Girotra, Saket, additional, Almousalli, Omar, additional, Krishnam, Mayil S., additional, Milliken, Jeffrey C., additional, Patel, Pranav M., additional, Seto, Arnold H., additional, Harley, Kevin T., additional, Gibson, Michael A., additional, Allen, Byron J., additional, Coram, Rita, additional, Thomas, Sabu, additional, Schwartz, Ronald G., additional, Chen, Wei, additional, El Shahawy, Mahfouz, additional, Stafford, James, additional, Abernethy, William B., additional, Zurick, Andrew, additional, Meyer, Thomas M., additional, Morford, Ronald G., additional, Rutkin, Bruce, additional, Bokhari, Sabahat, additional, Sokol, Seth I., additional, Meisner, Jay, additional, Hamzeh, Ihab, additional, Misra, Arunima, additional, Wall, Matthew, additional, De Rosen, Veronica Lenges, additional, Alam, Mahboob, additional, Turner, Michael C., additional, Mulhearn, Thomas J., additional, Good, Arnold P., additional, Shammas, Nicolas W., additional, Chilton, Robert, additional, Nguyen, Patricia K., additional, Jezior, Matthew, additional, Gordon, Paul C., additional, Crain, Thomas, additional, Stenberg, Robert, additional, Pedalino, Ronald P., additional, Wiesel, Joseph, additional, Juang, George J., additional, Al‐Amoodi, Mohammed, additional, Wohns, David, additional, Lader, Ellis W., additional, Mumma, Michael, additional, Dharmarajan, Lekshmi, additional, McGarvey, Joseph F. X., additional, Downes, Thomas R., additional, Luckasen, Gary J., additional, Cheong, Benjamin, additional, Potluri, Srinivasa, additional, Mastouri, Ronald A., additional, Breall, Jeffery A., additional, Revtyak, George E., additional, Bazeley, Jonathan W., additional, Li, Dayuan, additional, Giedd, Kenneth, additional, Old, Wayne, additional, Burt, Francis, additional, Sokhon, Kozhaya, additional, Gopal, Deepika, additional, Valeti, Uma S., additional, Kobashigawa, Jon, additional, Govindan, Sajeev Chakanalil, additional, Nair, Rajesh Gopalan, additional, Manjunath, Cholenahally Nanjappa, additional, Moorthy, Nagaraja, additional, Manjunath, Satvic Cholenahally, additional, Narayanappa, Suryaprakash, additional, Pandit, Neeraj, additional, Nath, Ranjit Kumar, additional, Dwivedi, S. K., additional, Narain, V. S., additional, Chandra, Sharad, additional, Wander, Gurpreet S., additional, Tandon, Rohit, additional, Ralhan, Sarju, additional, Aslam, Naved, additional, Goyal, Abhishek, additional, Bhargava, Balram, additional, Karthikeyan, G., additional, Ramakrishnan, S., additional, Seth, Sandeep, additional, Yadav, Rakesh, additional, Singh, Sandeep, additional, Roy, Ambuj, additional, Parakh, Neeraj, additional, Verma, Sunil Kumar, additional, Narang, Rajiv, additional, Mishra, Sundeep, additional, Naik, Nitish, additional, Sharma, Gautam, additional, Choudhary, Shiv Kumar, additional, Patel, Chetan, additional, Gulati, Gurpreet, additional, Sharma, Sanjeev, additional, Bahl, V. K., additional, Mathew, Anoop, additional, Punnoose, Eapen, additional, Gadkari, Milind Avdhoot, additional, Gadage, Siddharth, additional, Pillay, Tapan Umesh, additional, Satheesh, Santhosh, additional, Mathur, Atul, additional, Kaul, Upendra, additional, Christopher, Johann, additional, Menon, Rajeev, additional, Kumar, Nirmal, additional, Oomman, Abraham, additional, Mao, Robert, additional, Solomon, Hilda, additional, Naik, Sudhir, additional, Khan, Sajeeda Parveen, additional, Grant, Purvez, additional, Kachru, Ranjan, additional, Ajit Kumar, V. K., additional, Ganapathi, Sanjay, additional, Jayakumar, K., additional, Sivadasanpillai, Harikrishnan, additional, Sasidharan, Bijulal, additional, Kapilamoorthy, T. R., additional, Polamuri, Praneeth, additional, Senior, Roxy, additional, Gurunathan, Sothinathan, additional, Karogiannis, Nikolaos, additional, Shah, Benoy N., additional, Trimlett, Richard HJ, additional, Rubens, Michael B., additional, Nicol, Edward D., additional, Mittal, Tarun K., additional, Hampson, Reinette, additional, Gamma, Reto Andreas, additional, de Belder, Mark A., additional, Thambyrajah, Jeet, additional, Nageh, Thuraia, additional, Davies, John R., additional, Lindsay, Steven J., additional, Kurian, John, additional, Jamil, Haqeel, additional, Raheem, Osama, additional, Hoye, Angela, additional, Donnelly, Patrick, additional, Valecka, Bernardas, additional, Chauhan, Anoop, additional, Barr, Craig, additional, Alfakih, Khaled, additional, Byrne, Jonathan, additional, Webb, Ian, additional, Henriksen, Peter, additional, OKane, Peter, additional, de Silva, Ramesh, additional, Conway, Dwayne S. G., additional, Sirker, Alexander A, additional, Hoole, Stephen P., additional, Witherow, Fraser N., additional, Johnston, Nicola, additional, Harbinson, Mark, additional, Walsh, Simon, additional, Douglas, Hanna, additional, Luckie, Matthew, additional, Sobolewska, Jolanta, additional, Jeetley, Paramjit, additional, Patel, Niket, additional, Kotecha, Tushar, additional, Travill, Christopher, additional, Karimullah, Iqbal, additional, Al‐Bustami, Mahmud, additional, Braganza, Denise, additional, Henderson, Robert, additional, Pointon, Kate, additional, Naik, Surendra, additional, Mathew, Thomas, additional, Berry, Colin, additional, Collison, Damien, additional, Roditi, Giles, additional, Moriarty, Andrew J., additional, Glover, Jason D., additional, Pradhan, Jiwan, additional, Mikhail, Ghada, additional, Francis, Darrel P., additional, Gosselin, Gilbert, additional, Diaz, Ariel, additional, Rheault, Philippe, additional, Barrero, Miguel, additional, Gagné, Carl‐Éric, additional, Pépin‐Dubois, Yanek, additional, Costa, Ricardo, additional, Sia, Ying Tung, additional, Lemay, Catherine, additional, Gisbert, Alejandro, additional, Gervais, Pierre, additional, Rheault, Alain, additional, Phaneuf, Denis Carl, additional, Garg, Pallav, additional, Chow, Benjamin J. W., additional, Hessian, Renee C., additional, Beanlands, Rob S., additional, Davies, Richard F., additional, Bainey, Kevin R., additional, Cheema, Asim N., additional, Bagai, Akshay, additional, Wald, Ron, additional, Goodman, Shaun, additional, Graham, John Joseph, additional, Peterson, Mark, additional, Chow, Chi‐Ming, additional, Abramson, Beth, additional, Cheema, Asim Nazir, additional, Vakani, Mohammad Tariq, additional, Cha, James, additional, Howarth, Andrew G, additional, Wong, Graham, additional, Uxa, Amar, additional, Galiwango, Paul, additional, Kassam, Saleem, additional, Mukherjee, Ashok, additional, Ricci, A. Joseph, additional, Lam, Andy, additional, Mehta, Shamir, additional, Udell, Jacob, additional, Généreux, Philippe, additional, Hameed, Adnan, additional, Daba, Ledjalem, additional, Hueb, Whady, additional, Rezende, Paulo Cury, additional, Silva, Expedito Eustáquio Ribeiro, additional, Hueb, Alexandre Ciappina, additional, Smanio, Paola Emanuela Poggio, additional, de Quadros, Alexandre Schaan, additional, Kalil, Renato Abdala Karam, additional, da Costa Vieira, José Luiz, additional, Grossmann, Gabriel, additional, de Oliveira, Pedro Píccaro, additional, Bridi, Leonardo, additional, Savaris, Simone, additional, Vitola, João V., additional, Cerci, Rodrigo J., additional, Farias, Fabio R., additional, Fernandes, Miguel M., additional, Marin‐Neto, José Antonio, additional, Schmidt, André, additional, de Oliveira Lima Filho, Moysés, additional, Oliveira, Ricardo Mendes, additional, Chierice, João Reynaldo Abbud, additional, Polanczyk, Carísi A., additional, Furtado, Mariana V., additional, Smidt, Luis F., additional, Carvalho, Antonio Carlos, additional, Pucci, Gustavo, additional, Lyra, Flavio, additional, Junior, Alvaro Rabelo Alves, additional, Dracoulakis, Marianna D. A., additional, Lima, Rodolfo G. S. D, additional, Figueiredo, Estevao, additional, Caramori, Paulo Ricardo, additional, Tumelero, Rogerio, additional, Dall’Orto, Frederico, additional, Mesquita, Claudio T., additional, Colafranseschi, Alexandre S., additional, Oliveira, Amarino C., additional, Carvalho, Luiz A., additional, Palazzo, Isabella C., additional, Sousa, Andre S., additional, da Silva, Expedito Eustáquio Ribeiro, additional, de Barros, Pedro Gabriel Melo, additional, de Pádua Silva Baptista, Luciana, additional, Rodrigues, Marcelo Jamus, additional, de Resende, Marcos Valério Coimbra, additional, Saraiva, Jose Francisco, additional, Costantini, Costantino, additional, Demkow, Marcin, additional, Pracon, Radoslaw, additional, Kepka, Cezary, additional, Teresinska, Anna, additional, Kryczka, Karolina, additional, Henzel, Jan, additional, Solecki, Mateusz, additional, Kaczmarska, Edyta, additional, Mazurek, Tomasz, additional, Drozdz, Jaroslaw, additional, Czarniak, Bartosz, additional, Frach, Malgorzata, additional, Szymczyk, Konrad, additional, Niedzwiecka, Iwona, additional, Sobczak, Sebastian, additional, Ciurus, Tomasz, additional, Jakubowski, Piotr, additional, Misztal‐Teodorczyk, Magdalena, additional, Teodorczyk, Dawid, additional, Fratczak, Aleksandra, additional, Szkopiak, Marcin, additional, Lebioda, Patrycja, additional, Wlodarczyk, Michal, additional, Plachcinska, Anna, additional, Kusmierek, Jacek, additional, Miller, Magdalena, additional, Marciniak, Halina, additional, Wojtczak‐Soska, Karolina, additional, Luczak, Katarzyna, additional, Tarchalski, Tomasz, additional, Cichocka‐Radwan, Anna, additional, Szwed, Hanna, additional, Szulczyk, Grazyna Anna, additional, Witkowski, Adam, additional, Kukula, Krzysztof, additional, Celinska‐Spodar, Malgorzta, additional, Zalewska, Joanna, additional, Gajos, Grzegorz, additional, Bury, Krzysztof, additional, Pruszczyk, Piotr, additional, Roik, Marek, additional, Loboz‐Grudzien, Krystyna, additional, Sokalski, Leszek, additional, Brzezinska, Barbara, additional, Lesiak, Maciej, additional, Lanocha, Magdalena, additional, Reczuch, Krzysztof W., additional, Kalarus, Zbigniew, additional, Swiatkowski, Andrzej, additional, Szulik, Mariola, additional, Musial, Wlodzimierz J., additional, Bockeria, Leo, additional, Petrosyan, Karen, additional, Trifonova, Tatiana, additional, Chernyavskiy, Alexander M., additional, Kretov, Evgeniy I., additional, Grazhdankin, Igor O., additional, Bershtein, Leonid L., additional, Sayganov, Sergey A., additional, Kuzmina‐Krutetskaya, Anastasia M., additional, Zbyshevskaya, Elizaveta V., additional, Katamadze, Nana O., additional, Demchenko, Elena A., additional, Kozlov, Pavel S., additional, Kozulin, Vikentiy Y., additional, Lubinskaya, Ekaterina I., additional, Lopez‐Sendon, Jose, additional, Castro, Almudena, additional, Salicio, Elena Refoyo, additional, Guzman, Gabriela, additional, Galeote, Gabriel, additional, Valbuena, Silvia, additional, Peteiro, Jesús, additional, Martínez‐Ruíz, María Dolores, additional, Pérez‐Fernández, Ruth, additional, Cuenca‐Castillo, José J., additional, Flores‐Ríos, Xacobe, additional, Prada‐Delgado, Óscar, additional, Barge‐Caballero, Gonzalo, additional, Juanatey, Jose Ramon Gonzalez, additional, Bayarri, Miguel Souto, additional, Nuñez, Virginia Pubull, additional, Sanchez, Raymundo Ocaranza, additional, Alvarez, Belen Cid, additional, Gil, Carlos Peña, additional, Monzonis, Amparo Martinez, additional, Sionis, Alessandro, additional, Perales, Montserrat Vila, additional, Padró, Josep Maria, additional, Peñaranda, Antonio Serra, additional, Picart, Joan García, additional, Iglesias, Antonino Ginel, additional, Marimon, Xavier Garcia‐Moll, additional, Lladó, Guillem Pons, additional, Costa, Francesc Carreras, additional, Miro, Vicente, additional, Diez, Jose L., additional, Calvillo, Pilar, additional, Ortuño, F. Marin, additional, Chávarri, M. Valdés, additional, Montolliu, A. Tello, additional, Bermudez, E. Pinar, additional, De La Morena, G., additional, Blancas, Montserrat Gracida, additional, Luena, Jose Enrique Castillo, additional, Fernandez‐Aviles, Francisco, additional, Chen, Jiyan, additional, Wu, Yongjian, additional, Ma, Yitong, additional, Yang, Yining, additional, Ji, Zheng, additional, Yang, Xinchun, additional, Lin, Wenhua, additional, Zeng, Hesong, additional, Fu, Xin, additional, Yang, Bin, additional, Wang, Songtao, additional, Cheng, Gong, additional, Zhao, Yulan, additional, Fang, Xuehua, additional, Zeng, Qiutang, additional, Su, Xi, additional, Li, Qingxian, additional, Nie, Shao‐ping, additional, Yu, Qin, additional, Wang, Jian’an, additional, Zhang, Shuyang, additional, Liu, Zhenyu, additional, Perna, Gian Piero, additional, Marini, Marco, additional, Gabrielli, Gabriele, additional, Provasoli, Stefano, additional, Verna, Edoardo, additional, Monti, Lorenzo, additional, Nardi, Barbara, additional, Di Chiara, Antonio, additional, Mortara, Andrea, additional, Galvani, Marcello, additional, Ottani, Filippo, additional, Sicuro, Marco, additional, Calabro, Paolo, additional, Formisano, Tiziana, additional, Tarantini, Giuseppe, additional, Cucchini, Umberto, additional, Andres, Anto Luigi, additional, Racca, Emanuela, additional, Briguori, Carlo, additional, Amati, Roberto, additional, Vergoni, William, additional, Russo, Aldo, additional, Fanelli, Raffaele, additional, Poh, Kian‐Keong, additional, Chai, Ping, additional, Lau, Titus, additional, Loh, Joshua P., additional, Tay, Edgar L., additional, Teoh, Kristine, additional, Teo, Lynette L., additional, Ong, Ching‐Ching, additional, Wong, Raymond C., additional, Loh, Poay‐Huan, additional, Kofidis, Theodoros, additional, Chan, Wan Xian, additional, Chan, Koo Hui, additional, Foo, David, additional, Kong, Jason Loh Kwok, additional, Er, Ching Min, additional, Jafary, Fahim Haider, additional, Chua, Terrance, additional, Doerr, Rolf, additional, Stumpf, Juergen, additional, Matschke, Klaus, additional, Simonis, Gregor, additional, Kadalie, Clemens T., additional, Sechtem, Udo, additional, Ong, Peter, additional, Schulze, P. Christian, additional, Goebel, Bjoern, additional, Lenk, Karsten, additional, Nickenig, Georg, additional, Schuchlenz, Herwig, additional, Weikl, Stefan, additional, Lang, Irene Marthe, additional, Huber, Kurt, additional, Jakl‐Kotauschek, Gabriele, additional, Vertes, Andras, additional, Varga, Albert, additional, Fontos, Geza, additional, Merkely, Bela, additional, Kerecsen, Gabor, additional, Hinic, Sasa, additional, Zdravkovic, Marija, additional, Mudrenovic, Vladan, additional, Crnokrak, Bogdan, additional, Beleslin, Branko D., additional, Boskovic, Nikola N., additional, Petrovic, Marija T., additional, Dobric, Milan R., additional, Markovic, Zeljko Z., additional, Mladenovic, Ana S., additional, Cemerlic‐Adjic, Nada, additional, Davidovic, Goran, additional, Vucic, Rada, additional, Dekleva, Milica Nikola, additional, Stankovic, Goran, additional, Apostolovic, Svetlana, additional, Escobedo, Jorge, additional, Baleón‐Espinosa, Rubén, additional, Campos‐Santaolalla, Arturo S., additional, Durán‐Cortés, Elihú, additional, Flores‐Palacios, José M., additional, García‐Rincón, Andrés, additional, Jiménez‐Santos, Moisés, additional, Peñafiel, Joaquín V., additional, Ortega‐Ramírez, José A., additional, Valdespino‐Estrada, Aquiles, additional, Rosas, Erick Alexánderson, additional, Selvanayagam, Joseph B., additional, Joseph, Majo X., additional, Thambar, Suku T., additional, Beltrame, John F., additional, Hillis, Graham S., additional, Thuaire, Christophe, additional, Dutoiu, Téodora, additional, Steg, Philippe Gabriel, additional, Juliard, Jean‐Michel, additional, Slama, Michel S., additional, El Mahmoud, Rami, additional, Nicollet, Eric, additional, Goube, Pascal, additional, Barone‐Rochette, Gilles, additional, Furber, Alain, additional, Bière, Loïc, additional, Laucevicius, Aleksandras, additional, Celutkiene, Jelena, additional, Kedhi, Elvin, additional, Timmer, Jorik, additional, Hermanides, Rik, additional, Kaplan, Eliza, additional, Riezebos, Robert K., additional, Samadi, Pouneh, additional, van Dongen, Elise, additional, Niehe, Sander R., additional, Suryapranata, Harry, additional, van Vugt, Stijn, additional, Ramos, Ruben, additional, Cacela, Duarte, additional, Santana, Ana, additional, Fiarresga, Antonio, additional, Sousa, Lidia, additional, Marques, Hugo, additional, Patricio, Lino, additional, Bernanrdes, Luis, additional, Rio, Pedro, additional, Carvalho, Ramiro, additional, Ferreira, Rui, additional, Silva, Tiago, additional, Rodrigues, Ines, additional, Modas, Pedro, additional, Portugal, Guilherme, additional, Fragata, Jose, additional, Pinto, Fausto J., additional, Menezes, Miguel Nobre, additional, Lopes, Guilhermina Cantinho, additional, Almeida, Ana Gomes, additional, Silva, Pedro Canas, additional, Nobre, Angelo, additional, Francisco, Ana Rita, additional, Ferreira, Nuno, additional, Lopes, Ricardo L., additional, Guzman, Luis, additional, Figal, Julio César, additional, Méndiz, Oscar, additional, Cortés, Claudia, additional, Favaloro, Roberto René, additional, Alvarez, Carlos, additional, Courtis, Javier, additional, Zeballos, Gabriela, additional, Schiavi, Lilia, additional, Rubio, Mariano, additional, Devlin, Gerard Patrick, additional, Fisher, Raewyn, additional, Stewart, Ralph Alan Huston, additional, White, Harvey Douglas, additional, Benatar, Jocelyne, additional, Kedev, Sasko, additional, Mitevska, Irena Peovska, additional, Kostovska, Elizabeta Srbinovska, additional, Pejkov, Hristo, additional, Eggers, Kai, additional, Frostfelt, Gunnar, additional, Johnston, Nina, additional, Olsowka, Maciej, additional, Åkerblom, Axel, additional, Soveri, Inga, additional, Aspberg, Johannes, additional, Sharir, Tali, additional, Elian, Dan, additional, Kerner, Arthur, additional, Massalha, Samia, additional, Fukuda, Keiichi, additional, Kohsaka, Shun, additional, Yasuda, Satoshi, additional, Nishimura, Shigeyuki, additional, Van de Werf, Frans, additional, Claes, Kathleen, additional, Hung, Chung‐Lieh, additional, Yun, Chun‐Ho, additional, Hou, Charles Jia‐Yin, additional, Kuo, Jen‐Yuan, additional, Yeh, Hung‐I, additional, Hung, Ta‐Chuan, additional, Li, Jiun‐Yi, additional, Chien, Chen‐Yen, additional, Tsai, Cheng‐Ting, additional, Liu, Chun‐Chieh, additional, Yu, Fa‐Chang, additional, Lin, Yueh‐Hung, additional, Lan, Wei‐Ren, additional, Yen, Chih‐Hsuan, additional, Tsai, Jui‐Peng, additional, Sung, Kuo‐Tzu, additional, Ntsekhe, Mpiko, additional, Pandie, Shaheen, additional, Viljoen, Charle A., additional, De Andrade, Marianne, additional, Moccetti, Tiziano, additional, Rossi, M. Grazia, additional, Abdelhamid, Magdy, additional, Adel, Ahmed, additional, Kamal, Ahmed, additional, Mahrous, Hossam, additional, El Kaffas, Sameh, additional, El Fishawy, Hussien, additional, Pop, Calin, additional, Claudia, Matei, additional, Popescu, Bogdan A., additional, Ginghina, Carmen, additional, Deleanu, Dan, additional, Iliescu, Vlad A., additional, Al‐Mallah, Mouaz H., additional, Aljzeeri, Ahmed, additional, Najm, Hani, additional, Alghamdi, Ali, additional, Ramos, Walter Enrique Mogrovejo, additional, Kuanprasert, Srun, additional, Prommintikul, Arintaya, additional, Nawarawong, Weerachai, additional, Woragidpoonpol, Surin, additional, Tepsuwan, Thitipong, additional, Taksaudom, Noppon, additional, Rimsukcharoenchai, Chataroon, additional, Euathrongchit, Juntima, additional, Wannasopha, Yutthaphan, additional, Yamwong, Sukit, additional, Sritara, Piyamitr, additional, Aramcharoen, Suthara, additional, Meemuk, Krissada, additional, Khairuddin, Ahmad, additional, Hadi, Hafidz Abd, additional, and Yahaya, Shaiful Azmi, additional

Published
2024
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23. High-sensitivity C-reactive protein predicts adverse outcomes after non-ST-segment elevation acute coronary syndrome regardless of GRACE risk score, but not after ST-segment elevation myocardial infarction

Author

Sergio Raposeiras Roubín, Cristina Barreiro Pardal, Filomena Roubín-Camiña, Raymundo Ocaranza Sanchez, Ezequiel Álvarez Castro, Beatriz Paradela Dobarro, Jose María García-Acuña, Pablo Aguiar Souto, Michel Jacquet Hervet, Maria José Castromán, Isabel Arufe, Belén Outes, María Victoria Reino-Maceiras, Emad Abu Assi, and José Ramón González-Juanatey

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Introduction: Atherosclerosis is an active process and the inflammatory component appears to be particularly correlated with the development of acute coronary syndromes (ACS). C-reactive protein (CRP) is an acute phase protein that appears in the circulation in response to inflammatory cytokines. The present study investigated the association between high-sensitivity C-reactive protein (hsCRP) on admission and follow-up prognosis after an ACS. Methods: We included 151 consecutive patients admitted to the coronary care unit with a diagnosis of ACS (47% ST-segment elevation myocardial infarction [STEMI]). The primary endpoint was the combination of cardiac death and myocardial reinfarction during the follow-up period (median 19.8 months, interquartile range 16.3–23.7 months). Results: The occurrence of follow-up events was significantly related to admission hsCRP level, which was an excellent predictor of cardiac death and reinfarction during follow-up (HR 1.091, 95% CI 1.014–1.174; p=0.019). Stratifying the population based on type of ACS, adjusted by variables associated with cardiac events in univariate analysis (hsCRP, diabetes, depressed ejection fraction and GRACE risk score), hsCRP proved to be an independent predictor of follow-up outcomes only in non-STEMI patients (HR 1.217, 95% CI: 1.093–1.356, p

Published
2013
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25. Changes in the Treatment Strategy Following Intracoronary Pressure Wire in a Contemporaneous Real-Life Cohort of Patients With Intermediate Coronary Stenosis. Results From a Nationwide Registry

Author

Oriol Rodriguez-Leor, Beatriz Toledano, Ramón López-Palop, Fernando Rivero, Salvatore Brugaletta, José Antonio Linares, Tomás Benito, Pilar Carrillo, Martí Puigfel, German Cediel, Mario Sadaba, Beatriz Vaquerizo, Juan Rondán, Iván Gómez, Fernando Alfonso, Roberto Sáez, Ana Planas, Fernando Lozano, Felipe Hernández, Manel Sabaté, José Ramón Ruíz-Arroyo, Francisco Torres, José María de la Torre Hernández, Enrique Gutiérrez, Ana Belén Cid-Álvarez, José Luís Díez, Luis Fernández, José Moreu, Soledad Ojeda, Pablo Cerrato, Valeriano Ruiz-Quevedo, Juan Sanchis, Antonio Gómez-Menchero, Raymundo Ocaranza, Mohsen Mohandes, José María Hernández, Miren Maite Alfageme, Pablo Aguiar, José Ramón López Mínguez, and Armando Pérez de Prado

Subjects
General Medicine, Cardiology and Cardiovascular Medicine
Published
2023

27. Adjusting RFR by Predictors of Disagreement, 'The Adjusted RFR': An Alternative Methodology to Improve the Diagnostic Capacity of Coronary Indices

Author

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

Subjects
Sensitivity, Especificidade, Specificity, Resting Full-cycle Ratio, Angina, Relação do Ciclo Completo de Repouso, Cardiology and Cardiovascular Medicine, Reserva de Fluxo Fracionado, Sensibilidade, Fractional Flow Reserve
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. Abstract Background Cutoff thresholds for the “resting full-cycle ratio” (RFR) oscillate in different series, suggesting that population characteristics may influence them. Likewise, predictors of discordance between the RFR and fractional flow reserve (FFR) have been documented. The RECOPA Study showed that diagnostic capacity is reduced in the RFR “grey zone”, requiring the performance of FFR to rule out or confirm ischemia. Objectives To determine predictors of discordance, integrate the information they provide in a clinical-physiological index, the “Adjusted RFR”, and compare its agreement with the FFR. Methods Using data from the RECOPA Study, predictors of discordance with respect to FFR were determined in the RFR “grey zone” (0.86 to 0.92) to construct an index (“Adjusted RFR”) that would weigh RFR together with predictors of discordance and evaluate its agreement with FFR. Results A total of 156 lesions were evaluated in 141 patients. Predictors of discordance were: chronic kidney disease, previous ischemic heart disease, lesions not involving the anterior descending artery, and acute coronary syndrome. Though limited, the “Adjusted RFR” improved the diagnostic capacity compared to the RFR in the “grey zone” (AUC-RFR = 0.651 versus AUC-“Adjusted RFR” = 0.749), also showing an improvement in all diagnostic indices when optimal cutoff thresholds were established (sensitivity: 59% to 68%; specificity: 62% to 75%; diagnostic accuracy: 60% to 71%; positive likelihood ratio: 1.51 to 2.34; negative likelihood ratio: 0.64 to 0.37). Conclusions Adjusting the RFR by integrating the information provided by predictors of discordance to obtain the “Adjusted RFR” improved the diagnostic capacity in our population. Further studies are required to evaluate whether clinical-physiological indices improve the diagnostic capacity of RFR or other coronary indices.

Published
2022

29. Prognostic impact of residual SYNTAX score in patients with ST-elevation myocardial infarction and multivessel disease: Analysis of an 8-year all-comers registry

Author

Braga, Carlos Galvão, primary, Cid-Alvarez, Ana Belén, additional, Diéguez, Alfredo Redondo, additional, Alvarez, Belén Alvarez, additional, Otero, Diego López, additional, Sánchez, Raymundo Ocaranza, additional, Pena, Xoan Sanmartin, additional, Salvado, Violeta González, additional, Trillo-Nouche, Ramiro, additional, and González-Juanatey, José R., additional

Published
2017
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30. CRT-100.39 Intravascular Lithotripsy for Treatment of Severely Calcified Coronary Artery Disease in a Real-Life Setting: Results From the REPLICA-EPIC18 Study

Author

Belen Cid Alvarez, Oriol Rodriguez Leor, Nieves Gonzalo, José Antonio Diarte Miguel, Juan Francisco Muñoz Camacho, Alfonso Jurado Román, Alejandro Diego Nieto, Juan Francisco Oteo, Fernando Rivero, Pablo Avanzas, Iñigo Lozano, Ramon Calviño, Jose Moreu, David Marti Sanchez, Jesus Jimenez Mazuecos, Raymundo Ocaranza-Sanchez, Jose Maria de la Torre, Mohsen Mohandes, Fernando Lozano, Miren Telleria, Jorge Palazuelos, Reyes Gonzalez, Victor Jimenez, Josep Gomez Lara, and Armando Perez de Prado

Subjects
Cardiology and Cardiovascular Medicine
Published
2023

31. Registro prospectivo del stent liberador de sirolimus con polímero estable de fluoroacrilato Angiolite: estudio EPIC02 – RANGO

Author

Armando Pérez de Prado, Raymundo Ocaranza-Sánchez, Fernando Lozano Ruiz-Poveda, José Moreu Burgos, Raquel Álvarez Ramos, Alberto Rodrigues, Luis Fernández González, Pablo Aguar, Bruno García del Blanco, Eduardo Pinar, Vicente Peral, Fermín Sainz Laso, José Ramón Rumoroso, Alfonso Torres, Manel Sabaté, and Ramiro Trillo Nouche

Subjects
trombosis del stent, stent liberador de sirolimus, estudio observacional, Internal medicine, RC31-1245, eficacia, fluoropolímero estable, seguridad
Abstract

Introducción y objetivos: Para confirmar los resultados observados en análisis preclínicos y clínicos del stent liberador de sirolimus Angiolite se diseñó el registro observacional de vida real RANGO. Métodos: El registro prospectivo multicéntrico incluyó pacientes con distintas indicaciones clínicas que recibieron al menos 1 stent Angiolite para tratar su enfermedad coronaria y que dieron su consentimiento informado. El objetivo primario fue la incidencia de fracaso del tratamiento de la lesión (FTL) a 6, 12 y 24 meses, definido como muerte de causa cardiaca, infarto de miocardio en relación con el vaso tratado o nueva revascularización de la lesión tratada. Los objetivos secundarios fueron los componentes individuales del objetivo primario y las incidencias de eventos cardiacos mayores (MACE) y de trombosis del stent. Se presentan los resultados del registro RANGO a 2 años en la población global, en los pacientes que recibieron stent Angiolite y en 2 subgrupos predefinidos de diabéticos y vasos pequeños ("64; 2,5 mm). Resultados: Se seleccionaron 646 pacientes (426 solo recibieron stents Angiolite) con un perfil de riesgo elevado: infarto previo (18,4%), revascularización coronaria previa (23,4%), presentación clínica como infarto agudo con elevación del segmento ST (23,1%) y enfermedad multivaso (47,8%). A los 2 años, la incidencia de FTL en el grupo global fue del 3,4%, la de MACE fue del 9,6% y la de trombosis del stent fue del 0,9%. En el grupo tratado solo con stents Angiolite, los resultados fueron similares (FTL 3,1%, MACE 8,0% y trombosis 0,7%). Los resultados no fueron significativamente diferentes en los diabéticos (FTL 3,0%, MACE 14,1% y trombosis 1,0%) y en los pacientes con vasos pequeños (FTL 4,3%, MACE 12,1% y trombosis 0%). Conclusiones: Los resultados del registro observacional RANGO a los 2 años en población de vida real con perfil de riesgo elevado confirman los excelentes resultados del stent Angiolite observados en estudios previos. Se plantea un seguimiento clínico a 5 años para descartar eventos muy tardíos.

Published
2021

32. Real-world registry of the durable Angiolite fluoroacrylate polymer-based sirolimus-eluting stent: the EPIC02 – RANGO study

Author

Fermin Sainz Laso, Raymundo Ocaranza-Sánchez, José Ramón Rumoroso, Fernando Lozano Ruiz-Poveda, Pablo Aguar, Raquel Álvarez Ramos, Eduardo Pinar, Alberto Rodrigues, Vicente Peral, Bruno García del Blanco, and Manel Sabaté, Luis Fernández González, Ramiro Trillo Nouche, Alfonso Torres, Armando Pérez de Prado, and José Moreu Burgos

Subjects
medicine.medical_specialty, Efficacy, business.industry, Stent thrombosis, medicine.medical_treatment, Sirolimus-eluting-stent, Stent, Durable fluoropolymer, Surgery, Sirolimus, Observational study, medicine, Medicine, cardiovascular diseases, Safety, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Introduction and objectives: After the positive pre-clinical and clinical results with Angiolite, a cobalt-chromium sirolimus-eluting stent, we decided to analyze its performance in a non-selected, real-world population: the RANGO registry. Methods: We conducted an observational, prospective, multicenter registry of patients with different clinical indications. All consecutive patients treated with percutaneous coronary intervention with, at least, 1 Angiolite stent and who gave their informed consent were included. The registry primary endpoint was the occurrence of target lesion failure (TLF) at 6, 12, and 24 months defined as cardiovascular death, myocardial infarction (MI) related to target vessel, and clinically driven target lesion revascularization. The secondary endpoints were the individual components of the primary endpoint, major adverse cardiovascular events (MACE: all-cause mortality, any MI, or any revascularization), and stent thrombosis. We describe the 2-year clinical results of the RANGO study in the entire population, in those who only received Angiolite stents, and in 2 predefined subgroups: diabetics and patients with small-vessels (≤ 2.5mm). Results: 646 patients (426 of them only received Angiolite stents) with a high-risk profile were recruited: prevalence of previous MI (18.4%), previous coronary revascularization (23.4%), clinical presentation as ST-segment elevation MI (23.1%), and multivessel disease (47.8%). At the 2-year follow-up, the rates of TLF, MACE, and stent thrombosis were 3.4%, 9.6%, and 0.9%, respectively. Similar results were observed among patients treated with Angiolite stents only: TLF, 3.1%; MACE, 8.0%; thrombosis, 0.7%. The rates were not significantly different for the diabetic (TLF, 3.0%; MACE, 14.1%; thrombosis, 1.0%), and small-vessel subgroups (TLF, 4.3%; MACE, 12.1%; thrombosis, 0%). Conclusions: In conclusion, the results of this observational registry on the use of Angiolite in a real-world population, including a high-risk population, corroborate the excellent results observed in previous studies, up to a 2-year follow-up. An extended 5-year follow-up is planned to discard the occurrence of late events.

Published
2021

33. Long-term (> 12 months) single-center registry of Magmaris implantation in the acute coronary syndrome setting

Author

Carlos González-Juanatey, and Raymundo Ocaranza-Sánchez, Jeremías Bayón, Melisa Santás-Álvarez, Verónica Gordo, and Rosa-Alba Abellás-Sequeiros

Subjects
medicine.medical_specialty, Acute coronary syndrome, business.industry, Magmaris, Single Center, medicine.disease, Term (time), Internal medicine, Bioresorbable scaffold thrombosis, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction and objectives: The results of Magmaris implantation in the acute coronary syndrome setting is uncertain and more studies will be needed to assess the long-term safety profile of these devices. The objective of this work was to conduct an observational study to analyze the clinical safety profile of Magmaris implanted in a single hospital center in the acute coronary syndrome setting beyond 12 months. Methods: Registry of 36 patients with Magmaris devices implanted between November 2016 through November 2018 with a diagnosis of acute coronary syndrome included consecutively. The primary endpoint was considered the device-oriented composite endpoint of target vessel myocardial infarction, target lesion failure, and cardiac death. Secondary endpoints included Magmaris related thrombosis. Results: Regarding the device-oriented combination, no target vessel myocardial infarction was observed, 0 cases (0%), while target lesion failure was seen in 2 cases (5.6%). There were no cases of Magmaris thrombosis at the follow-up and only 1 case of cardiac death (2.8%) was found 36 months after Magmaris implantation. The cause of death could not be determined since no autopsy was performed. Conclusions: Our results with long-term follow-up confirm that Magmaris has a favorable clinical profile in the acute coronary syndrome complex setting.

Published
2021

34. Registro unicéntrico a largo plazo (>12 meses) del implante de Magmaris en el síndrome coronario agudo

Author

Verónica Gordo, Raymundo Ocaranza-Sánchez y, Melisa Santás-Álvarez, Rosa-Alba Abellás-Sequeiros, Jeremías Bayón, and Carlos González-Juanatey

Subjects
Target lesion, Acute coronary syndrome, medicine.medical_specialty, business.industry, Trombosis armazón bioabsorbible, General Engineering, Magmaris, Autopsy, medicine.disease, Thrombosis, RC31-1245, Safety profile, Internal medicine, Clinical endpoint, Cardiology, Medicine, Síndrome coronario agudo, Myocardial infarction, business, Cause of death
Abstract

RESUMEN Introducción y objetivos: Los resultados del Magmaris en el síndrome coronario agudo son controvertidos y se necesitan más estudios para evaluar su seguridad a largo plazo. El objetivo del trabajo fue analizar mediante un estudio observacional la seguridad clínica más allá de 12 meses de los Magmaris implantados en un único centro hospitalario en pacientes con síndrome coronario agudo. Métodos: Se registraron de manera consecutiva 36 pacientes con Magmaris implantados entre noviembre de 2016 y noviembre de 2018 con diagnóstico de síndrome coronario agudo. Para el objetivo primario se consideró el combinado orientado al dispositivo de infarto de miocardio del vaso diana, fracaso de la lesión diana y muerte de causa cardiovascular. Como objetivo secundario se incluyó la trombosis del dispositivo. Resultados: En cuanto al combinado orientado al dispositivo no se observó infarto de miocardio del vaso diana (0%), en 2 casos (5,6%) se observó fracaso de la lesión diana y se constató 1 caso de muerte cardiaca (2,8%) a los 36 meses del implante del Magmaris, sin poder conocer la causa por no disponer de autopsia. Con respecto a los objetivos secundarios, no hubo casos de trombosis del Magmaris durante el seguimiento. Conclusiones: Nuestros resultados, con un seguimiento a largo plazo, apoyan...

Published
2021

35. Adjusting RFR by Predictors of Disagreement, 'The Adjusted RFR': An Alternative Methodology to Improve the Diagnostic Capacity of Coronary Indices

Author

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

Subjects
Fractional Flow Reserve, Myocardial, Cardiac Catheterization, Predictive Value of Tests, Coronary Stenosis, Humans, Coronary Artery Disease, Coronary Angiography, Severity of Illness Index, Coronary Vessels
Abstract

Cutoff thresholds for the "resting full-cycle ratio" (RFR) oscillate in different series, suggesting that population characteristics may influence them. Likewise, predictors of discordance between the RFR and fractional flow reserve (FFR) have been documented. The RECOPA Study showed that diagnostic capacity is reduced in the RFR "grey zone", requiring the performance of FFR to rule out or confirm ischemia.To determine predictors of discordance, integrate the information they provide in a clinical-physiological index, the "Adjusted RFR", and compare its agreement with the FFR.Using data from the RECOPA Study, predictors of discordance with respect to FFR were determined in the RFR "grey zone" (0.86 to 0.92) to construct an index ("Adjusted RFR") that would weigh RFR together with predictors of discordance and evaluate its agreement with FFR.A total of 156 lesions were evaluated in 141 patients. Predictors of discordance were: chronic kidney disease, previous ischemic heart disease, lesions not involving the anterior descending artery, and acute coronary syndrome. Though limited, the "Adjusted RFR" improved the diagnostic capacity compared to the RFR in the "grey zone" (AUC-RFR = 0.651 versus AUC-"Adjusted RFR" = 0.749), also showing an improvement in all diagnostic indices when optimal cutoff thresholds were established (sensitivity: 59% to 68%; specificity: 62% to 75%; diagnostic accuracy: 60% to 71%; positive likelihood ratio: 1.51 to 2.34; negative likelihood ratio: 0.64 to 0.37).Adjusting the RFR by integrating the information provided by predictors of discordance to obtain the "Adjusted RFR" improved the diagnostic capacity in our population. Further studies are required to evaluate whether clinical-physiological indices improve the diagnostic capacity of RFR or other coronary indices.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.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.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.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).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.

Published
2022

37. Initial Invasive or Conservative Strategy for Stable Coronary Disease

Author

Maron D. J., Hochman J. S., Reynolds H. R., Bangalore S., O'Brien S. M., Boden W. E., Chaitman B. R., Senior R., Lopez-Sendon J., Alexander K. P., Lopes R. D., Shaw L. J., Berger J. S., Newman J. D., Sidhu M. S., Goodman S. G., Ruzyllo W., Gosselin G., Maggioni A. P., White H. D., Bhargava B., Min J. K., John Mancini G. B., Berman D. S., Picard M. H., Kwong R. Y., Ali Z. A., Mark D. B., Spertus J. A., Krishnan M. N., Elghamaz A., Moorthy N., Hueb W. A., Demkow M., Mavromatis K., Bockeria O., Peteiro J., Miller T. D., Szwed H., Doerr R., Keltai M., Selvanayagam J. B., Gabriel Steg P., Held C., Kohsaka S., Mavromichalis S., Kirby R., Jeffries N. O., Harrell F. E., Rockhold F. W., Broderick S., Bruce Ferguson T., Williams D. O., Harrington R. A., Stone G. W., Rosenberg Y, ISCHEMIA Research Group: Joseph Ricci, A Tello Montoliu, A I Robero Aniorte, Abbey Mulder, Abhay A Laddu, Abhinav Goyal, Abhishek Dubey, Abhishek Goyal, Abigail Knighton, Abraham Oomman, Adam J Jaskowiak, Adam Kolodziej, Adam Witkowski, Adnan Hameed, Adriana Anesini, Afshan Hussain, Agne Juceviciene, Agne Urboniene, Agnes Jakal, Agnieszka Szramowska, Ahmad Khairuddin, Ahmed Abdel-Latif, Ahmed Adel, Ahmed Aljzeeri, Ahmed Kamal, Ahmed Talaat, Aimee Mann, Aira Contreras, Ajit Kumar, V K Kumar, Akemi Furukawa, Akshay Bagai, Akvile Smigelskaite, Alain Furber, Alain Rheault, Alaine Melanie Loehr, Alan Rosen, Albert Varga, Albertina Qelaj, Alberto Barioli, Aldo Russo, Alec Moorman, Alejandro Gisbert, Aleksandra Fratczak, Aleksandras Laucevicius, Alena Kuleshova, Alessandro Sionis, Alexander A Sirker, Alexander M Chernyavskiy, Alexandra Craft, Alexandra Vazquez, Alexandre Ciappina Hueb, Alexandre S Colafranseschi, Alexandre Schaan de Quadros, Alexandre Tognon, Ali Alghamdi, Alice Manica Muller, Aline Nogueira Rabaça, Aline Peixoto Deiro, Alison Hallam, Allegra Stone, Allison Schley, Almudena Castro, Alvaro Rabelo Ales, Amanda Germann, Amanda O'Malley, Amar Uxa, Amarachi Ojajuni, Amarino C Oliveira Jr, Amber B Hull, Ambuj Roy, Amer Zarka, Amir Janmohamed, Ammani Brown, Ammy Malinay, Amparo Martinez Monzonis, Amy J Richards, Amy Iskandrian, Amy Ollinger, Ana D Djordjevic-Dikic, Ana Fernández Martínez, Ana Gomes Almeida, Ana Paula Batista, Ana Rita Francisco, Ana S Mladenovic, Ana Santana, Anam Siddiqui, Anastasia M Kuzmina-Krutetskaya, Andras Vertes, Andre S Sousa, Andre Gabriel, André Schmidt, Andrea M Lundeen, Andrea Bartykowszki, Andrea Lorimer, Andrea Mortara, Andrea Pascual, Andreia Coelho, Andreia Rocha, Andrés García-Rincón, Andrew G Howarth, Andrew J Moriarty, Andrew Docherty, Andrew Starovoytov, Andrew Zurick, Andrzej Łabyk, Andrzej Swiatkowski, Andy Lam, Anelise Kawakami, Angela Hoye, Angela Kim, Angelique Smit, Angelo Nobre, Anil V Shah, Anja Ljubez, Anjali Anand, Ankush Sachdeva, Ann Greenberg, Ann Luyten, Ann Ostrander, Anna Di Donato, Anna Cichocka-Radwan, Anna Fojt, Anna Plachcinska, Anna Proietti, Anna Teresinska, Anne Marie Webb, Anne Cartwright, Anne Heath, Anne Mackin, Anong Amaritakomol, Anong Chaiyasri, Anoop Chauhan, Anoop Mathew, Anthony Gemignani, Anto Luigi Andres, Antonia Vega, Antonietta Hansen, Antonino Ginel Iglesias, Antonio Carlos Carvalho, Antonio Di Chiara, Antonio Serra Peñaranda, Antonio Carvalho, Antonio Colombo, Antonio Fiarresga, Anupama Rao, Aquiles Valdespino-Estrada, Araceli Boan, Areef Ishani, Ariel Diaz, Arijit Ghosh, Arintaya Prommintikul, Arline Roberts, Arnold H Seto, Arnold P Good, Arshed Quyyumi, Arthur J Labovitz, Arthur Kerner, Arturo S Campos-Santaolalla, Arunima Misra, Ashok Mukherjee, Ashok Seth, Ashraf Seedhom, Asim N Cheema, Asker Ahmed, Atul Mathur, Atul Verma, Audrey W Leong, Axel Åkerblom, Axelle Fuentes, Aynun Naher, Badhma Valaiyapathi, Baljeet Kaur, Bandula Guruge, Barbara Brzezińska, Barbara Nardi, Bartosz Czarniak, Bebek Singh, Begoña Igual, Bela Merkely, Belen Cid Alvarez, Benjamin J Spooner, Benjamin J W Chow, Benjamin Cheong, Benoy N Shah, Bernard de Bruyne, Bernardas Valecka, Bernhard Jäger, Beth A Archer, Beth Abramson, Beth Jorgenson, Bethany Harvey, Betsy O'Neal, Bev Atkinson, Bev Bozek, Bevin Lang, Bijulal Sasidharan, Bin Yang, Bin Zhang, Binoy Mannekkattukudy Kurian, Bjoern Goebel, Bob Hu, Bogdan A Popescu, Bogdan Crnokrak, Bolin Zhu, Bonnie J Kirby, Brandi D Zimbelman, Brandy Starks, Branko D Beleslin, Brenda Hart, Brian P Shapiro, Brian McCandless, Brianna Wisniewski, Brigham R Smith, Brooks Mirrer, Bruce McManus, Bruce Rutkin, Bruna Edilena Paulino, Bruna Maria Ascoli, Bryn Smith, Byron J Allen, C Michael Gibson, C Noel Bairey Merz, Calin Pop, Cameron Hague, Camila Thais de Ormundo, Candace Gopaul, Candice P Edillo, Carísi A Polanczyk, Carita Krannila, Carla Vicente, Carl-Éric Gagné, Carlo Briguori, Carlos Peña Gil, Carlos Alvarez, Carly Ohmart, Carmen C Beladan, Carmen Ginghina, Carol M Kartje, Caroline Alsweiler, Caroline Brown, Caroline Callison, Caroline Pinheiro, Caroline Rodgers, Caroline Spindler, Carolyn Corbett, Carrie Drum, Casey Riedberger, Catherine Bone, Catherine Fleming, Catherine Gordon, Catherine Jahrsdorfer, Catherine Lemay, Catherine Weick, Cathrine Patten, Cecilia Goletto, Cezary Kepka, Chandini Suvarna, Chang Xu, Chantale Mercure, Charle A Viljoen, Charlene Wiyarand, Charles Jia-Yin Hou, Charles Y Lui, Charles Cannan, Charles Cornet, Charlotte Pirro, Chataroon Rimsukcharoenchai, Chen Wang, Cheng-Ting Tsai, Chen-Yen Chien, Cheryl A Allardyce, Chester M Hedgepeth, Chetan Patel, Chiara Attanasio, Chih-Hsuan Yen, Chi-Ming Chow, Ching Min Er, Ching-Ching Ong, Cholenahally Nanjappa Manjunath, Chris Beck, Chris Buller, Christel Vassaliere, Christian Hamm, Christiano Caldeira, Christie Ballantyne, Christina Björklund, Christine R Hinton, Christine Bergeron, Christine Masson, Christine Roraff, Christine Shelley, Christophe Laure, Christophe Thuaire, Christopher Kinsey, Christopher McFarren, Christopher Spizzieri, Christopher Travill, Chun-Chieh Liu, Chung-Lieh Hung, Chunguang Li, Chun-Ho Yun, Chunli Xia, Ciarra Heard, Cidney Schultz, Clare Venn-Edmonds, Claudia P Hochberg, Claudia Wegmayr, Claudia Cortés, Claudia Escobar, Cláudia Freixo, Claudio T Mesquita, Clemens T Kadalie, Colin Berry, Constance Philander, Corine Thobois, Costantino Costantini, Courtney Page, Craig Atkinson, Craig Barr, Craig Paterson, Cristina Bare, Cynthia Baumann, Cynthia Burman, Dalisa Espinosa, Damien Collison, Dan Deleanu, Dan Elian, Dan Gao, Dana Oliver, Daniel P Vezina, Daniel O'Rourke, Daniele Komar, Danielle Schade, Darrel P Francis, Dastan Malaev, David A Bull, David E Winchester, David P Faxon, David Booth, David Cohen, David DeMets, David Foo, David Schlichting, David Taggart, David Waters, David Wohns, Davis Vo, Dawid Teodorczyk, Dawn Shelstad, Dawn Turnbull, Dayuan Li, Dean Kereiakes, Deborah O'Neill, Deborah Yip, Debra K Johnson, Debra Dees, Deepak L Bhatt, Deepika Gopal, Deepti Kumar, Deirdre Mattina, Deirdre Murphy, Delano R Small, Delsa K Rose, Dengke Jiang, Denis Carl Phaneuf, Denise Braganza, Denise Fine, Derek Cyr, Desiree Tobin, Diana Cukali, Diana Parra, Diane Camara, Diane Minshall Liu, Diego Adrián Vences, Diego Franca de Cunha, Dimitrios Stournaras, Dipti Patel, Dongze Li, Donna Exley, Dorit Grahl, Dragana Stanojevic, Duarte Cacela, Dwayne S G Conway, E Pinar Bermudez, Eapen Punnoose, Edgar L Tay, Edgar Karanjah, Edoardo Verna, Eduardo Hernandez-Rangel, Edward D Nicol, Edward O McFalls, Edward T Martin, Edyta Kaczmarska, Ekaterina I Lubinskaya, Elena A Demchenko, Elena Refoyo Salicio, Eli Feen, Elihú Durán-Cortés, Elisabeth M Janzen, Elise L Hannemann, Elise van Dongen, Elissa Restelli Piloto, Eliza Kaplan, Elizabeta Srbinovska Kostovska, Elizabeth Capasso-Gulve, Elizabeth Congdon, Elizabeth Ferguson, Elizaveta V Zbyshevskaya, Ellen Magedanz, Ellie Fridell, Ellis W Lader, Elvin Kedhi, Emanuela Racca, Emilie Tachot, Emily DeRosa, Encarnación Alonso-Álvarez, Eric Nicollet, Eric Peterson, Erick Alexánderson Rosas, Erick Donato Morales, Erin Orvis, Ermina Moga, Estelle Montpetit, Estevao Figueiredo, Eugene Passamani, Eugenia Nikolsky, Eunice Yeoh, Evgeniy I Kretov, Ewa Szczerba, Ewelina Wojtala, Expedito Eustáquio Ribeiro Silva, F Marin Ortuño, Fabio R Farias, Fabio Fimiani, Fabrizio Rolfo, Fa-Chang Yu, Fadi Hage, Fadi Matar, Fahim Haider Jafary, Fang Feng, Fang Liu, Fatima Ranjbaran, Fatima Rodriguez, Fausto J Pinto, Fauzia Rashid, Federica Ramani, Fei Wang, Fernanda Igansi, Filipa Silva, Filippo Ottani, Fiona Haines, Firas Al Solaiman, Flávia Egydio, Flavio Lyra, Florian Egger, Fran Farquharson, Frances Laube, Francesc Carreras Costa, Francesca de Micco, Francesca Bianchini, Francesca Pezzetta, Francesca Pietrucci, Francesco Orso, Francesco Pisano, Francis Burt, Francisca Patuleia Figueiras, Francisco Fernandez-Aviles, Francois Pierre Mongeon, Frans Van de Werf, Franziska Guenther, Fraser N Witherow, Fred Mohr, Frederico Dall'Orto, Fumiyuki Otsuka, G De La Morena, G Karthikeyan, Gabor Dekany, Gabor Kerecsen, Gabriel Galeote, Gabriel Grossmann, Gabriel Vorobiof, Gabriela Sanchez de Souza, Gabriela Guzman, Gabriela Zeballos, Gabriele Gabrielli, Gabriele Jakl-Kotauschek, Gail A Shammas, Gail Brandt, Gang Chen, Gary E Lane, Gary J Luckasen, Gautam Sharma, Gelmina Mikolaitiene, Gennie Yee, Georg Nickenig, George E Revtyak, George J Juang, Gerald Fletcher, Gerald Leonard, Gerard Patrick Devlin, Gerard Esposito, Gergely Ágoston, Gervasio Lamas, Geza Fontos, Ghada Mikhail, Gia Cobb, Gian Piero Perna, Gianpiero Leone, Giles Roditi, Gilles Barone-Rochette, Girish Mishra, Giuseppe Tarantini, Glenda Wong, Glenn S Hamroff, Glenn Rayos, Gong Cheng, Gonzalo Barge-Caballero, Goran Davidović, Goran Stankovic, Gordana Stevanovic, Grace Jingyan Wang, Grace M Young, Graceanne Wayser, Graciela Scaro, Graham S Hillis, Graham Wong, Grazyna Anna Szulczyk, Gregor Simonis, Gregory Kumkumian, Gretchen Ann Peichel, Grzegorz Gajos, Gudrun Steinmaurer, Guilherme G Rucatti, Guilherme Portugal, Guilhermina Cantinho Lopes, Guillem Pons Lladó, Gunnar Frostfelt, Gurpreet S Wander, Gurpreet Gulati, Gustavo Pucci, Hafidz Abd Hadi, Haibo Zhang, Haitao Wang, Halina Marciniak, Han Chen, Hanan Kerr, Hani Najm, Hanna Douglas, Hannah Phillips, Hao Dai, Haojian Dong, Haqeel Jamil, Harikrishnan Sivadasanpillai, Harry Suryapranata, Hassan Reda, Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona Niedzwiecka, J David Knight, Jacek Kusmierek, Jackie M White, Jackie Chow, Jacob Udell, Jacqueline E Tamis-Holland, Jacqueline Fannon, Jacquelyn A Quin, Jacquelyn Do, Jaekyeong Heo, Jakub Maksym, James E Davies, James H O'Keefe Jr, James J Jang, James Cha, James Harrison, James Hirsch, James Stafford, James Tatoulis, Jamie Rankin, Jan Henzel, Jan Orga, Jana Tancredi, Janaina Oliveira, Jane Burton, Jane Eckstein, Jane Marucci, Janet P Knight, Janet Blount, Janet Halliday, Janetta Kourzenkova, Janitha Raj, Jan-Malte Sinning, Jaqueline Pozzibon, Jaroslaw Drozdz, Jaroslaw Karwowski, Jason D Glover, Jason Loh Kwok, Jason T Call, Jason Linefsky, Jassira Gomes, Jati Anumpa, Javier J Garcia, Javier Courtis, Jay Meisner, K Jayakumar, Jayne Scales, Jean E Denaro, Jean Michel Juliard, Jean Ho, Jeanette K Stansborough, Jean-Michel Juliard, Jeanne Russo, Jeannette J M Schoep, Jeet Thambyrajah, Jeff Leimberger, Jeffery A Breall, Jeffrey A Kohn, Jeffrey C Milliken, Jeffrey Anderson, Jeffrey Blume, Jeffrey Kanters, Jeffrey Lorin, Jeffrey Moses, Jelena J Stepanovic, Jelena Celutkiene, Jelena Djokic, Jelena Stojkovic, Jenne M Jose, Jenne Manchery, Jennifer A Mull, Jennifer H Czerniak, Jennifer L Stanford, Jennifer Gillis, Jennifer Horst, Jennifer Isaacs, Jennifer Langdon, Jennifer Thomson, Jennifer Tomfohr, Jennifer White, Jen-Yuan Kuo, Jeremy Rautureau, Jerome Fleg, Jessica Berg, Jessica Rodriguez, Jessica Waldron, Jhina Patro, Jia Li, Jiajia Mao, Jiamin Liu, Jian'an Wang, Jianhua Li, Jianxin Zhang, Jie Qi, Jihyun Lyo, Jill Marcus, Jim Blankenship, Jing Zhang, Jingjing Liu, Jing-Yao Fan, Jiun-Yi Li, Jiwan Pradhan, Jiyan Chen, J M Rivera Caravaca, Jo Evans, Joan Garcia Picart, Joan Hecht, Joanna Jaroch, Joanna Zalewska, Joanne Kelly, Joanne Taaffe, João Reynaldo Abbud, João V Vitola, Joaquín V Peñafiel, Jocelyne Benatar, Jody Bindeman, Joe Sabik, Joel Klitch, Johann Christopher, Johannes Aspberg, John D Friedman, John F Beltrame, John F Heitner, John Joseph Graham, John R Davies, John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima Euathrongchit, Jyotsna Garg, K Manjula Rani, K Preethi, Kaatje Goetschalckx, Kai Eggers, Kamalakar Surineni, Kanae Hirase, T R Kapilamoorthy, Karen Calfas, Karen Gratrix, Karen Hallett, Karen Hultberg, Karen Nugent, Karen Petrosyan, Karen Swan, Karolina Kryczka, Karolina Wojtczak-Soska, Karolina Wojtera, Karsten Lenk, Karthik Ramasamy, Katarzyna Łuczak, Katarzyna Malinowska, Kate Pointon, Kate Robb, Katherine Martin, Kathleen Claes, Kathryn Carruthers, Kathy E Siegel, Katia Drouin, Katie Fowler-Lehman, Kavita Rawat, Kay Rowe, Keiichi Fukuda, Keith A A Fox, Ken Mahaffey, Kendra Unterbrink, Kenneth Giedd, Kerrie Van Loo, Kerry Lee, Kerstin Bonin, Kevin R Bainey, Kevin T Harley, Kevin Anstrom, Kevin Chan, Kevin Croce, Kevin Landolfo, Kevin Marzo, Keyur Patel, Khaled Abdul-Nour, Khaled Alfakih, Khaled Dajani, Khaled Ziada, Khaula Baloch, Khrystyna Kushniriuk, Kian-Keong Poh, Kim F Ireland, Kim Holland, Kimberly Ann Byrne, Kimberly E Halverson, Kimberly Elmore, Kimberly Miller-Cox, Kiran Reddy, Kirsten J Quiles, Kirsty Abercrombie, Klaus Matschke, Konrad Szymczyk, Koo Hui Chan, Kotiboinna Preethi, Kozhaya Sokhon, Krissada Meemuk, Kristian Thygesen, Kristin M Salmi, Kristin Newby, Kristina Wippler, Kristine Arges, Kristine Teoh, Krystal Etherington, Krystyna Łoboz-Grudzień, Krzysztof W Reczuch, Krzysztof Bury, Krzysztof Drzymalski, Krzysztof Kukuła, Kuo-Tzu Sung, Kurt Huber, Ladda Douangvila, Lance Sullenberger, Larissa Miranda Trama, Laszlone Matics, Laura Drew, Laura Flint, Laura Keinaite, Laura Sarti, Laurel Kolakaluri, Lawrence M Phillips, Lawrence Friedman, Lawrence Phillips, Lazar Velicki, Leah Howell, Leandro C Maranan, Leanne Cox, Ledjalem Daba, Lei Zhang, Lekshmi Dharmarajan, Leo Bockeria, Leonardo Pizzol Caetano, Leonardo Bridi, Leonid L Bershtein, Leszek Sokalski, Li Hai Yan, Li Li, Lia Nijmeijer, Lidia Sousa, Lihong Xu, Lihua Zhang, Lili Zhang, Lilia Schiavi, Lilian Mazza Barbosa, Lillian L Khor, Lina Felix-Stern, Linda L Hall, Linda M Hollenweger, Linda Arcand, Linda Davidson-Ray, Linda Schwarz, Lindsey N Sikora, Lingping Chi, Lino Patricio, Liping Zhang, Lisa Chaytor, Lisa Hatch, Lisa McCloy, Lisa Wong, Liselotte Persson, Lixin Jiang, Liz Low, Ljiljana Pupic, Loïc Bière, Lorenzo Monti, Lori Christensen, Lori Pritchard, Loriane Black, Lori-Ann Desimone, Lori-Ann Larmand, Lorraine McGregor, Louise Morby, Louise Thomson, Luc Harvey, Luciana de Pádua Baptista, Lucilla Garcia, Ludivine Eliahou, Ludmila Helmer, Luis F Smidt, Luis Bernanrdes, Luis Guzman, Luiz A Carvalho, Luyang Xiong, Lynette L Teo, Lynn M Neeson, Lynne Winstanley, M Barbara Srichai-Parsia, M Quintana Giner, M Sowjanya Reddy, M Valdés Chávarri, M Grazia Rossi, Maarten Simoons, Maayan Konigstein, Maciej Lesiak, Maciej Olsowka, Mafalda Selas, Magalie Corfias, Magdalena Madero Rovalo, Magdalena Łanocha, Magdalena Miller, Magdalena Misztal-Teodorczyk, Magdalena Rantinella, Magdy Abdelhamid, Magnolia Jimenez, Mahboob Alam, Mahevamma Mylarappa, Mahfouz El Shahawy, Mahmoud Mohamed, Mahmud Al-Bustami, Majo X Joseph, Malgorzata Frach, Małgorzta Celińska-Spodar, Malte Helm, Manas Chacko, Mandy Murphy, Manitha Vinod, Manjula Rani, Manu Dhawan, Manuela Mombelli, Marcel Weber, Marcello Galvani, Marcelo Jamus Rodrigues, Marcia F Dubin, Marcia F Werner Bayer, Marcin Szkopiak, Marco Antonio Monsalve, Marco Bizzaro Santos, Marco Magnoni, Marco Marini, Marco Sicuro, Marco Zenati, Marcos Valério Coimbra Resende, Marek Roik, Margalit Bentzvi, Margaret Gilsenan, Margaret Iraola, Margot C Quinn, Maria A Alfonso, Maria Antonieta Pereira Moraes, María Dolores Martínez-Ruíz, María Fernanda Canales, Maria Inês Caetano, Maria P Corral, Maria Pérez García, Maria Victoria Actis, Maria Aguirre, Maria Andreasson, Maria Aprile, Maria Colton, Maria Eugenia Martin, Maria Lasala, Maria Lorenzo, Maria Posada, Maria Shier, Maria Thottam, Mariana V Furtado, Mariana Yumi Okada, Marianna D A Dracoulakis, Marianne De Andrade, Mariano Rubio, Marie Essermark, Marielle Scherrer-Crosbie, Marija T Petrovic, Marija Zdravkovic, Marilyn Black, Marina Garcia, Mario J Garcia, Mariola Szulik, Marisa Orgera, Mark A de Belder, Mark Harbinson, Mark Hyun, Mark Peterson, Mark Xavier, Marlowe Mosley, Marta Capinha, Marta Marcinkiewicz-Siemion, Marta Swiderek, Martha Meyer, Martina Ceseri, Martina Tricoli, Marvin Kronenberg, Mary Williams, Mary Ann Champagne, Mary Colleen Rogge, Mary R Soltau, Mary Streif, Massimo Villella, Massoud Leesar, Matei Claudia, Mateusz Solecki, Matías Nicolás Mungo, Matthew Wall Jr, Matthew Budoff, Matthew Jezior, Matthew Luckie, Matthias Friedrich, Mauren P Haeffner, Maximilian Tscharre, Max-Paul Winter, Mayana Almeida, Mayil S Krishnam, Mayuri Patel, Meenakshi Mishra, Megan Manocchia, Meghana Kakade, Melanie J Munro, Melissa D Chaplin, Melissa LeFevre, Mervyn Andiapen, Michael A Gibson, Michael B Rubens, Michael C Turner, Michael D Shapiro, Michael W Lee, Michael Berlowitz, Michael Davidson, Michael Mack, Michael McDaniel, Michael Mumma, Michal Wlodarczyk, Michel G Khouri, Michel S Slama, Michele Rawlins, Michelle M Bonner, Michelle M Seib, Michelle Chang, Michelle Crowder, Michelle Dixon, Michelle Mayon, Michelle McEvoy, Michelle Yee, Miguel M Fernandes, Miguel Nobre Menezes, Miguel Souto Bayarri, Miguel Barrero, Mikhail T Torosoff, Milan R Dobric, Milan Dobric, Milica Nikola Dekleva, Milind Avdhoot Gadkari, Millie Gomez, Min Tun Kyaw, Miriam Brooks, Miroslav Stevo Martinovic, Mitchel B Lustre, Mohammad Tariq Vakani, Mohammad El-Hajjar, Mohammed Al-Amoodi, 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Riezebos, Robert M Donnino, Robert Bojar, Robert Chilton, Robert Guyton, Robert Henderson, Robert Kornberg, Robert Leber, Robert Mao, Robert Stenberg, Roberta P Santos, Roberto René Favaloro, Roberto Amati, Rodolfo G S D Lima, Rodrigo J Cerci, Rogerio Tumelero, Rohit Tandon, Roma Tewari, Romalisa Miranda-Peats, Ron Wald, Ronald A Mastouri, Ronald G Morford, Ronald G Schwartz, Ronald P Pedalino, Rongrong Hu, Ronnell A Hansen, Ronny A Cohen, Rory Hachamovitch, Rosa Homem, Rosa Sandonato, Rosane Laimer, Rosann Gans, Roxanne Yost, Roy Mathew, Rubén Baleón-Espinosa, Ruben Ramos, Rubine Gevorgyan, Rui Ferreira, Rui Jing, Ruth Pérez-Fernández, S K Dwivedi, S Ramakrishnan, Saadat Khan, Sabahat Bokhari, Sabu Thomas, Sadath Lubna, Sajeeda Parveen Khan, Sajeev Chakanalil Govindan, Saket Girotra, Saleem Kassam, Sallie Canada, Salvador Cruz-Flores, Samaa Mohamed, Samantha Ly, Sameh El Kaffas, Samia Massalha, Sampoornima Setty, Samuel Nwosu, Sandeep Seth, Sandeep Singh, Sander R Niehe, Sandra M 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Craig Barr, Craig Paterson, Cristina Bare, Cynthia Baumann, Cynthia Burman, Dalisa Espinosa, Damien Collison, Dan Deleanu, Dan Elian, Dan Gao, Dana Oliver, Daniel P Vezina, Daniel O'Rourke, Daniele Komar, Danielle Schade, Darrel P Francis, Dastan Malaev, David A Bull, David E Winchester, David P Faxon, David Booth, David Cohen, David DeMets, David Foo, David Schlichting, David Taggart, David Waters, David Wohns, Davis Vo, Dawid Teodorczyk, Dawn Shelstad, Dawn Turnbull, Dayuan Li, Dean Kereiakes, Deborah O'Neill, Deborah Yip, Debra K Johnson, Debra Dees, Deepak L Bhatt, Deepika Gopal, Deepti Kumar, Deirdre Mattina, Deirdre Murphy, Delano R Small, Delsa K Rose, Dengke Jiang, Denis Carl Phaneuf, Denise Braganza, Denise Fine, Derek Cyr, Desiree Tobin, Diana Cukali, Diana Parra, Diane Camara, Diane Minshall Liu, Diego Adrián Vences, Diego Franca de Cunha, Dimitrios Stournaras, Dipti Patel, Dongze Li, Donna Exley, Dorit Grahl, Dragana Stanojevic, Duarte Cacela, Dwayne S G Conway, E Pinar 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George J Juang, Gerald Fletcher, Gerald Leonard, Gerard Patrick Devlin, Gerard Esposito, Gergely Ágoston, Gervasio Lamas, Geza Fontos, Ghada Mikhail, Gia Cobb, Gian Piero Perna, Gianpiero Leone, Giles Roditi, Gilles Barone-Rochette, Girish Mishra, Giuseppe Tarantini, Glenda Wong, Glenn S Hamroff, Glenn Rayos, Gong Cheng, Gonzalo Barge-Caballero, Goran Davidović, Goran Stankovic, Gordana Stevanovic, Grace Jingyan Wang, Grace M Young, Graceanne Wayser, Graciela Scaro, Graham S Hillis, Graham Wong, Grazyna Anna Szulczyk, Gregor Simonis, Gregory Kumkumian, Gretchen Ann Peichel, Grzegorz Gajos, Gudrun Steinmaurer, Guilherme G Rucatti, Guilherme Portugal, Guilhermina Cantinho Lopes, Guillem Pons Lladó, Gunnar Frostfelt, Gurpreet S Wander, Gurpreet Gulati, Gustavo Pucci, Hafidz Abd Hadi, Haibo Zhang, Haitao Wang, Halina Marciniak, Han Chen, Hanan Kerr, Hani Najm, Hanna Douglas, Hannah Phillips, Hao Dai, Haojian Dong, Haqeel Jamil, Harikrishnan Sivadasanpillai, Harry Suryapranata, Hassan Reda, Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona Niedzwiecka, J David Knight, Jacek Kusmierek, Jackie M White, Jackie Chow, Jacob Udell, Jacqueline E Tamis-Holland, Jacqueline Fannon, Jacquelyn A Quin, Jacquelyn Do, Jaekyeong Heo, Jakub Maksym, James E Davies, James H O'Keefe Jr, James J Jang, James Cha, James Harrison, James Hirsch, James Stafford, James Tatoulis, Jamie Rankin, Jan Henzel, Jan Orga, Jana Tancredi, Janaina Oliveira, Jane Burton, Jane Eckstein, Jane Marucci, Janet P Knight, Janet Blount, Janet Halliday, Janetta Kourzenkova, Janitha Raj, Jan-Malte Sinning, Jaqueline Pozzibon, Jaroslaw Drozdz, Jaroslaw Karwowski, Jason D Glover, Jason Loh Kwok, Jason T Call, Jason Linefsky, Jassira Gomes, Jati Anumpa, Javier J Garcia, Javier Courtis, Jay Meisner, K Jayakumar, Jayne Scales, Jean E Denaro, Jean Michel Juliard, Jean Ho, Jeanette K Stansborough, Jean-Michel Juliard, Jeanne Russo, Jeannette J M Schoep, Jeet Thambyrajah, Jeff Leimberger, Jeffery A Breall, Jeffrey A Kohn, Jeffrey C Milliken, Jeffrey Anderson, Jeffrey Blume, Jeffrey Kanters, Jeffrey Lorin, Jeffrey Moses, Jelena J Stepanovic, Jelena Celutkiene, Jelena Djokic, Jelena Stojkovic, Jenne M Jose, Jenne Manchery, Jennifer A Mull, Jennifer H Czerniak, Jennifer L Stanford, Jennifer Gillis, Jennifer Horst, Jennifer Isaacs, Jennifer Langdon, Jennifer Thomson, Jennifer Tomfohr, Jennifer White, Jen-Yuan Kuo, Jeremy Rautureau, Jerome Fleg, Jessica Berg, Jessica Rodriguez, Jessica Waldron, Jhina Patro, Jia Li, Jiajia Mao, Jiamin Liu, Jian'an Wang, Jianhua Li, Jianxin Zhang, Jie Qi, Jihyun Lyo, Jill Marcus, Jim Blankenship, Jing Zhang, Jingjing Liu, Jing-Yao Fan, Jiun-Yi Li, Jiwan Pradhan, Jiyan Chen, J M Rivera Caravaca, Jo Evans, Joan Garcia Picart, Joan Hecht, Joanna Jaroch, Joanna Zalewska, Joanne Kelly, Joanne Taaffe, João Reynaldo Abbud, João V Vitola, Joaquín V Peñafiel, Jocelyne Benatar, Jody Bindeman, Joe Sabik, Joel Klitch, Johann Christopher, Johannes Aspberg, John D Friedman, John F Beltrame, John F Heitner, John Joseph Graham, John R Davies, John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima 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Stephanie M Lane, Stephanie Ferket, Stephanie Kelly, Stephanie Wasmiller, Stephen H McKellar, Stephen P Hoole, Stephen Fremes, Stephen Preston, Steve Leung, Steven A Fein, Steven J Lindsay, Steven P Sedlis, Steven Giovannone, Steven Michael, Steven Weitz, Stijn van Vugt, Subhash Banerjee, Sudhir Naik, Suellen Hosino, Sukie Desire, Sukit Yamwong, Suku T Thambar, Sulagna Mookherjee, Suman Singh, Sundeep Mishra, Sunil Kumar Verma, Supap Kulthawong, Supatchara Khwakhong, Surendra Naik, Suresh Babu, Surin Woragidpoonpol, Suryaprakash Narayanappa, Susan Derbyshire, Susan Gent, Susan Mathus, Susan Milbrandt, Susan Moore, Susan Regan, Susan Stinson, Susan Webber, Susana Silva, Susanna Stevens, Susanne Gruensfelder, Suthara Aramcharoen, Suvarna Kolhe, Suzana Tavares, Suzanne Arnold, Suzanne Welsh, Svetlana Apostolovic, Swapna Kunhunny, Ta-Chuan Hung, Taissa Zappernick, Tali Sharir, Talita Silva, Tamara Colaiácovo Soares, Tapan Umesh Pillay, Tarun K Mittal, Tatiana Trifonova, Tauane Bello 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Wu, Yu Kunwu, Yu Zhao, Yudong Peng, Yueh-Hung Lin, Yulan Zhao, Yumei Dong, Yunhai Zhao, Yutthaphan Wannasopha, Yvonne Taul, Zakir Sahul, Zalina Kudzoeva, Zbigniew Kalarus, Zeljko Z Markovic, Zhen Huang, Zheng Ji, Zhenyu Liu, Zhou Yue, Zhulin Zhang, Zhuxi Li, Zile Singh Meharwal, Ziliang Bai, Zixiang Yu, Zohra Huda, Zoltan Davidovits

Subjects
Male, Cardiac Catheterization, Computed Tomography Angiography, medicine.medical_treatment, Myocardial Ischemia, Coronary Disease, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Coronary Angiography, ISCHEMIA Research Group, law.invention, Angina, Coronary artery disease, 0302 clinical medicine, Randomized controlled trial, law, Cardiovascular Disease, Myocardial Revascularization, 030212 general & internal medicine, Coronary Artery Bypass, 11 Medical and Health Sciences, Cardiac catheterization, General Medicine, Middle Aged, humanities, Cardiovascular Diseases, Cardiology, Female, Human, medicine.medical_specialty, Ischemia, Article, 03 medical and health sciences, Geriatric cardiology, Percutaneous Coronary Intervention, General & Internal Medicine, Internal medicine, medicine, Humans, Angina, Unstable, Aged, business.industry, Coronary Artery Bypa, Percutaneous coronary intervention, Bayes Theorem, medicine.disease, Heart failure, Quality of Life, business
Abstract

BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS: Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS: Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).

Published
2020

38. Registro prospectivo del stent liberador de sirolimus con pol�mero estable de fluoroacrilato Angiolite: estudio EPIC02 � RANGO

Author

Fernando Lozano Ruiz-Poveda, Pablo Aguar Carrascosa, Bruno García del Blanco, Raymundo Ocaranza, José Moreu, Fermin Sainz Laso, Luis Fernández González, Manel Sabaté Tenas, Eduardo Pinar Bermúdez, Raquel Álvarez Ramos, R. Trillo Nouche, José Ramón Rumoroso Cuevas, Armando Pérez de Prado, Vicente Peral Disdier, Alfonso Torres, and Alberto Rodrigues

Subjects
education.field_of_study, medicine.medical_specialty, business.industry, medicine.medical_treatment, Population, General Engineering, Percutaneous coronary intervention, Stent, medicine.disease, Revascularization, Thrombosis, Internal medicine, medicine, Clinical endpoint, Cardiology, cardiovascular diseases, Myocardial infarction, business, education, Mace
Abstract

Introduction and objectives: After the positive pre-clinical and clinical results with Angiolite, a cobalt-chromium sirolimus-eluting stent, we decided to analyze its performance in a non-selected, real-world population: the RANGO registry. Methods: We conducted an observational, prospective, multicenter registry of patients with different clinical indications. All consecutive patients treated with percutaneous coronary intervention with, at least, 1 Angiolite stent and who gave their informed consent were included. The registry primary endpoint was the occurrence of target lesion failure (TLF) at 6, 12, and 24 months defined as cardiovascular death, myocardial infarction (MI) related to target vessel, and clinically driven target lesion revascularization. The secondary endpoints were the individual components of the primary endpoint, major adverse cardiovascular events (MACE: all-cause mortality, any MI, or any revascularization), and stent thrombosis. We describe the 2-year clinical results of the RANGO study in the entire population, in those who only received Angiolite stents, and in 2 predefined subgroups: diabetics and patients with small-vessels ("64; 2.5mm). Results: 646 patients (426 of them only received Angiolite stents) with a high-risk profile were recruited: prevalence of previous MI (18.4%), previous coronary revascularization (23.4%), clinical presentation as ST-segment elevation MI (23.1%), and multivessel disease (47.8%). At the 2-year follow-up, the rates of TLF, MACE, and stent thrombosis were 3.4%, 9.6%, and 0.9%, respectively. Similar results were observed among patients treated with Angiolite stents only: TLF, 3.1%; MACE, 8.0%; thrombosis, 0.7%. The rates were not significantly different for the diabetic (TLF, 3.0%; MACE, 14.1%; thrombosis, 1.0%), and small-vessel subgroups (TLF, 4.3%; MACE, 12.1%; thrombosis, 0%). Conclusions: In conclusion, the results of this observational registry on the use of Angiolite in a real-world population, including a high-risk population, corroborate the excellent results observed in previous studies, up to a 2-year follow-up. An extended 5-year follow-up is planned to discard the occurrence of late events

Published
2022

39. Angiography-derived physiology guidance versus usual care in an All-comers PCI population treated with the Healing-Targeted Supreme stent and Ticagrelor monotherapy: PIONEER IV trial design

Author

Hironori Hara, Patrick W. Serruys, Neil O'Leary, Chao Gao, Alicia Murray, Elaine Breslin, Scot Garg, Christophe Bureau, Johan HC Reiber, Emanuele Barbato, Adel Aminian, Luc Janssens, Liesbeth Rosseel, Edouard Benit, Gianluca Campo, Vincenzo Guiducci, Gianni Casella, Andrea Santarelli, Alfonso Franzè, Victor Alfonso Jimenez Diaz, Andrés Iñiguez, Salvatore Brugaletta, Manel Sabate, Ignacio J. Amat-Santos, Giovanni Amoroso, Joanna Wykrzykowska, Clemens von Birgelen, Samer Somi, Tommy Liu, Sjoerd H. Hofma, Nick Curzen, Ramiro Trillo, Raymundo Ocaranza, Anthony Mathur, Pieter C. Smits, Javier Escaned, Andreas Baumbach, William Wijns, Faisal Sharif, Yoshinobu Onuma, Health Technology & Services Research, Graduate School, Cardiology, ACS - Heart failure & arrhythmias, and ACS - Atherosclerosis & ischemic syndromes

Subjects
Ticagrelor, quantitative flow ratio, Drug-Eluting Stents, Coronary Artery Disease, Coronary Angiography, n/a OA procedure, NO, surgical procedures, operative, Percutaneous Coronary Intervention, Treatment Outcome, Healing-Targeted Supreme stent, Humans, Stents, cardiovascular diseases, Prospective Studies, ticagrelor monotherapy, Cardiology and Cardiovascular Medicine
Abstract

Background: Current ESC guidelines recommend the use of intra-coronary pressure guidewires for functional assessment of intermediate-grade coronary stenoses. Angiography-derived quantitative flow ratio (QFR) is a novel method of assessing these stenoses, and guiding percutaneous coronary intervention (PCI).Methods/Design: The PIONEER IV trial is a prospective, all-comers, multi-center trial, which will randomize 2,540 patients in a 1:1 ratio to PCI guided by angiography-derived physiology or usual care, with unrestricted use in both arms of the Healing-Targeted Supreme sirolimus-eluting stent (HT Supreme). The stent's fast, biologically healthy, and robust endothelial coverage allows for short dual-antiplatelet therapy (DAPT); hence the antiplatelet regimen of choice is 1-month DAPT, followed by ticagrelor monotherapy. In the angiography-derived physiology guided arm, lesions will be functionally assessed using on-line QFR, with stenting indicated in lesions with a QFR ≤0.80. Post-stenting, QFR will be repeated in the stented vessel(s), with post-dilatation or additional stenting recommended if the QFR0.05. Usual care PCI is performed according to standard clinical practice. The primary endpoint is a non–inferiority comparison of the patient-oriented composite endpoint (POCE) of all-cause death, any stroke, any myocardial infarction, or any clinically, and physiologically driven revascularization with a non–inferiority risk-difference margin of 3.2%, at 1-year post-procedure. Clinical follow-up will be up to 3 years.The PIONEER IV trial aims to demonstrate non–inferiority of QFR-guided PCI to usual care PCI with respect to POCE at 1-year in patients treated with HT Supreme stents and ticagrelor monotherapy.Clinical Trial Registration: ClinicalTrials.govUnique Identifier: NCT04923191Classifications: Interventional Cardiology

Published
2022

40. Amphilimus- vs. zotarolimus-eluting stents in patients with diabetes mellitus and coronary artery disease: the SUGAR trial

Author

Lara Fuentes, Pilar Jiménez-Quevedo, Guillem Muntané, Xavier Rossello, Bruno García del Blanco, Rafael Romaguera, Mar Alameda, María López-Benito, Gerard Roura, Eduardo Pinar, Montserrat Gracida, Josep Comín-Colet, Antonio Fernández-Ortiz, Marcelo Jiménez Kockar, Joan Antoni Gómez-Hospital, Neus Salvatella, Miguel Romero, Alfonso Freites, Virginia Pascual-Tejerino, Luis Ortega-Paz, Pablo Salinas, Francisco Bosa, José Luis Ferreiro, Stuart J. Pocock, Armando Pérez de Prado, Manel Sabaté, Mohsen Mohandes, Salvatore Brugaletta, Victor Alfonso Jimenez-Diaz, Antonio Gómez-Menchero, Angel Cequier, Josep Gomez-Lara, Sergio García-Blas, Carlos H. Salazar, Luis Teruel, José M. de la Torre Hernández, Dae-Hyun Lee, Pascual Bordes, Soledad Ojeda, Raymundo Ocaranza, Ramiro Trillo, Rocío Castillo-Poyo, Juan Sanchis, Felipe Hernández-Hernández, Carlos Macaya, and Pedro Martín

Subjects
medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, Revascularization, Malalties coronàries, Prosthesis Design, law.invention, Pròtesis de Stent, Percutaneous coronary intervention, Coronary artery disease, Coronary diseases, Clinical trials, Diabetes mellitus, Randomized controlled trial, law, Clinical endpoint, Medicine, Humans, Zotarolimus, Myocardial infarction, Drug-eluting stents, Sirolimus, Diabetis, business.industry, Diabetes, Stent, medicine.disease, equipment and supplies, Surgery, Treatment Outcome, Randomized trial, Cardiology and Cardiovascular Medicine, business, Stents (Surgery), medicine.drug, Assaigs clínics
Abstract

Aim Patients with diabetes mellitus are at high risk of adverse events after percutaneous revascularization, with no differences in outcomes between most contemporary drug-eluting stents. The Cre8 EVO stent releases a formulation of sirolimus with an amphiphilic carrier from laser-dug wells, and has shown clinical benefits in diabetes. We aimed to compare Cre8 EVO stents to Resolute Onyx stents (a contemporary polymer-based zotarolimus-eluting stent) in patients with diabetes. Methods and results We did an investigator-initiated, randomized, controlled, assessor-blinded trial at 23 sites in Spain. Eligible patients had diabetes and required percutaneous coronary intervention. A total of 1175 patients were randomly assigned (1:1) to receive Cre8 EVO or Resolute Onyx stents. The primary endpoint was target-lesion failure, defined as a composite of cardiac death, target-vessel myocardial infarction, and clinically indicated target-lesion revascularization at 1-year follow-up. The trial had a non-inferiority design with a 4% margin for the primary endpoint. A superiority analysis was planned if non-inferiority was confirmed. There were 106 primary events, 42 (7.2%) in the Cre8 EVO group and 64 (10.9%) in the Resolute Onyx group [hazard ratio (HR): 0.65, 95% confidence interval (CI): 0.44–0.96; P non-inferiority < 0.001; P superiority = 0.030]. Among the secondary endpoints, Cre8 EVO stents had significantly lower rate than Resolute Onyx stents of target-vessel failure (7.5% vs. 11.1%, HR: 0.67, 95% CI: 0.46–0.99; P = 0.042). Probable or definite stent thrombosis and all-cause death were not significantly different between groups. Conclusion In patients with diabetes, Cre8 EVO stents were non-inferior to Resolute Onyx stents with regard to target-lesion failure composite outcome. An exploratory analysis for superiority at 1 year suggests that the Cre8 EVO stents might be superior to Resolute Onyx stents with regard to the same outcome. Clinical trial registration ClinicalTrials.gov: NCT03321032.

Published
2022

41. The Role of Coronary Microvascular Disease in Cardiomyophaties

Author

Jeremías Bayón, Eva-Fernanda Rodriguez-González, Melisa Santás-Álvarez, Rosa-Alba Abellás-Sequeiros, Raymundo Ocaranza-Sánchez, and Carlos González_Juanatey

Abstract

Coronary microvascular disease (CMD) makes reference to the anatomically and functionally disorders affecting vascular compartments (25) and/or focal or diffuse vasoconstriction during acetylcholine challenge, with an important role in myocardial perfusion. The aim of this work is to review CMD, definition, clinical manifestations, diagnosis method (non invasive and invasive approach) and the role of CMD in the main cardiomiophaties, such as Hypertrophic cardiomiopathy, none idiomatic dilated cardiomiopathy and infiltrative miocardiophaty.

Published
2022

42. Left main percutaneous revascularization with adjuvant intracoronary lithotripsy: Optical coherence tomography evaluation

Author

Rosa Alba Abellas-Sequeiros, Jeremías Bayón Lorenzo, Raymundo Ocaranza-Sánchez, Melisa Santás Álvarez, and Carlos González-Juanatey

Subjects
medicine.medical_specialty, Percutaneous, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Lithotripsy, Revascularization, Coronary Angiography, Percutaneous Coronary Intervention, Optical coherence tomography, RC666-701, medicine, General Earth and Planetary Sciences, Diseases of the circulatory (Cardiovascular) system, Radiology, Cardiology and Cardiovascular Medicine, business, Adjuvant, Tomography, Optical Coherence, General Environmental Science
Published
2021

43. TCT-162 Real-Life Outcomes With Polymer-Free Sirolimus-Eluting Stent

Author

Fernando Lozano, Martin Negreira, Koldobika Garcia San Roman, Xacobe Flores-Ríos, Josepa Mauri, Bruno Garcia-Del-Blanco, Javier Balaguer, Javier Fdez Portales, Raymundo Ocaranza-Sanchez, Alfonso Torres, Ramiro Trillo Nouche, Maria Lopez, Sebastian Romani, and Ignacio Sanchez-Perez

Subjects
Cardiology and Cardiovascular Medicine
Published
2022

44. Clinical performance of a novel sirolimus-coated balloon in coronary artery disease: EASTBOURNE registry

Author

Antonio Colombo, Ignacio Sánchez Pérez, Irene Bossi, Bernardo Cortese, Giuseppe Seresini, Raymundo Ocaranza, Diego Milazzo, Susanna Benincasa, Luca Testa, Gaetano Di Palma, Gianluca Caiazzo, Alfonso Torres, Francesco Bedogni, Tay Mok Heang, Azeem Latib, Michele Cacucci, Maurizio Tespili, Anna Perotto, Amin Ariff Nuruddin, Alfonso Ielasi, and Fabrizio Tomai

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Time Factors, medicine.medical_treatment, Population, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Balloon, Revascularization, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Coated Materials, Biocompatible, Restenosis, Internal medicine, medicine, Humans, Prospective Studies, Registries, 030212 general & internal medicine, Myocardial infarction, Angioplasty, Balloon, Coronary, education, Aged, Sirolimus, education.field_of_study, business.industry, Drug-Eluting Stents, General Medicine, medicine.disease, Interim analysis, Treatment Outcome, Female, Cardiology and Cardiovascular Medicine, business, Immunosuppressive Agents, Follow-Up Studies
Abstract

Aims The purpose of the EASTBOURNE registry is to evaluate the immediate and long-term clinical performance of a novel sirolimus-coated balloon (SCB) in a real-world population of patients with coronary artery disease. We here present the prespecified interim analysis after the enrollment of the first 642 patients who obtained 1-year clinical follow-up. Methods EASTBOURNE is a prospective, international, multicenter, all-comer investigator-driven clinical registry, which is enrolling consecutive patients treated with SCB at 42 European and Asiatic centers. Primary study endpoint is target-lesion revascularization (TLR) at 12 months. Secondary endpoints are procedural success and major adverse cardiac events through 36 months. Results Diabetes mellitus was present in 41% of patients. Acute coronary syndrome was present in 45% of patients and de novo lesions were 55%; 83% of the in-stent restenosis (ISR) patients had drug-eluting stents restenosis. Lesion predilatation was performed in 95% of the cases and bailout stenting occurred in 7.5%. So far, 642 patients have a complete 12-month follow-up. TLR occurred in 2.5%, myocardial infarction in 2.3%, total death in 1% and major adverse cardiac events in 5.8% of patients. A prespecified analysis of comparison between ISR and de-novo lesions showed a significantly higher occurrence of TLR in the ISR population (5.4 vs. 0.2%, P = 0.0008). Conclusion The current interim analysis of 12-month follow-up of the EASTBOURNE registry shows good immediate performance and an adequate and encouraging safety profile through 12 months for this novel SCB.

Published
2020

45. Clinical follow-up of long nontapered sirolimus-eluting coronary stent in real-world patients with de novo lesions. The Billar registry

Author

Enric Domingo Ribas, Juan Casanova-Sandoval, Imanol Otaegui, Ramón Calviño Santos, Javier León Jiménez, Xavier Carrillo Suarez, Alfonso Torres, Juan Francisco Cara Muñoz, Josep Guindo, Leire Andraka, and Mónica Fuertes, Bruno García del Blanco, Ramiro Trillo Nouche, Joan Antoni Gómez, Raymundo Ocaranza Sánchez, and Juan E. Sánchez

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Coronary angioplasty, Malalties coronàries, Nontapered stents, Surgery, Pròtesis de Stent, Coronary diseases, Sirolimus, Coronary stent, Medicine, Drug-eluting stent, Cardiology and Cardiovascular Medicine, business, Stents (Surgery), medicine.drug
Abstract

Introduction and objectives: Coronary lesions with stent overlapping are associated with higher neointimal proliferation that leads to more restenosis. Furthermore, the tapering of coronary arteries is a major challenge when treating long coronary lesions. This study attempted to assess the safety and clinical level of performance of long nontapered sirolimus-eluting coronary stent systems (> 36 mm) to treat long and diffused de novo coronary lesions in real-world scenarios. Methods: This was a prospective, non-randomized, multicentre study that included 696 consecutive patients treated with the long nontapered BioMime sirolimus-eluting coronary stent system in long and diffused de novo coronary lesions. The safety endpoint was major adverse cardiovascular events defined as a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, and major bleeding at the 12-month follow-up. Results: Of a total of 696 patients, 38.79% were diabetic. The mean age of all the patients was 64.6 ± 14 years, and 80% were males. The indication for revascularization was acute coronary syndrome in 63.1%. A total of 899 lesions were identified out of which 742 were successfully treated with long BioMime stents (37 mm, 40 mm, 44 mm, and 48 mm). The cumulative incidence of major adverse cardiovascular events was 8.1% at the 12-month follow-up including cardiac death (2.09%), myocardial infarction (1.34%), and total stent thrombosis (0.5%). Conclusions: This study confirms the safety and good performance of long nontapered BioMime coronary stents to treat de novo coronary stenosis. Therefore, it can be considered a safe and effective treatment for long and diffused de novo coronary lesions in the routine clinical practice.

Published
2021

46. Aumento de niveles séricos de Ciclofilina C en el seguimiento de la enfermedad arterial coronaria: un biomarcador y posible predictor clínico

Author

Jeremías Bayón, Amparo Alfonso, Melisa Santás-Álvarez, Eva Alonso, Ana Testa-Fernández, Ramón Ríos-Vázquez, Raymundo Ocaranza-Sánchez, Rosa A. Abellás-Sequeiros, Juliana Elices-Teja, Luis Botana, and Carlos González-Juanatey

Subjects
Coronary artery disease, medicine.medical_specialty, business.industry, Internal medicine, Medicine, Biomarker (medicine), cardiovascular diseases, Cardiology and Cardiovascular Medicine, business, medicine.disease, Gastroenterology
Abstract

OBJECTIVE This study is aimed at investigating the changes in serum CypC levels and their relationship with cardiovascular events at 12 months of follow-up in coronary artery disease (CAD) patients. METHODS The study included a total of 125 subjects (40 patients with acute CAD, 40 patients with chronic CAD, and 45 control volunteers) and we analyzed plasma CypC levels from baseline to 6 and 12 months for a better understanding of its behavior in atherosclerosis. RESULTS Serum CypC levels were shown to be gradually increased in CAD patients (30.63 pg/mL ± 3.77 at baseline, 38.70 pg/mL ± 6.41 at 6 months [p = 0.25], and 47.27 pg/mL ± 5.65 at 12 months [p = 0.007]). In addition, serum CypC levels during the follow-up were a significant predictor of CAD (c-statistic 0.76 at 6 months and 0.89 at 12 months; p 2.3 mg/L plus NT-proBNP > 300 pg/mL together were significant predictors of cardiovascular events during the follow-up in CAD patients with CypC levels >17.5 pg/mL (p = 0.048). CONCLUSIONS Taken together, our results suggest that serum CypC levels increase during the follow-up in CAD patients and could be a novel biomarker with a possible prognostic value in combination with hsCRP and NT-proBNP.

Published
2021

47. Increase of serum cyclophilin C levels in the follow-up of coronary artery disease: a biomarker and possible clinical predictor

Author

Raymundo Ocaranza-Sánchez, A Abellas-Sequeiros, Amparo Alfonso, Jeremias Bayon, M Santas-Alvarez, Luis M. Botana, and C Gonzalez Juanatey

Subjects
Oncology, Coronary artery disease, medicine.medical_specialty, business.industry, Internal medicine, Biomarker (medicine), Medicine, Cardiology and Cardiovascular Medicine, business, medicine.disease, Cyclophilin C
Abstract

Background Traditional cardiovascular risk factors and a large number of biomarkers are well known in their association with the diagnosis and prognosis of coronary artery disease (CAD). Cyclophilin C (CypC) is a subfamily of immunophilins that modulates macrophage activation and redox homeostasis. Purpose This study is aimed at investigating the changes in serum CypC levels and their relationship with cardiovascular events at 12 months of follow-up in CAD patients. Methods The study included a total of 125 subjects (40 patients with acute CAD, 40 patients with chronic CAD and 45 control volunteers). We analyzed plasma CypC levels from baseline to 6 and 12 months for a better understanding of its behaviour in atherosclerosis. Results Serum CypC levels were shown to be gradually increased in CAD patients [(30.63 pg/mL ± 3.77 at baseline, 38.70 pg/mL ± 6.41 at 6 months (p=0.25) and 47.27 pg/mL ± 5.65 at 12 months (p=0.007)]. In addition, serum CypC levels during the follow-up were a significant predictor of CAD (c- statistic 0.76 at 6 months and 0.89 at 12 months; p2.3 mg/L plus NT-proBNP >300pg/mL together were significant predictors of cardiovascular events during the follow-up in CAD patients with CypC levels >17.5 pg/mL (p=0.048). Conclusions Taken together, our results suggest that serum CypC levels increase during the follow-up in CAD patients and could be a novel biomarker with a possible prognostic value in combination with hsCRP and NT-proBNP. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Instituto de Salud Carlos III. Spain

Published
2021

48. Increase of serum cyclophilin C levels in the follow-up of coronary artery disease: A biomarker and possible clinical predictor

Author

Jeremías, Bayón, Amparo, Alfonso, Melisa, Santás-Álvarez, Eva, Alonso, Ana, Testa-Fernández, Ramón, Ríos-Vázquez, Raymundo, Ocaranza-Sánchez, Rosa A, Abellás-Sequeiros, Juliana, Elices-Teja, Luis, Botana, and Carlos, González-Juanatey

Subjects
C-Reactive Protein, Risk Factors, Humans, Coronary Artery Disease, Prognosis, Risk Assessment, Biomarkers, Peptide Fragments, Cyclophilin C, Follow-Up Studies
Abstract

This study is aimed at investigating the changes in serum CypC levels and their relationship with cardiovascular events at 12 months of follow-up in coronary artery disease (CAD) patients.The study included a total of 125 subjects (40 patients with acute CAD, 40 patients with chronic CAD, and 45 control volunteers) and we analyzed plasma CypC levels from baseline to 6 and 12 months for a better understanding of its behavior in atherosclerosis.Serum CypC levels were shown to be gradually increased in CAD patients (30.63 pg/mL ± 3.77 at baseline, 38.70 pg/mL ± 6.41 at 6 months [p = 0.25], and 47.27 pg/mL ± 5.65 at 12 months [p = 0.007]). In addition, serum CypC levels during the follow-up were a significant predictor of CAD (c-statistic 0.76 at 6 months and 0.89 at 12 months; p0.001). Despite it, there was no significant association between CypC and cardiovascular events, but serum CypC levels tended to be higher in patients suffering cardiovascular events during the follow-up (29.02 pg/mL ± 6.39 vs. 79.96 pg/mL ± 22.18; p = 0.029). In this regard, plasma levels of high-sensitivity C-reactive protein (hsCRP)2.3 mg/L plus NT-proBNP300 pg/mL together were significant predictors of cardiovascular events during the follow-up in CAD patients with CypC levels17.5 pg/mL (p = 0.048).Taken together, our results suggest that serum CypC levels increase during the follow-up in CAD patients and could be a novel biomarker with a possible prognostic value in combination with hsCRP and NT-proBNP.Este estudio tiene como objetivo investigar los cambios en los niveles séricos de CypC y su relación con eventos cardiovasculares a los 12 meses de seguimiento en pacientes con EAC.El estudio incluyó un total de 125 sujetos (40 pacientes con EAC aguda, 40 pacientes con EAC crónica y 45 voluntarios de control) y se analizaron los niveles ­plasmáticos de CypC desde el inicio hasta los 6 y 12 meses para comprender mejor su comportamiento en la aterosclerosis.Se demostró que los niveles séricos de CypC aumentaron gradualmente en pacientes con CAD [(30.63 pg/ml ± 3.77 al inicio del estudio, 38.70 pg/ml ± 6.41 a los 6 meses (p = 0.25) y 47.27 pg/ml ± 5.65 a los 12 meses (p = 0,007)]. Además, los niveles séricos de CypC durante el seguimiento fueron un predictor significativo de EAC (estadístico c 0.76 a los 6 meses y 0.89 a los 12 meses; p0.001). A pesar de ello, no hubo asociación significativa entre CypC y eventos cardiovasculares, pero los niveles séricos de CypC tendieron a ser más altos en los pacientes que sufrieron eventos cardiovasculares durante el seguimiento (29.02 pg/mL ± 6.39 vs. 79.96 pg/mL ± 22.18; p = 0.029). En este sentido, los niveles plasmáticos de hsCRP2.3 mg/L más NT-proBNP300 pg/ml juntos fueron predictores significativos de eventos cardiovasculares durante el seguimiento en pacientes con EAC con niveles de CypC17.5 pg/ml (p = 0.048).Tomados en conjunto, nuestros resultados sugieren que los niveles séricos de CypC aumentan durante el seguimiento en pacientes con EAC y podría ser un nuevo biomarcador con un posible valor pronóstico en combinación con hsCRP y NT-proBNP.

Published
2021

49. 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

Author

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

Subjects
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.

Published
2021

50. TCT-140 Prognostic value of manual thrombus aspiration in patients undergoing Primary Percutaneous Coronary Intervention

Author

Ana Belén, Cid Alvarez, primary, Belen, Alvarez Alvarez, additional, Trillo, Ramiro, additional, Diego, Lopez Otero, additional, Raymundo, Ocaranza Sanchez, additional, Souto-Castro, Pablo, additional, Fernandez-Cisnal, Agustín, additional, Santiago, Gestal Romaní, additional, Eva, Pereira Lopez, additional, and Gonzalez-Juanatey, Jose Ramon, additional

Published
2014
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