Publications by authors named "Oriol Rodriguez-Leor"
Small-diameter vascular grafts (≤6 mm) are a key focus due to their frequent use in clinical applications and the challenges they present in terms of graft patency and long-term function. Swine serves as an ideal preclinical model for testing such grafts, as their arterial calibers and physiology closely resemble that of humans. This study provides a detailed protocol for testing experimental small-diameter vascular grafts (≤6 mm) in a translational model.
View Article and Find Full Text PDFIntroduction And Objectives: The optimal treatment of nonculprit angiographic intermediate lesions (diameter stenosis 40%-69%) in patients with ST-segment elevation myocardial infarction (STEMI) is still unknown. Lesions with fractional flow reserve (FFR) ≤ 0.80 are indicative of ischemia and benefit from revascularization.
View Article and Find Full Text PDFBackground: Empagliflozin and sacubitril/valsartan are established in heart failure treatment, but their effects after myocardial infarction (MI) are less clear. This study evaluated early empagliflozin initiation, with or without sacubitril/valsartan, on post-MI inflammation, oxidative stress, metabolism, fibrosis, cardiac function, and ventricular tachycardia (VT) risk in a pig model.
Methods: A total of 24 of 30 pigs survived the MI procedure and were subsequently randomized to receive beta-blocker treatment alone (control-MI), beta-blocker+empagliflozin, or beta-blocker+empagliflozin+sacubitril/valsartan.
Introduction And Objectives: Radiofrequency (RF) renal denervation (RDN) has been shown to be a safe and effective treatment option for patients with uncontrolled hypertension. This analysis sought to explore the cost-effectiveness of this therapy in Spain.
Methods: A decision-analytic Markov model projected clinical events, quality-adjusted life years (QALY) and costs over the patients' lifetime.
Background: Local impedance (LI) mapping is feasible and provides additional tissue characterization of the ventricular tachycardia substrate. Data on tissue composition underlying the LI spectrum are lacking.
Objective: To describe the tissue composition underlying different LI subtypes in a chronic myocardial infarction (MI) swine model.
Meta-long Papyrus: Meta-analysis of mid to long-term outcomes of PK Papyrus covered stent.
Catheter Cardiovasc Interv
September 2024
Article Synopsis
- Covered stents (CS), originally used for coronary perforation, are now being studied for their effectiveness in treating coronary aneurysms (CAA), although data on long-term outcomes is limited.
- This meta-analysis evaluates major adverse cardiac events (MACE) in patients treated with the new PK Papyrus CS over an average follow-up of 16.2 months, analyzing data from three observational trials.
- Results show a MACE rate of 14.3%, with higher rates in CAA patients compared to those with coronary perforation, highlighting the need for careful patient selection and treatment optimization for better outcomes.
Antiarrhythmic and Anti-Inflammatory Effects of Sacubitril/Valsartan on Post-Myocardial Infarction Scar.
Circ Arrhythm Electrophysiol
May 2024
Article Synopsis
- - Sacubitril/valsartan (Sac/Val) shows better outcomes than β-blockers in reducing heart failure risks and improving myocardial scar remodeling after a myocardial infarction (MI) in pigs.
- - In a study with 22 pigs post-MI, those treated with β-blocker plus Sac/Val exhibited significant reductions in inflammatory markers, scar mass, and specific types of collagen in the heart.
- - The combination treatment also led to lowered risk of ventricular tachycardia, indicating a potential therapeutic benefit for heart health after MI.
Introduction And Objectives: Functional assessment of coronary stenosis severity with the piezo-electric sensor pressure wire has shown a discrepancy of up to 20% between hyperemic and nonhyperemic indexes. No data are available with fiber-optic pressure wires. The aim of this study was to evaluate the incidence and factors related to the diagnostic discordance between these indexes with a fiber-optic pressure wire.
View Article and Find Full Text PDFArticle Synopsis
- Intravascular lithotripsy (IVL) is effective for treating calcified coronary lesions in patients with stable coronary disease, as shown in a study involving 426 patients across 26 centers in Spain.
- The study found that IVL was successfully delivered in 99% of cases, achieving procedural success in 66% of patients and similar outcomes for both acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) groups.
- The safety analysis showed a relatively low rate of major adverse cardiovascular events (MACE) at 30 days, with 3% overall (1% for CCS and 5% for ACS), indicating that IVL is both safe and effective in real-life clinical settings.
Predicted clinical and economic burden associated with reduction in access to acute coronary interventional care during the COVID-19 lockdown in two European countries.
Eur Heart J Qual Care Clin Outcomes
January 2024
Aims: As a consequence of untimely or missed revascularization of ST-elevation myocardial infarction (STEMI) patients during the COVID-19 pandemic, many patients died at home or survived with serious sequelae, resulting in potential long-term worse prognosis and related health-economic implications.This analysis sought to predict long-term health outcomes [survival and quality-adjusted life-years (QALYs)] and cost of reduced treatment of STEMIs occurring during the first COVID-19 lockdown.
Methods And Results: Using a Markov decision-analytic model, we incorporated probability of hospitalization, timeliness of PCI, and projected long-term survival and cost (including societal costs) of mortality and morbidity, for STEMI occurring during the first UK and Spanish lockdowns, comparing them with expected pre-lockdown outcomes for an equivalent patient group.
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.
Cardiovasc Revasc Med
June 2023
Article Synopsis
- The study focused on the use of intracoronary pressure wires in guiding treatment for patients with coronary artery disease, aiming to assess changes in diagnosis, treatment strategies, and clinical outcomes.
- Involving 1,414 patients and observing 1,781 lesions, the study found significant changes in the extent of coronary disease and treatment plans, with over half of the patients experiencing adjustments after using the pressure wire.
- The findings indicated that using the pressure wire was generally safe and led to a lower incidence of major adverse cardiovascular events (MACE), particularly when percutaneous coronary intervention (PCI) was the initial treatment strategy.
Background: New tools are needed to improve ventricular tachycardia (VT) substrate characterization and optimize outcomes. LI provides biophysical tissue characterization.
Objectives: The purpose of this study was to test local impedance (LI)-based mapping to predict critical ventricular tachycardia components after myocardial infarction (MI).
Article Synopsis
- Renal denervation (RDN) effectively lowers blood pressure (BP) in patients with uncontrolled hypertension, but its long-term effects on cardiovascular events were still being investigated.
- The study evaluated the impact of RDN on the time in therapeutic range (TTR) of BP and its correlation with cardiovascular outcomes using data from the Global SYMPLICITY Registry.
- Results showed that a 10% increase in TTR during the first 6 months post-RDN significantly reduced the risk of major cardiovascular events, including lower rates of heart attacks and strokes, over the next 30 months.
Objective: To assess the arrhythmic safety profile of the adipose graft transposition procedure (AGTP) and its electrophysiological effects on post-myocardial infarction (MI) scar.
Background: Myocardial repair is a promising treatment for patients with MI. The AGTP is a cardiac reparative therapy that reduces infarct size and improves cardiac function.
Instantaneous Wave-Free Ratio for the Assessment of Intermediate Left Main Coronary Artery Stenosis: Correlations With Fractional Flow Reserve/Intravascular Ultrasound and Prognostic Implications: The iLITRO-EPIC07 Study.
Circ Cardiovasc Interv
November 2022
Article Synopsis
- This study investigates the agreement between fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) in patients with intermediate stenosis in the left main coronary artery (LMCA), finding an 80% concordance between the two methods.
- The research involved 300 patients and emphasized the role of intravascular ultrasound (IVUS) for assessing cases where FFR and iFR results disagreed, identifying minimal lumen areas as a factor in decision-making.
- Over a 20-month follow-up, deferral of revascularization based on iFR and IVUS showed a lower incidence of major adverse cardiac events compared to those who underwent revascularization, suggesting that deferring treatment
Article Synopsis
- The study investigates how sex and previous cardiovascular disease (CVD) influence 30-day mortality in patients who experienced ST-elevation myocardial infarction (STEMI).
- It analyzed 4,366 patients across 83 centers in Spain, finding that women and those with prior CVD generally had higher unadjusted mortality rates.
- Surprisingly, after adjusting for other factors, the difference in mortality risk between men and women varied; women with prior CVD showed lower mortality risk compared to men, while no difference was evident in patients without CVD.
Angiographic and clinical outcome of SARS-CoV-2 positive patients with ST-segment elevation myocardial infarction undergoing primary angioplasty: A collaborative, individual patient data meta-analysis of six registry-based studies.
Eur J Intern Med
November 2022
Article Synopsis
- The PANDEMIC study analyzed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients with ST-Elevation Myocardial Infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI), finding concerning outcomes compared to SARS-CoV-2 negative patients.
- Results showed SARS-CoV-2-positive patients had significantly higher in-hospital mortality and poorer postprocedural blood flow (assessed by TIMI flow), with male patients at greater risk.
- Key factors predicting higher mortality in these patients included being aged 75 or older, having impaired postprocedural TIMI flow, and presenting with cardiogenic shock.
Introduction And Objectives: ST-segment elevation myocardial infarction (STEMI) networks should guarantee STEMI care with good clinical results and within the recommended time parameters. There is no contemporary information on the performance of these networks in Spain. The objective of this study was to analyze the clinical characteristics of patients, times to reperfusion, characteristics of the intervention performed, and 30-day mortality.
View Article and Find Full Text PDFWe systematically categorized the longer-term (≥3 years) structural and functional characteristics of the ABSORB bioresorbable vascular scaffold (BVS) using optical coherence tomography imaging and coronary vasomotor reactivity testing and further compared the functional characteristics of BVS stented versus remote coronary segments. A total of 92 patients (mean age 56.4 ± 9.
View Article and Find Full Text PDFArticle Synopsis
- * It presents a review of existing literature, dividing the findings into two parts: the first covers the epidemiology and diagnosis of cardiovascular issues in COVID-19 patients, while the second will focus on treatment strategies in a future edition.
- * The document serves as a resource rather than formal guidelines, reflecting current knowledge and clinical experiences, and emphasizes that recommendations may evolve with new research and should align with local healthcare advisories.