Silvio Vera

Hospital Universitario La Paz

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Itzíar Gómez

Hospital Clínico Universitario de Valladolid

Ignacio J. Amat‐Santos

Centro de Investigación Biomédica en Red

José Alberto San Román

Hospital Clínico Universitario de Valladolid

Daniel Tébar Márquez

Hospital La Paz Institute for Health Research

Luis Nombela‐Franco

Instituto de Investigación Sanitaria del Hospital Clínico San Carlos

Manuel Carrasco‐Moraleja

Centro de Investigación Biomédica en Red

Pilar Jiménez‐Quevedo

Hospital Clínico San Carlos

Antonio J. Muñoz-García

Hospital Clínico Universitario Virgen de la Victoria

Santiago Jiménez Valero

Hospital Universitario La Paz

Carlos Cortés

Hospital Clínico Universitario de Valladolid

Cooperative Institutions

Centro de Investigación en Red en Enfermedades Cardiovasculares

Centro de Investigación Biomédica en Red

Hospital Universitario La Paz

Instituto de Salud Carlos III

Hospital Clínico Universitario de Valladolid

Hospital Clínico San Carlos

Hospital La Paz Institute for Health Research

Centre for Biomedical Network Research on Rare Diseases

Sociedad Española de Cardiología

Universidad Complutense de Madrid

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

P752Acquired intracardiac shunts following transcatheter aortic valve replacement

European Heart Journal (2017)

Ignacio J. Amat‐Santos Paol Rojas Luis Nombela‐Franco Román Lezaún Ramón Rodríguez‐Olivares

10.1093/eurheartj/ehx501.p752

Cite

Citations (0)

Safety of intravenous cangrelor infusion during percutaneous coronary intervention in a real-world cohort of non-pretreated NSTEACS patients

European Heart Journal (2022)

Enrique Redondo A. Jurado Román Santiago Jiménez Valero Guillermo Galeote García Raúl Moreno Gómez

Abstract Background and purpose Since publication of latest ESC guidelines in 2020, pretreatment with an oral P2Y12 receptor inhibitor (P2Y12i) is no longer systematically recommended in patients with non-ST elevation acute coronary syndrome (NSTEACS) [1]. Therefore, from now on, NSTEACS patients will arrive to the cathlab to a larger extent without having a loading dose of an oral P2Y12i administered. Cangrelor, a potent intravenous P2Y12i, is an emerging option that provides a rapid onset of platelet inhibition, but it has not been widely used yet [2]. We aimed to evaluate safety of cangrelor real-world use in NSTEACS patients who had not received an oral P2Y12i before percutaneous coronary intervention (PCI). Methods Development of periprocedural thrombotic complications, ischaemic and bleeding events at 30 days was retrospectively evaluated in a cohort of non-pretreated NSTEACS patients referred to PCI. Comparison among those who underwent intravenous infusion of cangrelor and those who received a loading dose of an oral P2Y12i (ticagrelor, prasugrel or clopidogrel) at the moment of PCI was performed. Results Between January and December of 2020, 155 non-pretreated NSTEACS patients were referred to our cathlab; of whom, 89 underwent PCI and were included in the analysis (18.0% with unstable angina, 82.0% with NSTEMI). Mean age was 66.0±14.3 years, 21 (23.6%) were female and the mean GRACE risk score was 112±34. PCI was performed ad-hoc (immediately after diagnostic catheterization) in 81 patients (91.0%), whereas 15 patients (16.9%) required PCI to be done in more than two times. Procedure was performed exclusively by radial or cubital artery access in 78 patients (87.6%). Regarding antiplatelet drug administration, cangrelor was used in 14 patients (15.7%), prasugrel in 35 (39.3%), ticagrelor in 29 (32.6%) and clopidogrel in 11 (12.4%). No significant differences were found among patients in terms of development of ischaemic events at 30 days (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or stent thrombosis) or periprocedural thrombotic events (no-reflow, bailout use of anti-IIb/IIIb or intraprocedural stent thrombosis). The use of cangrelor did not raise the incidence of bleeding events at 30 days (7.1% vs. 15.1%, p=0.682) [Table 1]. Cangrelor tended to be more frequently used in high-risk NSTEMI patients (20.8% vs. 12.9%, p=0.357) and in case of complex PCI (26.3% vs. 7.8%, p=0.018) [Figure 1]. After controlling by both variables, cangrelor did not significantly increase the risk of bleeding or ischaemic events at 30 days either. Conclusions Intravenous infusion of cangrelor during PCI in non-pretreated NSTEACS patients shows no differences in terms of thrombotic or bleeding events in comparison to the administration of a loading dose of an oral P2Y12i. Our results also suggest that cangrelor could be a safe option in patients with high thrombus burden who require complex PCI. Funding Acknowledgement Type of funding sources: None.

Cangrelor

ST elevation

Tirofiban

10.1093/eurheartj/ehac544.1391

Cite

Citations (0)

Self-expandable transcatheter heart valves for aortic stenosis. Short-term outcome and matched hemodynamic performance

Revista Española de Cardiología (English Edition) (2020)

Silvio Vera Luis Nombela‐Franco Sandra Santos‐Martínez Raúl Moreno Victor Alfonso Jiménez Díaz

Cardiac skeleton

10.1016/j.rec.2020.09.014

Cite

Citations (4)

Prognostic impact of high flow nasal cannula compared to noninvasive positive-pressure ventilation in the treatment of acute pulmonary edema

Revista Portuguesa de Cardiologia (2021)

Williams Hinojosa Carolina Iglesias Silvio Vera Marta Cobo Marcos Aitor Uribarri

Nasal cannula

Positive pressure ventilation

Acute pulmonary edema

Noninvasive Ventilation

10.1016/j.repc.2021.04.004

Cite

Citations (5)

Acquired Aseptic Intracardiac Shunts Following Transcatheter Aortic Valve Replacement

КАРДИОЛОГИЯ УЗБЕКИСТАНА (2016)

Paol Rojas Ignacio J. Amat‐Santos Carlos Cortés Javier Castrodeza Javier Tobar

Valve replacement

10.1016/j.jcin.2016.09.034

Cite

Citations (18)

Time to coronary angiography in a real-life cohort of NSTEACS patients: are guidelines too optimistic?

European Heart Journal (2022)

Emilio Arbas Redondo A. Jurado Román Santiago Jiménez Valero Guillermo Galeote García Raúl Moreno Gómez

Abstract Background and purpose In 2020, new recommendations against routine use of pretreatment in NSTEACS have been established, especially if an early invasive strategy (within first 24 hours) is planned [1]. These recommendations are mainly based on evidence from clinical trials that have included short intervals of time to coronary angiography (CA) [2,3]. However, this timing seems hard to achieve in daily clinical practice, above all, when high-risk NSTEACS patients are now advised for an early invasive strategy. We aimed to assess the feasibility of these recommendations in real-world clinical practice. Methods We performed a retrospective analysis of a real-life cohort of NSTEACS patients referred to CA in a tertiary-level hospital between January and December 2020. Results We analysed 347 consecutive NSTEACS patients referred to CA (21.7% unstable angina, 78.3% NSTEMI). Percutaneous coronary intervention was performed in 60.5% and the radial or cubital artery access were exclusively used in 86.7%. Median time from hospital admission to CA was 39.4 hours (IQR: 20.7–67.0 hours) and 31.4% patients had the CA performed within first 24 hours (Figure 1). Main differences regarding clinical and risk-related variables among those patients who underwent CA before and after first 24 hours are shown in Table 1. More patients with NSTEMI and dynamic changes in ECG tended to be referred earlier to CA, while those with impaired renal function were more likely to receive a delayed strategy. There were 282 patients (82.7%) who met the high-risk criteria from current ESC guidelines on NSTEACS (GRACE risk score >140, ST transient elevation or depression in ECG, raise of cardiac troponin levels above the 99th percentile of the upper reference limit, cardiogenic shock or cardiac arrest at presentation); of whom, only 95 (33.7%) were referred to CA in the first 24 hours. No differences were found according to patients being admitted to PCI or non-PCI centres (32.1% vs. 30.9% had the CA performed within first 24 hours, p=0.81) or receiving pretreatment with a P2Y12 receptor inhibitor or not (31.7% vs. 31.0% of the CA ≤24 hours group; p=0.87). Conclusion Evidence from this real-life registry shows that median time from admission to CA is far from current recommendations for high-risk NSTEACS patients. This might represent an important limitation at the moment of translating guidelines to daily clinical practice, especially those who presume patients to have a CA performed within first 24 hours. Funding Acknowledgement Type of funding sources: None.

ST elevation

Unstable angina

10.1093/eurheartj/ehac544.1436

Cite

Citations (1)

TCT-319 Coronary Rotational Atherectomy Elective vs. Bailout in Patients With Severely Calcified Lesions and Chronic Renal Failure Trial

Journal of the American College of Cardiology (2024)

Guillermo Galeote Alfonso Jurado‐Román Borja Rivero Santana Javier Fernández Pablo Salinas

Bailout

Chronic renal failure

10.1016/j.jacc.2024.09.373

Cite

Citations (0)

4. TROMBECTOMÍA PERCUTÁNEA MEDIANTE TROMBOASPIRACIÓN EN LA TROMBOEMBOLIA PULMONAR DE ALTO RIESGO CON CONTRAINDICACIÓN PARA FIBRINOLISIS. LA ALTERNATIVA IDEAL

Revista Española de Cardiología (2023)

Daniel Tébar Márquez Alfonso Jurado Román Santiago Jiménez Valero Guillermo Galeote García Silvio Vera

10.1016/s0300-8932(24)01094-7

Cite

Citations (0)

3. ELECCIÓN DEL ACCESO CONTRALATERAL EN EL TAVI. ¿RADIAL O FEMORAL?

Revista Española de Cardiología (2023)

Daniel Tébar Márquez Guillermo Galeote García Alfonso Jurado Román Santiago Jiménez Valero Silvio Vera

10.1016/s0300-8932(24)00546-3

Cite

Citations (0)

Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Catheterization and Cardiovascular Interventions (2018)

Ignacio J. Amat‐Santos Paol Rojas Hipólito Gutiérrez Silvio Vera Javier Castrodeza

Empirically, transfemoral (TF) approach is the first choice for transcatheter aortic valve implantation (TAVI). We aimed to investigate whether transubclavian (TSc) and TF approaches present comparable major outcomes according to current evidence.We systematically searched PubMed, EMBASE, and Cochrane database for studies with symptomatic aortic stenosis patients who underwent TAVI through TF or TSc/axillary access from January/2006 to January/2017. Searched terms were: ("aortic stenosis" OR "transcatheter aortic" OR "TAVI" OR "TAVR") and ("transfemoral" OR "transaxillary" OR "transubclavian"). Major outcomes according to Valve Academic Research Consortium-2 criteria were gathered. The odds ratio (OR) was used as a summary statistic. A random-effects model was used. A fully percutaneous TSc TAVI case from our institution illustrates minimalist approach.Final analysis was made with six studies including 4,504 patients (3,886 TF and 618 TSc). Baseline characteristics of compared groups in individual studies were similar, with the exception of a higher logistic EuroSCORE in the TSc group (23.7 ± 1.92 vs. 21.17 ± 3.51, P = 0.04) and higher prevalence of coronary and peripheral artery disease with OR = 0.67 [95% CI: 0.54-0.83] (P = 0.0003) and OR = 0.08 [95% CI: 0.05-0.12] (P < 0.00001), respectively. TSc group presented comparable 30-day mortality (OR = 1.37; [95%CI: 0.85-2.21]; P = 0.20). There were no differences for procedural success, 30-day stroke rate, need for new pacemaker implantation, major vascular complications, and acute kidney injury requiring dialysis. Also, no differences were found concerning 1-year mortality.Our study suggests that TSc approach may be, not only an alternative route to TF approach for TAVI, but even a competitive one in certain patients with increased risk of femoral injury.

10.1002/ccd.27485

Cite

Citations (44)