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A Iñiguez Romo

Publications and source records attributed to A Iñiguez Romo.

8 recordsLinked to original sources
PubMed2000

[A comparison of the clinical and angiographic evolution of diabetic and nondiabetic patients treated by conventional angioplasty versus stent implantation in native coronary arteries].

INTRODUCTION AND OBJECTIVES: Diabetic patients have a high restenosis risk after balloon coronary angioplasty. Stent implantation in these patients appears to be a potential beneficial therapeutic option. The aim of this study was to compare the clinical and angiographic outcome of diabetic patients vs non-diabetic patients, treated with conventional angioplasty vs stent implantation in lesions located in native coronary arteries. MATERIAL AND METHODS: A total of 302 patients (58 diabetics and 244 non-diabetics) underwent a coronary angioplasty of one vessel in native coronary arteries with initial success and after at least six months clinical and angiographic follow-up were included in the study. Of the total number of patients, 100 were treated with conventional balloon angioplasty and 202 with stent implantation. Major adverse clinical events and angiographic restenosis rate were evaluated at follow-up. RESULTS: Mean age of patients was 65 years and 74% were male. Angiographic restenosis rate was similar in diabetic vs non-diabetic patients with stent implantation (24% vs 23% respectively). Nevertheless, diabetic patients treated with balloon angioplasty compared to diabetic patients treated with stenting, evolved with a higher restenosis rate (64% vs 24%; p < 0.05), and at the end of follow-up diabetics had need a higher rate of target vessel revascularization (40% vs 24%; p < 0.05), a lower major event free survival (56% vs 70%; p < 0.05) and worse symptomatic status (72% vs 36%; p < 0.05). CONCLUSIONS: Diabetic patients treated with conventional one vessel coronary balloon angioplasty evolved with a high restenosis rate and a bad mid-term clinical outcome. Stent implantation was able reduce to the restenosis rate and improve the mid-term clinical outcome, in a comparable population of diabetic patients.

Aged↗
PubMed2000

[Practice Guidelines of the Spanish Society of Cardiology for the management of cardiac disease in pregnancy].

Maternal adaptation to pregnancy includes reproductive hormone interaction plasma, volume changes with an increase in total body water, vascular alterations with a decrease in systemic resistance and modifications associated with hypercoagulability. These explain, in part, the appearance of signs and symptoms, even in a normal pregnant woman, that are difficult to distinguish from those occurring in heart disease and why some cardiac abnormalities are not well tolerated during pregnancy. Cardiovascular abnormalities are considered the first non-obstetric cause of morbidity and mortality during pregnancy. Rheumatic and congenital heart diseases are currently the most frequent cardiopathy found in women of childbearing age, followed by hypertension, coronary artery disease and arrhythmia. Although pregnancy is well tolerated by most women with heart disease, there are some cardiovascular abnormalities which place the mother and the infant at extremely high risk: patients with congestive heart failure and severe cardiac dysfunction, pulmonary hypertension, cyanotic congenital heart disease, Marfan's syndrome, severe obstructive lesions of the left side of the heart, patients with prosthetic cardiac valves and antecedents of peripartum cardiomyopathy should be encouraged to avoid pregnancy and the interruption of pregnancy may be advisable in cases with great risk of disability or death. The most severe cardiopathies significantly increase the risk of fetal loss and the presence of a congenital cardiac abnormality in either parent increases the risk of congenital cardiac disease in the fetus. Medical care must be initiated early, prior to conception and women with cardiopathy should be informed of the possible risks of pregnancy to both the mother and fetus.

Age Factors↗
PubMed2000

[Guidelines of the Spanish Society of Cardiology on magnetic resonance].

A wide perspective of the cardiac applications of magnetic resonance is presented in this report, including technical aspects of the practice, recommendations on the appropriate training of medical personnel for the practice of examination and also, an extensively commented review of the accepted clinical indications for the practice of a cardiac magnetic resonance imaging study at present.

Heart Diseases↗
PubMed1999

[The predictive factors of intra-stent restenosis].

INTRODUCTION AND OBJECTIVE: Stenting has contributed to improve the early angiographic result, the restenosis rate and the problem of acute and subacute coronary occlusion. In spite of this, the restenosis phenomenon still remains a problem to be completely solved. The aim of the study was to identify clinical, angiographical and procedural factors that are predictive of in-stent restenosis after successful implantation of coronary stent. MATERIAL AND METHODS: We retrospectively analyzed 202 lesions, in 176 consecutive patients who underwent stent implantation with success in our hospital between January 1995 and August 1998. All patients had a clinical follow-up and an angiography after six months of stent implantation. RESULTS: From 202 lesions evaluated, 47 evolved with restenosis (23%). The only independent predictive variables were: to be receiving hypolipemiant treatment before stenting (OR: 0.3; IC: 0.1-0.8), the use of high pressure for stent implantation (OR: 0.4; IC: 0.2-0.9), to implant stent in < 3.1 mm (OR: 2.2; IC: 1.1-4.5) and to have a residual stenosis > 30% after stenting (OR: 13; IC: 1.5-120). CONCLUSIONS: The only statistical variables associated with in-stent restenosis phenomenon were: be under hypolipemiant treatment before the procedure and the use of high pressures for stent implantation; while risk factors arose: to implant stent in vessels < 3.1 mm and suboptimal angiography result after stenting.

Angioplasty, Balloon, Coronary↗
PubMed1991

[Congenital anomalies of coronary artery origin: a diagnostic challenge].

From a series of 4,313 consecutive patients who underwent a diagnostic coronary angiogram, 16 (0.37%) presented a congenital anomalous origin of the coronary arteries. None of these patients had other congenital cardiac anomalies associated. Age was 57 +/- 9 years and 13 (81%) were male. The diagnostic catheterization was performed for unstable angina in 8 patients (50%), for stable angina in five (32%), for dyspnea in two and for atypical chest pain in the remaining patient. A previous myocardial infarction was present in 6 patients (37%) whereas one patient had apical hypertrophic cardiomyopathy. We observed absence of coronary lesions in 4 patients and severe coronary stenosis lesions in 12 patients (75%), five of those with lesions located in the anomalous vessel. The most frequent abnormality found was an anomalous origin of left circumflex coronary artery in 8 cases (50%), followed by an abnormal origin of the right coronary artery in 5 cases (31%), and an abnormal origin of the left coronary tree in 3 cases (19%) (left anterior descending coronary artery arising from the right coronary artery, a single coronary artery which originated in the left coronary sinus, and a left main coronary artery which originated in the noncoronary sinus). The relationship of the anomalous coronary artery to the great vessels was the following: A retro-aortic course in 11 patient (69%), by the anterior free wall in two (12.5%), interarterial in two (12.5%), and septal in one (6%). Finally, as an index of the difficulty to visualize the anomalous coronary artery, an unusual catheter was needed in six (37%) of the diagnostic procedures to reach the target vessel.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[The effects of ticlopidine administration at low doses on the incidence of restenosis following percutaneous transluminal coronary angioplasty].

The incidence of restenosis remains the same as initially reported (30%) and no therapeutic approach has reduced its appearance. Platelets-induced smooth muscle cell proliferation probably play a preponderant role in the pathogenesis of restenosis. The aim of this study was to evaluate the effects of ticlopidine (250 mg/day) on restenosis rate after single lesion coronary angioplasty. One hundred seventy nine consecutive patients were prospectively included in this study and were assigned to ticlopidine (group T, n = 91) or to a control group (n = 88) in an alternative fashion. Age (60 +/- 10 vs 58 +/- 9 years), gender (87% vs 87% male), treatment, coronary risk factors, lesion morphology, stenosis severity pre- and postangioplasty, type of vessel, collateral circulation, and left ventricular ejection fraction, were similar in the T and control groups, respectively. Unstable angina was more frequently found in group T patients (81% vs 65%, p less than 0.01). A late angiographic follow-up (7 +/- 2 months after angioplasty) revealed restenosis (greater than 50% luminal narrowing) in 26 patients (28%) in group T and in 21 patients (24%) in the control group (NS). At that time, 88% and 98% of patients without restenosis vs 35% and 48% of patients with restenosis were asymptomatic in the T and control groups, respectively. An exercise test prior to the late control angiogram was abnormal (angina and/or ST segment depression) in 77% and 73% of patients with restenosis in T and control groups, respectively. Thus, in our experience, ticlopidine at a dosage of 250 mg/day was unable to reduce restenosis rate after single lesion coronary angioplasty.

Angioplasty, Balloon, Coronary↗