Agenda

Seminario de Investigación IdISSC de noviembre’22

16 de noviembre de 2022

Modalidad online: URL de acceso a los seminarios: https://madrid.zoom.us/j/82112222618

13:00h

Memoria de la actividad científica 2021 del Instituto de Investigación Sanitaria del Hospital Clínico San Carlos

Dra. Elena Urcelay García. Directora Científica del Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC).

En esta sesión se presentarán los hitos de la actividad científica desarrollada a lo largo de la anualidad del 2021. Se destacan, entre otras, los datos de análisis bibliométrico, los proyectos de investigación, y las actividades de transferencia de tecnología y de divulgación científica.

13:05 h

Difusión Subvención nominativa FIBHCSC 2022

Dra. Joana Modolell Aguilar. Directora de la FIB-HCSC. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC).

Se presentará a la comunidad científica del IdISSC información disponible relativa a la Subvención nominativa destinada a las Fundaciones de Investigación Biomédica de la Comunidad de Madrid.

Se detallarán los objetivos, prioridades y propuesta de ejecución de gasto para el caso del Instituto de Investigación Sanitaria del Hospital Clínico San Carlos en 2022.

13:10 h

Efectos de la Administración Intravenosa de Acetilsalicilato de Lisina versus Aspirina Oral sobre la Respuesta Plaquetaria en Pacientes con un Infarto Agudo de Miocardio con Elevación del Segmento ST: un estudio farmacodinámico

Dr. Luis David Vivas Balcones

Facultativo Especialista de Área Cardiología. Grupo de Investigación traslacional en síndromes miocárdicos agudos. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC)

Background. Prasugrel and ticagrelor, new P2Y12-ADP receptor antagonists, are associated with greater pharmacodynamic inhibition and reduction of cardiovascular events in patients with an acute coronary syndrome. However, evidence is lacked about the effects of achieving faster and stronger cyclooxygenase inhibition with intravenous lysine acetylsalicylate (LA) compared to oral aspirin. Recently, we demonstrated in healthy volunteers that the administration of intravenous LA resulted in a significantly reduction of platelet reactivity compared to oral aspirin. Loading dose of LA achieves platelet inhibition faster, greater and with less variability than aspirin. However, there are no data of this issue in patients with an ST-segment elevation myocardial infarction (STEMI).

Methods. This is a prospective, randomized, multicenter, open platelet function study conducted in STEMI patients. Subjects were randomly assigned to receive a loading dose (LD) of intravenous LA 450mg plus oral ticagrelor 180mg, or LD of aspirin 300mg plus ticagrelor 180mg orally. Platelet function was evaluated at baseline, 30 min, 1h, 4h and 24h using multiple electrode aggregometry and vasodilator-stimulated phosphoprotein phosphorylation (VASP). The primary endpoint of the study is the inhibition of platelet aggregation (IPA) after arachidonic acid (AA) 0.5mM at 30 min. Secondary endopoints were the IPA at 1, 4, and 24 hours after AA, and non-AA pathways through the sequence (ADP and TRAP).

Results. A total of 32 STEMI patients were randomized (16 LA, 16 aspirin). The inhibition of platelet aggregation after AA 0.5mM at 30 min was greater in subjects treated with LA compared with aspirin: 166 vs. 412 respectively (p = 0.001). This differential effect was observed at 1 hour (p 0 0.01), but not at 4 and 24 hours. Subjects treated with LA presented less variability and faster and greater inhibition of platelet aggregation wit AA compared with aspirin. Conclusion. The administration of intravenous LA resulted in a significantly reduction of platelet reactivity compared to oral aspirin on ticagrelor inhibited platelets in patients with STEMI. Loading dose of LA achieves an earlier platelet inhibition, and with less variability than aspirin.

Bibliografía

Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC).. Eur Heart J. 2018;39:119-177.
Vivas D, Angiolillo DJ. Platelet P2Y12 receptor inhibition: an update on clinical drug development. Am J Cardiovasc Drugs. 2010;10:217-226.
Vivas D, Martín A, Bernardo E, Ortega-Pozzi MA, Tirado G, Fernández C, et al. Impact of Intravenous Lysine Acetylsalicylate Versus Oral Aspirin on Prasugrel-Inhibited Platelets: Results of a Prospective, Randomized, Crossover Study (the ECCLIPSE Trial). Circ Cardiovasc Interv. 2015;8:e002281. DOI: 10.1161/CIRCINTERVENTIONS.114.002281.

13:35 h

Caracterización mediante T-1 mapping de la fibrosis miocárdica difusa asociada a obesidad en el infarto agudo de miocardio. Mecanismos implicados y relación con la evolución clínica