IdISSC Research Seminar – June’22

01 June 2022

13:00 h

Results of the coupe study: emergency coronary angiography in out-of-hospital cardiac arrest

Dr. Ana Viana Tejedor

Cardiology Assistant and Coordinator of the Acute Cardiology Care Unit of the Hospital Clínico San Carlos. Health Research Institute of the Hospital Clínico San Carlos (IdISSC).

Introduction and objectives: The role of urgent coronary angiography and angioplasty in patients with recovered out-of-hospital cardiac arrest (OHCA) without ST-segment elevation is controversial. Our aim is to assess whether coronary angiography improves survival with good neurological prognosis in this population.

Methods: In this multicentre, randomised clinical trial, we included 69 patients who survived non-ST-elevation PCEH and were randomised to receive either urgent (UC) or delayed coronary angiography (DC). The primary efficacy endpoint was the composite of dependency-free hospital survival. The safety endpoint was a composite of major cardiac events, including death, reinfarction, bleeding and ventricular arrhythmias.

Results: Sixty-six patients were included in the primary analysis. In-hospital survival was 62.5% in the UC group and 58.8% in the DC group (HR, 0.96; 95% CI, 0.45-2.09; P = ,93). In-hospital survival with good neurological prognosis was 59.4% in the CU group and 52.9% in the CD group (HR, 1.29; 95%CI, 0.60-2.73; P = ,4986). No differences were found in secondary endpoints, except for the incidence of acute renal failure, which was more frequent in the UC group (15.6% vs 0%, P = ,002) and of infections, more prevalent in the DC group (46.9% vs 73.5 %, P = ,003) Conclusions: In this study of patients with a non-ST-elevation PCEH, a UC was not beneficial in terms of survival with good neurological prognosis compared to a DC.

Bibliography

  1. Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary síndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2021 abr 7;42:1289-1367.
  2. Nolan JP, Sandroni C, Böttiger BW, et al.European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Intensive Care Med. 2021;47:369-421.
  3. Lemkes JS, Janssens GN, van der Hoeven NW, et al. Coronary angiography after cardiac arrest without ST segment elevation. N Engl J Med 2019;380:1397-1407.

13:30 h

Cell therapy in articular cartilage and rotator cuff regeneration processes

Dr. Yaiza Lópiz Morales

Area Specialist and Member of the Shoulder and Elbow Surgery Unit of the Hospital Clínico San Carlos de Madrid Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC).

Currently, rotator cuff and articular cartilage repair surgeries, due to the different types of approach and existing techniques, do not achieve satisfactory results in all cases, with a significant percentage of tendon ruptures in the case of the rotator cuff and a repair tissue in the case of cartilage that is far from the characteristics of hyaline cartilage in terms of both durability and resistance.

This has led to the search for therapeutic alternatives aimed at improving this regeneration process by guiding the repair response through appropriate signalling based on the key elements of tissue engineering: transporters, molecules and cells. This seminar will review the lines of research carried out by our department in this field and the future applications of tissue engineering processes in the treatment of the aforementioned problems.

Connection link: https://madrid.zoom.us/j/82112222618

Download the programme

If you have any questions, please contact us by e-mail:

fibgestor.hcsc@salud.madrid.org