Primer hospital con angioplastia primaria sistemática

1. Eulogio García

2. Julio 1991. Hospital Universitario Gregorio Marañón
Inspiración: “In Laboratory events during
primary angioplasty“ Kahn/Haztler group . Circulation, 1991
Motivación: Incrementar actividad C.
Intervencionista
Apoyo: Jefe de servicio ( J.L. Delcán)
dirección, enfermería
Oposición: Médicos U.C. y el club t-pa

3. Compromiso
Estudio Randomizado de Infarto Anterior (
AP vs t-pa )
Paciente con menos de 5 horas desde
comienzo del dolor
Los pacientes con IAM anterior y
contraindicación fibrinolisis…AP
Pacientes con infartos extensos…AP
Pacientes con Killip 3-4…AP
Muy pronto…todos AP. Dificultad para
incluir pacientes en protocolo

4. Impacto
Incremento actividad 25%
Recelo exterior
Debates
Dificultad en convencer autoridades de
establecimiento de redes
Rentabilidad : mejoría progresiva de
resultados y producción científica

5. Acumulación de experiencia clínica
1. Capacidad de respuesta : 40 minutos
llamada – balón
2. Establecimiento de sistemática de trabajo (
condicionamiento clínico )
3. 1991-2000 : más de 2000 casos realizados
4. Introducción de cambios en tratamiento :
stent, antiplaquetarios, aspiración …etc
5. Tratamiento de elección en cualquier
contexto clínico

6. NUMEROS ( 1991-2007)
Procedimientos : 3750
Stents : 3300
Dispositivos de aspiración : 392
Balones de contrapulsación : 330
Médicos tratados : 25
Políticos tratados : 12

13. Debates científicos
Congreso nacional SEC ( Madrid 1995 )
Congresos regionales
Congreso nacional SEC ( 1998 )

14. Eulogio García
Hospital Gregorio Marañon
MADRID

15. Eulogio García MD
Hospital Gregorio Marañon
MADRID - Spain

17. CONVENCIMIENTO ADMINISTRATIVO
Tiene Madrid los medios necesarios ?
1. Situación geográfica idónea
2. Sistema de trasporte médico adecuado
3. Población concentrada
4. Hospitales preparados,
con experiencia, geográficamente
bien situados

18. CONCLUSIONES
Con tiempos de traslado razonables, los resultados de
ACTP primaria post –traslado son superiores al
tratamiento trombolítico in situ.
A la espera de resultados de angioplastia facilitada, parece
razonable el tratamiento antiagragante pre-traslado.
Las premisas anteriores y experiencia
en otras disciplinas ( trauma, cancer )
indican la necesidad urgente de centros
de infarto.

19. INICIATIVAS Y RESPUESTAS
COLABORACIÓN CON SISTEMAS DE TRASPORTE
1. Sesiones de información y proyectos
2. Elaboración de programa de colaboración
3. Buena acogida de la iniciativa

20. RESPUESTA ADMINISTRATIVA
Proyecto presentado en 2001 : RIMA
Respuesta : Silencio
Razones : Proyecto inadecuado ?,
Argumentación poco convincente?
Temor al gasto ?
Influencias negativas ajenas ?

21. EDITORIAL
[Primary angioplasty: this balloon is of
general interest, indeed]. Eulogio García Revista
Esp de Cardiologia 07/2002; 55(6):565-7. · 3.20 Impact Factor

22. ESTUDIOS MONOCENTRICOS
[Primary coronary angioplasty in acute anterior myocardial infarction:
immediate results].
E J García, J L Delcán, J Elízaga, M Abeytua, J Soriano, J A García Robles, J Botas, L
López-Bescós, T Echeverría, A Beloscar
[show abstract]
Revista Espa de Cardiologia 02/1994; 47(1):40-6. · 3.20 Impact Factor
Primary angioplasty versus systemic thrombolysis in anterior myocardial
infarction.
E García, J Elízaga, N Pérez-Castellano, J A Serrano, J Soriano, M Abeytua, J Botas, R
Rubio, E López de Sá, J L López-Sendón, J L Delcán
[Show abstract]
Journal of the American College of Cardiology 03/1999; 33(3):605-11. · 14.09 Impact
Factor

23. METANÁLISIS
Comparison of Primary Coronary Angioplasty and Intravenous
Thrombolytic Therapy for Acute Myocardial InfarctionA Quantitative
Review
W. Douglas Weaver, R. John Simes, Amadeo Betriu, Cindy L. Grines, Felix Zijlstra,
Eulogio Garcia, Lilliana Grinfeld, Raymond J. Gibbons, Expedito E. Ribeiro, Marcus A.
DeWood, Flavio Ribichini
[show abstract]
JAMA The Journal of the American Medical Association 278(23):2093-2098. · 29.98
Impact Factor

24. ESTUDIOS MULTICENTRICOS
Coronary angioplasty with or without stent implantation for acute
myocardial infarction. Stent Primary Angioplasty in Myocardial Infarction
Study Group.
C L Grines, D A Cox, G W Stone, E Garcia, L A Mattos, A Giambartolomei, B R
Brodie, O Madonna, M Eijgelshoven, A J Lansky, W W O'Neill, M C Morice
[Show abstract]
New England Journal of Medicine 12/1999; 341(26):1949-56. · 51.66 Impact Factor
Comparison of angioplasty with stenting, with or without abciximab, in
acute myocardial infarction.
Gregg W Stone, Cindy L Grines, David A Cox, Eulogio Garcia, James E Tcheng, John J
Griffin, Giulio Guagliumi, Thomas Stuckey, Mark Turco, John D Carroll, Barry D
Rutherford, Alexandra J Lansky
[show abstract]
New England Journal of Medicine 04/2002; 346(13):957-66. · 51.66 Impact Factor

25. ROTURA CARDIACA
Primary angioplasty reduces the risk of left ventricular free wall rupture
compared with thrombolysis in patients with acute myocardial infarction.
Raúl Moreno, José López-Sendón, Eulogio García, Leopoldo Pérez de Isla, Esteban López
de Sá, Ana Ortega, Mar Moreno, Rafael Rubio, Javier Soriano, Manuel Abeytua, Miguel-
Angel García-Fernández
[show abstract]
Journal of the American College of Cardiology 02/2002; 39(4):598-603. · 14.09 Impact
Factor
Frequency of left ventricular free-wall rupture in patients with acute
myocardial infarction treated with primary angioplasty.
R Moreno, E López de Sá, J L López-Sendón, E García, J Soriano, M Abeytua, J Elízaga,
J Botas, R Rubio, M Moreno, M A García-Fernández, J L Delcán
[Show abstract]
The American Journal of Cardiology 04/2000; 85(6):757-60, A8. · 3.21 Impact Factor

26. CIRCULACION COLATERAL
Influence of collateral circulation on in-hospital death from anterior acute
myocardial infarction.
N Pérez-Castellano, E J García, M Abeytua, J Soriano, J A Serrano, J Elízaga, J Botas, J
L López-Sendón, J L Delcán
[show abstract]
Journal of the American College of Cardiology 03/1998; 31(3):512-8. · 14.09 Impact
Factor

27. EDAD Y SEXO
Outcome in elderly patients undergoing primary coronary intervention for
acute myocardial infarction: results from the Controlled Abciximab and Device
Investigation to Lower Late Angioplasty Complications (CADILLAC) trial.
Giulio Guagliumi, Gregg W Stone, David A Cox, Thomas Stuckey, James E Tcheng, Mark
Turco, Giuseppe Musumeci, John J Griffin, Alexandra J Lansky, Roxana Mehran, Cindy L
Grines, Eulogio Garcia
[show abstract]
Circulation 09/2004; 110(12):1598-604. · 15.20 Impact Factor
Gender differences in outcomes after primary angioplasty versus primary
stenting with and without abciximab for acute myocardial infarction: results of
the Controlled Abciximab and Device Investigation to Lower Late Angioplasty
Complications (CADILLAC) trial.
Alexandra J Lansky, Cody Pietras, Ricardo A Costa, Yoshihiro Tsuchiya, Bruce R Brodie,
David A Cox, Eve D Aymong, Thomas D Stuckey, Eulogio Garcia, James E Tcheng, Roxana
Mehran, Manuela Negoita, Martin Fahy, Ecaterina Cristea, Mark Turco, Martin B Leon,
Cindy L Grines, Gregg W Stone
[show abstract]
Circulation 04/2005; 111(13):1611-8. · 15.20 Impact Factor

28. PERFUSION MIOCÁRDICA
Combined prognostic utility of ST-segment recovery and myocardial blush after
primary percutaneous coronary intervention in acute myocardial infarction.
Paul Sorajja, Bernard J Gersh, Costantino Costantini, Michael G McLaughlin, Peter
Zimetbaum, David A Cox, Eulogio Garcia, James E Tcheng, Roxana Mehran, Alexandra J
Lansky, David E Kandzari, Cindy L Grines, Gregg W Stone
[show abstract]
European Heart Journal 05/2005; 26(7):667-74. · 14.10 Impact Factor
Relationship between infarct artery location, epicardial flow, and myocardial
perfusion after primary percutaneous revascularization in acute myocardial
infarction.
David E Kandzari, James E Tcheng, Bernard J Gersh, David A Cox, Thomas Stuckey, Mark
Turco, Roxana Mehran, Eulogio Garcia, Peter Zimetbaum, Michael G McGlaughlin,
Alexandra J Lansky, Costantino O Costantini, Cindy L Grines, Gregg W Stone
[show abstract]
American heart journal 06/2006; 151(6):1288-95. · 4.65 Impact Factor
Impact of ST-segment resolution after primary angioplasty on outcomes after
myocardial infarction in elderly patients: an analysis from the CADILLAC trial.
Abhiram Prasad, Gregg W Stone, Eve Aymong, Peter J Zimetbaum, Michael McLaughlin,
Roxana Mehran, Eulogio Garcia, James E Tcheng, David A Cox, Cindy L Grines, Bernard J
Gersh [show abstract]
American heart journal 04/2004; 147(4):669-75. · 4.65 Impact Factor

29. PERFUSION MIOCÁRDICA
Prognostic utility of comparative methods for assessment of ST-segment
resolution after primary angioplasty for acute myocardial infarction: the
Controlled Abciximab and Device Investigation to Lower Late Angioplasty
Complications (CADILLAC) trial.
Michael G McLaughlin, Gregg W Stone, Eve Aymong, Graham Gardner, Roxana Mehran,
Alexandra J Lansky, Cindy L Grines, James E Tcheng, David A Cox, Thomas Stuckey,
Eulogio Garcia, Giulio Guagliumi, Mark Turco, Mark E Josephson, Peter Zimetbaum
[show abstract]
Journal of the American College of Cardiology 09/2004; 44(6):1215-23. · 14.09 Impact
Factor
Frequency, correlates, and clinical implications of myocardial perfusion after
primary angioplasty and stenting, with and without glycoprotein IIb/IIIa
inhibition, in acute myocardial infarction.
Costantino O Costantini, Gregg W Stone, Roxana Mehran, Eve Aymong, Cindy L Grines,
David A Cox, Thomas Stuckey, Mark Turco, Bernard J Gersh, James E Tcheng, Eulogio
Garcia, John J Griffin, Giulio Guagliumi, Martin B Leon, Alexandra J Lansky
[show abstract]
Journal of the American College of Cardiology 08/2004; 44(2):305-12. · 14.09 Impact
Factor

30. PLATELETS
Impact of in-hospital acquired thrombocytopenia in patients undergoing
primary angioplasty for acute myocardial infarction.
Eugenia Nikolsky, H Mehrdad Sadeghi, Mark B Effron, Roxana Mehran, Alexandra J
Lansky, Yingbo Na, David A Cox, Eulogio Garcia, James E Tcheng, John J Griffin,
Thomas D Stuckey, Mark Turco, John D Carroll, Cindy L Grines, Gregg W Stone
[show abstract]
The American Journal of Cardiology 08/2005; 96(4):474-81. · 3.21 Impact Factor
Impact of baseline platelet count in patients undergoing primary
percutaneous coronary intervention in acute myocardial infarction (from
the CADILLAC trial).
Eugenia Nikolsky, Cindy L Grines, David A Cox, Eulogio Garcia, James E Tcheng,
Mehrdad Sadeghi, Roxana Mehran, Alexandra J Lansky, Yingbo Na, Gregg W Stone
[show abstract]
The American Journal of Cardiology 04/2007; 99(8):1055-61. · 3.21 Impact Factor

31. REOPRO
Benefits and risks of abciximab use in primary angioplasty for acute myocardial
infarction: the Controlled Abciximab and Device Investigation to Lower Late
Angioplasty Complications (CADILLAC) trial.
James E Tcheng, David E Kandzari, Cindy L Grines, David A Cox, Mark Effron, Eulogio
Garcia, John J Griffin, Giulio Guagliumi, Thomas Stuckey, Mark Turco, Martin Fahy,
Alexandra J Lansky, Roxana Mehran, Gregg W Stone
[show abstract]
Circulation 10/2003; 108(11):1316-23. · 15.20 Impact Factor
Impact of stenting and abciximab in patients with diabetes mellitus undergoing primary
angioplasty in acute myocardial infarction (the CADILLAC trial).
Thomas D Stuckey, Gregg W Stone, David A Cox, James E Tcheng, Eulogio Garcia, John
Carroll, Giulio Guagliumi, Barry D Rutherford, John J Griffin, Mark Turco, Alexandra J
Lansky, Roxana Mehran, Martin Fahy, Bruce R Brodie, Cindy L Grines
[show abstract]
The American Journal of Cardiology 02/2005; 95(1):1-7. · 3.21 Impact Factor
Outcomes following bail-out abciximab administration during primary intervention in
acute myocardial infarction (The CADILLAC Trial).
Dale T Ashby, Eve A Aymong, James E Tcheng, Cindy L Grines, David A Cox, Roxana
Mehran, Eulogio Garcia, John J Griffin, Giulio Guagliumi, Thomas Stuckey, Mark Turco,
Alexandra J Lansky, Gregg W Stone
[show abstract]
The American Journal of Cardiology 12/2003; 92(9):1091-4. · 3.21 Impact Factor

32. ASPIRACION DE TROMBO STENT.
Mid-term results of thrombus extraction in patients with ST elevation
myocardial infarction: One center experience with the X-SIZER catheter
system
Eulogio Garcia, Alejandro Alvarez, Jose M. Cubero, Agustin LaCorte, Manuel Abeytua,
Jose L. Lopez-Sendon, Esteban Lopez de Sa, Amalia Mota
Journal of the American College of Cardiology , 2003; 41:356. · 14.09 Impact Factor
XAMINE ST trial
T. Lefevre, E. Garcia, Reimers B et al. JACC 2005;46:246-252. 14.09 Impact factor
Journal of the American College of Cardiology,
[Results of coronary stenting in acute myocardial infarction].
R Moreno, E García, J Soriano, M Abeytua, J Elízaga, J Botas, J L López Sendón, J L
Delcán
[Show abstract]
Revista Espa de Cardiologia 01/2000; 53(1):27-34. · 3.20 Impact Factor

33. NEUTROPHILS
Relation between leucocyte count, myonecrosis, myocardial perfusion, and
outcomes following primary angioplasty.
Abhiram Prasad, Gregg W Stone, Thomas D Stuckey, Costantino O Costantini, Roxana
Mehran, Eulogio Garcia, James E Tcheng, David A Cox, Cindy L Grines, Alexandra J
Lansky, Bernard J Gersh
[show abstract]
The American Journal of Cardiology 04/2007; 99(8):1067-71. · 3.21 Impact Factor
Neutrophil count and infarct size in patients with acute myocardial infarction.
Pablo Avanzas, Juan Quiles, Esteban López de Sá, Ana Sánchez, Rafael Rubio, Eulogio
García, José Luis López-Sendón
International Journal of Cardiology 11/2004; 97(1):155-6. · 5.51 Impact Factor

34. MULTIVASO, SHOCK.
[Results of primary angioplasty in patients with multivessel
disease].
R Moreno, E García, J Elízaga, M Abeytua, J Soriano, J Botas, J L López-Sendón, J L
Delcán
[Show abstract]
Revista Espa de Cardiologia 07/1998; 51(7):547-55. · 3.20 Impact Factor
Efficacy of invasive strategy for the management of acute
myocardial infarction complicated by cardiogenic shock.
N Pérez-Castellano, E García, J A Serrano, J Elízaga, J Soriano, M Abeytua, J Botas, R
Rubio, E López de Sá, J L López-Sendón, J L Delcán
[Show abstract]
The American Journal of Cardiology 05/1999; 83(7):989-93. · 3.21 Impact Factor

35. INSUFICIENCIA RENAL
Impact of renal insufficiency in patients undergoing primary angioplasty
for acute myocardial infarction.
H Mehrdad Sadeghi, Gregg W Stone, Cindy L Grines, Roxana Mehran, Simon R Dixon,
Alexandra J Lansky, Martin Fahy, David A Cox, Eulogio Garcia, James E Tcheng, John J
Griffin, Thomas D Stuckey, Mark Turco, John D Carroll
[show abstract]
Circulation 12/2003; 108(22):2769-75. · 15.20 Impact Factor

36. RESCATE, GUIAS
Coronary stenting during rescue angioplasty after failed thrombolysis.
R Moreno, E García, M Abeytua, J Soriano, J Elizaga, J Botas, J L López-Sendón, J L
Delcán
[Show abstract]
Catheterization and Cardiovascular Interventions 06/1999; 47(1):1-5. · 2.51 Impact Factor
[The clinical management guidelines of the Sociedad Española de Cardiología
in acute myocardial infarct].
F Arós, A Loma-Osorio, A Alonso, J J Alonso, A Cabadés, I Coma-Canella, L García-
Castrillo, E García, E López de Sá, P Pabón, J M San José, A Vera, F Worner
[Show abstract]
Revista Espa de Cardiologia 11/1999; 52(11):919-56. · 3.20 Impact Factor

37. BETA-BLOQUEANTES
Impact of intravenous beta-blockade before primary angioplasty on survival
in patients undergoing mechanical reperfusion therapy for acute myocardial
infarction.
Amir Halkin, Cindy L Grines, David A Cox, Eulogio Garcia, Roxana Mehran, James E
Tcheng, John J Griffin, Giulio Guagliumi, Bruce Brodie, Mark Turco, Barry D
Rutherford, Eve Aymong, Alexandra J Lansky, Gregg W Stone
[show abstract]
Journal of the American College of Cardiology 06/2004; 43(10):1780-7. · 14.09 Impact
Factor
Effects of prior beta-blocker therapy on clinical outcomes after primary
coronary angioplasty for acute myocardial infarction.
Kishore J Harjai, Gregg W Stone, Judith Boura, Lorelei Grines, Eulogio Garcia, Bruce
Brodie, David Cox, William W O'Neill, Cindy Grines
[show abstract]
The American Journal of Cardiology 04/2003; 91(6):655-60. · 3.21 Impact Factor

38. TOTAL
PUBLICACIONES:
242
FACTOR DE IMPACTO: 1130.32
IAM
PUBLICACIONES : 68
FACTOR DE IMPACTO : 475.66

39. Muchas Gracias