Papers by Ignacio M Bluro
Archivos peruanos de cardiología y cirugía cardiovascular, Jun 30, 2023
Esta obra tiene una licencia de Creative Commons Atribución 4.0 Internacional Artículo Original C... more Esta obra tiene una licencia de Creative Commons Atribución 4.0 Internacional Artículo Original Características clínicas y tiempos de atención en una unidad de dolor torácico del servicio de emergencias de un centro argentino
Revista Argentina de Cardiología, Oct 1, 2015
Journal of the American College of Cardiology, Nov 1, 2021
Argentine Journal of Cardiology, Aug 5, 2015
13.01 - Pulmonary hypertension, Sep 4, 2022
Revista Argentina de Cardiologia, 2018
Vascular, Sep 20, 2021
Objective Patients with peripheral artery disease (PAD) are at increased risk of major adverse li... more Objective Patients with peripheral artery disease (PAD) are at increased risk of major adverse limb events (MALE). Furthermore, MALE have several clinical implications and a poor prognosis, so prevention is a fundamental issue. The main objective of the present meta-analysis of randomized clinical trials is to evaluate the effect of different lipid-lowering therapies on MALE incidence in patients with PAD. Methods A meta-analysis of randomized studies that evaluated the use of lipid-lowering therapy in patients with PAD and reported MALE was performed, after searching the PubMed/MEDLINE, Embase, ScieLO, Google Scholar, and Cochrane Controlled Trials databases. A fixed- or random-effects model was used. Results Five randomized clinical trials including 11,603 patients were identified and considered eligible for the analyses (5903 subjects were allocated to receive lipid-lowering therapy, while 5700 subjects were allocated to the respective placebo/control arms). The present meta-analysis revealed that lipid-lowering therapy was associated with a lower incidence of MALE (OR: 0.76, 95% confidence interval: 0.66–0.87; I2: 28%) compared to placebo/control groups. The sensitivity analysis shows that the results are robust. Conclusion This study demonstrated that the use of lipid-lowering therapy compared with the placebo/control arms was associated with a marked reduction in the risk of MALE. Physicians involved in the monitoring and treatment of patients with PAD must work hard to ensure adequate lipid-lowering medication in these patients.
Revista Argentina de Cardiología, Jul 20, 2018
Revista Argentina de Cardiología, 2015
Argentine Journal of Cardiology, Sep 22, 2011
Costo-efeCtividad de estrategias en aCv y foramen oval permeable / aníbal m. arias y col.
Revista Argentina de Cardiología, Apr 1, 2010
Estudios epidemiológicos y de intervención demostraron que el nivel de apolipoproteína B (ApoB), ... more Estudios epidemiológicos y de intervención demostraron que el nivel de apolipoproteína B (ApoB), de apolipoproteína A1 (ApoA1) y la relación entre ambas son predictores independientes de riesgo cardiovascular. No disponemos de datos regionales actualizados sobre la distribución, los valores de referencia y las metas de estos biomarcadores.
Argentine Journal of Cardiology, Jan 3, 2017
Background: Patients with peripheral vascular disease represent a group at high risk of cardiovas... more Background: Patients with peripheral vascular disease represent a group at high risk of cardiovascular events, and must therefore achieve the secondary prevention goals recommended in the guidelines. Objectives: Primary: To determine what percentage of patients undergoing peripheral revascularization surgery reached LDL cholesterol goals at 6 months of the intervention compared with patients undergoing coronary artery bypass grafting. Secondary: To determine the percentage of patients reaching these levels at 18 months of follow-up, the percentage of patients with total cholesterol dosage and lipid fraction (LDL-C, HDL-C and TG) assessment at 6 and 18 months of follow-up and the percentage of statin use during the previous year and during the long term follow-up after surgery. Methods: The degree of lipid control in a retrospective cohort of patients undergoing peripheral revascularization surgery was compared with another group of patients undergoing coronary artery bypass grafting at 6 months and 18 months of the procedure. Results: A total of 468 individuals, 98 undergoing surgery for peripheral vascular disease and 370 for coronary artery disease were followed up for a period of 18 months. Mean LDL-C at 6 months of surgery was significantly higher in the vascular than in the coronary patients (98.8±35 mg/dl vs. 84.7±25 mg/dl, p=0.001), but lost significance at 18 months (93.3±23 mg/dl vs. 88±26 mg/ dl, p=0.25). The percentage of patients achieving LDL-C targets <100 mg/dl was 27.5% vs. 48.6% (p <0.0001) at 6 months in the vascular and coronary patients, respectively, and 22.5% vs. 37.3% (p=0.006) at 18 months. Conclusion: A lower percentage of patients undergoing surgical procedures for peripheral revascularization achieve LDL-C targets compared with those undergoing coronary revascularization.
Infl uencia del tabaquismo en los niveles plasmáticos de lípidos y apolipoproteínas en una poblac... more Infl uencia del tabaquismo en los niveles plasmáticos de lípidos y apolipoproteínas en una población sana 40 | 45 Pág | 40 Antecedentes: Las alteraciones en los niveles de los lípidos plasmáticos podrían ser un mecanismo por el cual el tabaquismo aumenta el riesgo cardiovascular. Diseño: Estudio de corte transversal. Objetivo: Determinar la infl uencia del tabaquismo en los niveles plasmáticos de lípidos, apolipoproteína B (ApoB) y apolipoproteína A-1 (Apo A-1) en una población sana de nuestro país. Métodos: Las concentraciones de lípidos (colesterol total, C-HDL, C-LDL, triglicéridos) y apolipoproteínas fueron determinadas en muestras obtenidas de dadores de sangre, y se las analizó de acuerdo con el estatus tabáquico. Se desarrollaron modelos de regresión lineal múltiple para evaluar la relación entre los niveles de C-HDL y ApoA-1 con el tabaquismo, y se realizaron ajustes por sexo, edad, peso y nivel de triglicéridos. Los pacientes con diabetes, hipertensión, enfermedad cardiovascular o utilización previa de hipolipemiantes fueron excluidos. Resultados: 400 pacientes fueron incluidos (edad media 36 años, 67 % hombres). Los fumadores presentaron niveles más bajos de C-HDL (47±10 vs. 52±17 mg/dL, p<0.05) y ApoA-1 (155±25 vs.165±33 mg/dL, p<0.05) que el grupo de no fumadores. Luego de ajustar por la edad, el sexo, el peso corporal y el nivel de triglicéridos, los fumadores tuvieron 8.7 mg/dL menos de ApoA-1 (IC 95 % 0.5-17, p<0.05) y 4.3 mg/dL menos de C-HDL (IC 95 % 0.2-8, p<0,05) que los no fumadores. No se encontraron diferencias signifi cativas en los niveles de colesterol, C-LDL, ApoB y triglicéridos al comparar ambos grupos. Conclusión: En esta población sana, el tabaquismo fue asociado con niveles más bajos de C-HDL y ApoA-1. Estos hallazgos podrían explicar parcialmente el mayor riesgo cardiovascular que presentan los fumadores. Palabras claves: Lípidos-Apolipoproteínas-Tabaquismo-Riesgo cardiovascular Background: Changes in plasma lipids levels could be one of the mechanisms by which smoking increases cardiovascular risk. Design: Cross sectional study. Objective: To determine the infl uence of smoking in plasma lipids levels, apolipoprotein B (ApoB) and apolipoprotein A-1 (Apo A-1) in a healthy population of our country. Methods: Lipids and apolipoproteins levels were determinated in samples obtained from blood givers and were analyzed according to the smoking status. We developed multiple linear regression models assessed the relationship between levels of HDL-C and ApoA-1 with smoking, adjusting for sex, age, weight and triglyceride level. Patients with diabetes, hypertension, history of cardiovascular disease or lipid-lowering therapy were excluded. Results: 400 patients were included (mean age 36 years, 67% male). Smokers presented lower level of HDL-C (47±10 vs. 52±17 mg/dL, p<0.05) and ApoA-1 (155±25 vs. 165±33 mg/dL, p<0.05) that the group of nonsmokers. After adjusting for age, sex, body weight and triglycerides levels, smokers had 8.7 mg/dL less of ApoA-I levels (CI 95% 0.5-17, p<0.05) and 4.3 mg/dL less of HDL-C levels (CI 95% 0.2-8, p<0,05) than non-smokers. There were no signifi cant differences in levels of cholesterol, LDL-C and triglycerides when comparing both groups. Conclusion: In this healthy population, smoking was associated with lower levels of HDL-C and ApoA-I. These fi ndings could partly explain the increased cardiovascular risk in smokers.
Advances in respiratory medicine, Feb 24, 2022
This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
Vascular Medicine, Apr 25, 2022
Background: Despite strong association of elevated lipoprotein (a) (Lp(a)) levels with incident c... more Background: Despite strong association of elevated lipoprotein (a) (Lp(a)) levels with incident coronary and cerebrovascular disease, data for incident peripheral artery disease (PAD) are less robust. The main objective of the present systematic review was to analyze the association between elevated Lp(a) levels and PAD outcomes. Methods: This systematic review was performed according to PRISMA guidelines. A literature search was performed to detect randomized clinical trials or observational studies with a cohort design that evaluated the association between Lp(a) levels and PAD outcomes. Results: Fifteen studies including 493,650 subjects were identified and considered eligible for this systematic review. This systematic review showed that the vast majority of the studies reported a significant association between elevated Lp(a) levels and the risk of PAD outcomes. The elevated Lp(a) levels were associated with a higher risk of incident claudication (RR: 1.20), PAD progression (HR: 1.41), restenosis (HR: 6.10), death and hospitalization related to PAD (HR: 1.37), limb amputation (HR: 22.75), and lower limb revascularization (HR: 1.29 and 2.90). In addition, the presence of elevated Lp(a) values were associated with a higher risk of combined PAD outcomes, with HRs in a range between 1.14 and 2.80, despite adjusting for traditional risk factors. Heterogeneity of results can be explained by different patient populations studied and varying Lp(a) cut-off points of Lp(a) analyzed. Conclusion: This systematic review suggests that evidence is available to support an independent positive association between Lp(a) levels and the risk of future PAD outcomes. PROSPERO Registration No.: 289253.
CardioVascular and Interventional Radiology, 2022
Common femoral artery (CFA) is a critical segment of the lower-limb arterial tree. We sought to p... more Common femoral artery (CFA) is a critical segment of the lower-limb arterial tree. We sought to propose an extensive classification in order to appraise a diagnostic and therapeutic approach. A retrospective cohort of CFA lesions with endovascular therapy was evaluated. We appraised the extension, the degree of stenosis and the calcium burden. A new group “IV” included lesions that started at the external iliac artery or common iliac artery extending into the CFA and affecting its bifurcation. The primary outcome was the need for a retrograde bailout access after failed anterograde access and the procedural time. From 2012 to 2020, a total of 58 lower limbs in patients with CFA lesions were included. New proposed group IV compromised 36% of lesions. Additionally, procedural time was significantly longer in group IV lesions compared with the rest (76.9 ± 32.23 min vs 47.67 ± 17.93 min, p < 0.01), as was the requirement of retrograde bailout access (23.8 vs 2.6%, p = 0.03). Occlusive lesions were associated with longer procedural times and bailout retrograde access compared to stenotic lesions (74.7 ± 33.6 min vs 48.29 ± 16 min, p < 0.001 and 26.1 vs 0%, p = 0.006, respectively), as well as heavy calcification compared to mild or moderate calcification (73.18 ± 28.15 vs 51.86 ± 25.1, p = 0.06 and 29.4 vs 2.4%, p = 0.009, respectively). Secondary clinical outcomes and target lesion revascularization did not differ among groups. Our classification includes a new group of extensive and frequent lesions, which did not fit in previous classifications.
Revista Argentina de Cardiología, 2016
INTRODUCCION : El objetivo de este trabajo es analizar nuestros resultados en el tratamiento endo... more INTRODUCCION : El objetivo de este trabajo es analizar nuestros resultados en el tratamiento endovascular de los pacientes con sintomas de claudicacion intermitente. MATERIAL Y METODOS : Entre octubre de 2010 y enero de 2015 se trataron 115 extremidades en 90 pacientes. El objetivo primario fue evaluar el exito tecnico, complicaciones y seguimiento clinico. RESULTADOS: Se consiguio el exito tecnico en 99.1% de las extremidades. La media de seguimiento fue de 18 meses (entre 1-36 meses). Se realizo el seguimiento en el 96.5% de las extremidades, 93.7% se encontraban asintomaticas; 3.6% sintomaticas con mejoria y 2.7% sin cambios clinicos. CONCLUSION : El tratamiento endovascular para el paciente claudicantes es seguro, eficaz y presenta baja morbimortalidad asociada en grupos experimentados. En aquellos pacientes que deseen incrementar de forma significativa el perimetro de marcha el tratamiento endovascular deberia considerarse como el tratamiento de eleccion.
Argentine Journal of Cardiology, 2018
Background: Increased pulmonary vascular resistance, assessed by right catheterization, is usuall... more Background: Increased pulmonary vascular resistance, assessed by right catheterization, is usually mentioned as a relative contraindication for inclusion in the list of heart transplantation since it is associated with failure of the implanted right ventricle. There is evidence suggesting that the behavior of the pulmonary circulation depends on its interaction with theright ventricle, so a parameter that evaluates ventricular-arterial coupling could predict right ventricular failure better than isolated hemodynamic parameters. Objective: The aim of this study was to assess the ability of the tricuspid annular plane systolic excursion/pulmonary systolic pressure ratio (TAPSE/PSP) to predict the incidence of post-transplantation right ventricular failure compared with invasive hemodynamic parameters measured before transplantation. Methods: This was a retrospective cohort study using variables prospectively collected from the heart transplantation database of a University Hospital of...
Argentine Journal of Cardiology, 2015
Vascular and Endovascular Surgery, 2021
Purpose: This technical note aims to show a challenging endovascular treatment approach of a gian... more Purpose: This technical note aims to show a challenging endovascular treatment approach of a giant and tortuous ruptured popliteal artery aneurism Materials and Methods: An 86-year-old male patient was admitted for acute lower right limb ischemia. Angio-MSCT showed highly calcified superficial femoral artery, with a 180° bend in distal portion, followed by a large popliteal aneurism (63 × 61 mm) with a large extent hematoma (142 × 112 × 104 mm). Endovascular approach was chosen due to high morbidity. Results: Anterior puncture of right superficial femoral artery was performed under ultrasound guidance. Despite various intents, the 0.035 hydrophilic coated wire could not be crossed distally through the aneurism. Retrograde access was performed via tibio-peroneal trunk under fluoroscopic guidance with a micropuncture set. A stiff 0.035″ Glidewire® was successfully advanced into the proximal portion of the aneurism through a 5F vertebral catheter externalized with a snare from the femo...
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Papers by Ignacio M Bluro