Try a new search

Format these results:

Searched for:

person:alviac01

in-biosketch:true

Total Results:

113


Prognostic performance of the IABP-SHOCK II Risk Score among cardiogenic shock subtypes in the critical care cardiology trials network registry

Alviar, Carlos L; Li, Boyangzi K; Keller, Norma M; Bohula-May, Erin; Barnett, Christopher; Berg, David D; Burke, James A; Chaudhry, Sunit-Preet; Daniels, Lori B; DeFilippis, Andrew P; Gerber, Daniel; Horowitz, James; Jentzer, Jacob C; Katrapati, Praneeth; Keeley, Ellen; Lawler, Patrick R; Park, Jeong-Gun; Sinha, Shashank S; Snell, Jeffrey; Solomon, Michael A; Teuteberg, Jeffrey; Katz, Jason N; van Diepen, Sean; Morrow, David A; ,
BACKGROUND:Risk stratification has potential to guide triage and decision-making in cardiogenic shock (CS). We assessed the prognostic performance of the IABP-SHOCK II score, derived in Europe for acute myocardial infarct-related CS (AMI-CS), in a contemporary North American cohort, including different CS phenotypes. METHODS:The critical care cardiology trials network (CCCTN) coordinated by the TIMI study group is a multicenter network of cardiac intensive care units (CICU). Participating centers annually contribute ≥2 months of consecutive medical CICU admissions. The IABP-SHOCK II risk score includes age > 73 years, prior stroke, admission glucose > 191 mg/dl, creatinine > 1.5 mg/dl, lactate > 5 mmol/l, and post-PCI TIMI flow grade < 3. We assessed the risk score across various CS etiologies. RESULTS:= 0.17) and the IABP-SHOCK II score revealed a significant risk gradient within each SCAI stage. CONCLUSIONS:In an unselected international multicenter registry of patients admitted with CS, the IABP- SHOCK II score only moderately predicted in-hospital mortality in a broad population of CS regardless of etiology or irrespective of right, left, or bi-ventricular involvement.
PMID: 38190931
ISSN: 1097-6744
CID: 5639692

Intracardiac Versus Transesophageal Echocardiography Guided Percutaneous Debulking of Tricuspid Endocarditis

Zhang, Robert S; Bailey, Eric; Maqsood, Muhammad H; Harari, Rafael; Bernard, Samuel; Xia, Yuhe; Keller, Norma; Alviar, Carlos L; Bangalore, Sripal
PMID: 38401653
ISSN: 1879-1913
CID: 5634712

Outcomes of Patients with Cardiogenic Shock in Hub and Spoke Centers: The importance of Protocol Standardization at a Network Level

Alviar, Carlos L; Hall, Sylvie; Mebazaa, Alexandre
PMID: 38367907
ISSN: 1532-8414
CID: 5636172

Resource use among patients with transcatheter cardiac valve procedures admitted to contemporary cardiac intensive care units: insights from CCCTN

Bhatt, Ankeet S; Berg, David D; Palazzolo, Michael G; Alviar, Carlos L; Bohula, Erin A; Morrow, David A
PMID: 37798090
ISSN: 2048-8734
CID: 5633702

Catheter-based therapy for intermediate or high-risk pulmonary embolism is associated with lower in-hospital mortality in patients with cancer: Insights from the National Inpatient Sample

Leiva, Orly; Yuriditsky, Eugene; Postelnicu, Radu; Yang, Eric H; Mukherjee, Vikramjit; Greco, Allison; Horowitz, James; Alviar, Carlos; Bangalore, Sripal
BACKGROUND:Pulmonary embolism (PE) is a common complication among patients with cancer and is a significant contributor to morbidity and mortality. Catheter-based therapies (CBT), including catheter-directed thrombolysis (CDT) and mechanical thrombectomy, have been developed and are used in patients with intermediate or high-risk PE. However, there is a paucity of data on outcomes in patients with cancer as most clinical studies exclude this group of patients. AIMS/OBJECTIVE:To characterize outcomes of patients with cancer admitted with intermediate or high-risk PE treated with CBT compared with no CBT. METHODS:Patients with an admission diagnosis of intermediate or high-risk PE and a history of cancer from October 2015 to December 2018 were identified using the National Inpatient Sample. Outcomes of interest were in-hospital death or cardiac arrest (CA) and major bleeding. Inverse probability treatment weighting (IPTW) was utilized to compare outcomes between patients treated with and without CBT. Variables that remained unbalanced after IPTW were adjusted using multivariable logistic regression. RESULTS:A total of 2084 unweighted admissions (10,420 weighted) for intermediate or high-risk PE and cancer were included, of which 136 (6.5%) were treated with CBT. After IPTW, CBT was associated with lower death or CA (aOR 0.54, 95% CI 0.46-0.64) but higher major bleeding (aOR 1.41, 95% CI 1.21-1.65). After stratifying by PE risk type, patients treated with CBT had lower risk of death or CA in both intermediate (aOR 0.52, 95% CI 0.36-0.75) and high-risk PE (aOR 0.48, 95% CI 0.33-0.53). However, patients with CBT were associated with increased risk of major bleeding in intermediate-risk PE (aOR 2.12, 95% CI 1.67-2.69) but not in those with high-risk PE (aOR 0.84, 95% CI 0.66-1.07). CONCLUSIONS:Among patients with cancer hospitalized with intermediate or high-risk PE, treatment with CBT was associated with lower risk of in-hospital death or CA but higher risk of bleeding. Prospective studies and inclusion of patients with cancer in randomized trials are warranted to confirm our findings.
PMID: 37997287
ISSN: 1522-726x
CID: 5608872

Quality and rapidity of anticoagulation in patients with acute pulmonary embolism undergoing mechanical thrombectomy

Zhang, Robert S; Ho, Alvin M; Elbaum, Lindsay; Greco, Allison A; Hall, Sylvie; Postelnicu, Radu; Mukherjee, Vikramjit; Maqsood, Muhammad H; Keller, Norma; Alviar, Carlos L; Bangalore, Sripal
The primary objective of our study was to determine the proportion of intermediate-risk PE patients undergoing mechanical thrombectomy (MT) who achieved therapeutic anticoagulation (AC) at the time of the procedure. The salient findings of our study showed that only a minority of patients (14.3%) were in the therapeutic range by ACT at the time of MT (primary outcome). Furthermore, in this higher-risk PE cohort selected for MT, 18.2% of patients were subtherapeutic after initially reaching therapeutic AC, 43% experienced supratherapeutic AC at some point before MT, and less than half (43%) attained therapeutic AC at 6 hours, highlighting the necessity for optimizing anticoagulation practices in acute PE.
PMID: 38071002
ISSN: 1097-6744
CID: 5589832

Role of Advanced Practice Providers in the Cardiac Intensive Care Unit Team

Tennyson, Carolina D; Bowers, Margaret T; Dimsdale, Allison W; Dickinson, Sharon M; Sanford, R Monica; McKenzie-Solis, Jordan D; Schimmer, Hannah D; Alviar, Carlos L; Sinha, Shashank S; Katz, Jason N
PMID: 38057076
ISSN: 1558-3597
CID: 5589702

Validating the Composite Pulmonary Embolism Shock Score for Predicting Normotensive Shock in Intermediate-Risk Pulmonary Embolism

Zhang, Robert S; Alam, Usman; Sharp, Andrew S P; Giri, Jay S; Greco, Allison A; Secemsky, Eric A; Postelnicu, Radu; Sethi, Sanjum S; Alviar, Carlos L; Bangalore, Sripal
PMID: 38063026
ISSN: 1941-7632
CID: 5591522

Percutaneous Debulking of a Tricuspid Valve Papillary Fibroelastoma: A Rare Presentation and Management Approach

Zhang, Robert S; Harari, Rafael; Kelly, Sean M; Talmor, Nina; Rhee, Aaron J; Panhwar, Muhammad S; Yee-Chang, Melissa; Nayar, Ambika C; Keller, Norma M; Alviar, Carlos L; Bangalore, Sripal
PMID: 38047386
ISSN: 1942-0080
CID: 5597802

Network meta-analysis of temporary mechanical circulatory support in acute myocardial infarction cardiogenic shock

Jentzer, Jacob C; Watanabe, Atsuyuki; Kuno, Toshiki; Bangalore, Sripal; Alviar, Carlos L
We performed a network meta-analysis of 11 published randomized clinical trials examining the use of temporary mechanical circulatory support (MCS) devices in adults with acute myocardial infarction cardiogenic shock, including 1,053 total patients with an observed in-hospital or 30-day mortality of 40.4%. None of the temporary MCS devices was associated with lower in-hospital or 30-day mortality compared with initial medical therapy or any other MCS device, either individually or in combination. These data do not support the routine use of temporary MCS devices for the purpose of reducing short-term mortality in unselected patients with acute myocardial infarction cardiogenic shock.
PMID: 37591368
ISSN: 1097-6744
CID: 5607772