Eulogio García
Julio 1991. Hospital Universitario Gregorio Marañón 
Inspiración: “In Laboratory events during 
primary angioplasty“ Kahn/...
Compromiso 
Estudio Randomizado de Infarto Anterior ( 
AP vs t-pa ) 
Paciente con menos de 5 horas desde 
comienzo del dol...
Impacto 
Incremento actividad 25% 
Recelo exterior 
Debates 
Dificultad en convencer autoridades de 
establecimiento de re...
Acumulación de experiencia clínica 
1. Capacidad de respuesta : 40 minutos 
llamada – balón 
2. Establecimiento de sistemá...
NUMEROS ( 1991-2007) 
Procedimientos : 3750 
Stents : 3300 
Dispositivos de aspiración : 392 
Balones de contrapulsación :...
Debates científicos 
Congreso nacional SEC ( Madrid 1995 ) 
Congresos regionales 
Congreso nacional SEC ( 1998 )
Eulogio García 
Hospital Gregorio Marañon 
MADRID
Eulogio García MD 
Hospital Gregorio Marañon 
MADRID - Spain
CONVENCIMIENTO ADMINISTRATIVO 
Tiene Madrid los medios necesarios ? 
1. Situación geográfica idónea 
2. Sistema de traspor...
CONCLUSIONES 
Con tiempos de traslado razonables, los resultados de 
ACTP primaria post –traslado son superiores al 
trata...
INICIATIVAS Y RESPUESTAS 
COLABORACIÓN CON SISTEMAS DE TRASPORTE 
1. Sesiones de información y proyectos 
2. Elaboración d...
RESPUESTA ADMINISTRATIVA 
Proyecto presentado en 2001 : RIMA 
Respuesta : Silencio 
Razones : Proyecto inadecuado ?, 
Argu...
EDITORIAL 
[Primary angioplasty: this balloon is of 
general interest, indeed]. Eulogio García Revista 
Esp de Cardiologia...
ESTUDIOS MONOCENTRICOS 
[Primary coronary angioplasty in acute anterior myocardial infarction: 
immediate results]. 
E J G...
METANÁLISIS 
Comparison of Primary Coronary Angioplasty and Intravenous 
Thrombolytic Therapy for Acute Myocardial Infarct...
ESTUDIOS MULTICENTRICOS 
Coronary angioplasty with or without stent implantation for acute 
myocardial infarction. Stent P...
ROTURA CARDIACA 
Primary angioplasty reduces the risk of left ventricular free wall rupture 
compared with thrombolysis in...
CIRCULACION COLATERAL 
Influence of collateral circulation on in-hospital death from anterior acute 
myocardial infarction...
EDAD Y SEXO 
Outcome in elderly patients undergoing primary coronary intervention for 
acute myocardial infarction: result...
PERFUSION MIOCÁRDICA 
Combined prognostic utility of ST-segment recovery and myocardial blush after 
primary percutaneous ...
PERFUSION MIOCÁRDICA 
Prognostic utility of comparative methods for assessment of ST-segment 
resolution after primary ang...
PLATELETS 
Impact of in-hospital acquired thrombocytopenia in patients undergoing 
primary angioplasty for acute myocardia...
REOPRO 
Benefits and risks of abciximab use in primary angioplasty for acute myocardial 
infarction: the Controlled Abcixi...
ASPIRACION DE TROMBO STENT. 
Mid-term results of thrombus extraction in patients with ST elevation 
myocardial infarction:...
NEUTROPHILS 
Relation between leucocyte count, myonecrosis, myocardial perfusion, and 
outcomes following primary angiopla...
MULTIVASO, SHOCK. 
[Results of primary angioplasty in patients with multivessel 
disease]. 
R Moreno, E García, J Elízaga,...
INSUFICIENCIA RENAL 
Impact of renal insufficiency in patients undergoing primary angioplasty 
for acute myocardial infarc...
RESCATE, GUIAS 
Coronary stenting during rescue angioplasty after failed thrombolysis. 
R Moreno, E García, M Abeytua, J S...
BETA-BLOQUEANTES 
Impact of intravenous beta-blockade before primary angioplasty on survival 
in patients undergoing mecha...
TOTAL 
PUBLICACIONES: 
242 
FACTOR DE IMPACTO: 1130.32 
IAM 
PUBLICACIONES : 68 
FACTOR DE IMPACTO : 475.66
Muchas Gracias
01 primer hospital con angioplastía primaria sistemática c. real
01 primer hospital con angioplastía primaria sistemática c. real
01 primer hospital con angioplastía primaria sistemática c. real
01 primer hospital con angioplastía primaria sistemática c. real
01 primer hospital con angioplastía primaria sistemática c. real
01 primer hospital con angioplastía primaria sistemática c. real
01 primer hospital con angioplastía primaria sistemática c. real
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01 primer hospital con angioplastía primaria sistemática c. real

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01 primer hospital con angioplastía primaria sistemática c. real

  1. 1. Eulogio García
  2. 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. 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. 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. 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. 6. NUMEROS ( 1991-2007) Procedimientos : 3750 Stents : 3300 Dispositivos de aspiración : 392 Balones de contrapulsación : 330 Médicos tratados : 25 Políticos tratados : 12
  7. 7. Debates científicos Congreso nacional SEC ( Madrid 1995 ) Congresos regionales Congreso nacional SEC ( 1998 )
  8. 8. Eulogio García Hospital Gregorio Marañon MADRID
  9. 9. Eulogio García MD Hospital Gregorio Marañon MADRID - Spain
  10. 10. 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
  11. 11. 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.
  12. 12. 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
  13. 13. RESPUESTA ADMINISTRATIVA Proyecto presentado en 2001 : RIMA Respuesta : Silencio Razones : Proyecto inadecuado ?, Argumentación poco convincente? Temor al gasto ? Influencias negativas ajenas ?
  14. 14. 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
  15. 15. 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
  16. 16. 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
  17. 17. 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
  18. 18. 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
  19. 19. 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
  20. 20. 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
  21. 21. 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
  22. 22. 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
  23. 23. 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
  24. 24. 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
  25. 25. 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
  26. 26. 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
  27. 27. 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
  28. 28. 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
  29. 29. 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
  30. 30. 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
  31. 31. TOTAL PUBLICACIONES: 242 FACTOR DE IMPACTO: 1130.32 IAM PUBLICACIONES : 68 FACTOR DE IMPACTO : 475.66
  32. 32. Muchas Gracias

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