Mauricio Cohen - Academia.edu (original) (raw)
Papers by Mauricio Cohen
The American journal of medicine, Jun 4, 2017
The outcomes related to chest pain associated with cocaine use and its burden on healthcare syste... more The outcomes related to chest pain associated with cocaine use and its burden on healthcare system are not well studied. Data were collected from the Nationwide Inpatient Sample (2001 - 2012). Subjects were identified by using the ICD-9-CM codes. Primary outcome was a composite of mortality, myocardial infarction, stroke and cardiac arrest. We identified 363,143 admissions for cocaine induced chest pain. Mean age was 44.9 (+ 21.1) years with male predominance. Left heart catheterizations were performed in 6.7%, whereas the frequency of acute MI and percutaneous coronary interventions were 0.69% and 0.22% respectively. The in-hospital mortality was 0.09% and the primary outcome occurred in 1.19% of patients. Statistically significant predictors of primary outcome included female sex (OR=1.16, CI 1.00-1.35, p=0.046), age > 50 years (OR=1.24, CI 1.07-1.43, p=0.004), history of heart failure (OR=1.63, CI 1.37-1.93, p<0.001), supraventricular tachycardia (OR=2.94, CI 1.34-6.42, p=0...
Journal of the American College of Cardiology, 2016
Journal of the American College of Cardiology, 2016
Journal of the American College of Cardiology, 2016
Ventricular septal rupture (VSR) is a sporadic but lethal complication after an acute myocardial ... more Ventricular septal rupture (VSR) is a sporadic but lethal complication after an acute myocardial infarction (MI). With the advent of reperfusion strategies, VSRs have become all the more infrequent, yet the outcomes continue to negatively impact the clinical prognosis of these patients while
Journal of the American College of Cardiology, 2016
Journal of the American College of Cardiology, 2016
TCT-23 Contemporary Trends in Utilization of Mechanical Circulatory Support in Patients Hospitali... more TCT-23 Contemporary Trends in Utilization of Mechanical Circulatory Support in Patients Hospitalized After Out-of-Hospital Cardiac Arrest Nileshkumar Patel, Nish Patel, Gabriel Hernandez, Shilpkumar Arora, Apurva Badheka, Abhishek Deshmukh, Eduardo DeMarchena, Mauricio Cohen, Carlos Alfonso, Deepak Bhatt, Navin Kapur University of Miami, MIAMI, Florida, United States; University of Miami Miller School of Medicine, Miami, Florida, United States; Novosibirsk State Research Institute of Circulation Pathology; Mount Sinai st luke’s roosevelt, New York, New York, United States; Yale university, New haven, Connecticut, United States; UAMS erwqeqweqw, little rock, Arkansas, United States; University of Miami, Miami, Florida, United States; University of Miami Hospital, Miami, Florida, United States; University of Miami Miller School of Medicine, Miami, Florida, United States; Brigham and Women’s Hospital, Boston, Massachusetts, United States; Tufts Medical Center, Boston, Massachusetts, United States
Journal of the American College of Cardiology, 2016
Journal of the American College of Cardiology, 2016
The American Journal of Cardiology, 2016
Data Revues 00029149 Unassign S0002914913010576, May 30, 2013
Circulation, Nov 20, 2012
Background Balloon aortic valvuloplasty (BAV) is a palliative treatment for severe aortic stenosi... more Background Balloon aortic valvuloplasty (BAV) is a palliative treatment for severe aortic stenosis that is increasingly performed as a bridge to transcatheter aortic valve replacement. While chronic kidney disease (CKD) is a frequent comorbidity in elderly patients with aortic stenosis undergoing BAV, its impact on in-hospital outcomes has not yet been determined. Methods We conducted a retrospective analysis of 421 consecutive patients who underwent non-emergent BAV at two high-volume centers. We analyzed baseline and procedural characteristics as well as in-hospital outcomes according to the presence or absence of CKD, defined as a glomerular filtration rate of 2 . All adverse events were adjudicated by a blinded, independent clinical events committee. Results Of the 421 patients who underwent BAV, 251 (59.2%) had CKD. Patients with CKD had significantly higher rates of mortality (8.0% vs. 2.4%, p=0.02) and major bleeding (14.3% vs. 7.6%, p=0.04) as well as net adverse clinical events (18.7% vs. 11.2%, p=0.04) compared to patients without CKD. A secondary analysis stratifying the groups by type of antithrombotic used revealed an almost 3-fold decrease in major bleeding events in CKD patients treated with bivalirudin compared to those receiving heparin (5.8% vs. 14.9%, p=0.01). After multivariate analysis controlling for multiple confounders, CKD remained associated with an increased risk for bleeding (OR 1.99; 95%CI [0.83, 4.78]; p=0.12) and death (OR 2.12; 95%CI [0.61, 7.33]; p=0.24), without statistical significance. Conclusions CKD is associated with an increased risk of in-hospital mortality and bleeding complications post-BAV. Further research is warranted to determine whether adverse outcomes in CKD patients can be reduced through selective use of novel devices or alternative pharmacological approaches.
Clinical cardiology, 2016
Fibrinolytic therapy is still used in patients with ST-segment elevation myocardial infarction (S... more Fibrinolytic therapy is still used in patients with ST-segment elevation myocardial infarction (STEMI) when the primary percutaneous coronary intervention cannot be provided in a timely fashion. Management strategies and outcomes in transferred fibrinolytic-treated STEMI patients have not been well assessed in real-world settings. Using the Nationwide Inpatient Sample from 2008 to 2012, we identified 18 814 patients with STEMI who received fibrinolytic therapy and were transferred to a different facility within 24 hours. The primary outcome was in-hospital mortality. Secondary outcomes included gastrointestinal bleeding, bleeding requiring transfusion, intracranial hemorrhage (ICH), length of stay, and cost. The patients were divided into 3 groups: those who received medical therapy alone (n = 853; 4.5%), those who underwent coronary artery angiography without revascularization (n = 2573; 13.7%), and those who underwent coronary artery angiography with revascularization (n = 15 388;...
Journal of interventional cardiology, 2015
To compare the utilization and outcomes in patients who had percutaneous coronary interventions (... more To compare the utilization and outcomes in patients who had percutaneous coronary interventions (PCIs) performed with intra-aortic balloon pump (IABP) versus percutaneous ventricular assist devices (PVADs) such as Impella and TandemHeart and identify a sub-group of patient population who may derive the most benefit from the use of PVADs over IABP. Despite the lack of clear benefit, the use of PVADs has increased substantially in the last decade when compared to IABP. We performed a cross sectional study including using the Nationwide Inpatient Sample. Procedures performed with hemodynamic support were identified through appropriate ICD-9-CM codes. We identified 18,094 PCIs performed with hemodynamic support. IABP was the most commonly utilized hemodynamic support device (93%, n = 16, 803) whereas 6% (n = 1069) were performed with PVADs and 1% (n = 222) utilized both IABP and PVAD. Patients in the PVAD group were older in age and had greater burden of co-morbidities whereas IABP grou...
Journal of the American College of Cardiology, 2015
Catheterization and Cardiovascular Interventions, 2014
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2014
We sought to assess if bivalirudin use during balloon aortic valvuloplasty (BAV) would affect cli... more We sought to assess if bivalirudin use during balloon aortic valvuloplasty (BAV) would affect clinical outcomes compared with heparin. We compared the outcomes of consecutive patients who underwent elective or urgent BAV with intraprocedural use of bivalirudin or heparin at two high-volume centres. All in-hospital events post BAV were adjudicated by an independent, blinded clinical events committee. Of 427 patients, 223 patients (52.2%) received bivalirudin and 204 (47.8%) received heparin. Compared with patients who received heparin, patients who received bivalirudin had significantly less major bleeding (4.9% vs. 13.2%, p=0.003). Net adverse clinical events (NACE, major bleeding or major adverse cardiovascular events [MACE]) were also reduced (11.2% vs. 20.1%, p=0.01). There was no significant difference in the rates of MACE (mortality, myocardial infarction or stroke, 6.7% vs. 11.3%, p=0.1), or vascular complications (major, 2.7% vs. 2.0%; minor, 4.5% vs. 4.9%; p=0.83). After mul...
Revista argentina de …, 2005
Journal of the American College of Cardiology, 2013
Journal of the American College of Cardiology, 2014
The American journal of medicine, Jun 4, 2017
The outcomes related to chest pain associated with cocaine use and its burden on healthcare syste... more The outcomes related to chest pain associated with cocaine use and its burden on healthcare system are not well studied. Data were collected from the Nationwide Inpatient Sample (2001 - 2012). Subjects were identified by using the ICD-9-CM codes. Primary outcome was a composite of mortality, myocardial infarction, stroke and cardiac arrest. We identified 363,143 admissions for cocaine induced chest pain. Mean age was 44.9 (+ 21.1) years with male predominance. Left heart catheterizations were performed in 6.7%, whereas the frequency of acute MI and percutaneous coronary interventions were 0.69% and 0.22% respectively. The in-hospital mortality was 0.09% and the primary outcome occurred in 1.19% of patients. Statistically significant predictors of primary outcome included female sex (OR=1.16, CI 1.00-1.35, p=0.046), age > 50 years (OR=1.24, CI 1.07-1.43, p=0.004), history of heart failure (OR=1.63, CI 1.37-1.93, p<0.001), supraventricular tachycardia (OR=2.94, CI 1.34-6.42, p=0...
Journal of the American College of Cardiology, 2016
Journal of the American College of Cardiology, 2016
Journal of the American College of Cardiology, 2016
Ventricular septal rupture (VSR) is a sporadic but lethal complication after an acute myocardial ... more Ventricular septal rupture (VSR) is a sporadic but lethal complication after an acute myocardial infarction (MI). With the advent of reperfusion strategies, VSRs have become all the more infrequent, yet the outcomes continue to negatively impact the clinical prognosis of these patients while
Journal of the American College of Cardiology, 2016
Journal of the American College of Cardiology, 2016
TCT-23 Contemporary Trends in Utilization of Mechanical Circulatory Support in Patients Hospitali... more TCT-23 Contemporary Trends in Utilization of Mechanical Circulatory Support in Patients Hospitalized After Out-of-Hospital Cardiac Arrest Nileshkumar Patel, Nish Patel, Gabriel Hernandez, Shilpkumar Arora, Apurva Badheka, Abhishek Deshmukh, Eduardo DeMarchena, Mauricio Cohen, Carlos Alfonso, Deepak Bhatt, Navin Kapur University of Miami, MIAMI, Florida, United States; University of Miami Miller School of Medicine, Miami, Florida, United States; Novosibirsk State Research Institute of Circulation Pathology; Mount Sinai st luke’s roosevelt, New York, New York, United States; Yale university, New haven, Connecticut, United States; UAMS erwqeqweqw, little rock, Arkansas, United States; University of Miami, Miami, Florida, United States; University of Miami Hospital, Miami, Florida, United States; University of Miami Miller School of Medicine, Miami, Florida, United States; Brigham and Women’s Hospital, Boston, Massachusetts, United States; Tufts Medical Center, Boston, Massachusetts, United States
Journal of the American College of Cardiology, 2016
Journal of the American College of Cardiology, 2016
The American Journal of Cardiology, 2016
Data Revues 00029149 Unassign S0002914913010576, May 30, 2013
Circulation, Nov 20, 2012
Background Balloon aortic valvuloplasty (BAV) is a palliative treatment for severe aortic stenosi... more Background Balloon aortic valvuloplasty (BAV) is a palliative treatment for severe aortic stenosis that is increasingly performed as a bridge to transcatheter aortic valve replacement. While chronic kidney disease (CKD) is a frequent comorbidity in elderly patients with aortic stenosis undergoing BAV, its impact on in-hospital outcomes has not yet been determined. Methods We conducted a retrospective analysis of 421 consecutive patients who underwent non-emergent BAV at two high-volume centers. We analyzed baseline and procedural characteristics as well as in-hospital outcomes according to the presence or absence of CKD, defined as a glomerular filtration rate of 2 . All adverse events were adjudicated by a blinded, independent clinical events committee. Results Of the 421 patients who underwent BAV, 251 (59.2%) had CKD. Patients with CKD had significantly higher rates of mortality (8.0% vs. 2.4%, p=0.02) and major bleeding (14.3% vs. 7.6%, p=0.04) as well as net adverse clinical events (18.7% vs. 11.2%, p=0.04) compared to patients without CKD. A secondary analysis stratifying the groups by type of antithrombotic used revealed an almost 3-fold decrease in major bleeding events in CKD patients treated with bivalirudin compared to those receiving heparin (5.8% vs. 14.9%, p=0.01). After multivariate analysis controlling for multiple confounders, CKD remained associated with an increased risk for bleeding (OR 1.99; 95%CI [0.83, 4.78]; p=0.12) and death (OR 2.12; 95%CI [0.61, 7.33]; p=0.24), without statistical significance. Conclusions CKD is associated with an increased risk of in-hospital mortality and bleeding complications post-BAV. Further research is warranted to determine whether adverse outcomes in CKD patients can be reduced through selective use of novel devices or alternative pharmacological approaches.
Clinical cardiology, 2016
Fibrinolytic therapy is still used in patients with ST-segment elevation myocardial infarction (S... more Fibrinolytic therapy is still used in patients with ST-segment elevation myocardial infarction (STEMI) when the primary percutaneous coronary intervention cannot be provided in a timely fashion. Management strategies and outcomes in transferred fibrinolytic-treated STEMI patients have not been well assessed in real-world settings. Using the Nationwide Inpatient Sample from 2008 to 2012, we identified 18 814 patients with STEMI who received fibrinolytic therapy and were transferred to a different facility within 24 hours. The primary outcome was in-hospital mortality. Secondary outcomes included gastrointestinal bleeding, bleeding requiring transfusion, intracranial hemorrhage (ICH), length of stay, and cost. The patients were divided into 3 groups: those who received medical therapy alone (n = 853; 4.5%), those who underwent coronary artery angiography without revascularization (n = 2573; 13.7%), and those who underwent coronary artery angiography with revascularization (n = 15 388;...
Journal of interventional cardiology, 2015
To compare the utilization and outcomes in patients who had percutaneous coronary interventions (... more To compare the utilization and outcomes in patients who had percutaneous coronary interventions (PCIs) performed with intra-aortic balloon pump (IABP) versus percutaneous ventricular assist devices (PVADs) such as Impella and TandemHeart and identify a sub-group of patient population who may derive the most benefit from the use of PVADs over IABP. Despite the lack of clear benefit, the use of PVADs has increased substantially in the last decade when compared to IABP. We performed a cross sectional study including using the Nationwide Inpatient Sample. Procedures performed with hemodynamic support were identified through appropriate ICD-9-CM codes. We identified 18,094 PCIs performed with hemodynamic support. IABP was the most commonly utilized hemodynamic support device (93%, n = 16, 803) whereas 6% (n = 1069) were performed with PVADs and 1% (n = 222) utilized both IABP and PVAD. Patients in the PVAD group were older in age and had greater burden of co-morbidities whereas IABP grou...
Journal of the American College of Cardiology, 2015
Catheterization and Cardiovascular Interventions, 2014
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2014
We sought to assess if bivalirudin use during balloon aortic valvuloplasty (BAV) would affect cli... more We sought to assess if bivalirudin use during balloon aortic valvuloplasty (BAV) would affect clinical outcomes compared with heparin. We compared the outcomes of consecutive patients who underwent elective or urgent BAV with intraprocedural use of bivalirudin or heparin at two high-volume centres. All in-hospital events post BAV were adjudicated by an independent, blinded clinical events committee. Of 427 patients, 223 patients (52.2%) received bivalirudin and 204 (47.8%) received heparin. Compared with patients who received heparin, patients who received bivalirudin had significantly less major bleeding (4.9% vs. 13.2%, p=0.003). Net adverse clinical events (NACE, major bleeding or major adverse cardiovascular events [MACE]) were also reduced (11.2% vs. 20.1%, p=0.01). There was no significant difference in the rates of MACE (mortality, myocardial infarction or stroke, 6.7% vs. 11.3%, p=0.1), or vascular complications (major, 2.7% vs. 2.0%; minor, 4.5% vs. 4.9%; p=0.83). After mul...
Revista argentina de …, 2005
Journal of the American College of Cardiology, 2013
Journal of the American College of Cardiology, 2014