Browsing by Autor "Sergio Morales Acosta"

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1308eP Efficacy of isatuximab plus dexamethasone versus non isatuximab-based treatments in refractory multiple myeloma: A systematic review and meta-analysis
(Elsevier BV, 2025) Víctor Castillo; Luis E. Cueva-Cañola; Alex Torres; A. Pérez; Alejandro Campos-Muñoz; Abraham Zenteno-Aguilar; Karoly Pamela Zuñiga Montaño; Sergio Morales Acosta; Wagner Rios-García; Carlos Eduardo Espinosa Temaxte
Abstract 4341436: Semaglutide as an effective therapy for heart failure: Evidence from a meta-analysis of 6,479 patients
(Lippincott Williams & Wilkins, 2025) J. Ruiz; Luis E. Cueva; Claudia Martinez‐Tapia; Carmen Chávez; Arianna Correa Siancas; Sergio Morales Acosta; Sol Juárez; Fátima Paico Bances; Adriana Robles; E Cubas
Background: Heart failure (HF) remains a leading cause of morbidity and mortality worldwide, with limited therapeutic options for improving long-term cardiovascular outcomes. Semaglutide, a GLP-1 agonist, has shown promising effects in improving cardiovascular function and metabolic control. However, its overall efficacy in patients with heart failure has not yet been established. Methods: We conducted searches of PubMed, Embase, Scopus, and Web of Science through February 21, 2025, identifying randomized controlled trials (RCTs) and cohort studies comparing semaglutide with placebo in patients with HF. The main outcomes were variation from baseline in 6-minute walk distance traveled (6MWD), C-reactive protein (CRP) concentration, amino-terminal prohormone brain natriuretic peptide (NT-proBNP) concentration, body weight, waist circumference, adjudicated HF event (hospitalization or urgent visit), cardiac mortality, all-cause mortality, serious adverse events (SAEs), and cardiac events. Relative risks (RR), mean differences (MD), and hazard ratios (HR) with their 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed with the I 2 statistic. Results: Four RCTs and two cohort studies were included, with a total population of 6,479 patients with HF, of whom 3,200 (49.39%) received semaglutide and 3,279 (50.61%) received placebo. Treatment with semaglutide was associated with a significant increase in 6MWD (RR: 16.60; 95%CI: 10.58 to 22.62; p < 0.00001), a reduction in CRP (RR:0.59; 95%CI: 0.49 to 0.70; p<0.00001) and NT-proBNP (RR:0.81; 95%CI: 0.74 to 0.89; p<0.00001), a decrease in body weight (MD:-6.11; 95%CI: -11.41 to -0.82; p=0.02) and waist circumference (MD:-7.43; 95%CI: -9.26 to -5.60; p<0.00001). In addition, lower adjudicated HF events (RR:0.69; 95%CI: 0.50 to 0.97; p=0.03), SAEs (RR:0.77; 95%CI: 0.66 to 0.91; p=0.001), cardiac events (RR:0.54; 95%CI: 0.32 to 0.92; p=0.02), all-cause mortality (RR:0.80; 95%CI: 0.67 to 0.95; p=0.01) and cardiac mortality (HR:0.72; 95%CI: 0.60 to 0.86; p=0.0003). Conclusion: This meta-analysis is one of the first to approach the potential of semaglutide in patients with HF. Semaglutide significantly improves functional capacity and metabolic parameters while reducing cardiac events, SAEs, and mortality. These findings suggest that semaglutide may represent a promising therapeutic option in this population and further research is warranted to confirm these results.
Abstract 4357666: Definitive Therapeutic Efficacy of Colchicine for Cardiovascular Disease A Systematic Review and Meta-Analysis in 37,812 Patients
(Lippincott Williams & Wilkins, 2025) Luis E. Cueva; Claudia Martinez‐Tapia; Ana Castro; Carlos Eduardo Espinosa Temaxte; Víctor Castillo; Karoly Pamela Zuñiga Montaño; José Gerardo González‐González; Adriana Campos; Abraham Zenteno-Aguilar; Sergio Morales Acosta
Background and Aims: Cardiovascular disease is a global health concern requiring effective prevention. Colchicine has gained interest for reducing cardiovascular events in high-risk patients. This study evaluates the efficacy and safety of colchicine in preventing these events. Methods: A systematic search was conducted in PubMed, CENTRAL, and Embase databases according to PRISMA guidelines, including studies up to August 26, 2024. Measures of effect included relative risk (RR) and mean differences. Meta-regressions and sensitivity analyses were performed to explore heterogeneity, which was quantified using the I 2 statistic. The certainty of evidence was assessed using the GRADE approach. Results: Analysis of 37,812 patients showed colchicine significantly reduced the risk of acute myocardial infarction (moderate certainty) (RR=0.81 [95% CI: 0.71-0.92], p=0.002), pericarditis (high certainty) (RR=0.48 [95% CI: 0.39-0.59], p<0.00001), atrial fibrillation (high certainty) (RR=0.74 [95% CI: 0.66-0.84], p<0.00001), acute coronary syndrome (high certainty) (RR=0.39 [95% CI: 0.23-0.65], p=0.0004) and hospitalization (high certainty) (RR=0.52 [95% CI: 0.38-0.70], p<0.0001). Outcomes such as cardiovascular mortality (moderate certainty), total mortality (moderate certainty), non-cardiovascular mortality (low certainty), length of hospital stay (low certainty), and cardiac tamponade (very low certainty) did not show statistically significant differences. Significant adverse effects included gastrointestinal disorders such as diarrhea, flatulence, nausea, and elevated ALT or AST levels. Conclusions: Colchicine effectively reduces cardiovascular event risk but may cause gastrointestinal side effects. Its benefit in cardiovascular prevention is clear, yet safety should be evaluated prudently.
Abstract 4360333: Pulmonary Vein Isolation Combined With Linear Ablation Improves Outcomes in Persistent Atrial Fibrillation: A Systematic Review and Meta-Analysis of 1,431 Patients
(Lippincott Williams & Wilkins, 2025) Luis E. Cueva; Juan Carlos Ruiz; Karoly Pamela Zuñiga Montaño; Sergio Morales Acosta; Diego Ramos Ypanaqué; José Hurtado; L. Urrego Rivera
Background: Persistent atrial fibrillation (AF) involves extensive atrial remodeling beyond pulmonary vein (PV) triggers, making catheter ablation less effective than in paroxysmal AF. PV isolation (PVI) is standard, but outcomes remain limited by broader arrhythmogenic substrates. Linear ablation aims to interrupt reentrant circuits and may improve outcomes when combined with PVI. However, its benefits remain debated due to procedural risks and incomplete lesions. Methods: We conducted a systematic review and meta-analysis (PRISMA guidelines), searching PubMed, Embase, Scopus, and Web of Science up to February 24, 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies comparing PVI plus linear ablation versus PVI alone in adults with persistent AF. The primary outcome was AF recurrence; secondary outcomes were atrial arrhythmia recurrence and complications. Hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed using the I 2 statistic. Significant heterogeneity was considered present if I 2 ≥ 50% and/or p < 0.10. Sensitivity was assessed using leave-one-out analysis, and heterogeneity was explored using subgroup analyses. Publication bias was also assessed using funnel plots. Results: Out of 113 articles, 4 were included (3 RCTs and 1 cohort study), with 1,431 patients: 696 (48.6%) underwent PVI plus linear ablation, and 735 (51.4%) underwent PVI alone. PVI plus linear ablation reduced AF recurrence (HR: 0.71; 95% CI: 0.54-0.91; p=0.009) and atrial arrhythmias (HR: 0.79; 95% CI: 0.64-0.98; p=0.03) compared to PVI alone. No significant difference in complications was found (RR: 0.43; 95% CI: 0.06-2.92; p=0.39). No significant heterogeneity or possible publication bias (symmetry in the funnel plots) was observed. Conclusion: This is the first meta-analysis exploring the addition of linear ablation to PVI in persistent AF. The findings suggest that this strategy reduces the risk of atrial arrhythmia recurrence without increasing complications, supporting its potential role in persistent AF ablation strategies. However, the limited number of studies and procedural variability highlight the need for further large-scale RCTs to confirm these results and guide patient selection. Clinicians should carefully consider individual patient characteristics and procedural factors when deciding on the best ablation approach.
MM-897: Efficacy of Isatuximab Plus Dexamethasone Versus No Isatuximab-Based Treatments in Refractory Multiple Myeloma: A Systematic Review and Meta-Analysis
(Elsevier BV, 2025) Víctor Castillo; Luis E. Cueva-Cañola; Alex Torres; A. Pérez; Alejandro Muñóz; Abraham Zenteno-Aguilar; Karoly P Zuñiga-Montaño; Carlos Espinosa-Temaxte; Sergio Morales Acosta; Wagner Rios-Acosta