Alfredo E. Rodríguez Explained

Alfredo E. Rodríguez
Citizenship:	Argentine
Education:	BS in medical surgery Ph.D. in Coronary Angioplasty and Intracoronary Thrombolysis MD in Hemodynamics and Angiography
Occupation:	Interventional cardiologist, clinical researcher, and author
Work Institutions:	Cardiovascular Research Center (CECI) Otamendi Hospital

Alfredo E. Rodríguez is an Argentine interventional cardiologist, clinical researcher, and author. He is the Chief of Interventional Cardiology Service at Otamendi Hospital and Director and Founder of the Cardiovascular Research Center (CECI) a non -profit Research Organization in Buenos Aires Argentina.

Rodríguez has conducted research in the field of cardiology with a particular focus on coronary angioplasty bypass surgeries, myocardial infarction, diabetes, and hemodynamics. He is the author of several books, including Coronary Transluminal Angioplasty and Controversies in Cardiology^[1] and has been the recipient of the Rafael Bullrich Award and the Geronimo H. Alvarez Prize.^[2]

Rodriguze is an Academic Editor of Academia Medicine Journal and the Editor in Chief of Argentina Journal of Cardiovascular Interventions.^[3]

Education

Rodríguez received his medical degree from Córdoba National University, School of Medicine in 1974, and completed his residency in the Cardiology Department at Hospital Privado Sanatorio Güemes. He then completed his PhD in Coronary Angioplasty and Intracoronary Thrombolysis from Córdoba Catholic University. Following his PhD, he focused on Hemodynamics and Angiography and received an MD from the Argentine Collegium of Hemodynamics.^[2]

Career

In 1981, Rodriguez had training in coronary angioplasty for a short period of 3 months at the San Francisco Heart Institute led by Richard K Myler. Rodríguez is the former assistant director and Chief of Interventional Cardiology Service at Hospital Privado Sanatorio Güemes and Interventional Cardiology Service at Sanatorio Anchorena. He also held an appointment as the Director of Post Graduate Medical School at the Buenos Aires University School of Medicine at the Sanatorio Otamendi Unit. Additionally, he founded and currently serves as the Director of the Cardiovascular Research Center (CECI) in Buenos Aires, a non-profit Clinical Research Organization and is the Chief of the Interventional Cardiology Service at Otamnedi Hospital in Buenos Aires and in Sanatorio Las Lomas in San Isidro.^[4]

Research

Rodríguez is known for his clinical research in the area of cardiology, with an interest in interventional cardiology including coronary restenosis as well as myocardial infarction and diabetes. He has published several manuscripts.

Interventional cardiology

Throughout his research career, Rodríguez has worked on comprehending the efficacy of percutaneous coronary interventions in patients with multivessel disease^[5] by comparing it with the coronary artery bypass technique.^{[6] [7] [8]} Additionally, he reported that transluminal coronary angioplasty treatment had no significant in-hospital complications^[9] but a lower efficacy rate when compared to coronary artery bypass in patients with multiple vessel disease, called ERACI I and II trials^{[10] [11]} He conducted multiple randomized clinical trials between 1993 and 2005, including those in 1993, 1995, 1997, 2001,^[6] and 2005,^[5] to elucidate the aftereffects of interventional treatments among cardiac patients. He was the first to describe the role of acute wall recoil in the pathophysiology of coronary balloon angioplasty and the prevention of this phenomenon with bare metal stent implantation.^{[12] [13]}

During his work on myocardial infarction, Rodríguez evaluated the efficacy of several angioplasty approaches, including tirofiban and abciximab infusion, as well as the implantation of both Sirolimus-Eluting and uncoated stents.^[14] In 1998, he published the first randomized trial comparing balloon angioplasty with stents in acute myocardial infarction, known as the GRAMI trial, in the American Journal of Cardiology.^[15] He suggested the use of rheolytic thrombectomy prior to stenting of the infarct artery in patients suffering from acute myocardial infarction and exhibiting evidence of coronary thrombus.^[16] Additionally, he presented the consideration of Abciximab plus IRA as the routine reperfusion strategy in patients with percutaneous mechanical revascularization.^{[17] [18]} During the early 2000s, he examined the problem of DES (drug-eluting stents) late stent thrombosis, and reported on a trial related to this issue in 2006 in the Journal of the American College of Cardiology, as well as in European Heart Journal and Euro Intervention in 2007.^[19] In 2006, he also conducted a randomized trial that demonstrated the benefits of using oral immunosuppressive drugs to prevent restenosis following bare metal stent implantation.^[20] Later in 2023, he conducted research on the issue of non-cardiac death and cancer, and proposed the limited use of drug-eluting stent transplantation according to patient's age, lesion complexity, and life expectancy.^[21]

In his book, Controversies in Cardiology, Rodríguez has discussed topics that are characterized by ambiguity, ongoing discussions, or a lack of agreement according to existing guidelines. He has highlighted three main areas i.e., cardiovascular risks, its diagnosis, and management. Jorge Lerman commended this book for its ability to explore controversial topics that have not been widely discussed and provide a comprehensive analysis of each subject. He further added that "This innovative format constitutes an attractive incentive for the reader who is interested in learning about the advances in cardiovascular science."^[22]

Diabetes and cardiac care

In addition to his work comparing angioplasty approaches and coronary artery bypass, as an interventional cardiologist, Rodríguez has also studied the impact of diabetes on the mortality and efficacy of heart surgeries among diabetic patients.^[23] He proposed that using a coronary PC coated stent during the percutaneous intervention in diabetic patients with small coronary arteries has the ability to provide improved angiographic outcomes.^[24] Additionally, he noted that the use of paclitaxel-eluting balloons followed by bare-metal stents in treating diabetic patients showed a notably favorable result compared to treating them with a single bare-metal stent.^[25] His research further elucidated that a coronary artery bypass graft is a better option than percutaneous coronary intervention as it decreases the risk of mortality and other major cardiovascular issues in nondiabetic patients.^[26]

Awards and honors

• 1996, 2007 and 2015 – Best abstract, Latin America Society of Cardiology (SOLACI)
• 1981 – Rafael Bullrich Award, National Academy of Medicine
• 1993 – Award for Best Work on Cardiology, Argentine Foundation of Cardiology
• 1995 – Award for best work in Interventional Cardiology, Roberto Villavicencio Foundation
• 2001 – Geronimo H. Alvarez, National Academy of Medicine
• 2005 – Best Abstract, European Congress of Cardiology
• 2018 – Outstanding personality of the autonomous city of Buenos Aires in the field of Medical Sciences, Buenos Aires House of Representatives

Bibliography

Selected books

• Therapeutics by catheterization in ischemic cardiopathy (Transluminal Angioplasty – Coronary Thrombolysis)
• Coronary Transluminal Angioplasty
• Up-to-date tendencies in Cardiology
• Controversies in Cardiology

Selected articles

• Rodríguez, A., Bernardi, V., Navia, J., Baldi, J., Grinfeld, L., Martinez, J., ... & ERACI II Investigators. (2001). Argentine randomized study: coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple-vessel disease (ERACI II): 30-day and one-year follow-up results. Journal of the American College of Cardiology, 37(1), 51–58.
• Antoniucci, D., Rodríguez, A., & Hempelet, A. (2004). A randomized trial comparing primary infarct artery stenting with or without abciximab in acute myocardial infarction. ACC Current Journal Review, 3(13), 50.
• Rodríguez, A. E., Mieres, J., Fernandez-Pereira, C., Vigo, C. F., Rodríguez-Alemparte, M., Berrocal, D., ... & Palacios, I. (2006). Coronary stent thrombosis in the current drug-eluting stent era: insights from the ERACI III trial. Journal of the American College of Cardiology, 47(1), 205–207.
• Rodríguez-Granillo, D. S., Raizner, A. E., Palacios, I., Vigo, W., Delgado, J., Fernandez-Pereira, C., ... & Alfredo, M. Oral Rapamycin After Coronary Bare-Metal Stent Implantation to Prevent.
• Rodríguez, A. E., Rodríguez-Granillo, G. A., & Palacios, I. F. (2007). Late stent thrombosis: the Damocles sword of drug eluting stents. Eurointervention, 2, 512–7.
• Rodríguez, A. E., Maree, A. O., Mieres, J., Berrocal, D., Grinfeld, L., Fernandez-Pereira, C., ... & Palacios, I. F. (2007). Late loss of early benefit from drug-eluting stents when compared with bare-metal stents and coronary artery bypass surgery: 3 years follow-up of the ERACI III registry. European heart journal, 28(17), 2118–2125.
• Hlatky, M. A., Boothroyd, D. B., Bravata, D. M., Boersma, E., Booth, J., Brooks, M. M., ... & Pocock, S. J. (2009). Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. The Lancet, 373(9670), 1190–1197.
• Rodríguez, A. E., Palacios, I., Rodríguez-Granillo, A. M., Mieres, J. R., Tarragona, S., Fernandez-Pereira, C., ... & Antoniucci, D. (2014). Comparison of cost-effectiveness of oral rapamycin plus bare-metal stents versus first generation of drug-eluting stents (from the Randomized Oral Rapamycin in Argentina [ORAR] 3 trial). The American Journal of Cardiology, 113(5), 815–821.
• Head, S. J., Milojevic, M., Daemen, J., Ahn, J. M., Boersma, E., Christiansen, E. H., ... & Kappetein, A. P. (2018). Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. The Lancet, 391(10124), 939–948..
• De Luca, G., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Busljetik, O., ... & Verdoia, M. (2023). Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry. Journal of Clinical Medicine, 12(6), 2116.
• Rodríguez, A. E., Fernandez-Pereira, C., Mieres, J. R., & Rodríguez-Granillo, A. M. (2023). High Non-Cardiac Death Incidence Should Be a Limitation of Drug-Eluting Stents Implantation? Insights from Recent Randomized Data. Diagnostics, 13(7), 1321

Notes and References

1. Web site: Controversies in Cardiology – Book Review.
2. Web site: Alfredo E Rodríguez | Resultados de la búsqueda | Centro CECI.
3. Web site: Revista Argentina de Cardioangiología Intervencionista. www.revistacaci.org.ar.
4. Web site: Centro de Estudios en Cardiología Intervencionista | Buenos Aires, Argentina | CECI.
5. Long-Term Safety and Efficacy of Percutaneous Coronary Intervention With Stenting and Coronary Artery Bypass Surgery for Multivessel Coronary Artery Disease: A Meta-Analysis With 5-Year Patient-Level Data From the ARTS, ERACI-II, MASS-II, and SoS Trials. Joost. Daemen. Eric. Boersma. Marcus. Flather. Jean. Booth. Rod. Stables. Alfredo. Rodríguez. Gaston. Rodríguez-Granillo. Whady A.. Hueb. Pedro A.. Lemos. Patrick W.. Serruys. September 9, 2008. Circulation. 118. 11. 1146–1154. 10.1161/CIRCULATIONAHA.107.752147. 18725490 . 13532979 . free.
6. Argentine randomized study: coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple-vessel disease (ERACI II): 30-day and one-year follow-up results. Alfredo. Rodríguez. Victor. Bernardi. Jose. Navia. Julio. Baldi. Liliana. Grinfeld. Jorge. Martinez. Daniel. Vogel. Roberto. Grinfeld. Alejandro. Delacasa. Marcelo. Garrido. Raul. Oliveri. Eduardo. Mele. Igor. Palacios. William. O’Neill. January 20, 2001. Journal of the American College of Cardiology. 37. 1. 51–58. 10.1016/S0735-1097(00)01052-4. 11153772 .
7. Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. Mark A. Hlatky. Derek B. Boothroyd. Dena M. Bravata. Eric. Boersma. Jean. Booth. Maria M. Brooks. Didier. Carrié. Tim C. Clayton. Nicolas. Danchin. Marcus. Flather. Christian W. Hamm. Whady A. Hueb. Jan. Kähler. Sheryl F. Kelsey. Spencer B. King. Andrzej S. Kosinski. Neuza. Lopes. Kathryn M. McDonald. Alfredo. Rodríguez. Patrick. Serruys. Ulrich. Sigwart. Rodney H. Stables. Douglas K. Owens. Stuart J. Pocock. April 4, 2009. The Lancet. 373. 9670. 1190–1197. ScienceDirect. 10.1016/S0140-6736(09)60552-3. 19303634 . 2911429 .
8. Meta-analysis of randomised trials comparing coronary angioplasty with bypass surgery. S. J. Pocock. R. A. Henderson. A. F. Rickards. J. R. Hampton. S. B. King. C. W. Hamm. J. Puel. W. Hueb. J-J. Goy. A. Rodríguez. November 4, 1995. The Lancet. 346. 8984. 1184–1189. 10.1016/S0140-6736(95)92897-9. 7475657 . 22757316 . free.
9. Argentine randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease (ERACI): In-hospital results and 1-year follow-up. Alfredo. Rodríguez. Fernando. Boullon. Nestor. Perez-Baliño. Claudia. Paviotti. Maria I. Sosa. Liprandi. Igor F.. Palacios. October 1, 1993. Journal of the American College of Cardiology. 22. 4. 1060–1067. 10.1016/0735-1097(93)90416-X. 8409041 . free.
10. Three-year follow-up of the argentine randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease (ERACI). Alfredo. Rodríguez. Eduardo. Mele. Ernesto. Peyregne. Fernando. Bullon. Nestor. Perez-Baliño. Maria I.. Sosa Liprandi. Igor F.. Palacios. April 1, 1996. Journal of the American College of Cardiology. 27. 5. 1178–1184. ScienceDirect. 10.1016/0735-1097(95)00592-7. 8609339 . 33030141 .
11. Five-year follow-up of the Argentine randomized trial of coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple vessel disease (ERACI II). August 16, 2005. Journal of the American College of Cardiology. 46. 4. 582–588. 10.1016/j.jacc.2004.12.081. 16098419 . Rodriguez . Alfredo E. . Baldi . Julio . Pereira . Carlos Fernández . Navia . Jose . Alemparte . Máximo Rodriguez . Delacasa . Alejandro . Vigo . Federico . Vogel . Daniel . O'Neill . William . Palacios . Igor F. . ERACI II Investigators . free .
12. Argentine randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease (ERACI): in-hospital results and 1-year follow-up. ERACI Group. A.. Rodríguez. F.. Boullon. N.. Perez-Baliño. C.. Paviotti. M. I.. Liprandi. I. F.. Palacios. October 20, 1993. Journal of the American College of Cardiology. 22. 4. 1060–1067. 10.1016/0735-1097(93)90416-x. 8409041. free.
13. Optimal coronary balloon angioplasty with provisional stenting versus primary stent (OCBAS). Alfredo. Rodríguez. Francisco. Ayala. Victor. Bernardi. Omar. Santaera. Eugenio. Marchand. Cesar. Pardiñas. Carlos. Mauvecin. Daniel. Vogel. Lari C. Harrell. Igor F. Palacios. November 20, 1998. Journal of the American College of Cardiology. 32. 5. 1351–1357. 10.1016/S0735-1097(98)00388-X. 9809947 . free.
14. Comparison of Angioplasty With Infusion of Tirofiban or Abciximab and With Implantation of Sirolimus-Eluting or Uncoated Stents for Acute Myocardial Infarction: The MULTISTRATEGY Randomized Trial. Marco. Valgimigli. Gianluca. Campo. Gianfranco. Percoco. Leonardo. Bolognese. Corrado. Vassanelli. Salvatore. Colangelo. Nicoletta. de Cesare. Alfredo E.. Rodríguez. Maurizio. Ferrario. Raul. Moreno. Tommaso. Piva. Imad. Sheiban. Giampaolo. Pasquetto. Francesco. Prati. Marco S.. Nazzaro. Giovanni. Parrinello. Roberto. Ferrari. for the. Multicentre Evaluation of Single High-Dose Bolus Tirofiban vs Abciximab With Sirolimus-Eluting Stent or Bare Metal Stent in Acute Myocardial Infarction Study (MULTISTRATEGY) Investigators. April 16, 2008. JAMA. 299. 15. 1788–1799. Silverchair. 10.1001/jama.299.15.joc80026. 18375998 .
15. In-Hospital and Late Results of Coronary Stents Versus Conventional Balloon Angioplasty in Acute Myocardial Infarction (GRAMI trial). Alfredo. Rodrı́guez. Victor. Bernardi. Mario. Fernández. Carlos. Mauvecı́n. Francisco. Ayala. Omar. Santaera. Jorge. Martı́nez. Eduardo. Mele. GaryS. Roubin. Igor. Palacios. JohnA. Ambrose. June 1, 1998. The American Journal of Cardiology. 81. 11. 1286–1291. ScienceDirect. 10.1016/S0002-9149(98)00154-4. 9631964 .
16. Comparison of AngioJet Rheolytic Thrombectomy Before Direct Infarct Artery Stenting With Direct Stenting Alone in Patients With Acute Myocardial Infarction. Angela. Migliorini. Amerigo. Stabile. Alfredo E.. Rodríguez. Caterina. Gandolfo. Alfredo M.. Rodríguez Granillo. Renato. Valenti. Guido. Parodi. Franz-Josef. Neumann. Antonio. Colombo. David. Antoniucci. October 20, 2010. Journal of the American College of Cardiology. 56. 16. 1298–1306. 10.1016/j.jacc.2010.06.011. 20691553 .
17. A randomized trial comparing primary infarct artery stenting with or without abciximab in acute myocardial infarction. David. Antoniucci. Alfredo. Rodríguez. Albrecht. Hempel. Renato. Valenti. Angela. Migliorini. Federico. Vigo. Guido. Parodi. Carlos. Fernandez-Pereira. Guia. Moschi. Antonio. Bartorelli. Giovanni Maria. Santoro. Leonardo. Bolognese. Antonio. Colombo. December 20, 2003. Journal of the American College of Cardiology. 42. 11. 1879–1885. 10.1016/j.jacc.2003.07.017. 14662245 .
18. Abciximab-Supported Infarct Artery Stent Implantation for Acute Myocardial Infarction and Long-Term Survival: A Prospective, Multicenter, Randomized Trial Comparing Infarct Artery Stenting Plus Abciximab With Stenting Alone. David. Antoniucci. Angela. Migliorini. Guido. Parodi. Renato. Valenti. Alfredo. Rodriguez. Albrecht. Hempel. Gentian. Memisha. Giovanni Maria. Santoro. April 13, 2004. Circulation. 109. 14. 1704–1706. 10.1161/01.CIR.0000126284.40075.98. 15066943 . 379325 .
19. Web site: Late stent thrombosis: the Damocle's sword of drug eluting stents?.
20. Oral rapamycin after coronary bare-metal stent implantation to prevent restenosis: the Prospective, Randomized Oral Rapamycin in Argentina (ORAR II) Study. April 18, 2006. Journal of the American College of Cardiology. 47. 8. 1522–1529. PubMed. 10.1016/j.jacc.2005.12.052. 16630986 . Rodriguez . A. E. . Granada . J. F. . Rodriguez-Alemparte . M. . Vigo . C. F. . Delgado . J. . Fernandez-Pereira . C. . Pocovi . A. . Rodriguez-Granillo . A. M. . Schulz . D. . Raizner . A. E. . Palacios . I. . O'Neill . W. . Kaluza . G. L. . Stone . G. . ORAR II Investigators .
21. High Non-Cardiac Death Incidence Should Be a Limitation of Drug-Eluting Stents Implantation? Insights from Recent Randomized Data. Alfredo E.. Rodríguez. Carlos. Fernandez-Pereira. Juan Ramon. Mieres. Alfredo Matias. Rodríguez-Granillo. January 20, 2023. Diagnostics. 13. 7. 1321. 10.3390/diagnostics13071321 . 37046540 . 10093159 . free .
22. Web site: Controversies in Cardiology.
23. Long-Term Outcome of PCI Versus CABG in Insulin and Non–Insulin-Treated Diabetic Patients. George D.. Dangas. Michael E.. Farkouh. Lynn A.. Sleeper. May. Yang. Mikkel M.. Schoos. Carlos. Macaya. Alexandre. Abizaid. Christopher E.. Buller. Gerard. Devlin. Alfredo E.. Rodríguez. Alexandra J.. Lansky. F. Sandra. Siami. Michael. Domanski. Valentin. Fuster. September 20, 2014. Journal of the American College of Cardiology. 64. 12. 1189–1197. 10.1016/j.jacc.2014.06.1182. 25236509 . 205564562 . free.
24. Drug-coated balloons for de novo coronary lesions: results from the Valentines II trial. Ron. Waksman. Antonio. Serra. Joshua P.. Loh. Fazila Tun-Nesa. Malik. Rebecca. Torguson. Stefanie. Stahnke. Rembert Pogge. von Strandmann. Alfredo E.. Rodriguez. September 8, 2013. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 9. 5. 613–619. PubMed. 10.4244/EIJV9I5A98. 24058077.
25. One-year outcome of patients with diabetes mellitus after percutaneous coronary intervention with three different revascularization strategies: Results from the DiabEtic Argentina Registry (DEAR). Juan. Mieres. Carlos. Fernandez-Pereira. Gustavo. Risau. Leonardo. Solorzano. Ricardo. Pauletto. Alfredo Matias. Rodríguez-Granillo. Bibiana. Rubilar. Pieter. Stella. Alfredo E.. Rodríguez. September 1, 2012. Cardiovascular Revascularization Medicine. 13. 5. 265–271. ScienceDirect. 10.1016/j.carrev.2012.06.001. 22796496 .
26. Long-term outcome of PCI versus CABG in insulin and non-insulin-treated diabetic patients: results from the FREEDOM trial. September 23, 2014. Journal of the American College of Cardiology. 64. 12. 1189–1197. 10.1016/j.jacc.2014.06.1182. 25236509 . Dangas . G. D. . Farkouh . M. E. . Sleeper . L. A. . Yang . M. . Schoos . M. M. . MacAya . C. . Abizaid . A. . Buller . C. E. . Devlin . G. . Rodriguez . A. E. . Lansky . A. J. . Siami . F. S. . Domanski . M. . Fuster . V. . FREEDOM Investigators . 205564562 . free .