1
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Albuquerque F, Lima R, Campante Teles R, Gomes D, Lopes P, Felix Oliveira A, Goncalves M, Brito J, Raposo L, Leal S, Mesquita Gabriel H, De Araujo Goncalves P, De Sousa Almeida M, Mendes M. Peri-procedural, 30-day and 1 year-outcomes in chronic dialysis patients undergoing transcatheter aortic valve implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients on chronic dialysis (CD) due to end-stage renal disease (ESRD) with symptomatic severe aortic stenosis eligible for transcatheter aortic valve implantation (TAVI) were excluded from randomized clinical trials. Our study aimed to investigate the outcomes of patients with chronic dialysis who underwent TAVI.
Methods
Single center analysis on prospectively collected data of all consecutive patients who underwent TAVI between January 2011 and December 2020 according to baseline renal function: chronic dialysis group (CD) and control group (CTRL). Procedural, 30-day and 1-year outcomes were assessed. Outcomes were defined in accordance with the VARC-3 criteria.
Results
A total of 875 patients underwent TAVI during the study period, of whom 22 (2.5%) were on chronic dialysis. Patients on CD were younger (median age 80 years, [IQR 73–84] vs 84 years, [IQR 80–87]; p<0.001), more likely to be men [365/863 (42.8%) vs 18/22 (81.8%); p<0.001] and more likely to have peripheral vascular disease [41/853 (4.8%) vs 7/22 (31.8%); p=0.031] and lower body mass index (median 24.1 kg/m2, [IQR 21.5–26.5] vs 26.3 kg/m2, [IQR 23.7–29.3]). Short-term major or life-threatening bleeding were significantly higher in CD patients (odds ratio [95% confidential interval]: 3.67 [1.50–8.96], p 0.005). In contrast, no differences were found regarding rates of vascular complications requiring intervention (OR [95% CI]: 1.35 [0.31–5.90], p=0.662), permanent pacemaker implantation (OR [95% CI]: 0.87 [0.25–2.98], p=1.000) or stroke (OR [95% CI]: 1.51 [0.20–11.64], p=0.504). Importantly, dialysis patients had significantly higher rates of in-hospital, 30-day and 1-year mortality rates (13.6 vs 2.1%, p<0.001; 18.9% vs 2.9, p<0.001 and 26.4% vs 10.7%, p<0.001, respectively). On multivariate analysis, after adjusting for age, gender, relevant co-morbidities, and procedure-related complications, CD remained independently associated with mortality at 1-year. Survival curves during follow up are presented in Figure 1.
Conclusions
Chronic dialysis patients submitted to TAVI had significantly higher rates of short-term life threatening and/or major bleeding, short-term and long-term mortality. Careful selection of patients who would benefit from TAVI among patients with ERDS requiring dialysis is necessary to prevent high rates of postprocedural complications and improve outcomes of this high-risk population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - R Lima
- Hospital Santa Cruz , Carnaxide , Portugal
| | | | - D Gomes
- Hospital Santa Cruz , Carnaxide , Portugal
| | - P Lopes
- Hospital Santa Cruz , Carnaxide , Portugal
| | | | | | - J Brito
- Hospital Santa Cruz , Carnaxide , Portugal
| | - L Raposo
- Hospital Santa Cruz , Carnaxide , Portugal
| | - S Leal
- Hospital Santa Cruz , Carnaxide , Portugal
| | | | | | | | - M Mendes
- Hospital Santa Cruz , Carnaxide , Portugal
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2
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R Santos R, Paiva M, Gomes D, Presume J, Custodio P, Andrade MJ, Raposo L, Durazzo A, Moreno L, Mendes M. Value of cardiopulmonary exercise test submaximal parameters in the assessment of aortic stenosis patients. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Exercise test is recommended for risk stratification of asymptomatic patients with severe aortic stenosis (AS), although a significant number of patients can't perform a maximal exercise test, increasing the potential value of sub-maximal parameters for the assessment of these patients.
Aim
To assess which parameters could be useful for risk stratification in case of a submaximal Cardiopulmonary Exercise Testing (CPET) in asymptomatic patients with severe AS.
Methods
Retrospective evaluation of adult patients with asymptomatic severe AS, in a single center, who underwent CPET between December 2016 and November 2021. All patients underwent a treadmill CPET using an exercise protocol with progressive increase in workload. Patients were divided in group A (maximal CPET) or group B, respectively, if respiratory exchange ratio (RER) was >1.10 at peak exercise or below this value. Known parameters accessed in a submaximal CPET were evaluated: mean minute ventilation/carbon dioxide production slope (VE/VCO2), VO2 value in first ventilatory threshold (VT1), peak circulatory power, and oxygen uptake efficiency slope (OUES).
Results
CPET was performed in 25 patients with severe asymptomatic AS (80 years ± 7 years, 56% male), median AVA was 0.86 cm2 [IQR 0.65–0.95 cm2] and transaortic pressure gradient was 46 mmHg [IQR 41–55 mmHg]. The most used protocol was a ramp slope. Nineteen patients (76%) didn't reach a RER>1.10 (group B) due to respiratory (26%) or peripheral limitation (53%). Comparing both groups, group B patients showed a shorter duration of exercise of (8±3 min vs. 9±4 min, p=0.422), and a lowest mean peak VO2 (16.3±3.6 vs. 20.5±6.9 ml/kg/min, p=0.207). In our population, bivariate analyses demonstrated that OUES was the only submaximal parameter that could discriminate both groups: Group B patients had the lowest values (1.53 [IQR 1.47–1.70] vs. 1.94 [IQR 1.56–2.11], p=0.042). ROC curve analysis of OUES values revealed an AUC of 0.78 (p=0.042) for maximal CPET prediction. The cut-off point with most sensitivity (S) and specificity (E) obtained using the Youden index (0.62) was 1.9 (S≈67%; E≈95%) (Figure 1).
Conclusions
In our cohort of asymptomatic AS patients, even with submaximal CPET, OUES accurately identify patients with higher degrees of functional limitation. Whether OUES is useful as prognostic marker to the workflow treatment of AS it's worth to be assessed prospectively.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Paiva
- Hospital Santa Cruz , Lisbon , Portugal
| | - D Gomes
- Hospital Santa Cruz , Lisbon , Portugal
| | - J Presume
- Hospital Santa Cruz , Lisbon , Portugal
| | - P Custodio
- Hospital de Vila Franca de Xira , Vila Franca de Xira , Portugal
| | | | - L Raposo
- Hospital Santa Cruz , Lisbon , Portugal
| | - A Durazzo
- Hospital Santa Cruz , Lisbon , Portugal
| | - L Moreno
- Hospital Santa Cruz , Lisbon , Portugal
| | - M Mendes
- Hospital Santa Cruz , Lisbon , Portugal
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3
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Albuquerque F, Gomes D, De Araujo Goncalves P, Lopes P, Goncalves M, Felix Oliveira A, Brito J, Leal S, Raposo L, Mesquita Gabriel H, Campante Teles R, De Sousa Almeida M, Mendes M. Vascular closure device in TAVI with a dedicated endovascular plug-based device – experience from a high-volume tertiary center. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Vascular complications at the access site are important adverse events during transcatheter aortic valve implantation (TAVI). Effective, reproducible, and safe closure of large bore arteriotomies remains challenging as management strategies vary among centers and operators. MANTAÒ is a dedicated plug-based vascular closure device (VCD) recently approved for percutaneous access site closure. This study aimed to describe our experience and to determine the safety and effectiveness of MANTAÒ for large bore arteriotomies during transfemoral TAVI.
Methods
Single center retrospective analysis on prospectively collected data of all consecutive patients who underwent transfemoral TAVI from 2018 to 2020. The primary safety outcomes were access-related vascular injury and bleeding complications according to VARC-3 criteria. Technical success was defined as puncture closure obtained with MANTAÒ without the use of unplanned endovascular or surgical intervention. A secondary analysis according to center experience was performed.
Results
Of the 535 patients that underwent transfemoral TAVI during the study period (median age = 84 [IQR 80–87], 39.4% male; median EuroSCORE II of 3.89% [IQR 2.62–5.39]), MANTAÒ VCD was deployed in 320 (59.8%). Overall, 32 (10.0%) patients suffered an access-related vascular injury and 22 (6.6%) had a bleeding complication (Figure 1A). Technical success was achieved in most cases (n=298; 93.1%). 30-day mortality rate was 1.6% (n=5). Since the first deployment in mid-2018, the rates of MANTA-related complications decreased with increasing experience and a steep learning curve effect was noted (Figure 1B).
Conclusions
MANTAÒ was rapidly adopted as the default strategy for vascular access site closure after TAVI at our center. A relatively steep learning was observed, suggesting that few procedures are required to acquire device proficiency. In addition, our results suggest that MANTA Ò can effectively close large bore arteriotomies with a low risk of severe complications.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - D Gomes
- Hospital Santa Cruz , Carnaxide , Portugal
| | | | - P Lopes
- Hospital Santa Cruz , Carnaxide , Portugal
| | | | | | - J Brito
- Hospital Santa Cruz , Carnaxide , Portugal
| | - S Leal
- Hospital Santa Cruz , Carnaxide , Portugal
| | - L Raposo
- Hospital Santa Cruz , Carnaxide , Portugal
| | | | | | | | - M Mendes
- Hospital Santa Cruz , Carnaxide , Portugal
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4
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Rocha B, Nolasco T, Teles R, Madeira S, Vale N, Madeira M, Brito J, Raposo L, Goncalves P, Gabriel HM, Sousa-Uva M, Abecasis M, Almeida M, Neves JP, Mendes M. TAVI via alternative access routes: patient selection and 10-year center experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Femoral access is considered the gold standard for transcatheter aortic valve implantation (TAVI). However, this route might be precluded due to the presence of tortuosity, small vessel diameter and/or peripheral artery disease. We aimed to investigate TAVI through an alternative access (AA), focusing on the selection criteria and clinical outcomes compared to the femoral route (TF).
Methods
We conducted an all-comers longitudinal single-centre prospective registry in whom a TAVI was performed. The feasibility, safety and efficacy of TAVI by means of an access route other than standard TF was assessed, according to the VARC-2 criteria. The prospective surgical criteria used at our institution to accept an AA route were: a) TF deemed inappropriate; b) acceptable haemorrhagic risk; c) acceptable general anaesthesia risk; and d) adequate anatomy and diameter within acceptable range (subclavian, axillar, transaortic) or e) age <85 years and non-frail patient (transapical). The primary endpoint was all-cause death at 1-year.
Results
From 2008 to 2018, there were 548 patients submitted to TAVI [median age 84 (79–87) years, males 45.4%]. An AA route was used in 100 patients (79 trans-apical, 9 trans-aortic, and 12 trans-subclavian), with a decreasing rate over follow-up (−11% per year). Compared to TF, these patients were younger [80 (77–84) vs. 85 (80–87) years; p<0.001) with a similar baseline surgical risk as per EuroSCORE II [5.1 (3.3–9.0) vs. 4.7 (3.3–7.0); p=0.410). AA patients presented a higher burden of atherosclerotic disease, namely coronary (54.0 vs. 41.3%; p<0.001) and peripheral artery disease (35.0 vs. 16.5%, p<0.001) despite a lower number of other comorbidities (e.g. glomerular filtration rate <50mL/min: 53.1 vs. 64.8%; p=0.030). Left ventricular ejection fraction (56±13 vs 55±12%; p=0.203) and aortic stenosis severity (e.g. valve area: 0.70±0.19 vs. 0.67±0.18cm2; p=0.302) were similar between groups. Haemorrhagic events (minor or major) following TAVI were less often documented in the AA group (11.0 vs 21.7%; p=0.015), contrasting with de novo atrial fibrillation (18.5 vs 7.6%; p=0.048). Overall, 67 patients met the primary endpoint (18.8 vs 16.2%; p=0.584). After adjusted multivariate analysis, the independent predictors of one-year mortality did not include the TAVI access route.
Conclusion
In the first 10 years of experience, 1 in every 6 patients was treated with a TAVI by means of an AA, most often trans-apically initially and, nowadays, via a trans-subclavian approach. The use of meticulous prospective selection criteria seems to explain the one-year similar results, regardless of the access route.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B Rocha
- Hospital de Santa Cruz, Lisbon, Portugal
| | - T Nolasco
- Hospital de Santa Cruz, Lisbon, Portugal
| | - R Teles
- Hospital de Santa Cruz, Lisbon, Portugal
| | - S Madeira
- Hospital de Santa Cruz, Lisbon, Portugal
| | - N Vale
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Madeira
- Hospital de Santa Cruz, Lisbon, Portugal
| | - J Brito
- Hospital de Santa Cruz, Lisbon, Portugal
| | - L Raposo
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | | | | | - M Abecasis
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Almeida
- Hospital de Santa Cruz, Lisbon, Portugal
| | - J P Neves
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Lisbon, Portugal
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5
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Gama F, Goncalves PA, Abecasis J, Ferreira AM, Freitas P, Cavaco D, Gabriel HM, Brito J, Raposo L, Adragao P, Almeida MS, Mendes M, Teles RC. Predicting pacemaker dependency after TAVI with pre-procedural MSCT. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and aim
High degree conduction disturbances is a burdensome complication of transcatheter aortic valve implantation (TAVI). There is limited data whether such disorders are permanent or reversible. Anatomic surrogates, such as membranous septum [MS, a distance marker from aortic annulus to His-bundle surge] and calcium distribution within aortic valve have been associated with pacemaker (PM) implantation. The aim of our study was to assess predictors of long-term pacemaker dependency following TAVI.
Methods
Single center prospectively included patients that underwent pacemaker implantation following TAVI (March 2017 to September 2020). Patients who were lost to follow up, with bicuspid aortic valve, previously implanted PM and non-available or low quality MSCT exam were excluded. On MSCT, MS length was measured on modified coronal view, the aortic-valvular complex (AVC) was characterized by leaflet sector and calcium distribution was assessed on a J-score threshold of 850-Hounsfield units. Pacemaker dependency was assessed by reducing ventricular pacing to 30 bpm and defined by subsequent complete AV dissociation in patients in sinus rhythm or an escape rhythm <50 bpm in atrial fibrillation, in addition of >90% pacing percentage since implantation.
Results
From the 352 patients with inclusion criteria, 67 underwent PM implantation (19%) and 55 included in the analysis (male 33.9%, median age=85) (Figure). Median time for pacemaker implantation was 3 days [interquartile range (IQR) 3–5 days], mostly due to complete auriculo-ventricular block (76.4%, N=42). PM dependency occurred in 14 out of 55 (25.5%) patients at mean follow up of 500±363 days. Patients with PM dependency tended to have deeper implantation depth, (6.2 mm vs 5.5 mm, p=0.096) and a significantly shorter MS (5.8 mm vs 6.8 mm, P-value = 0.031) (Table). Increasing MS length was independently associated with a lower risk of PM dependency [odds ratio (OR) 0.58 per mm; 95% CI: 0.35–0.98, p=0.04] regardless prosthesis choice. MS length under 5 mm had 97.6% specificity (95% CI: 87.1–99.9) and 85.7% positive predictive value for pacemaker dependency (AUC=76.7; 95% CI 63.3–87).
Conclusion
Our findings highlight the importance of MSCT-derived MS length to stratify the risk of long term need for pacemaker. Patients with short MS (<5mm) in addition to conduction abnormality following TAVI had a high likelihood of PM dependency on the long term and should be considered for prompt PM implantation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Gama
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | - J Abecasis
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | - P Freitas
- Hospital de Santa Cruz, Carnaxide, Portugal
| | - D Cavaco
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | - J Brito
- Hospital de Santa Cruz, Carnaxide, Portugal
| | - L Raposo
- Hospital de Santa Cruz, Carnaxide, Portugal
| | - P Adragao
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | - M Mendes
- Hospital de Santa Cruz, Carnaxide, Portugal
| | - R C Teles
- Hospital de Santa Cruz, Carnaxide, Portugal
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6
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Oliveira L, Campante Teles R, Machado C, Madeira S, Vale N, Almeida C, Brito J, Leal S, Raposo L, Araujo Goncalves P, Pacheco A, Mesquita Gabriel H, Almeida M, Martins D, Mendes M. Impact of COVID-19 pandemic on ST-elevation myocardial infarction: data from two Portuguese centers. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Recently during the COVID-19 pandemic there was a general belief in a reduction of hospital admissions due to non-infectious causes, namely cardiovascular diseases.
Objectives
To evaluate the impact of the pandemic in the admissions by ST elevation acute myocardial infarction (STEMI), during the first pandemic wave.
Methods
Multicentric and retrospective analysis of consecutive patients presenting in two Portuguese hospital centers with STEMI in two sequential periods – P1 (1st March to 30th April) and P2 (1st May to 30th June). A comparison of patient's clinical and hospital outcomes data was performed between the year 2020 and 2017 to 2019 for both periods.
Results
A total of 347 consecutive STEMI patients were included in this study. The patient's baseline characteristics and cardiovascular risk factors were similar across the considered periods. During P1 of 2020, in comparison with previous years, a reduction in the number of STEMI patients was observed (26.0±4.2 vs 16.5±4.9 cases per month; p=0.033), contrary to what was observed during P2 (19.5±0.7 vs 20.5±0.7 cases per month; p=0.500). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs 9.1%; p=0.033). A global trend in longer delays in time-key bundles of STEMI care was noted, namely pain to first medical contact, door to needle, door to wire crossing and symptoms to wire crossing times, however without statistical significance. Mortality rate was six-fold higher during P1 comparing to previous years (1.9% vs 12.1%; p=0.005), and also an increase in the number of mechanical complications (0.0% vs 3.0%; p=0.029) was observed.
Conclusions
During the first COVID-19 pandemic wave there were fewer patients presenting with STEMI at catheterization laboratory for coronary angioplasty. These patients presented more mechanical complications and higher mortality rates.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Oliveira
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | | | - C Machado
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - S Madeira
- Hospital Santa Cruz, Lisbon, Portugal
| | - N Vale
- Hospital Santa Cruz, Lisbon, Portugal
| | - C Almeida
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - J Brito
- Hospital Santa Cruz, Lisbon, Portugal
| | - S Leal
- Hospital Santa Cruz, Lisbon, Portugal
| | - L Raposo
- Hospital Santa Cruz, Lisbon, Portugal
| | | | - A Pacheco
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | | | - M Almeida
- Hospital Santa Cruz, Lisbon, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - M Mendes
- Hospital Santa Cruz, Lisbon, Portugal
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7
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Sa Mendes G, Lopes P, Campante Teles R, Araujo Goncalves P, Raposo L, Abecasis J, Brito J, Nolasco T, Madeira M, Felix Oliveira A, Goncalves M, Mendes M, Sousa Almeida M. Long-term durability of transcatheter aortic valve replacement: outcomes from a contemporary cohort from a tertiary reference center at 5-years and beyond. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and aim
Long-term data on the durability of transcatheter heart valves is scarce. This is of particular interest as indications expand to younger and lower surgical risk patients. We sought to assess the incidence of long-term structural valve dysfunction (SVD) and bioprosthetic valve failure (BVF) in a cohort of patients with TAVR who reached at least 5-year follow-up, as compared to surgical aortic valve replacement (SAVR), performed within the same time-frame at the same institution.
Methods and results
Consecutive patients with at least 5-year available follow-up, who underwent TAVR between November 2008 to December 2015 in a tertiary single center, were included. From a group of 246 patients undergoing TAVR, 126 had available follow-up data (age at implantation: 83.0 [77.8–87.0] years; EuroScore II: 4.54 [2.60–6.29]%; follow-up: 5.94 [5.06–7.67] years). First generation Corevalve® and Sapien® prosthesis were implanted in 56% and 38% patients, respectively.
SVD and BVF were defined according to the new consensus statement from the EAPCI endorsed by the ESC and the EACTS. Mean transaortic pressure gradients decreased from 53.2±1.3 mmHg (pre-TAVR) to 10.4±0.4 mmHg (at discharge or up to one-year after TAVR, p<0.001), and there was a small non-significant increase at the fifth-year and the last available follow-up (11.2±0.6 mmHg; 14.7±1.8 mmHg, respectively). Moderate and severe SVD were reported in 12 and 4 patients, respectively (8-year cumulative incidence function to SVD: 2.67%; 95% CI, 2.12–3.89). Of these 8 had BVF, 7 of them with hospitalization for acute heart failure. A total of 4 patients died and none required reintervention (redo TAVR or SAVR). BVF for non-SVD were observed in 4 patients (2 subclinic thrombosis successfully treated with anticoagulation and 2 paravalvular regurgitation due to endocarditis).
As comparator, from a cohort of 587 patients submitted to biological SAVR, 247 (age 75.0 [70.0–79.0] years; EuroScore II 1.43 [1.06–2.17]%) had available long-term follow-up (6.89 [6.08–8.19] years). Moderate and severe SVD were reported in 42 and 3 patients, respectively (8-year cumulative incidence function to SVD: 3.13%; 95% CI, 2.45–4.21). These events were clinically relevant (BVF) in 19 of them: 8 performed TAVR valve-in-valve procedures and 3 redo SAVR. At the fifth-year of follow-up the incidence of SVD was not statistically different between TAVR (8%) and SAVR (15%), with a p for comparison of 0.137.
Conclusions
In our population of patients with symptomatic severe aortic stenosis treated with first-generation percutaneous bioprostheses, TAVR was associated with a low incidence of BVF and SVD at the long-term follow-up. These outcomes seem indistinct from those occurring in patients submitted to conventional SAVR
Funding Acknowledgement
Type of funding sources: None. KM curve reporting probability of SVD
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Affiliation(s)
| | - P Lopes
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | | | - L Raposo
- Hospital de Santa Cruz, Carnaxide, Portugal
| | - J Abecasis
- Hospital de Santa Cruz, Carnaxide, Portugal
| | - J Brito
- Hospital de Santa Cruz, Carnaxide, Portugal
| | - T Nolasco
- Hospital de Santa Cruz, Carnaxide, Portugal
| | - M Madeira
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | | | - M Mendes
- Hospital de Santa Cruz, Carnaxide, Portugal
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8
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Silva C, Goncalves M, Lopes P, Ventosa A, Calqueiro J, Freitas PN, Guerreiro S, Brito J, Abecasis J, Raposo L, Saraiva C, Goncalves PA, Gabriel HM, Almeida M, Ferreira AM. Patients undergoing invasive coronary angiography after a positive single-photon emission computed tomography or a positive stress cardiac magnetic resonance - What to expect at the cath lab. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Randomized controlled trials comparing stress cardiac magnetic resonance (CMR) and single-photon emission computed tomography (SPECT) suggest similar diagnostic accuracy for detecting obstructive coronary artery disease (CAD). However, there are few data on whether or not this remains true in routine clinical practice.
The aim of this study was to assess the clinical and angiographic characteristics of patients undergoing invasive coronary angiography (ICA) after a positive stress CMR or positive SPECT, and to compare their positive predictive value with published results from the CE-MARC trial.
Methods
In this retrospective tertiary-center analysis, we included 429 patients (mean age 67 ± 10 years, 28% women, 42% diabetic) undergoing ICA between January 2016 and December 2020, after a positive stress CMR or positive SPECT. Regarding stress test, an adenosine protocol was performed in all stress CMR and in 76.4% (n = 272) of stress SPECT.
Stress test results, including ischemia location and severity, were classified as reported by their primary readers. Patients with missing data on key variables, and those in whom microvascular disease was considered likely in the original stress test report were excluded. Obstructive CAD was defined as any coronary artery stenosis ≥ 50% in a vessel compatible with the ischemic territory on stress testing.
Results
Out of the total 429 patients, 356 (83%) were referred after a positive SPECT, and 73 (17%) after a positive stress CMR. Patients did not differ regarding age, cardiovascular risk factors, previous revascularization or left ventricular dysfunction, but patients with SPECT were more frequently male (p = 0.046). Overall, 320 patients (75%) had obstructive CAD on ICA. The prevalence of obstructive CAD was similar in patients with positive SPECT vs. positive stress CMR (76.1% vs. 80.8%, respectively, p = 0.385). There were also no significant differences in the prevalence of left main or 3-vessel disease (9.0% vs. 9.6%, p = 0.871, and 19.7% vs. 23.3% p = 0.483, respectively). Revascularization was performed or planned in 59.3% of patients in the SPECT group, and 52.1% of those in the stress CMR group (p = 0.255). The positive predictive values of both techniques were similar to those reported in the CE-MARC trial (Figure), and would increase to 88.1% and 89.4% for SPECT and stress CMR, respectively, if patients reported as having only mild ischemia were excluded.
Conclusion
In this tertiary center analysis, stress CMR and SPECT showed similar positive predictive values, comparable to those reported in the CE-MARC trial.
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Affiliation(s)
- C Silva
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - P Lopes
- Hospital de Santa Cruz, Lisbon, Portugal
| | - A Ventosa
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - PN Freitas
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - J Brito
- Hospital de Santa Cruz, Lisbon, Portugal
| | - J Abecasis
- Hospital de Santa Cruz, Lisbon, Portugal
| | - L Raposo
- Hospital de Santa Cruz, Lisbon, Portugal
| | - C Saraiva
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - HM Gabriel
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Almeida
- Hospital de Santa Cruz, Lisbon, Portugal
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9
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Choroba K, Machura B, Szlapa-Kula A, Malecki JG, Raposo L, Roma-Rodrigues C, Cordeiro S, Baptista PV, Fernandes AR. Square planar Au(III), Pt(II) and Cu(II) complexes with quinoline-substituted 2,2':6',2″-terpyridine ligands: From in vitro to in vivo biological properties. Eur J Med Chem 2021; 218:113404. [PMID: 33823390 DOI: 10.1016/j.ejmech.2021.113404] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022]
Abstract
Cancer is the second leading cause of death worldwide. Cisplatin has challenged cancer treatment; however, resistance and side effects hamper its use. New agents displaying improved activity and more reduced side effects relative to cisplatin are needed. In this work we present the synthesis, characterization and biological activities of three complexes with quinoline-substituted 2,2':6',2″-terpyridine ligand: [Pt(4'-(2-quin)-terpy)Cl](SO3CF3) (1), [Au(4'-(2-quin)-terpy)Cl](PF6)2·CH3CN (2) and [Cu(4'-(2-quin)-terpy)Cl](PF6) (3). The three complexes displayed a high antiproliferative activity in ovarian carcinoma cell line (A2780) and even more noticeable in a colorectal carcinoma cell line (HCT116) following the order 3 > 2 > 1. The complexes IC50 are at least 20 × lower than the IC50 displayed by cisplatin (15.4 μM) in HCT116 cell line while displaying at the same time, much reduced cytotoxicity in a normal dermal fibroblast culture. These cytotoxic activities seem to be correlated with the inclination angles of 2-quin unit to the central pyridine. Interestingly, all complexes can interact with calf-thymus DNA (CT-DNA) in vitro via different mechanisms, although intercalation seems to be the preferred mechanism at least for 2 and 3 at higher concentrations of DNA. Moreover, circular dichroism (CD) data seems to indicate that complex 3, more planar, induces a high destabilization of the DNA double helix (shift from B-form to Z-form). Higher the deviation from planar, the lower the cytotoxicity displayed by the complexes. Cellular uptake may be also responsible for the different cytotoxicity exhibited by complexes with 3 > 2 >1. Complex 2 seems to enter cells more passively while complex 1 and 3 might enter cells via energy-dependent and -independent mechanisms. Complexes 1-3 were shown to induce ROS are associated with the increased apoptosis and autophagy. Moreover, all complexes dissipate the mitochondrial membrane potential leading to an increased BAX/BCL-2 ratio that triggered apoptosis. Complexes 2 and 3 were also shown to exhibit an anti-angiogenic effect by significantly reduce the number of newly formed blood vessel in a CAM model with no toxicity in this in vivo model. Our results seem to suggest that the increased cytotoxicity of complex 3 in HCT116 cells and its potential interest for further translation to pre-clinical mice xenografts might be associated with: 1) higher % of internalization of HCT116 cells via energy-dependent and -independent mechanisms; 2) ability to intercalate DNA and due to its planarity induced higher destabilization of DNA; 3) induce intracellular ROS that trigger apoptosis and autophagy; 4) low toxicity in an in vivo model of CAM; 5) potential anti-angiogenic effect.
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Affiliation(s)
- Katarzyna Choroba
- Institute of Chemistry, University of Silesia, Szkolna 9, 40-006, Katowice, Poland.
| | - Barbara Machura
- Institute of Chemistry, University of Silesia, Szkolna 9, 40-006, Katowice, Poland
| | - Agata Szlapa-Kula
- Institute of Chemistry, University of Silesia, Szkolna 9, 40-006, Katowice, Poland
| | - Jan G Malecki
- Institute of Chemistry, University of Silesia, Szkolna 9, 40-006, Katowice, Poland
| | - Luis Raposo
- UCIBIO, Departamento de Ciências da Vida, NOVA School of Science and Technology, Campus de Caparica, 2829-516, Caparica, Portugal
| | - Catarina Roma-Rodrigues
- UCIBIO, Departamento de Ciências da Vida, NOVA School of Science and Technology, Campus de Caparica, 2829-516, Caparica, Portugal
| | - Sandra Cordeiro
- UCIBIO, Departamento de Ciências da Vida, NOVA School of Science and Technology, Campus de Caparica, 2829-516, Caparica, Portugal
| | - Pedro V Baptista
- UCIBIO, Departamento de Ciências da Vida, NOVA School of Science and Technology, Campus de Caparica, 2829-516, Caparica, Portugal
| | - Alexandra R Fernandes
- UCIBIO, Departamento de Ciências da Vida, NOVA School of Science and Technology, Campus de Caparica, 2829-516, Caparica, Portugal.
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10
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Beijnink CWH, Thim T, van der Heijden DJ, Klem I, Al-Lamee R, Vos JL, Koop Y, Dijkgraaf MGW, Beijk MAM, Kim RJ, Davies J, Raposo L, Baptista SB, Escaned J, Piek JJ, Maeng M, van Royen N, Nijveldt R. Instantaneous wave-free ratio guided multivessel revascularisation during percutaneous coronary intervention for acute myocardial infarction: study protocol of the randomised controlled iMODERN trial. BMJ Open 2021; 11:e044035. [PMID: 33452200 PMCID: PMC7813313 DOI: 10.1136/bmjopen-2020-044035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Recent randomised clinical trials showed benefit of non-culprit lesion revascularisation in ST-elevation myocardial infarction (STEMI) patients. However, it remains unclear whether revascularisation should be performed at the index procedure or at a later stage. METHODS AND ANALYSIS The instantaneous wave-free ratio (iFR) Guided Multivessel Revascularisation During Percutaneous Coronary Intervention for Acute Myocardial Infarction trial is a multicentre, randomised controlled prospective open-label trial with blinded evaluation of endpoints. After successful primary percutaneous coronary intervention (PCI), eligible STEMI patients with residual non-culprit lesions are randomised, to instantaneous wave-free ratio guided treatment of non-culprit lesions during the index procedure versus deferred cardiac MR-guided management within 4 days to 6 weeks. The primary endpoint of the study is the combined occurrence of all-cause death, recurrent myocardial infarction and hospitalisation for heart failure at 12 months follow-up. Clinical follow-up includes questionnaires at 3 months and outpatient visits at 6 months and 12 months after primary PCI. Furthermore, a cost-effectiveness analysis will be performed. ETHICS AND DISSEMINATION Permission to conduct this trial has been granted by the Medical Ethical Committee of the Amsterdam University Medical Centres (loc. VUmc, ID NL60107.029.16). The primary results of this trial will be shared in a main article and subgroup analyses or spin-off studies will be shared in secondary papers. TRIAL REGISTRATION NUMBER NCT03298659.
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Affiliation(s)
| | - Troels Thim
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
| | | | - Igor Klem
- Cardiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Rasha Al-Lamee
- Cardiology, Imperial College London Faculty of Medicine, London, UK
| | | | - Yvonne Koop
- Cardiology, Radboudumc, Nijmegen, The Netherlands
| | - Marcel G W Dijkgraaf
- Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC - Locatie AMC, Amsterdam, The Netherlands
| | - Marcel A M Beijk
- Cardiology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Raymond J Kim
- Cardiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Justin Davies
- Faculty of Medicine, Imperial College London, London, UK
| | - Luis Raposo
- Cardiology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
| | | | - Javier Escaned
- Interventional Cardiology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Jan J Piek
- Cardiology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
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11
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Thim T, van der Hoeven NW, Musto C, Nijveldt R, Götberg M, Engstrøm T, Smits PC, Oldroyd KG, Gershlick AH, Escaned J, Baptista SB, Raposo L, van Royen N, Maeng M. Evaluation and Management of Nonculprit Lesions in STEMI. JACC Cardiovasc Interv 2020; 13:1145-1154. [PMID: 32438985 DOI: 10.1016/j.jcin.2020.02.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 02/08/2023]
Abstract
Nonculprit lesions are frequently observed in patients with ST-segment elevation myocardial infarction. Results from recent randomized clinical trials suggest that complete revascularization after ST-segment elevation myocardial infarction improves outcomes. In this state-of-the-art paper, the authors review these trials and consider how best to determine which nonculprit lesions require revascularization and when this should be performed.
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Affiliation(s)
- Troels Thim
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
| | | | - Carmine Musto
- Department of Interventional Cardiology, San Camillo Hospital, Rome, Italy
| | - Robin Nijveldt
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Matthias Götberg
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Thomas Engstrøm
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Pieter C Smits
- Department of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands
| | - Keith G Oldroyd
- Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom
| | - Anthony H Gershlick
- University of Leicester, University Hospitals of Leicester, Leicester Biomedical Research Unit, Leicester, United Kingdom
| | - Javier Escaned
- Hospital Clinico San Carlos IDISSC, Complutense University, Madrid, Spain
| | - Sergio Bravo Baptista
- University Clinic of Cardiology, Faculty of Medicine at University of Lisbon, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - Luis Raposo
- Cardiology Department, Santa Cruz Hospital-CHLO, Lisbon, Portugal
| | - Niels van Royen
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
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12
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Sa Mendes G, Oliveira A, Campante Teles R, Araujo Goncalves P, Brito J, Mesquita Gabriel H, Raposo L, Goncalves M, Lopes P. Vascular closure devices in TAVI: MANTA versus ProGlide in a propensity-matched population. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Vascular complications increase morbidity and mortality in transcatheter aortic valve implantation (TAVI). A collagen plug-based closure device - MANTA® was recently introduced as an alternative to the suture-mediated ProGlide® vascular closure device (VCD). Data regarding the efficacy and safety comparing both VCD is scarce. The present study sought to compare the effectiveness of both devices.
Methods
Single center retrospective analysis on prospectively collected data of 300 consecutive patients who underwent TAVI using MANTA® or ProGlide® since 2018. A 1:1 propensity-score matched population derived by a multivariate logistic regression model based on age, sex, body mass index, pre-procedural haemoglobin, EuroSCORE II, main access calcification and the sheath-to-artery ratio. The primary endpoint was the composite of major or life-threatening bleeding (VARC-2 definition), femoral artery stenosis/dissection, pseudoaneurysm and need for endovascular/surgical bailout intervention.
Results
The propensity score matching resulted in 129 matched pairs. The median age was 84 years old [IQR 80–87], 42% males with a median EuroSCOREII of 4.29% [IQR 3.05–6.24].
There were no differences in the primary endpoint between MANTA ® and ProGlide® cohorts (3.9% vs 7.8%, p=0.287, respectively). The rates of the primary endpoint with the MANTA® device decreased with center experience, with relatively steep learning curve effect concerning device success.
Major or life-threatening bleeding (3.1% vs 5.4%, p=0.540) and pseudoaneurysm (0.8% vs 2.3%, p=0.622) occurred less frequently in MANTA® cohort, but the differences did not reach statistical significance. Endovascular (stent or balloon) or surgical rescue intervention (9.3% vs 5.4%, p=0.341) and femoral artery stenosis/dissection (6.2% vs 3.1%, p=0.376), were also similar rates. In ProGlide® cohort, to achieve VCD success (without primary endpoint events), 15.5% needed more than 2 devices, significantly different from MANTA ® (p<0,001).
Conclusions
In patients undergoing transfemoral TAVI, the MANTA® VCD showed a similar efficacy and safety compared to the ProGlide® device and it reduced significantly the need of additional VCDs for completion of hemostasis. These results were obtained despite a clear learning curve associated with MANTA.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - A Oliveira
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | | | - J Brito
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | - L Raposo
- Hospital de Santa Cruz, Carnaxide, Portugal
| | | | - P Lopes
- Hospital de Santa Cruz, Carnaxide, Portugal
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13
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Albuquerque F, Brizido C, Madeira S, Teles R, Raposo L, Gabriel H, Leal S, Goncalves M, Brito J, Goncalves P, Almeida M, Mendes M. Patterns of revascularization in stable ischemic heart disease in the pre-ISCHEMIA era. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
New evidence on the role of myocardial revascularization in stable ischemic heart disease (SIHD), recently presented, showed that revascularization guided by the presence of moderate-to severe ischemia relieves angina more effectively than optimal medical therapy (OMT), without a significant benefit in hard clinical endpoints.
Aim
To assess the representativeness of the ISCHEMIA trial in a real-world population and compare management strategies between patients who fulfill the eligibility criteria of the trial (Group 1, G1) and those who do not (Group 2, G2).
Methods and population
Single centre retrospective analysis including all consecutive patients referred to coronary angiography (CA) for SIHD from January 2018 to December 2019. Patients were stratified in two groups (G1 and G2) according to the ISCHEMIA trial inclusion and exclusion criteria. G1 was compared with G2 and with a subset of G2 with obstructive coronary artery disease (CAD), defined as ≥70% luminal stenosis in at least one coronary artery or >50% for the left main.
Results
A total of 1020 patients underwent CA, of whom only 124 (12.2%) would have been eligible for the ISCHEMIA trial (G1). Overall, there were no significant differences in baseline characteristics between the two groups. G1 patients had more extensive and severe disease, presenting more frequently with proximal left anterior descending (LAD) involvement (26.6% vs 10.4%; p<0.001), two vessel disease without proximal LAD stenosis (23.4% vs 10.3%; p<0.001) and three vessel disease (18.5% vs 5.9%; p<0.001). These patients had higher rates of revascularization, both CABG (25.8% vs 10.8%, p<0.001) and PCI (56.5% vs 39.5%, p<0.001). However, when comparing G1 with the subset of G2 patients with obstructive CAD, G1 patients had higher rates of CABG (26.8% vs 17.8%, p=0.034) but there were no differences on the rates of PCI (58.0% vs 56.9%, p=0.916).
Conclusions
Patients included in the ISCHEMIA trial are underrepresented in a real-world population of SIHD patients referred to coronary angiography. PCI rates were similar among patients with at least one significant coronary artery stenosis, regardless of previous evidence or severity of ischemia. Our findings underline the need for further refinement in criteria for revascularization in SIHD.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - C Brizido
- Hospital Santa Cruz, Carnaxide, Portugal
| | - S Madeira
- Hospital Santa Cruz, Carnaxide, Portugal
| | - R Teles
- Hospital Santa Cruz, Carnaxide, Portugal
| | - L Raposo
- Hospital Santa Cruz, Carnaxide, Portugal
| | - H Gabriel
- Hospital Santa Cruz, Carnaxide, Portugal
| | - S Leal
- Hospital Santa Cruz, Carnaxide, Portugal
| | | | - J Brito
- Hospital Santa Cruz, Carnaxide, Portugal
| | | | - M Almeida
- Hospital Santa Cruz, Carnaxide, Portugal
| | - M Mendes
- Hospital Santa Cruz, Carnaxide, Portugal
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14
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Ventura Gomes R, Oliveira A, Goncalves M, Madeira S, Vale N, Brito J, Leal S, Raposo L, Araujo Goncalves P, Mesquita Gabriel H, Campante Teles R, Sousa Almeida M. Risk stratification in unprotected left main coronary disease: do we have the tools? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The evolution of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) techniques made the choice of the optimal revascularization strategy of unprotected left main coronary disease (ULMD) challenging. Scoring systems are useful tools for the decision-making process and for risk stratification.
Purpose
To evaluate 1) the performance of the SYNTAX score I (SSI) and II (SSII) and Euroscore II (EII) in risk stratification and 2) the outcome predictors of patients (pts) with ULMD, according to the treatment strategy chosen (PCI or CABG).
Methods
Retrospective single centre cohort study of 440 consecutive pts (age 68±11 years; 76.6% male) with significant ULMD (defined as left main coronary artery stenosis >50%, with no patent arterial or venous bypass graft to left anterior descending artery), who were submitted to PCI (n=135) or CABG (n=307), between January 2006 and December 2018. Median follow-up (FU) was 4.0±1.8 years.
The primary outcome was a composite of cardiovascular (CV) death, non-fatal myocardial infarction (MI) and target lesion revascularization (TLR).
Results
During the FU period, there were 112 (25.5%) CV deaths, 26 (5,9%) non-fatal MI and 53 (12.0%) TLR.
Multivariate analysis of pts submitted to PCI showed that SSII and anatomical complete revascularization were independent predictors of the primary outcome (HR 1.045, CI 1.015–1.075, p=0.003 and HR 3,014, CI 1.655–5.489, p<0.0001, respectively). The 63 pts submitted to PCI, who had a SSII favoring CABG, had slightly more adverse events (42.9% vs 41.7%, p=0.889).
In the CABG cohort, only SSII was an independent predictor of the outcome by multivariate analysis (HR 1.061, CI 1.035–1.086, p<0.0001).
The ROC curve analysis for all cohort presented no discriminative capacity for SSI (AUC 0.538, CI 0.482–0.593, p=0.186) and a weak discrimination for SSII (AUC 0.659, CI 0.605–0.713, p<0.0001) and EII (AUC 0.653, CI 0.599–0.707, p<0.0001; Figure 1). The difference between SSII and EII was not statistically significant (DeLong test p=0.828). Similar results were found when analysing the CAGB group, however, in PCI cohort, SII and EII showed an acceptable discriminative capacity (AUC 0.722, CI 0.636–0.809, p<0.0001 and AUC 0.700, CI 0.610–0.791, p<0.0001, respectively).
Conclusion
In a real-world ULMD population, the most common risk scores, mainly those integrating anatomical and clinical features, presented a very modest role in the risk stratification, both in chronic and acute coronary syndromes. However, in pts with ULMD submitted to PCI, those risk scores had a more significant role in the risk stratification of these pts.
Figure 1. SSI, SSII, EII ROC curves for all cohort
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Ventura Gomes
- Hospital de Vila Franca de Xira, Cardiology, Vila Franca de Xira, Portugal
| | - A Oliveira
- Hospital de Santa Cruz, Cardiology, Carnaxide, Portugal
| | - M Goncalves
- Hospital de Santa Cruz, Cardiology, Carnaxide, Portugal
| | - S Madeira
- Hospital de Santa Cruz, Cardiology, Carnaxide, Portugal
| | - N Vale
- Hospital de Santa Cruz, Cardiology, Carnaxide, Portugal
| | - J Brito
- Hospital de Santa Cruz, Cardiology, Carnaxide, Portugal
| | - S Leal
- Hospital de Santa Cruz, Cardiology, Carnaxide, Portugal
| | - L Raposo
- Hospital de Santa Cruz, Cardiology, Carnaxide, Portugal
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15
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Cerrato E, Mejía-Rentería H, Dehbi HM, Ahn JM, Cook C, Dupouy P, Baptista SB, Raposo L, Van Belle E, Götberg M, Davies JE, Park SJ, Escaned J. Revascularization Deferral of Nonculprit Stenoses on the Basis of Fractional Flow Reserve. JACC Cardiovasc Interv 2020; 13:1894-1903. [DOI: 10.1016/j.jcin.2020.05.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/16/2020] [Accepted: 05/12/2020] [Indexed: 01/26/2023]
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16
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Felix-Oliveira A, Campante Teles R, Ferreira A, Brito J, Goncalves PA, Raposo L, Gabriel HM, Nolasco T, Cunha G, Abecasis J, Saraiva C, Almeida MS, Mendes M. P3382Vascular calcium Index: an imaging tool to predict vascular complications and major bleeding in TF-TAVI. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Vascular calcification has been associated with worse outcomes in transfemoral TAVI (TF-TAVI). However, there is currently no simple method to assess it and identify different patterns of calcification in an objective and quantitative manner. The purpose of this study was to develop a quantitative score of aortic (Ao) and ileofemural (IF) calcification and to assess its ability to predict life-threatening bleeding (LTB) and major vascular complications during TF-TAVI.
Methods
Case-control single center retrospective study of patients undergoing TF-TAVI between Nov2015 and Aug2018 including 183 consecutive patients (99 women, mean age 83±3 years, mean Euroscore II - ESII - 6.0±4.1). The Vascular Calcium Score was calculated for the entire Ao and IF vessels using a modified Agatston score derived from contrast-enhanced CT images, with calcium threshold locally adjusted for luminal attenuation (mean attenuation + 5x SD). A luminal attenuation threshold >600UH impaired vascular calcium evaluation and patients were excluded. LTB and major vascular complications were adjudicated according to the VARC-2 classification and identified by chart review by and independent team.
Results
Thirty patients (16%) suffered major bleeding and 13 (7%) experienced LTB. Major vascular injury occurred in 11 patients (6%). The median total vascular calcium score (TCS) was 11752 AU (IQR: 6388–19844) and median IF score (IFS) was 2210AU (IQR: 865–4170). TCS indexed for body surface area (TCSi) was predictor of LTB (AUC: 0.78±0.07, p<0.05) and of major vascular complications (AUC: 0.85±0.05, p<0.05). After multivariate analysis, iTCS and glomerular filtration rate (GFR) remained as predictors of LTB with an HR of 1.11 for each increase in 1000UA/m2 of TCSi (95% CI: 1.03–1.18) and 0.94 (95% CI: 0.88–0.985) respectively, independently of the ESII. iTCS and GFR were also independently associated with major vascular complications (p<0.05). Patients with an iTCS above 9750AU/m2 have an odds ratio of 7.7 (95% CI: 2.0 - 29.2) for LTB. This cut-off has a sensitivity of 77% and a specificity of 70% for LTB. Similarly, patients with an iTCS above 9750AU/m2 have an odds ratio of 10.3 (95% CI: 22 - 49.3) for major vascular injury.
Conclusions
A quantitative score for vascular calcification in contrast-enhanced CT images was developed. iTCS was independently associated with life-threatening bleeding and major vascular complications.
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Affiliation(s)
| | | | - A Ferreira
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - J Brito
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - P A Goncalves
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - L Raposo
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - H M Gabriel
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - T Nolasco
- Hospital Santa Cruz, Cardiac Surgery, Carnaxide, Portugal
| | - G Cunha
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - J Abecasis
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - C Saraiva
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - M S Almeida
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
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17
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Carvalheira Dos Santos R, Raposo L, Madeira S, Brito J, Goncalves M, Brizido C, Vale N, Leal S, Sousa P, Araujo Goncalves P, Mesquita Gabriel H, Campante Teles R, Almeida M, Mendes M. P4575UA and NSTEMI in the era of high-sensitivity Troponin: impact on patient risk profile and management. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aim
High-sensitivity troponin assays (HST) entered the clinical arena to facilitate exclusion of ACS in the emergency department (ER) in patients presenting with chest pain. Due to its higher sensitivity there is the potential for an overestimation of the diagnosis of NSTEMI, and possibly ACS overall. We assessed the impact of HST in the classification of ACS (NSTEMI vs UA) and its ability to predict obstructive coronary disease (CAD), in a population of pts referred to coronary angiography (ICA).
Methods
Retrospective analysis of 1844 pts with suspected NSTEMI or UA referred for ICA from a single ER between Feb 2013 and Nov 2018. Standard Troponin-I was used until Feb 2016 and HST thereafter. The characteristics of UA and NSTEMI pts before and after the introduction of HST were compared. Multivariate binary logistic regression models were used to access the association of different troponin assays with CAD (>50% for LM and >70% for the remaining). Sensitivity, specificity, NPV and PPV for angiographic CAD were also determined.
Results
The relative proportion of patients with UA and NSTEMI was similar between study periods: 31% vs 29% and 69% vs 71%, respectively (p=0.3). Clinical and angiographic characteristics did not differ in UA pts before and after the use of HST. NSTEMI patients in the HST era were less frequently women (39% vs 32%, p=0.026), had higher creatinine (0.93 IQR 0.75–1.3 vs 1.0 IQR 0.82–1.38), higher number of lesions (2 IQR 1–4 vs 3 IQR 1–4) and a lower rate of normal coronary arteries (10.5% vs 3.9%, p<0.001). The prevalence of significant CAD in this population, before and after HST, was 65% and 73%, respectively (p=0.001). However, when clinically relevant characteristics and judgement were accounted for, both standard troponin (OR 0.99, 95% CI 0.99–1.01) and HST (1.0, 95% CI 1.0–1.0) were poor predictors of significant CAD. Sensitivity was 69% vs 72%, specificity 30% vs 30%, PPV 65% vs 73% and NNP 34% vs 28%, respectively. Finally, rates of percutaneous intervention did not differ between the two periods (30% vs 33.5%, p=0.157), nor between ACS types within each period.
CAD/PCI in ACS within each period
Conclusion
The introduction of HST did not result in an increase of the diagnosis of NSTEM vs UA, suggesting that clinical judgment remains an important determinant of the diagnosis of ACS. Also there was no evidence of an increase in PCI rates, despite worse CAD severity in NSTEMI patients.
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Affiliation(s)
| | - L Raposo
- Hospital de Santa Cruz, Lisbon, Portugal
| | - S Madeira
- Hospital de Santa Cruz, Lisbon, Portugal
| | - J Brito
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - C Brizido
- Hospital de Santa Cruz, Lisbon, Portugal
| | - N Vale
- Hospital de Santa Cruz, Lisbon, Portugal
| | - S Leal
- Hospital de Santa Cruz, Lisbon, Portugal
| | - P Sousa
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | | | | | - M Almeida
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Lisbon, Portugal
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Dias Ferreira Reis JP, Strong C, Roque D, Morais L, Mendonca T, Modas PD, Farto E Abreu P, Almeida M, Cacela D, Morais C, Mendes M, Cruz Ferreira R, Bravo Baptista S, Raposo L, Ramos R. P3633Should we continue to routinely revascularize patients during valve surgery in optimal medical therapy era? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Optimal management of stable obstructive coronary artery disease (CAD) in patients (pts) undergoing heart valve surgery remains controversial. The aim of the present study is to evaluate the effective prognostic role of CABG in pts undergoing valve surgery who had concomitant CAD.
Methods
We conducted a retrospective multicenter survival analysis using multivariable Cox models and Kaplan-Meier curves of consecutive pts undergoing valve surgery with or without concomitant CABG between January 2015 and February 2017.
Results
From 1196 consecutive pts undergoing valvular surgery in 3 portuguese centers, 257 (21.5%) were found to have obstructive CAD (55.6% male, mean age 74±8 y.o., mean follow-up time 16±8 months, aortic valve disease 78.8%). No coronary revascularization (R) was attempted in 177 pts, complete R was achieved in 40 and R was anatomically incomplete in the remaining 40 pts. Age (75 vs 77.3 y.o.; p=0.202), multivessel disease (46.3% vs 53.8%, p=0.270), aortic valve disease (91.0% vs 92.5%, p=0.683), left ventricular ejection fraction <40% (11.8% vs 19.4%, p=0.272) were comparable between nonrevascularized and revascularized pts; SYNTAX score was low and also similar in both groups (7±12 vs 7±5, p=0.856). Left main disease (8.5% vs 17.5%, p=0.034) and EUROSCORE IIrisk score (2.3±2 vs 3.2±2, p=0.011) was higher for those with any revascularization. Non-revascularized pts had significantly lower all-cause mortality at follow up than those with any R (10.2% vs 21.2%, p=0.016). However, both in-hospital (4% vs 7.5%, p=0.230) and cardiovascular mortality (6.9% vs 7.1%, p=1.00) were similar. In a multivariate analysis, independent predictors for all-cause mortality were: any surgical R (HR 4.52, CI95% 2.09–9.78), baseline atrial fibrillation (HR 2.51, CI95% 1.07–5.90), left main disease (HR 3.153, CI95% 1.26–7.90) and peripheral artery disease (HR 2.95, CI95% 1.036–8.421). All-cause mortality for pts with obstructive CAD was higher than in pts with no CAD (13.6% vs 6.2, p<0.001). Interestingly, however, after multivariable adjustment, complete R was not found to be protective as compared to no R (HR 0.79, IC 0.31–2.06, p=0.633)
Kaplan-Meier Plots
Conclusion
Significant CAD is associated with worse outcomes in pts undergoing valve surgery. In this study, standard angiographically-guided R was not associated with improved results. Randomized controlled trials are needed to further assess risk stratification and the role of coronary R of stable CAD in this setting.
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Affiliation(s)
| | - C Strong
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - D Roque
- Hospital Prof Fernando da Fonseca EPE, Cardiology, Amadora, Portugal
| | - L Morais
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Mendonca
- Hospital de Santa Marta, Lisbon, Portugal
| | - P D Modas
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Farto E Abreu
- Hospital Prof Fernando da Fonseca EPE, Cardiology, Amadora, Portugal
| | - M Almeida
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - D Cacela
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Morais
- Hospital Prof Fernando da Fonseca EPE, Cardiology, Amadora, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | | | - S Bravo Baptista
- Hospital Prof Fernando da Fonseca EPE, Cardiology, Amadora, Portugal
| | - L Raposo
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - R Ramos
- Hospital de Santa Marta, Lisbon, Portugal
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Carvalho Mendonca TJ, Strong C, Roque D, Morais L, Reis JP, Daniel PM, Abreu P, Almeida M, Cacela D, Morais C, Mendes M, Ferreira RC, Baptista SB, Raposo L, Ramos R. P3628Contemporary coronary artery disease prevalence in a valvular heart disease population undergoing surgery. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients undergoing heart valve surgery are routinely evaluated for the presence of Coronary Artery Disease (CAD), with the standard practice of combining valve intervention with a revascularization procedure, notably Coronary Artery Bypass Graft (CABG). Older studies suggest rates as high as 50% prevalence of CAD in this population. However, CAD prevalence, its treatment and prognostic implication has been questioned recently.
Objectives
The goal of this study is to evaluate the baseline characteristics, prevalence of CAD and treatment strategies in a contemporary population with valvular heart disease (VHD) referred for valve surgery.
Methods
In a national multicentre registry, consecutive patients, from Jan 2015 to Dec 2016, with a formal indication for heart valve surgery referred for a pre-op routine coronary angiogram were systematically analysed. Baseline characteristics, valve pathology and CAD prevalence and patterns were determined. Obstructive CAD was defined as luminal angiographic stenosis ≥70% (≥50% for left main artery). The prognostic impact of the different valve disease and CAD treatment strategies were assessed.
Results
1175 patients (mean age 72.5±10.1; male 49.2%) fulfilled the clinical or echocardiographic indication for valve surgery by European guidelines. Valvular disease prevalence was: aortic stenosis (66.7%), aortic regurgitation (6.6%), mitral stenosis (6%), mitral regurgitation (19.2%), tricuspid regurgitation (7.5%). Mean follow-up time was 29.06±18.46 months. Prevalence of comorbidities was: Diabetes Mellitus (DM) 26%, chronic obstructive pulmonary disease (COPD) 5.7% and chronic kidney disease (CKD) 23.4%. Mean Euroscore II was 2.6%. Obstructive CAD was present in 27.3% patients. Mean Syntax score was 10.2 (<22 in 88%, 23–32 in 10.2% and >33 in 1.8%). Left main artery and 3-vessel disease were found in 13.1% and 11.8% of patients with CAD, respectively. Valvular surgery was ultimately performed in 80.3%. In patients with CAD, 57.3% were revascularized. All-cause mortality rate during follow-up was 12.9%, with 7.8% from cardiovascular causes. In univariate analysis DM, COPD, CKD, NYHA class, obstructive CAD and no surgery (p<0.05) were associate with mortality on follow up. In multivariate analysis obstructive CAD (OR 2.36, 95% CI 1.53–3.65, p<0.01) and no surgery (OR 6.05, 95% CI 3.95–9.30, p<0.01) persisted as independent all-cause mortality predictors.
Conclusion
In a contemporary cohort of patients with VHD and surgical indication, CAD prevalence is lower (27.3%) than described in literature. Mortality rates were higher in patients with obstructive CAD, worse NYHA functional class and in those who never underwent surgery.
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Affiliation(s)
| | - C Strong
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - D Roque
- Hospital Prof Fernando da Fonseca EPE, Department of Cardiology, Amadora, Portugal
| | - L Morais
- Hospital de Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - J P Reis
- Hospital de Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - P M Daniel
- Hospital de Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - P Abreu
- Hospital Prof Fernando da Fonseca EPE, Department of Cardiology, Amadora, Portugal
| | - M Almeida
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - D Cacela
- Hospital de Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - C Morais
- Hospital Prof Fernando da Fonseca EPE, Department of Cardiology, Amadora, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - R C Ferreira
- Hospital de Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - S B Baptista
- Hospital Prof Fernando da Fonseca EPE, Department of Cardiology, Amadora, Portugal
| | - L Raposo
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - R Ramos
- Hospital de Santa Marta, Department of Cardiology, Lisbon, Portugal
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Freitas P, Riberias R, Teles RC, Brito J, Oliveira A, Mendes G, Silva C, Nolasco T, Goncalves PA, Gabriel HM, Raposo L, Andrade MJ, Ferreira A, Almeida M, Mendes M. P2651TAVI procedure and significant paravalvular leaks: angiography-only versus transesophageal-guided. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Freitas
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - R Riberias
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - R C Teles
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - J Brito
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - A Oliveira
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - G Mendes
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - C Silva
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - T Nolasco
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - P A Goncalves
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - H M Gabriel
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - L Raposo
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - M J Andrade
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - A Ferreira
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - M Almeida
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
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Maroń A, Czerwińska K, Machura B, Raposo L, Roma-Rodrigues C, Fernandes AR, Małecki JG, Szlapa-Kula A, Kula S, Krompiec S. Spectroscopy, electrochemistry and antiproliferative properties of Au(iii), Pt(ii) and Cu(ii) complexes bearing modified 2,2′:6′,2′′-terpyridine ligands. Dalton Trans 2018; 47:6444-6463. [DOI: 10.1039/c8dt00558c] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Impact of the metal centre and the substituent incorporated into a terpy framework.
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Leone A, Cialdella P, Martin-Reyes R, Baptista S, Amabile N, Raposo L. cFFR as an alternative to FFR: please do not contrast simplicity! EUROINTERVENTION 2017; 13:e1487-e1488. [DOI: 10.4244/eijv13i12a236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Raposo L, Baptista S, Ramos R, Santos L, Jorge E, Machado C, Costa J, Nunes L, Sousa MJ, Rodrigues A, Seca L, Fernandes R. TCT-709 One year clinical outcome of FFR based management of patients sustaining an Acute Coronary Syndrome: a lesion-based analysis from the POST-IT prospective study. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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24
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Vale N, Madeira S, Almeida M, Seabra Gomes R, Castro M, Rodrigues G, Raposo L, Gabriel H, Goncalves P, Teles R, Mendes M. P6111First generation drug eluting stents outperform bare metal stents in 10-year survival. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Vale N, Madeira S, Teles R, Tralhao A, Brito J, Ribeiras R, Almeida M, Raposo L, Goncalves P, Gabriel H, Mendes M. P6325Five-year durability and haemodynamic performance of transcatheter aortic valves versus surgical bioprotheses. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cueva Recalde JF, Velcea A, Aguiar Rosa S, Surkova E, Bucciarelli V, Kupczynska K, Miskowiec D, Reskovic Luksic V, Verseckaite R, Jillott N, Muraru D, Muraru D, Borizanova A, Caroli S, Guerreiro S, Miskowiec D, Miskowiec D, Mahmoud HM, Peovska Mitevska I, Babukov R, Brecht A, Garcia-Sanchez MJ, Gayan Ordas J, Lacambra Blasco I, Mihaila S, Andronic AA, Marcu S, Vinereanu D, Galrinho A, Branco L, Timoteo A, Cunha P, Lousinha A, Valente B, Pereira Silva T, Oliveira M, Cruz Ferreira R, Aalen J, Samset E, Bidviene J, Aruta P, Romeo G, Sambugaro F, Badano LP, Muraru D, Bianco F, Di Blasio A, Izzicupo P, Ghinassi B, Napolitano G, Di Baldassarre A, Gallina S, Michalski B, Miskowiec D, Kasprzak JD, Lipiec P, Kupczynska K, Michalski B, Simiera M, Lipiec P, Wejner-Mik P, Wierzbowska-Drabik K, Ojrzanowski M, Kasprzak JD, Pasalic M, Separovic Hanzevacki J, Mizariene V, Montvilaite A, Unikaite R, Bieseviciene M, Jurkevicius R, Wilson S, Marotta C, Mihaila S, Calore C, Bidviene J, Surkova E, Romeo G, Aruta P, Palermo C, Badano LP, Marotta C, Mihaila S, Calore C, Aruta P, Romeo G, Surkova E, Bidviene J, Iliceto S, Badano LP, Kinova E, Kundurzhiev T, Goudev A, Bellsham-Revell HR, Bell AJ, Miller OI, Simpson JM, Raposo L, Andrade MJ, Horta E, Reis C, Almeida M, Mendes M, Wejner-Mik P, Kasprzak JD, Qawoq HD, Zycinski P, Wcislo T, Kupczynska K, Lipiec P, Wejner-Mik P, Kasprzak JD, Qawoq HD, Zycinski P, Wcislo T, Kupczynska K, Lipiec P, Abdel Raouf O, Kheir A, Halawa S, Al-Ghamdi M, Ghabashi A, Srbinovska E, Antova E, Bosevski M, Bazilev VV, Bartosh FL, Bathe M, Oertelt-Prigione S, Seeland U, Regitz-Zagrosek V, Baumann G, Stangl K, Stangl V, Knebel F, Dreger H, Barreiro-Perez M, Arribas-Jimenez A, Martin-Garcia A, Diaz-Pelaez E, Rama-Merchan JC, Cruz-Gonzalez I, Sanchez PL. HIT Poster session 2P479Strain concordance in a real-world setting: experience in our laboratory after equipment upgradeP4803D echocardiography is a fast-learning and reliable method for the measurements of left atrial volumesP481Echocardiographic parameters associated with long-term appropriate antiarrhythmic therapies in cardiac resynchronization therapy defibrillator patientsP482Noninvasively measured global wasted myocardial work allows for quantitative assessment of typical left ventricular mechanical dyssynchrony pattern in patients with left bundle branch blockP483The impact of adherence to physical exercise on the improvement of cardiovascular remodeling and metabolic status in healthy untrained postmenopausal womenP484The impact of the latest chamber quantification recommendations on the prediction of left atrial appendage thrombus presenceP485The cardiac-enriched miRNAs plasma levels (miR-1, miR-133a, miR-499) reflect the impaired left ventricular systolic function and correlate with cardiac necrosis markers in early phase of NSTE-ACSP486Acute regional myocardial deformation changes in patients with severe aortic stenosis and preserved ejection fraction after isolated aortic valve replacementP487Left ventricular rotational deformation in asymptomatic patients with chronic aortic regurgitation and normal left ventricular ejection fraction P488The appropriate use of transthoracic echocardiography for the exclusion of infective endocarditisP489In patients with hypertrophic cardiomyopathy, left ventricular mass and shape by three-dimensional echocardiography are related with dynamic obstruction and functional capacityP490Mitral leaflet sizing in hypertrophic cardiomyopathy: impact of method and timingP491Echocardiographic predictors of atrial fibrillation in obese womenP492Echocardiographic risk factors for 30 day mortality after the hybrid procedure for hypoplastic left heart syndromeP493Left ventricular mass is an independent predictor of coronary flow reserve: insights from a single centre stress echo cohortP494Transesophageal echocardigoraphy uner conscious sedation for guiding cryoballoon pulmonary vein isolation in paroxysmal atrial fibrillation - the safety and feasibility studyP495Transesophageal echocardigoraphy under conscious sedation for guiding cryoballoon pulmonary vein isolation in paroxysmal atrial fibrillation - the safety and feasibility studyP496Three-dimensional trans-esophageal echocardiography assessment of the immediate morphological changes of the mitral annulus after percutaneous mitral edge-to-edge repairP497Clinical value of global and regional longitudinal strain in prediction of myocardial ischemia in asymptomatic diabetes type 2 patientsP499Comparison of prognostic operative risk impact on the global longitudinal strain right ventricle (GLS RV) and tricuspid annular plane systolic excursion (TAPSE) values in patients with ischemic cardioP498Right heart function in early diastolic dysfunction: 2D speckle-tracking echocardiography-based assessment of right atrial and right ventricular functionP500 Comparison of 2D, 3D transesophageal echocardiography and computed tomography during the assessment of left atrial appendage closure. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Leone AM, Martin-Reyes R, Baptista SB, Amabile N, Raposo L, Franco Pelaez JA, Trani C, Cialdella P, Basile E, Zimbardo G, Burzotta F, Porto I, Aurigemma C, Rebuzzi AG, Faustino M, Niccoli G, Abreu PF, Slama MS, Spagnoli V, Telleria Arrieta M, Amat Santos IJ, de la Torre Hernandez JM, Lopez Palop R, Crea F. The Multi-center Evaluation of the Accuracy of the Contrast MEdium INduced Pd/Pa RaTiO in Predicting FFR (MEMENTO-FFR) Study. EUROINTERVENTION 2016; 12:708-15. [DOI: 10.4244/eijv12i6a115] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Madeira S, Teles RC, Abecasis J, Vale NC, Ribeiras R, Brito J, Raposo L, Almeida MD. TCT-641 Significance of aortic regurgitation pre-transcatheter aortic valve implantation. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vale NC, Brito J, Teles RC, Raposo L. TCT-634 N-terminal Brain Natriuretic Peptide Predicts Mortality After Transcatheter Aortic Valve Implantation. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Raposo L, Madeira S, Teles RC, Santos M, Gabriel HM, Gonçalves P, Brito J, Leal S, Almeida M, Mendes M. Neurologic complications after transradial or transfemoral approach for diagnostic and interventional cardiac catheterization: A propensity score analysis of 16,710 cases from a single centre prospective registry. Catheter Cardiovasc Interv 2015; 86:61-70. [DOI: 10.1002/ccd.25884] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/31/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Luis Raposo
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - Sérgio Madeira
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - Rui Campante Teles
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - Miguel Santos
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - Henrique Mesquita Gabriel
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - Pedro Gonçalves
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - João Brito
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - Silvio Leal
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - Manuel Almeida
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
| | - Miguel Mendes
- Cardiology Department - UNICARV; Hospital De Santa Cruz, Centro Hospitalar De Lisboa Ocidental; Lisbon Portugal
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Madeira S, Raposo L, Goncalves P, Santos M, Teles R, Gabriel H, Brito J, Leal S, Mendes M, Almeida M. Incidence of periprocedural stroke and transient ischemic attack after transradial or transfemoral approach for diagnostic and interventional cardiac catheterization. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Santos CM, Cale R, Teles RC, Carvalho MS, Raposo L, Goncalves PA, Almeida MS, Vinhas H, Pereira H, Mendes M. Is the radial artery suitable for recatheterization? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marques IB, Silva RDM, Moraes CE, Azevedo LS, Nahas WC, David-Neto E, Furmanczyk-Zawiska A, Baczkowska T, Chmura A, Szmidt J, Durlik M, Joslin J, Blaker P, White B, Marinaki A, Sanderson J, Goldsmith DJ, Medani S, Traynor C, Mohan P, Little D, Conlon P, Molina M, Gonzalez E, Gutierrez E, Sevillano A, Polanco N, Morales E, Hernandez A, Praga M, Morales JM, Andres A, Park SJ, Kim TH, Kim YW, Kim YH, Kang SW, Kujawa-Szewieczek A, Szotowska M, Kuczera P, Chudek J, Wiecek A, Kolonko A, Mahrova A, Svagrova K, Bunc V, Stollova M, Teplan V, Hundt F, van Heteren P, Woitas R, Cavallo MC, Sepe V, Conte F, Albrizio P, Bottazzi A, Geraci PM, Alpay N, Gumber MR, Kute VB, Vanikar AV, Patel HV, Shah PR, Engineer DP, Trivedi HL, Golebiewska JE, Debska-Slizien A, Rutkowski B, Matias P, Martins AR, Raposo L, Jorge C, Weigert A, Birne R, Bruges M, Adragao T, Almeida M, Mendes M, Machado D, Masin-Spasovska J, Dohcev S, Stankov O, Stavridis S, Saidi S, Dejanova B, Rambabova-Busletic I, Dejanov P, Spasovski G, Nho KW, Kim YH, Han DJ, Park SK, Kim SB, Fenoglio R, Lazzarich EE, Cagna D, Cena T, Conti N, Quaglia M, Radin E, Izzo C, Stratta P, Oh IH, Park JS, Lee CH, Kang CM, Kim GH, Leone F, Lofaro D, Gigliotti P, Lupinacci S, Toteda P, Vizza D, Perri A, Papalia T, Bonofiglio R, di Loreto P, de Silvestro L, Montanaro D, Martino F, Sandrini S, Minetti E, Cabiddu G, Yildirim T, Yilmaz R, Turkmen E, Abudalal A, Altindal M, Ertoy-Baydar D, Erdem Y, Panuccio V, Tripepi R, Parlongo G, Versace MC, Politi R, Zoccali C, Mallamaci F, Porrini E, Silva I, Diaz J, Ibernon M, Moreso F, Benitez R, Delgado Mallen P, Osorio J, Lauzurica R, Torres A, Ersoy A, Koca N, Gullu Koca T, Kirhan E, Sarandol E, Ersoy C, Dirican M, Milne J, Suter V, Mikhail A, Akalin H, Dizdar O, Ersoy A, Pascual J, Torio A, Garcia C, Hernandez J, Perez-Saez MJ, Mir M, Anna F, Crespo M, Carta P, Zanazzi M, Antognoli G, Di Maria L, Caroti L, Minetti E, Dizdar O, Ersoy A, Akalin H, Ray DS, Mukherjee K, Bohidar NP, Pattanaik A, Das P, Thukral S, Kimura T, Yagisawa T, Ishikawa N, Sakuma Y, Fujiwara T, Nukui A, Gavela EE, Sancho AA, Kanter JJ, Avila AA, Beltran SS, Pallardo LL, Dawoud FG, Aithal V, Mikhail A, Majernikova M, Rosenberger J, Prihodova L, Nagyova I, Jarcuskova M, Roland R, Groothoff JW, van Dijk JP, van Agteren M, de Weerd A, van de Wetering J, IJzermans J, Betjes M, Weimar W, Popoola J, Reed A, Tavarro R, Chryssanthopoulou C, MacPhee I, Mayor M, Franco S, Jara P, Ayala R, Orue MG, Martinez A, Martinez M, Wasmouth N, Arik G, Yasar A, Turkmen E, Yildirim T, Altindal M, Abudalal A, Yilmaz S, Arici M, Bihari Bansal S, Pokhariyal S, Jain S, Sethi S, Ahlawat R, Kher V, Martins LS, Aguiar P, Dias L, Fonseca I, Henriques AC, Cabrita A, Davide J, Sparkes TM, Trofe-Clark J, Reese PP, Jakobowski D, Goral S, Doll SL, Abt PL, Sawinski D, MBloom RD, Knap B, Lukac J, Lukin M, Majcen I, Pavlovec F, Kandus A, Bren AF, Kong JM, Jeong JH, Ahn J, Lee DR, Son SH, Kim BC, Choi WY, Whang EJ, Czajka B, Malgorzewicz S, Debska-Slizien A, Rutkowski B, Panizo N, Rengel MA, Vega A, Abad S, Tana L, Arroyo D, Rodriguez-Ferrero M, Perez de Jose A, Lopez-Gomez JM, Koutroutsos K, Sackey J, Paolini L, Ramkhelawon R, Tavarro R, Chowrimootoo M, Whelan D, Popoola J, Szotowska M, Kuczera P, Chudek J, Wiecek A, Kolonko A, Slatinska J, Honsova E, Wohlfahrtova M, Slimackova E, Rajnochova SB, Viklicky O, Yankovoy A, Smith ISJ, Wylie E, Ruiz-Esteban P, Lopez V, Garcia-Frias P, Cabello M, Gonzalez-Molina M, Vozmediano C, Hernandez D, Pavlovic J, Radivojevic D, Lezaic V, Simic-Ogrizovic S, Lausevic M, Naumovic R, Ersoy A, Koca N, Kirhan E, Gullu Koca T, Ersoy C, Sarandol E, Dirican M, Sakhuja V, Gundlapalli S, Rathi M, Jha V, Kohli HS, Sharma A, Minz M, Nimgirova A, Esayan A, Kayukov I, Zuyeva E, Bilen Y, Cankaya E, Keles M, Gulcan E, Turkeli M, Albayrak B, Uyanik A, Yildirim R, Molitor N, Praktiknjo M, Woitas R, Abeygunaratne TN, Balasubramanian S, Baker R, Nicholson T, Toprak O, Sari Y, Keceli S, Kurt H, Rocha A, Malheiro J, Martins LS, Fonseca I, Dias L, Pedroso S, Almeida M, Henriques A, Nihei C, Bacelar Marques I, Seguro CA, David-Neto E, Mate G, Martin N, Colon L, Casellas L, Garangou D, de la Torre M, Torguet P, Garcia I, Calabia J, Valles M, Pruthi R, Calestani M, Leydon G, Ravanan R, Roderick P, Korkmaz S, Ersoy A, Gulten S, Koca N. Transplantation - clinical studies II. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gray LJ, Barros H, Raposo L, Khunti K, Davies MJ, Santos AC. The development and validation of the Portuguese risk score for detecting type 2 diabetes and impaired fasting glucose. Prim Care Diabetes 2013; 7:11-18. [PMID: 23357741 DOI: 10.1016/j.pcd.2013.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 01/03/2013] [Accepted: 01/04/2013] [Indexed: 01/28/2023]
Abstract
AIMS To develop and validate a non-invasive score for detecting undiagnosed impaired fasting glucose (IFG) and type 2 diabetes (T2DM) in a Portuguese population. METHODS We used data from 3,374 individuals aged 18-94 years from a Portuguese cross-sectional study. We developed a logistic regression model for predicting IFG/T2DM (diagnosed using fasting glucose). We externally validated the score using data from two cohorts of the EPI-Porto study, cross-sectional (n = 2,131) and data from the 5 year follow-up (n = 1,304). RESULTS The final model included age, sex, BMI and hypertension with an area under the ROC curve of 70.1 (95%CI 68.4, 71.7). Using a cut-point which classifies 50% of the EPI-Porto cross-sectional data as high-risk gave sensitivity 73.2% (95%CI 68.5%, 77.6%), specificity 55.5% (53.1%, 57.8%), positive predictive value (PPV) 27.0% (24.3%, 29.8%) and negative predictive value (NPV) 90.2% (88.3%, 92.0%) for IFG/T2DM. Using the same cut-point on the prospective data classified 45% as high-risk; sensitivity 69.1% (63.4%, 74.4%), specificity 63.3% (60.0%, 66.5%), PPV 38.0% (33.9%, 42.4%), and NPV 86.2% (83.3%, 88.8%). CONCLUSION The Portuguese risk score can be used to identify those at high risk of both prevalent undiagnosed and incident IFG/T2DM.
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Affiliation(s)
- Laura J Gray
- University of Leicester, Department of Health Sciences, Leicester, UK.
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Calé R, Almeida M, Gonçalves P, José Rebocho M, Raposo L, Teles R, Mendes M. Complications of endomyocardial biopsy after heart transplantation. A lesser evil. Revista Portuguesa de Cardiologia (English Edition) 2012. [DOI: 10.1016/j.repce.2011.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Brito J, Teles R, Almeida M, de Araújo Gonçalves P, Raposo L, Sousa P, Mendes M. Predictive value of SYNTAX score in risk stratification of patients undergoing unprotected left main coronary artery angioplasty. J Invasive Cardiol 2011; 23:494-499. [PMID: 22147395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The SYNTAX score is a useful tool to evaluate percutaneous coronary intervention risk regarding the number, complexity, and location of lesions. Despite its proven value in the prognosis of three-vessel disease, there are few data about its usefulness in other selected subsets of patients. This study aimed to evaluate the prognostic value of the SYNTAX score in a population of patients who underwent unprotected left main coronary artery (ULMCA) angioplasty in our hospital. METHODS This was a single-center study that included 118 patients (79.7% male; mean age, 66 ± 12 years) who underwent ULMCA angioplasty between March 1999 and December 2008. Multivariate Cox logistic regression analysis was used to assess the relation of SYNTAX score to the incidence of cardiovascular death and major adverse cardiac events (MACE) - an endpoint comprised of cardiovascular death, non-fatal acute myocardial infarction, and target vessel revascularization. RESULTS At 30 days, there were 5 cardiovascular deaths (4.2%). In the mean follow-up of 32 ± 24 months, there were 17 cardiovascular deaths (14.4%) and 30 MACE (25.4%). At 30 days, SYNTAX score had no predictive value, but at long-term follow-up, it significantly predicted the occurrence of cardiovascular death (adjusted hazard ratio, 1.069; 95% CI, 1.030-1.109; P<.0001) and MACE (adjusted hazard ratio, 1.044; 95% CI, 1.013-1.076; P=.005), even after adjustment for potential confounders. Area under the curve for the occurrence of cardiovascular death and MACE was 0.75 (P=.0006) and 0.63 (P=.032), respectively. CONCLUSIONS In this population of patients undergoing ULMCA angioplasty, SYNTAX score was demonstrated to be a valuable tool to predict long-term cardiovascular mortality.
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Affiliation(s)
- João Brito
- Hospital Santa Cruz, Cardiology, Av. Prof. Dr. Reinaldo dos Santos, Carnaxide, Portugal.
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Khachatryan V, Sirunyan AM, Tumasyan A, Adam W, Bergauer T, Dragicevic M, Erö J, Fabjan C, Friedl M, Frühwirth R, Ghete VM, Hammer J, Hänsel S, Hartl C, Hoch M, Hörmann N, Hrubec J, Jeitler M, Kasieczka G, Kiesenhofer W, Krammer M, Liko D, Mikulec I, Pernicka M, Rohringer H, Schöfbeck R, Strauss J, Taurok A, Teischinger F, Waltenberger W, Walzel G, Widl E, Wulz CE, Mossolov V, Shumeiko N, Gonzalez JS, Benucci L, Ceard L, De Wolf EA, Janssen X, Maes T, Mucibello L, Ochesanu S, Roland B, Rougny R, Selvaggi M, Van Haevermaet H, Van Mechelen P, Van Remortel N, Adler V, Beauceron S, Blyweert S, D'Hondt J, Devroede O, Kalogeropoulos A, Maes J, Maes M, Tavernier S, Van Doninck W, Van Mulders P, Van Onsem GP, Villella I, Charaf O, Clerbaux B, De Lentdecker G, Dero V, Gay APR, Hammad GH, Hreus T, Marage PE, Thomas L, Vander Velde C, Vanlaer P, Wickens J, Costantini S, Grunewald M, Klein B, Marinov A, Ryckbosch D, Thyssen F, Tytgat M, Vanelderen L, Verwilligen P, Walsh S, Zaganidis N, Basegmez S, Bruno G, Caudron J, De Favereau De Jeneret J, Delaere C, Demin P, Favart D, Giammanco A, Grégoire G, Hollar J, Lemaitre V, Militaru O, Ovyn S, Pagano D, Pin A, Piotrzkowski K, Quertenmont L, Schul N, Beliy N, Caebergs T, Daubie E, Alves GA, De JesusDamiao D, Pol ME, Souza MHG, Carvalho W, Da Costa EM, Martins CDO, De Souza SF, Mundim L, Nogima H, Oguri V, Goicochea JMO, Da Silva WLP, Santoro A, Do Amaral SMS, Sznajder A, De Araujo FTDS, Dias FA, Dias MAF, Tomei TRFP, Gregores EM, Marinho F, Novaes SF, Padula SS, Darmenov N, Dimitrov L, Genchev V, Iaydjiev P, Piperov S, Rodozov M, Stoykova S, Sultanov G, Tcholakov V, Trayanov R, Vankov I, Dyulendarova M, Hadjiiska R, Kozhuharov V, Litov L, Marinova E, Mateev M, Pavlov B, Petkov P, Bian JG, Chen GM, Chen HS, Jiang CH, Liang D, Liang S, Wang J, Wang J, Wang X, Wang Z, Yang M, Zang J, Zhang Z, Ban Y, Guo S, Hu Z, Li W, Mao Y, Qian SJ, Teng H, Zhu B, Cabrera A, Moreno BG, Rios AAO, Oliveros AFO, Sanabria JC, Godinovic N, Lelas D, Lelas K, Plestina R, Polic D, Puljak I, Antunovic Z, Dzelalija M, Brigljevic V, Duric S, Kadija K, Morovic S, Attikis A, Fereos R, Galanti M, Mousa J, Nicolaou C, Ptochos F, Razis PA, Rykaczewski H, Abdel-basit A, Assran Y, Mahmoud MA, Hektor A, Kadastik M, Kannike K, Müntel M, Raidal M, Rebane L, Azzolini V, Eerola P, Czellar S, Härkönen J, Heikkinen A, Karimäki V, Kinnunen R, Klem J, Kortelainen MJ, Lampén T, Lassila-Perini K, Lehti S, Lindén T, Luukka P, Mäenpää T, Tuominen E, Tuominiemi J, Tuovinen E, Ungaro D, Wendland L, Banzuzi K, Korpela A, Tuuva T, Sillou D, Besancon M, Dejardin M, Denegri D, Fabbro B, Faure JL, Ferri F, Ganjour S, Gentit FX, Givernaud A, Gras P, de Monchenault GH, Jarry P, Locci E, Malcles J, Marionneau M, Millischer L, Rander J, Rosowsky A, Titov M, Verrecchia P, Baffioni S, Bianchini L, Bluj M, Broutin C, Busson P, Charlot C, Dobrzynski L, de Cassagnac RG, Haguenauer M, Miné P, Mironov C, Ochando C, Paganini P, Sabes D, Salerno R, Sirois Y, Thiebaux C, Wyslouch B, Zabi A, Agram JL, Andrea J, Besson A, Bloch D, Bodin D, Brom JM, Cardaci M, Chabert EC, Collard C, Conte E, Drouhin F, Ferro C, Fontaine JC, Gelé D, Goerlach U, Greder S, Juillot P, Karim M, Le Bihan AC, Mikami Y, Van Hove P, Fassi F, Mercier D, Baty C, Beaupere N, Bedjidian M, Bondu O, Boudoul G, Boumediene D, Brun H, Chanon N, Chierici R, Contardo D, Depasse P, El Mamouni H, Falkiewicz A, Fay J, Gascon S, Ille B, Kurca T, Le Grand T, Lethuillier M, Mirabito L, Perries S, Sordini V, Tosi S, Tschudi Y, Verdier P, Xiao H, Roinishvili V, Anagnostou G, Edelhoff M, Feld L, Heracleous N, Hindrichs O, Jussen R, Klein K, Merz J, Mohr N, Ostapchuk A, Perieanu A, Raupach F, Sammet J, Schael S, Sprenger D, Weber H, Weber M, Wittmer B, Ata M, Bender W, Erdmann M, Frangenheim J, Hebbeker T, Hinzmann A, Hoepfner K, Hof C, Klimkovich T, Klingebiel D, Kreuzer P, Lanske D, Magass C, Masetti G, Merschmeyer M, Meyer A, Papacz P, Pieta H, Reithler H, Schmitz SA, Sonnenschein L, Steggemann J, Teyssier D, Bontenackels M, Davids M, Duda M, Flügge G, Geenen H, Giffels M, Ahmad WH, Heydhausen D, Kress T, Kuessel Y, Linn A, Nowack A, Perchalla L, Pooth O, Rennefeld J, Sauerland P, Stahl A, Thomas M, Tornier D, Zoeller MH, Martin MA, Behrenhoff W, Behrens U, Bergholz M, Borras K, Cakir A, Campbell A, Castro E, Dammann D, Eckerlin G, Eckstein D, Flossdorf A, Flucke G, Geiser A, Glushkov I, Hauk J, Jung H, Kasemann M, Katkov I, Katsas P, Kleinwort C, Kluge H, Knutsson A, Krücker D, Kuznetsova E, Lange W, Lohmann W, Mankel R, Marienfeld M, Melzer-Pellmann IA, Meyer AB, Mnich J, Mussgiller A, Olzem J, Parenti A, Raspereza A, Raval A, Schmidt R, Schoerner-Sadenius T, Sen N, Stein M, Tomaszewska J, Volyanskyy D, Walsh R, Wissing C, Autermann C, Bobrovskyi S, Draeger J, Enderle H, Gebbert U, Kaschube K, Kaussen G, Klanner R, Mura B, Naumann-Emme S, Nowak F, Pietsch N, Sander C, Schettler H, Schleper P, Schröder M, Schum T, Schwandt J, Srivastava AK, Stadie H, Steinbrück G, Thomsen J, Wolf R, Bauer J, Buege V, Chwalek T, Daeuwel D, De Boer W, Dierlamm A, Dirkes G, Feindt M, Gruschke J, Hackstein C, Hartmann F, Heinrich M, Held H, Hoffmann KH, Honc S, Kuhr T, Martschei D, Mueller S, Müller T, Neuland MB, Niegel M, Oberst O, Oehler A, Ott J, Peiffer T, Piparo D, Quast G, Rabbertz K, Ratnikov F, Renz M, Sabellek A, Saout C, Scheurer A, Schieferdecker P, Schilling FP, Schott G, Simonis HJ, Stober FM, Troendle D, Wagner-Kuhr J, Zeise M, Zhukov V, Ziebarth EB, Daskalakis G, Geralis T, Kesisoglou S, Kyriakis A, Loukas D, Manolakos I, Markou A, Markou C, Mavrommatis C, Petrakou E, Gouskos L, Mertzimekis T, Panagiotou A, Evangelou I, Foudas C, Kokkas P, Manthos N, Papadopoulos I, Patras V, Triantis FA, Aranyi A, Bencze G, Boldizsar L, Debreczeni G, Hajdu C, Horvath D, Kapusi A, Krajczar K, Laszlo A, Sikler F, Vesztergombi G, Beni N, Molnar J, Palinkas J, Szillasi Z, Veszpremi V, Raics P, Trocsanyi ZL, Ujvari B, Bansal S, Beri SB, Bhatnagar V, Jindal M, Kaur M, Kohli JM, Mehta MZ, Nishu N, Saini LK, Sharma A, Sharma R, Singh AP, Singh JB, Singh SP, Ahuja S, Bhattacharya S, Chauhan S, Choudhary BC, Gupta P, Jain S, Jain S, Kumar A, Shivpuri RK, Choudhury RK, Dutta D, Kailas S, Kataria SK, Mohanty AK, Pant LM, Shukla P, Suggisetti P, Aziz T, Guchait M, Gurtu A, Maity M, Majumder D, Majumder G, Mazumdar K, Mohanty GB, Saha A, Sudhakar K, Wickramage N, Banerjee S, Dugad S, Mondal NK, Arfaei H, Bakhshiansohi H, Etesami SM, Fahim A, Hashemi M, Jafari A, Khakzad M, Mohammadi A, Najafabadi MM, Mehdiabadi SP, Safarzadeh B, Zeinali M, Abbrescia M, Barbone L, Calabria C, Colaleo A, Creanza D, De Filippis N, De Palma M, Dimitrov A, Fedele F, Fiore L, Iaselli G, Lusito L, Maggi G, Maggi M, Manna N, Marangelli B, My S, Nuzzo S, Pacifico N, Pierro GA, Pompili A, Pugliese G, Romano F, Roselli G, Selvaggi G, Silvestris L, Trentadue R, Tupputi S, Zito G, Abbiendi G, Benvenuti AC, Bonacorsi D, Braibant-Giacomelli S, Capiluppi P, Castro A, Cavallo FR, Cuffiani M, Dallavalle GM, Fabbri F, Fanfani A, Fasanella D, Giacomelli P, Giunta M, Grandi C, Marcellini S, Meneghelli M, Montanari A, Navarria FL, Odorici F, Perrotta A, Rossi AM, Rovelli T, Siroli G, Travaglini R, Albergo S, Cappello G, Chiorboli M, Costa S, Tricomi A, Tuve C, Barbagli G, Broccolo G, Ciulli V, Civinini C, D'Alessandro R, Focardi E, Frosali S, Gallo E, Genta C, Lenzi P, Meschini M, Paoletti S, Sguazzoni G, Tropiano A, Benussi L, Bianco S, Colafranceschi S, Fabbri F, Piccolo D, Fabbricatore P, Musenich R, Benaglia A, Cerati GB, De Guio F, Di Matteo L, Ghezzi A, Govoni P, Malberti M, Malvezzi S, Martelli A, Massironi A, Menasce D, Moroni L, Paganoni M, Pedrini D, Ragazzi S, Redaelli N, Sala S, de Fatis TT, Tancini V, Buontempo S, Montoya CAC, Cimmino A, De Cosa A, De Gruttola M, Fabozzi F, Iorio AOM, Lista L, Noli P, Paolucci P, Azzi P, Bacchetta N, Bellan P, Bellato M, Branca A, Carlin R, De Mattia M, Dorigo T, Gasparini F, Gasparini U, Giubilato P, Gonella F, Gresele A, Gulmini M, Kaminskiy A, 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Futyan D, Bryer AG, Hall G, Hatherell Z, Hays J, Iles G, Karapostoli G, Lyons L, Magnan AM, Marrouche J, Nandi R, Nash J, Nikitenko A, Papageorgiou A, Pesaresi M, Petridis K, Pioppi M, Raymond DM, Rompotis N, Rose A, Ryan MJ, Seez C, Sharp P, Sparrow A, Tapper A, Tourneur S, Acosta MV, Virdee T, Wakefield S, Wardrope D, Whyntie T, Barrett M, Chadwick M, Cole JE, Hobson PR, Khan A, Kyberd P, Leslie D, Martin W, Reid ID, Teodorescu L, Hatakeyama K, Bose T, Jarrin EC, Clough A, Fantasia C, Heister A, St John J, Lawson P, Lazic D, Rohlf J, Sperka D, Sulak L, Avetisyan A, Bhattacharya S, Chou JP, Cutts D, Esen S, Ferapontov A, Heintz U, Jabeen S, Kukartsev G, Landsberg G, Narain M, Nguyen D, Segala M, Speer T, Tsang KV, Borgia MA, Breedon R, Sanchez MCDLB, Cebra D, Chertok M, Conway J, Cox PT, Dolen J, Erbacher R, Friis E, Ko W, Kopecky A, Lander R, Liu H, Maruyama S, Miceli T, Nikolic M, Pellett D, Robles J, Schwarz T, Searle M, Smith J, Squires M, Tripathi M, Sierra RV, Veelken C, Andreev V, Arisaka K, Cline D, Cousins R, Deisher A, Duris J, Erhan S, Farrell C, Hauser J, Ignatenko M, Jarvis C, Plager C, Rakness G, Schlein P, Tucker J, Valuev V, Babb J, Clare R, Ellison J, Gary JW, Giordano F, Hanson G, Jeng GY, Kao SC, Liu F, Liu H, Luthra A, Nguyen H, Pasztor G, Satpathy A, Shen BC, Stringer R, Sturdy J, Sumowidagdo S, Wilken R, Wimpenny S, Andrews W, Branson JG, Dusinberre E, Evans D, Golf F, Holzner A, Kelley R, Lebourgeois M, Letts J, Mangano B, Muelmenstaedt J, Padhi S, Palmer C, Petrucciani G, Pi H, Pieri M, Ranieri R, Sani M, Sharma V, Simon S, Tu Y, Vartak A, Würthwein F, Yagil A, Barge D, Bellan R, Campagnari C, D'Alfonso M, Danielson T, Geffert P, Incandela J, Justus C, Kalavase P, Koay SA, Kovalskyi D, Krutelyov V, Lowette S, McColl N, Pavlunin V, Rebassoo F, Ribnik J, Richman J, Rossin R, Stuart D, To W, Vlimant JR, Witherell M, Bornheim A, Bunn J, Chen Y, Gataullin M, Kcira D, Litvine V, Ma Y, Mott A, Newman HB, Rogan C, Shin K, Timciuc V, Traczyk P, Veverka J, Wilkinson R, Yang Y, Zhu RY, Akgun B, Calamba A, Carroll R, Ferguson T, Iiyama Y, Jang DW, Jun SY, Liu YF, Paulini M, Russ J, Terentyev N, Vogel H, Vorobiev I, Cumalat JP, Dinardo ME, Drell BR, Edelmaier CJ, Ford WT, Heyburn B, Lopez EL, Nauenberg U, Smith JG, Stenson K, Ulmer KA, Wagner SR, Zang SL, Agostino L, Alexander J, Blekman F, Chatterjee A, Das S, Eggert N, Fields LJ, Gibbons LK, Heltsley B, Henriksson K, Hopkins W, Khukhunaishvili A, Kreis B, Kuznetsov V, Liu Y, Kaufman GN, Patterson JR, Puigh D, Riley D, Ryd A, Saelim M, Shi X, Sun W, Teo WD, Thom J, Thompson J, Vaughan J, Weng Y, Winstrom L, Wittich P, Biselli A, Cirino G, Winn D, Abdullin S, Albrow M, Anderson J, Apollinari G, Atac M, Bakken JA, Banerjee S, Bauerdick LAT, Beretvas A, Berryhill J, Bhat PC, Bloch I, Borcherding F, Burkett K, Butler JN, Chetluru V, Cheung HWK, Chlebana F, Cihangir S, Demarteau M, Eartly DP, Elvira VD, Fisk I, Freeman J, Gao Y, Gottschalk E, Green D, Gunthoti K, Gutsche O, Hahn A, Hanlon J, Harris RM, Hirschauer J, Hooberman B, James E, Jensen H, Johnson M, Joshi U, Khatiwada R, Kilminster B, Klima B, Kousouris K, Kunori S, Kwan S, Limon P, Lipton R, Lykken J, Maeshima K, Marraffino JM, Mason D, McBride P, McCauley T, Miao T, Mishra K, Mrenna S, Musienko Y, Newman-Holmes C, O'Dell V, Popescu S, Pordes R, Prokofyev O, Saoulidou N, Sexton-Kennedy E, Sharma S, Soha A, Spalding WJ, Spiegel L, Tan P, Taylor L, Tkaczyk S, Uplegger L, Vaandering EW, Vidal R, Whitmore J, Wu W, Yang F, Yumiceva F, Yun JC, Acosta D, Avery P, Bourilkov D, Chen M, Di Giovanni GP, Dobur D, Drozdetskiy A, Field RD, Fisher M, Fu Y, Furic IK, Gartner J, Goldberg S, Kim B, Klimenko S, Konigsberg J, Korytov A, Kotov K, Kropivnitskaya A, Kypreos T, Matchev K, Mitselmakher G, Muniz L, Pakhotin Y, Petterson M, Prescott C, Remington R, Schmitt M, Scurlock B, Sellers P, Skhirtladze N, Snowball M, Wang D, Yelton J, Zakaria M, Ceron C, Gaultney V, Kramer L, Lebolo LM, Linn S, Markowitz P, Martinez G, Mesa D, Rodriguez JL, Adams T, Askew A, Bochenek J, Chen J, Diamond B, Gleyzer SV, Haas J, Hagopian S, Hagopian V, Jenkins M, Johnson KF, Prosper H, Sekmen S, Veeraraghavan V, Baarmand MM, Dorney B, Guragain S, Hohlmann M, Kalakhety H, Ralich R, Vodopiyanov I, Adams MR, Anghel IM, Apanasevich L, Bai Y, Bazterra VE, Betts RR, Callner J, Cavanaugh R, Dragoiu C, Garcia-Solis EJ, Gerber CE, Hofman DJ, Khalatyan S, Lacroix F, O'Brien C, Silvestre C, Smoron A, Strom D, Varelas N, Akgun U, Albayrak EA, Bilki B, Cankocak K, Clarida W, Duru F, Lae CK, McCliment E, Merlo JP, Mermerkaya H, Mestvirishvili A, Moeller A, Nachtman J, Newsom CR, Norbeck E, Olson J, Onel Y, Ozok F, Sen S, Wetzel J, Yetkin T, Yi K, Barnett BA, Blumenfeld B, Bonato A, Eskew C, Fehling D, Giurgiu G, Gritsan AV, Guo ZJ, Hu G, Maksimovic P, Rappoccio S, Swartz M, Tran NV, Whitbeck A, Baringer P, Bean A, Benelli G, Grachov O, Murray M, Noonan D, Radicci V, Sanders S, Wood JS, Zhukova V, Bandurin D, Bolton T, Chakaberia I, Ivanov A, Makouski M, Maravin Y, Shrestha S, Svintradze I, Wan Z, Gronberg J, Lange D, Wright D, Baden A, Boutemeur M, Eno SC, Ferencek D, Gomez JA, Hadley NJ, Kellogg RG, Kirn M, Lu Y, Mignerey AC, Rossato K, Rumerio P, Santanastasio F, Skuja A, Temple J, Tonjes MB, Tonwar SC, Twedt E, Alver B, Bauer G, Bendavid J, Busza W, Butz E, Cali IA, Chan M, Dutta V, Everaerts P, Ceballos GG, Goncharov M, Hahn KA, Harris P, Kim Y, Klute M, Lee YJ, Li W, Loizides C, Lopez J, Luckey PD, Ma T, Nahn S, Paus C, Roland C, Roland G, Rudolph M, Stephans GSF, Sumorok K, Sung K, Wenger EA, Xie S, Yang M, Yilmaz Y, Yoon AS, Zanetti M, Cole P, Cooper SI, Cushman P, Dahmes B, De Benedetti A, Dudero PR, Franzoni G, Haupt J, Klapoetke K, Kubota Y, Mans J, Rekovic V, Rusack R, Sasseville M, Singovsky A, Cremaldi LM, Godang R, Kroeger R, Perera L, Rahmat R, Sanders DA, Summers D, Bloom K, Bose S, Butt J, Claes DR, Dominguez A, Eads M, Keller J, Kelly T, Kravchenko I, Lazo-Flores J, Lundstedt C, Malbouisson H, Malik S, Snow GR, Baur U, Godshalk A, Iashvili I, Kharchilava A, Kumar A, Smith K, Zennamo J, Alverson G, Barberis E, Baumgartel D, Boeriu O, Chasco M, Kaadze K, Reucroft S, Swain J, Wood D, Zhang J, Anastassov A, Kubik A, Odell N, Ofierzynski RA, Pollack B, Pozdnyakov A, Schmitt M, Stoynev S, Velasco M, Won S, Antonelli L, Berry D, Hildreth M, Jessop C, Karmgard DJ, Kolb J, Kolberg T, Lannon K, Luo W, Lynch S, Marinelli N, Morse DM, Pearson T, Ruchti R, Slaunwhite J, Valls N, Warchol J, Wayne M, Ziegler J, Bylsma B, Durkin LS, Gu J, Hill C, Killewald P, Ling TY, Rodenburg M, Williams G, Adam N, Berry E, Elmer P, Gerbaudo D, Halyo V, Hebda P, Hunt A, Jones J, Laird E, Lopes Pegna D, Marlow D, Medvedeva T, Mooney M, Olsen J, Piroué P, Saka H, Stickland D, Tully C, Werner JS, Zuranski A, Acosta JG, Huang XT, Lopez A, Mendez H, Oliveros S, Vargas JER, Zatserklyaniy A, Alagoz E, Barnes VE, Bolla G, Borrello L, Bortoletto D, Everett A, Garfinkel AF, Gecse Z, Gutay L, Jones M, Koybasi O, Laasanen AT, Leonardo N, Liu C, Maroussov V, Meier M, Merkel P, Miller DH, Neumeister N, Potamianos K, Shipsey I, Silvers D, Svyatkovskiy A, Yoo HD, Zablocki J, Zheng Y, Jindal P, Parashar N, Boulahouache C, Cuplov V, Ecklund KM, Geurts FJM, Liu JH, Morales J, Padley BP, Redjimi R, Roberts J, Zabel J, Betchart B, Bodek A, Chung YS, de Barbaro P, Demina R, Eshaq Y, Flacher H, Garcia-Bellido A, Goldenzweig P, Gotra Y, Han J, Harel A, Miner DC, Orbaker D, Petrillo G, Vishnevskiy D, Zielinski M, Bhatti A, Demortier L, Goulianos K, Lungu G, Mesropian C, Yan M, Atramentov O, Barker A, Duggan D, Gershtein Y, Gray R, Halkiadakis E, Hidas D, Hits D, Lath A, Panwalkar S, Patel R, Richards A, Rose K, Schnetzer S, Somalwar S, Stone R, Thomas S, Cerizza G, Hollingsworth M, Spanier S, Yang ZC, York A, Asaadi J, Eusebi R, Gilmore J, Gurrola A, Kamon T, Khotilovich V, Montalvo R, Nguyen CN, Pivarski J, Safonov A, Sengupta S, Tatarinov A, Toback D, Weinberger M, Akchurin N, Bardak C, Damgov J, Jeong C, Kovitanggoon K, Lee SW, Mane P, Roh Y, Sill A, Volobouev I, Wigmans R, Yazgan E, Appelt E, Brownson E, Engh D, Florez C, Gabella W, Johns W, Kurt P, Maguire C, Melo A, Sheldon P, Velkovska J, Arenton MW, Balazs M, Boutle S, Buehler M, Conetti S, Cox B, Francis B, Hirosky R, Ledovskoy A, Lin C, Neu C, Patel T, Yohay R, Gollapinni S, Harr R, Karchin PE, Mattson M, Milstène C, Sakharov A, Anderson M, Bachtis M, Bellinger JN, Carlsmith D, Dasu S, Efron J, Gray L, Grogg KS, Grothe M, Hall-Wilton R, Herndon M, Klabbers P, Klukas J, Lanaro A, Lazaridis C, Leonard J, Liu J, Lomidze D, Loveless R, Mohapatra A, Parker W, Reeder D, Ross I, Savin A, Smith WH, Swanson J, Weinberg M. Search for quark compositeness with the dijet centrality ratio in pp collisions at √s=7 TeV. Phys Rev Lett 2010; 105:262001. [PMID: 21231646 DOI: 10.1103/physrevlett.105.262001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Indexed: 05/30/2023]
Abstract
A search for quark compositeness in the form of quark contact interactions, based on hadronic jet pairs (dijets) produced in proton-proton collisions at √s=7 TeV, is described. The data sample of the study corresponds to an integrated luminosity of 2.9 pb(-1) collected with the CMS detector at the LHC. The dijet centrality ratio, which quantifies the angular distribution of the dijets, is measured as a function of the invariant mass of the dijet system and is found to agree with the predictions of the standard model. A statistical analysis of the data provides a lower limit on the energy scale of quark contact interactions. The sensitivity of the analysis is such that the expected limit is 2.9 TeV; because the observed value of the centrality ratio at high invariant mass is below the expectation, the observed limit is 4.0 TeV at the 95% confidence level.
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Calé R, Ferreira J, Aguiar C, Santos N, Carmo P, Figueira J, Raposo L, Gonçalves P, Silva JA. Diagnosis of myocardial infarction using the new universal definition: is it enough for risk stratification and guiding decision for revascularization? Acute Card Care 2010; 12:130-137. [PMID: 20954791 DOI: 10.3109/17482941.2010.528431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED Abstract Objectives: Evaluate the new ESC/ACCF/AHA/WHF universal definition of myocardial infarction (MI) in relation to its prognostic implications and the role for guiding decision for revascularization. It was also compared with the multivariable based GRACE Risk Score (GRS). METHODS Single centre registry of 389 consecutive patients admitted with non-ST-segment elevation (NSTE) ACS. We calculated the adjusted HR & 95%CI for death/MI at 30-days and one-year follow-up, between the presence or absence of MI using: (1) universal definition: > 99th URL for cTnI (> 0.06 ng/ml) or MBm (> 3.2 ng/ml); (2) MBm > 2 × URL (> 12.2 ng/ml); 3) old WHO: MBact > 2 × URL (> 32U/l). Logistic analysis was performed to test the interaction between tertiles of biomarkers or GRS and the effect of revascularization on the outcome. RESULTS The universal definition increased the incidence of MI in 3.5-fold for cTnI, but was not an independent predictor of outcome. The GRS was the only independent predictor of prognosis at 30-days and one-year. The interaction with the prognostic impact of revascularization was only present for the GRS categorized by tertiles. CONCLUSIONS In a contemporary unselected population with NSTE-ACS, the universal definition of MI alone was not adequate for risk assessment and revascularization decision making. These purposes were fully addressed with the GRS.
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Affiliation(s)
- Rita Calé
- Hospital Santa Cruz, CHLO, Cardiology, Lisbon, Portugal.
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KS, Grothe M, Hall-Wilton R, Herndon M, Klabbers P, Klukas J, Lanaro A, Lazaridis C, Leonard J, Liu J, Lomidze D, Loveless R, Mohapatra A, Parker W, Reeder D, Ross I, Savin A, Smith WH, Swanson J, Weinberg M. Search for dijet resonances in 7 TeV pp collisions at CMS. Phys Rev Lett 2010; 105:211801. [PMID: 21231289 DOI: 10.1103/physrevlett.105.211801] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Indexed: 05/30/2023]
Abstract
A search for narrow resonances in the dijet mass spectrum is performed using data corresponding to an integrated luminosity of 2.9 pb⁻¹ collected by the CMS experiment at the Large Hadron Collider. Upper limits at the 95% confidence level are presented on the product of the resonance cross section, branching fraction into dijets, and acceptance, separately for decays into quark-quark, quark-gluon, or gluon-gluon pairs. The data exclude new particles predicted in the following models at the 95% confidence level: string resonances, with mass less than 2.50 TeV, excited quarks, with mass less than 1.58 TeV, and axigluons, colorons, and E6 diquarks, in specific mass intervals. This extends previously published limits on these models.
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Ribeiro J, Albuquerque A, Gama Ribeiro V, Hsin HT, Huang JH, Chiu KM, Belfiore R, Chen ZS, Lin PC, Chen LY, Chu SH, Efthimiadis I, Skendros P, Sarantopoulos A, Boura P, Delewi R, Nijveldt R, Carriere C, Van Der Laan AM, Hirsch A, Van Der Vleuten PA, Klees M, Tijssen JGP, Zijlstra F, Van Rossum AC, Piek JJ, Backus BE, Six AJ, Barbati G, Kelder JH, Mosterd A, Mast EG, Mast TP, Braam R, Tio R, Veldkamp R, Doevendans PA, Delewi R, Nijveldt R, Fabris E, Van Der Laan AM, Hirsch A, Van Der Vleuten PA, Klees M, Tijssen JGP, Zijlstra F, Van Rossum AC, Piek JJ, Paarup Dridi N, Holmvang L, Possa F, Engstroem T, Rekik S, Brunet J, Hager FX, Bayet G, Meille L, Quatre JM, Sainsous J, Chu PH, Tang CH, Nait D, Ibatov A, Pogosova N, Koltunov IE, Sapunova ID, Vigodin VA, Uhliar R, Gilis-Januszewski T, Mellwig KP, Wiemer M, Gilis-Januszewski J, Milo M, Peterschroeder A, Schmidt A, Brockmeyer B, Horstkotte D, Suzuki A, Eki Y, Higuchi H, Yukawa A, Yamauchi R, Sato Y, Sinagra G, Endo Y, Martinez Garcia V, Salazar Mendigucha Garcia J, Ariza Sole A, Sanchez Salado JC, Lorente Tordera V, Homs Vila S, Gomez Hospital JA, Cequier Fillat A, Esplugas Oliveras E, Marques N, Andion Ogando R, Hernandez Luis C, Sandin Fuentes M, Tapia Ballesteros C, Vegas Valle JM, Gonzalez Garcia IA, Duro Aguado IA, Palomino Doza AJ, Gomez Salvador I, San Roman Calvar JA, Mimoso J, Nikishin AG, Mamarasulov TM, Pirnazarov MM, Koracevic G, Pavlovic M, Glasnovic J, Damjanovic M, Stojkovic A, Kostic T, Todorovic L, Gomes V, Petrovic S, Zivkovic M, Djordjevic-Radojkovic D, Cherneva ZCH, Denchev SD, Heltai K, Becker D, Merkely B, Nikulina N, Yakushin SS, Agra Bermejo RM, Akinina SA, Furmenko GI, Boytsov A, Yakushin SS, Nikulina NN, Furmenko GI, Akinina SA, Dores H, Leal S, Rosario I, Emad Abu Assi EAA, Bronze L, Abecasis J, Correia MJ, Arroja I, Fonseca C, Aleixo A, Silva A, Dores H, Leal S, Rosario I, Sergio Raposeiras Roubin SRR, Monge J, Abecasis J, Correia MJ, Bronze L, Arroja I, Aleixo A, Silva A, Rosario I, Leal S, Dores H, Pilar Cabanas Grandio PCG, Correia MJ, Monge JC, Abecasis J, Arroja I, Aleixo A, Silva A, Palmisano P, Zaccaria M, Zanna D, Marangelli V, Carlos Pena Gil CPG, Caiati C, Ciccone MM, Favale S, Picon Heras R, Loureiro MJ, Nunez-Gil I, Garcia Rubira JC, Acebal C, Ruiz-Mateos B, Ibanez B, Jose Maria Garcia Acuna JMGA, Fernandez-Ortiz A, Macaya C, Rosario I, Dores H, Leal S, Monge JC, Correia MJ, Bronze Carvalho L, Arroja I, Fonseca C, Jose Ramon Gonzalez Juanatey JRGJ, Aleixo A, Silva A, Urazovskaya I, Vinogradova D, Vasilieva E, Shpektor A, Faustino A, Seca L, Barra S, Providencia R, Daly MJ, Silva J, Gomes P, Costa G, Caetano F, Costa M, Leitao-Marques A, Conti E, Musumeci MB, Lauri FM, Dito E, Scott P, De Giusti M, Lallo A, Fusco D, Davoli M, Volpe M, Autore C, Gamra H, Dridi Z, Hassine M, Addad F, Owens CG, Gherissi I, Reda A, Mahjoub M, Bouraoui S, Abdennadher M, Betbout F, Mota PMFP, Silva JD, Providencia RA, Leitao-Marques A, Tomlin A, Nikolic Heitzler V, Babic Z, Milicic 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Chromov-Borisov NN, Vorlat A, Snoep L, Claeys MJ, Gonzalez-Pacheco H, Vrints CJ, Palazzuoli A, Caputo M, Quatrini I, Calabro A, Antonelli G, Campagna MS, Franci B, Nuti R, Maisel A, Martinez-Sanchez C, Paulo C, Mascarenhas J, Patacho M, Pimenta J, Bettencourt P, Negrini M, Minora T, Marino P, Seregni R, Tavlueva E, Rahnavardi M, Barbarash O, Barbarash L, Janota T, Kudlicka J, Malik K, Wichterle D, Hradec J, Faria R, Mimoso J, Marques N, Keshtkar-Jahromi M, Trigo J, Marques V, Gomes V, Body R, Carley SD, Mcdowell G, Nuttall M, Wibberley C, France M, Cruickshank JK, Vakili H, Mackway-Jones K, Cavusoglu Y, Cavusoglu A, Unluoglu I, Tek M, Demirustu C, Unalacak M, Gorenek B, Birdane A, Yuksel F, Gholamin S, Ata N, Leon M, Cozma C, Mitu F, Matos L, Carvalho ACC, Almeida DR, Oliveira W, Dias CB, Barra SNC, Razavi SM, Gomes P, Silva J, Providencia R, Seca L, Leitao Marques A, Burazor I, Burazor M, Krstic M, Lazovic M, Stojkovic A, Gilis-Januszewski T, Vukmanovic M, Djordjevic J, Radovanovic Z, Ilic D, Bosnjakovic P, Margato R, Ferreira AC, Mateus PS, Ribeiro H, Fontes P, Mellwig KP, Moreira JI, Teixeira T, Silva JD, Costa M, Leitao-Marques A, Conte G, Menozzi A, Solinas E, Bolognesi MG, Tadonio I, Wiemer M, Mantovani F, Cattabiani A, Vignali L, Ardissino D, Scafa Udriste A, Fruntelata A, Tautu O, Calmac L, Alexandrescu A, Niculescu R, Gilis-Januszewski J, Tatu-Chitoiu G, Dorobantu M, Djordjevic Radojkovic D, Apostolovic S, Perisic Z, Damjanovic M, Jankovic R, Salinger Martinovic S, Koracevic G, Todorovic L, Peterschroeder A, Bozinovic N, Matos L, Carvalho ACC, Almeida DR, Oliveira W, Dias CB, Santos C, Ferreira J, Carmo P, Costa F, Koerfer J, Brito J, Sousa P, Cardoso G, Correia I, Aguiar C, Silva A, Fountoulaki K, Kastellanos S, Voltirakis E, Kokotos A, Horstkotte D, Michalakeas C, Kontsas K, Hasioti K, Iliodromitis ET, Anastasiou-Nana M, Andion Ogando R, Hernandez Luis C, Sandin Fuentes MG, Tapia Ballesteros C, Vegas Valle JM, Vrsalovic M, Zatarain Nicolas E, Amat Santos IJ, Martinez Uruena N, Alvarado Montes De Oca M, San Roman Calvar JA, Belohlavek J, Dytrych V, Kovarnik T, Smid O, Kral A, Getaldic B, Linhart A, Aroutunov AG, Intwala S, Sondore D, Juhnevica D, Trusinskis K, Strenge K, Jegere I, Narbute I, Grave A, Vrkic N, Erglis A, Shaalan HSH, Pagava Z, Agladze R, Shakarishvili R, Sharashidze N, Gujejiani L, Saatashvili G, Martins H, Saraiva F, Pintaric H, Baptista R, Jorge E, Mendes PL, Monteiro P, Costa S, Franco F, Providencia LA, Gaber R, Gaber R, Hristova K, Khan S, Katova TZ, Kostova V, Simova Y, Parepa I, Suceveanu AI, Suceveanu A, Mazilu L, Voinea FL, Craiu E, Obradovic S, Wasan B, Salinger S, Vukotic S, Rafajlovski S, Romanovic R, Koracevic G, Antonijevic N, Gligic B, Hutyra M, Skala T, Horak D, Moretti L, Vindis D, Taborsky M, Contine A, Del Pinto M, Angeli F, Verdecchia P, Borgognoni F, Grikstaite E, Pantano P, Ambrosio G, Grossi P, Cavallini C, Bonanad C, Sanchis J, Bodi V, Nunez J, Bosch X, Heras M, Pellicer M, Llacer A, Seca LF, 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Jarai R, Pavlovic I, Farhan S, Schwarz M, Jakl G, Huber K, Jarai R, Schwarz M, Smetana P, Jakl G, Perkmann T, Farhan S, Huber K, Mayr A, Mair J, Klug G, Schocke M, Trieb T, Jaschke W, Pachinger O, Metzler B, Bronze Carvalho L, Azevedo J, Andrade ML, Arroja I, Relvas MJ, Coucello J, Monge J, Morais G, Seabra M, Aleixo A, Afamefule F, Luaces Mendez M, Teijeiro-Mestre R, Nunez-Gil IJ, Leco-Gil N, Madronal-Cerezo E, Zannin I, Ruiz J, Orynchak MA, Vakalyuk II, Vakalyuk IP, Berezin A, Panasenko T, Cavusoglu Y, Cavusoglu A, Unluoglu I, Tek M, Demirustu C, Gorenek B, Unalacak M, Birdane A, Yuksel F, Ata N, Lee WP, Halcox JPJ, Cavusoglu Y, Beyaztas A, Entok E, Demirustu C, Uslu I, Birdane A, Gorenek B, Ata N, Schaefer A, Flierl U, Seydelmann N, Bauersachs J, Calmac L, Craiu E, Ionescu DD, Nanea T, Pop C, Marinescu S, Macarie C, Tatu Chitoiu G, Fruntelata AG, Dorobantu M, Hamdi S, Maazoun Y, Neji A, Farhat O, Majdoub M, Ben Hamda K, Maatouk F, Balanescu SM, Benedek I, Nedelciuc I, Deleanu D, Dobreanu D, Olinic D, Petrescu L, Ortan F, Mot S, Tatu Chitoiu G, Sinnaeve PR, Moreels S, Adriaenssens T, Dubois C, Coosemans M, Vydt T, Desmet W, Sinnaeve PR, Moreels S, Vydt T, Dubois C, Adriaenssens T, Coosemans M, Desmet W, Poli M, Trambaiolo P, Corsi F, De Luca M, Mustilli M, Lukic V, Simonetti M, Ferraiuolo G, Tobing D, Rifnaldi R, Juzar D, Firdaus I, Dharma S, Irmalita I, Kalim H, Bejiqi R, Retkoceri R, Bejiqi H, Kryeziu L, Kelmendi M, Borovci SH, Victor SM, Gnanaraj A, Deshmukh R, Mullasari AS, Yahalom M, Kaiyal RS, Roguin N, Bornstein J, Atar S, Farah R, Seca LF, Faustino A, Silva J, Providencia R, Gomes P, Barra S, Caetano F, Costa M, Leitao Marques AM, Margato R, Sousa P, Ribeiro H, Rocha L, Correia A, Moreira JI, Carvalho HC, Afifi M, Abed N, Santos N, Serrao M, Cafe H. Abstracts. Eur Heart J Suppl 2010. [DOI: 10.1093/eurheartj/suq023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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A, Lazaridis C, Leonard J, Lomidze D, Loveless R, Mohapatra A, Polese G, Reeder D, Savin A, Smith WH, Swanson J, Weinberg M. First measurement of Bose-Einstein correlations in proton-proton collisions at √s=0.9 and 2.36 TeV at the LHC. Phys Rev Lett 2010; 105:032001. [PMID: 20867758 DOI: 10.1103/physrevlett.105.032001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Indexed: 05/29/2023]
Abstract
Bose-Einstein correlations have been measured using samples of proton-proton collisions at 0.9 and 2.36 TeV center-of-mass energies, recorded by the CMS experiment at the CERN Large Hadron Collider. The signal is observed in the form of an enhancement of pairs of same-sign charged particles with small relative four-momentum. The size of the correlated particle emission region is seen to increase significantly with the particle multiplicity of the event.
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Bocci A, Bolognesi S, Breuker H, Brona G, Bunkowski K, Camporesi T, Cano E, Cattai A, Cerminara G, Christiansen T, Coarasa Perez JA, Covarelli R, Curé B, Dahms T, De Roeck A, Elliott-Peisert A, Funk W, Gaddi A, Gennai S, Gerwig H, Gigi D, Gill K, Giordano D, Glege F, Gomez-Reino Garrido R, Gowdy S, Guiducci L, Hansen M, Hartl C, Harvey J, Hegner B, Henderson C, Hoffmann HF, Honma A, Innocente V, Janot P, Lecoq P, Leonidopoulos C, Lourenço C, Macpherson A, Mäki T, Malgeri L, Mannelli M, Masetti L, Mavromanolakis G, Meijers F, Mersi S, Meschi E, Moser R, Mozer MU, Mulders M, Nesvold E, Orsini L, Perez E, Petrilli A, Pfeiffer A, Pierini M, Pimiä M, Racz A, Rolandi G, Rovelli C, Rovere M, Ryjov V, Sakulin H, Schäfer C, Schwick C, Segoni I, Sharma A, Siegrist P, Simon M, Sphicas P, Spiga D, Spiropulu M, Stöckli F, Traczyk P, Tropea P, Tsirou A, Veres GI, Vichoudis P, Voutilainen M, Zeuner WD, Bertl W, Deiters K, Erdmann W, Gabathuler K, Horisberger R, Ingram Q, Kaestli HC, König S, Kotlinski D, Langenegger U, Meier F, Renker D, Rohe T, Sibille J, Starodumov A, Caminada L, Chen Z, Cittolin S, Dissertori G, Dittmar M, Eugster J, Freudenreich K, Grab C, Hervé A, Hintz W, Lecomte P, Lustermann W, Marchica C, Meridiani P, Milenovic P, Moortgat F, Nardulli A, Nessi-Tedaldi F, Pape L, Pauss F, Punz T, Rizzi A, Ronga FJ, Sala L, Sanchez AK, Sawley MC, Schinzel D, Sordini V, Stieger B, Tauscher L, Thea A, Theofilatos K, Treille D, Weber M, Wehrli L, Weng J, Amsler C, Chiochia V, De Visscher S, Ivova Rikova M, Millan Mejias B, Regenfus C, Robmann P, Rommerskirchen T, Schmidt A, Tsirigkas D, Wilke L, Chang YH, Chen KH, Chen WT, Go A, Kuo CM, Li SW, Lin W, Liu MH, Lu YJ, Wu JH, Yu SS, Bartalini P, Chang P, Chang YH, Chang YW, Chao Y, Chen KF, Hou WS, Hsiung Y, Kao KY, Lei YJ, Lin SW, Lu RS, Shiu JG, Tzeng YM, Ueno K, Wang CC, Wang M, Wei JT, Adiguzel A, Ayhan A, Bakirci MN, Cerci S, Demir Z, Dozen C, Dumanoglu I, Eskut E, Girgis S, Gökbulut G, Güler Y, Gurpinar E, Hos I, Kangal EE, Karaman T, Kayis Topaksu A, Nart A, Onengüt G, Ozdemir K, Ozturk S, Polatöz A, Sahin O, Sengul O, Sogut K, Tali B, Topakli H, Uzun D, Vergili LN, Vergili M, Zorbilmez C, Akin IV, Aliev T, Bilmis S, Deniz M, Gamsizkan H, Guler AM, Ocalan K, Ozpineci A, Serin M, Sever R, Surat UE, Zeyrek M, Deliomeroglu M, Demir D, Gülmez E, Halu A, Isildak B, Kaya M, Kaya O, Ozbek M, Ozkorucuklu S, Sonmez N, Levchuk L, Bell P, Bostock F, Brooke JJ, Cheng TL, Cussans D, Frazier R, Goldstein J, Hansen M, Heath GP, Heath HF, Hill C, Huckvale B, Jackson J, Kreczko L, Mackay CK, Metson S, Newbold DM, Nirunpong K, Smith VJ, Ward S, Basso L, Bell KW, Belyaev A, Brew C, Brown RM, Camanzi B, Cockerill DJA, Coughlan JA, Harder K, Harper S, Kennedy BW, Olaiya E, Radburn-Smith BC, Shepherd-Themistocleous CH, Tomalin IR, Womersley WJ, Worm SD, Bainbridge R, Ball G, Ballin J, Beuselinck R, Buchmuller O, Colling D, Cripps N, Cutajar M, Davies G, Della Negra M, Foudas C, Fulcher J, Futyan D, Guneratne Bryer A, Hall G, Hatherell Z, Hays J, Iles G, Karapostoli G, Lyons L, Magnan AM, Marrouche J, Nandi R, Nash J, Nikitenko A, Papageorgiou A, Pesaresi M, Petridis K, Pioppi M, Raymond DM, Rompotis N, Rose A, Ryan MJ, Seez C, Sharp P, Sparrow A, Stoye M, Tapper A, Tourneur S, Vazquez Acosta M, Virdee T, Wakefield S, Wardrope D, Whyntie T, Barrett M, Chadwick M, Cole JE, Hobson PR, Khan A, Kyberd P, Leslie D, Reid ID, Teodorescu L, Bose T, Clough A, Heister A, St John J, Lawson P, Lazic D, Rohlf J, Sulak L, Andrea J, Avetisyan A, Bhattacharya S, Chou JP, Cutts D, Esen S, Heintz U, Jabeen S, Kukartsev G, Landsberg G, Narain M, Nguyen D, Speer T, Tsang KV, Borgia MA, Breedon R, Calderon De La Barca Sanchez M, Cebra D, Chertok M, Conway J, Cox PT, Dolen J, Erbacher R, Friis E, Ko W, Kopecky A, Lander R, Liu H, Maruyama S, Miceli T, Nikolic M, Pellett D, Robles J, Schwarz T, Searle M, Smith J, Squires M, Tripathi M, Vasquez Sierra R, Veelken C, Andreev V, Arisaka K, Cline D, Cousins R, Deisher A, Erhan S, Farrell C, Felcini M, Hauser J, Ignatenko M, Jarvis C, Plager C, Rakness G, Schlein P, Tucker J, Valuev V, Wallny R, Babb J, Clare R, Ellison J, Gary JW, Hanson G, Jeng GY, Kao SC, Liu F, Liu H, Luthra A, Nguyen H, Pasztor G, Satpathy A, Shen BC, Stringer R, Sturdy J, Sumowidagdo S, Wilken R, Wimpenny S, Andrews W, Branson JG, Dusinberre E, Evans D, Golf F, Holzner A, Kelley R, Lebourgeois M, Letts J, Mangano B, Muelmenstaedt J, Padhi S, Palmer C, Petrucciani G, Pi H, Pieri M, Ranieri R, Sani M, Sharma V, Simon S, Tu Y, Vartak A, Würthwein F, Yagil A, Barge D, Blume M, Campagnari C, D'Alfonso M, Danielson T, Garberson J, Incandela J, Justus C, Kalavase P, Koay SA, Kovalskyi D, Krutelyov V, Lamb J, Lowette S, Pavlunin V, Rebassoo F, Ribnik J, Richman J, Rossin R, Stuart D, To W, Vlimant JR, Witherell M, Bornheim A, Bunn J, Gataullin M, Kcira D, Litvine V, Ma Y, Newman HB, Rogan C, Shin K, Timciuc V, Veverka J, Wilkinson R, Yang Y, Zhu RY, Akgun B, Carroll R, Ferguson T, Jang DW, Jun SY, Paulini M, Russ J, Terentyev N, Vogel H, Vorobiev I, Cumalat JP, Dinardo ME, Drell BR, Ford WT, Heyburn B, Luiggi Lopez E, Nauenberg U, Smith JG, Stenson K, Ulmer KA, Wagner SR, Zang SL, Agostino L, Alexander J, Blekman F, Chatterjee A, Das S, Eggert N, Fields LJ, Gibbons LK, Heltsley B, Hopkins W, Khukhunaishvili A, Kreis B, Kuznetsov V, Kaufman GN, Patterson JR, Puigh D, Riley D, Ryd A, Shi X, Sun W, Teo WD, Thom J, Thompson J, Vaughan J, Weng Y, Wittich P, Biselli A, Cirino G, Winn D, Abdullin S, Albrow M, Anderson J, Apollinari G, Atac M, Bakken JA, Banerjee S, Bauerdick LAT, Beretvas A, Berryhill J, Bhat PC, Bloch I, Borcherding F, Burkett K, Butler JN, Chetluru V, Cheung HWK, Chlebana F, Cihangir S, Demarteau M, Eartly DP, Elvira VD, Fisk I, Freeman J, Gao Y, Gottschalk E, Green D, Gutsche O, Hahn A, Hanlon J, Harris RM, James E, Jensen H, Johnson M, Joshi U, Khatiwada R, Kilminster B, Klima B, Kousouris K, Kunori S, Kwan S, Limon P, Lipton R, Lykken J, Maeshima K, Marraffino JM, Mason D, McBride P, McCauley T, Miao T, Mishra K, Mrenna S, Musienko Y, Newman-Holmes C, O'Dell V, Popescu S, Pordes R, Prokofyev O, Saoulidou N, Sexton-Kennedy E, Sharma S, Smith RP, Soha A, Spalding WJ, Spiegel L, Tan P, Taylor L, Tkaczyk S, Uplegger L, Vaandering EW, Vidal R, Whitmore J, Wu W, Yumiceva F, Yun JC, Acosta D, Avery P, Bourilkov D, Chen M, Di Giovanni GP, Dobur D, Drozdetskiy A, Field RD, Fu Y, Furic IK, Gartner J, Kim B, Klimenko S, Konigsberg J, Korytov A, Kotov K, Kropivnitskaya A, Kypreos T, Matchev K, Mitselmakher G, Pakhotin Y, Piedra Gomez J, Prescott C, Remington R, Schmitt M, Scurlock B, Sellers P, Wang D, Yelton J, Zakaria M, Ceron C, Gaultney V, Kramer L, Lebolo LM, Linn S, Markowitz P, Martinez G, Mesa D, Rodriguez JL, Adams T, Askew A, Chen J, Diamond B, Gleyzer SV, Haas J, Hagopian S, Hagopian V, Jenkins M, Johnson KF, Prosper H, Sekmen S, Veeraraghavan V, Baarmand MM, Guragain S, Hohlmann M, Kalakhety H, Mermerkaya H, Ralich R, Vodopiyanov I, Adams MR, Anghel IM, Apanasevich L, Bazterra VE, Betts RR, Callner J, Cavanaugh R, Dragoiu C, Garcia-Solis EJ, Gerber CE, Hofman DJ, Khalatian S, Lacroix F, Shabalina E, Smoron A, Strom D, Varelas N, Akgun U, Albayrak EA, Bilki B, Cankocak K, Clarida W, Duru F, Lae CK, McCliment E, Merlo JP, Mestvirishvili A, Moeller A, Nachtman J, Newsom CR, Norbeck E, Olson J, Onel Y, Ozok F, Sen S, Wetzel J, Yetkin T, Yi K, Barnett BA, Blumenfeld B, Bonato A, Eskew C, Fehling D, Giurgiu G, Gritsan AV, Guo ZJ, Hu G, Maksimovic P, Rappoccio S, Swartz M, Tran NV, Whitbeck A, Baringer P, Bean A, Benelli G, Grachov O, Murray M, Radicci V, Sanders S, Wood JS, Zhukova V, Bandurin D, Bolton T, Chakaberia I, Ivanov A, Kaadze K, Maravin Y, Shrestha S, Svintradze I, Wan Z, Gronberg J, Lange D, Wright D, Baden D, Boutemeur M, Eno SC, Ferencek D, Hadley NJ, Kellogg RG, Kirn M, Mignerey A, Rossato K, Rumerio P, Santanastasio F, Skuja A, Temple J, Tonjes MB, Tonwar SC, Twedt E, Alver B, Bauer G, Bendavid J, Busza W, Butz E, Cali IA, Chan M, D'Enterria D, Everaerts P, Gomez Ceballos G, Goncharov M, Hahn KA, Harris P, Kim Y, Klute M, Lee YJ, Li W, Loizides C, Luckey PD, Ma T, Nahn S, Paus C, Roland C, Roland G, Rudolph M, Stephans GSF, Sumorok K, Sung K, Wenger EA, Wyslouch B, Xie S, Yilmaz Y, Yoon AS, Zanetti M, Cole P, Cooper SI, Cushman P, Dahmes B, De Benedetti A, Dudero PR, Franzoni G, Haupt J, Klapoetke K, Kubota Y, Mans J, Petyt D, Rekovic V, Rusack R, Sasseville M, Singovsky A, Cremaldi LM, Godang R, Kroeger R, Perera L, Rahmat R, Sanders DA, Sonnek P, Summers D, Bloom K, Bose S, Butt J, Claes DR, Dominguez A, Eads M, Keller J, Kelly T, Kravchenko I, Lazo-Flores J, Lundstedt C, Malbouisson H, Malik S, Snow GR, Baur U, Iashvili I, Kharchilava A, Kumar A, Smith K, Strang M, Zennamo J, Alverson G, Barberis E, Baumgartel D, Boeriu O, Reucroft S, Swain J, Wood D, Zhang J, Anastassov A, Kubik A, Ofierzynski RA, Pozdnyakov A, Schmitt M, Stoynev S, Velasco M, Won S, Antonelli L, Berry D, Hildreth M, Jessop C, Karmgard DJ, Kolb J, Kolberg T, Lannon K, Lynch S, Marinelli N, Morse DM, Ruchti R, Slaunwhite J, Valls N, Warchol J, Wayne M, Ziegler J, Bylsma B, Durkin LS, Gu J, Killewald P, Ling TY, Williams G, Adam N, Berry E, Elmer P, Gerbaudo D, Halyo V, Hunt A, Jones J, Laird E, Lopes Pegna D, Marlow D, Medvedeva T, Mooney M, Olsen J, Piroué P, Stickland D, Tully C, Werner JS, Zuranski A, Acosta JG, Huang XT, Lopez A, Mendez H, Oliveros S, Ramirez Vargas JE, Zatzerklyaniy A, Alagoz E, Barnes VE, Bolla G, Borrello L, Bortoletto D, Everett A, Garfinkel AF, Gecse Z, Gutay L, Jones M, Koybasi O, Laasanen AT, Leonardo N, Liu C, Maroussov V, Merkel P, Miller DH, Neumeister N, Potamianos K, Shipsey I, Silvers D, Yoo HD, Zablocki J, Zheng Y, Jindal P, Parashar N, Cuplov V, Ecklund KM, Geurts FJM, Liu JH, Morales J, Padley BP, Redjimi R, Roberts J, Betchart B, Bodek A, Chung YS, de Barbaro P, Demina R, Flacher H, Garcia-Bellido A, Gotra Y, Han J, Harel A, Miner DC, Orbaker D, Petrillo G, Vishnevskiy D, Zielinski M, Bhatti A, Demortier L, Goulianos K, Hatakeyama K, Lungu G, Mesropian C, Yan M, Atramentov O, Gershtein Y, Gray R, Halkiadakis E, Hidas D, Hits D, Lath A, Rose K, Schnetzer S, Somalwar S, Stone R, Thomas S, Cerizza G, Hollingsworth M, Spanier S, Yang ZC, York A, Asaadi J, Eusebi R, Gilmore J, Gurrola A, Kamon T, Khotilovich V, Montalvo R, Nguyen CN, Pivarski J, Safonov A, Sengupta S, Toback D, Weinberger M, Akchurin N, Bardak C, Damgov J, Jeong C, Kovitanggoon K, Lee SW, Mane P, Roh Y, Sill A, Volobouev I, Wigmans R, Yazgan E, Appelt E, Brownson E, Engh D, Florez C, Gabella W, Johns W, Kurt P, Maguire C, Melo A, Sheldon P, Velkovska J, Arenton MW, Balazs M, Buehler M, Conetti S, Cox B, Hirosky R, Ledovskoy A, Neu C, Yohay R, Gollapinni S, Gunthoti K, Harr R, Karchin PE, Mattson M, Milstène C, Sakharov A, Anderson M, Bachtis M, Bellinger JN, Carlsmith D, Dasu S, Dutta S, Efron J, Gray L, Grogg KS, Grothe M, Hall-Wilton R, Herndon M, Klabbers P, Klukas J, Lanaro A, Lazaridis C, Leonard J, Lomidze D, Loveless R, Mohapatra A, Polese G, Reeder D, Savin A, Smith WH, Swanson J, Weinberg M. Transverse-momentum and pseudorapidity distributions of charged hadrons in pp collisions at square root of s = 7 TeV. Phys Rev Lett 2010; 105:022002. [PMID: 20867699 DOI: 10.1103/physrevlett.105.022002] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Indexed: 05/29/2023]
Abstract
Charged-hadron transverse-momentum and pseudorapidity distributions in proton-proton collisions at square root of s = 7 TeV are measured with the inner tracking system of the CMS detector at the LHC. The charged-hadron yield is obtained by counting the number of reconstructed hits, hit pairs, and fully reconstructed charged-particle tracks. The combination of the three methods gives a charged-particle multiplicity per unit of pseudorapidity dN(ch)/dη|(|η|<0.5) = 5.78 ± 0.01(stat) ± 0.23(syst) for non-single-diffractive events, higher than predicted by commonly used models. The relative increase in charged-particle multiplicity from square root of s = 0.9 to 7 TeV is [66.1 ± 1.0(stat) ± 4.2(syst)]%. The mean transverse momentum is measured to be 0.545 ± 0.005(stat) ± 0.015(syst) GeV/c. The results are compared with similar measurements at lower energies.
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Calé R, Ferreira J, Aguiar C, Santos N, Carmo P, Figueira J, Raposo L, Gonçalves P, Silva JA. NEW UNIVERSAL DEFINITION OF MYOCARDIAL INFARCTION FOR RISK STRATIFICATION AND REVASCULARIZATION DECISION MAKING: IS IT ENOUGH? J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)60916-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Baptista J, Teles RC, da Silva PC, Pereira H, Marques L, Santos R, Carvalho H, Martins D, Farto e Abreu P, Araújo J, Teles RC, Almeida M, Raposo L, da Silva PC, Gabriel HM, Pereira H, Vinhas H, Leitão-Marques A, Costa M, Baptista J, Santos R, Seixo F, Farto e Abreu P, Carvalho H, Luz A, Martins D, Araújo J, Silva B. Five-year clinical results of coronary angioplasty with drug-eluting stents. National initiative in strategic innovation, iNOS. Rev Port Cardiol 2010; 29:243-251. [PMID: 20545251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION The use of drug-eluting stents (DES) is beneficial in patients undergoing percutaneous coronary intervention (PCI) and there is particular interest in long-term follow-up. OBJECTIVE We aimed to assess and characterize early DES use in Portugal during 2003 and patient follow-up over a 5-year period. We developed a web-based database to collect and organize patient and procedural data from PCI performed in ten cardiovascular interventional centers sharing the same database. METHODS This was a multicenter retrospective study that included 1833 consecutive angiographically successful coronary angioplasties in which a DES was implanted in 2003. A subgroup of patients with 5-year clinical follow-up after the initial procedure was selected for which there was at least a 90% follow-up rate during one quarter of 2003. Demographic, clinical and angiographic characteristics of the entire population were assessed. In the clinical follow-up cohort, the incidence of major adverse cardiac events (MACE)--death, myocardial infarction and surgical or percutaneous target lesion revascularization--was analyzed by survival curves and logistic regression analysis. RESULTS Of the total population, 23% were female, and mean age was 62 +/- 11 years (25-92). The main risk factors were hypertension (60.5%), dyslipidemia (42.9%), smoking (45.1%) and diabetes (23.9%, of whom 13.2% were on insulin therapy). There was a history of myocardial infarction, PCI or bypass surgery respectively in 23.1%, 25.1%, and 9.7% of the patients. Multivessel disease was present in 59.9% of patients (mean of 1.86 +/- 0.81 vessels). PCI was performed on average in 1.24 +/- 0.48 lesions, and complete revascularization in 58.8%. A total of 2058 stents were used (mean of 1.62 +/- 0.84) in 1271 patients. The longitudinal substudy included only 320 PCIs, for which follow-up was achieved in 319 (99%; median: 1875 days, P25: 1457 days, P75: 2045 days). Thirty-seven deaths (11.6%) and 61 MACE (19.1%) occurred in this group, with no differences between insulin-treated and other diabetic patients. CONCLUSION This is the first study to analyze the early Portuguese experience with drug-eluting stents. The clinical results compare favorably with the first published international registries. The on-line platform used was successful in collecting data in a standardized format on the clinical experience of multiple centers.
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Affiliation(s)
- José Baptista
- Unidade de Intervenção Cardiovascular, Hospital de Santa Cuz, Carnaxide.
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de Araujo Goncalves P, Seabra-Gomes R, Teles R, Almeida M, Aguiar C, Raposo L, Ferreira J, Pereira Machado F. Complementary effects of sirolimus-eluting stents and glycoprotein IIb/IIIa inhibitors for percutaneous coronary intervention in diabetic patients: one-year follow up of a single-centre registry. Heart 2006; 92:1155-6. [PMID: 16844874 PMCID: PMC1861127 DOI: 10.1136/hrt.2005.079780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sequeira J, Raposo L, Costa J, Vasconcelos C, Limbert C, Matos R. W04.149 CRPhs is correlated with obesity and pulse pressure in type 2 diabetics. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90148-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Goncalves PA, Ferreira J, Raposo L, Aguiar C, Seabra-Gomes R. 1021-98 Is metabolic dysfunction equivalent to diabetes as a prognostic marker in acute coronary syndrome? J Am Coll Cardiol 2004. [DOI: 10.1016/s0735-1097(04)91059-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mendes WS, Aragão NJ, Santos HJ, Raposo L, Vasconcelos PF, Rosa ES, Elkhoury MR. Hantavirus pulmonary syndrome in Anajatuba, Maranhão, Brazil. Rev Inst Med Trop Sao Paulo 2001; 43:237-40. [PMID: 11558007 DOI: 10.1590/s0036-46652001000400013] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The authors report a confirmed case of hantavirus pulmonary syndrome in the rural area of the municipality of Anajatuba, state of Maranhão. Two other suspected cases from the same region are also described. The confirmed case involved a previously healthy young woman who died with signs and symptoms of acute respiratory insufficiency 5 days after presenting fever, myalgia and a dry cough. The patient was a student who was helping her parents with work in the fields; it was a habit of the family to store rice inside the house. The suspected cases involved two first-degree relatives working as field hands who died of acute respiratory insufficiency 24 and 48 hours, respectively, after presenting fever, myalgia and a dry cough. Both stored rice and corn inside their home. People living in the region reported massive infestations with rats in the woods and fields.
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Affiliation(s)
- W S Mendes
- Núcleo de Patologia Tropical e Medicina Social, Universidade Federal do Maranhão, São Luís, MA, Brasil.
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Abstract
The role of longitudinally and circumferentially oriented fibres in left ventricular wall motion was examined by digitising echocardiograms of the mitral ring (whose motion reflects long axis change) and of the standard minor axis in 36 healthy individuals, 36 patients with coronary artery disease, 16 with left ventricular hypertrophy, 44 with mitral valve disease (24 of whom had undergone mitral valve replacement). In the controls long axis shortening significantly preceded minor axis shortening (mean (1 SD) difference 25 (40) ms) so that the minor axis increased more during isovolumic contraction (0.25 v 0.09 cm), indicating that the left ventricle became more spherical. Changes in the long and short axes were synchronous at end ejection and in early diastole in the controls. Epicardial excursion preceded endocardial excursion by 50 (20) ms at its peak. These time relations were consistently disturbed in all patient groups, irrespective of the extent of fractional shortening of the minor axis. The onset of long axis shortening was delayed, and this was often associated with premature shortening of the minor axis, the normal spherical shape change during isovolumic contraction was lost, and peak epicardial and endocardial changes became more synchronous. In patients with coronary disease these changes are the expected consequence of ischaemic injury to longitudinally orientated subendocardial fibres. In left ventricular hypertrophy their presence consistently showed systolic dysfunction when orthodox measures were still normal. They were more pronounced after mitral valve replacement when the papillary muscles had been sectioned; long axis shortening was reduced during systole and prolonged into early diastole, while normal shortening of the minor axis was maintained only by abnormal epicardial excursion. Relations between long and short axis motion in healthy individuals are characteristic, and their loss is an early index of systolic ventricular disease. These disturbances precede changes in orthodox measures such as fractional shortening or peak velocity of circumferential fibre shortening.
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Affiliation(s)
- C J Jones
- Cardiac Department, Brompton Hospital, London
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Abstract
To define the range of cardiac involvement in the Churg-Strauss syndrome, M mode, continuous wave Doppler, and cross sectional echocardiograms were recorded in twelve patients with the disorder. The M mode recordings were digitised and the cross sectional images were recorded with standardised gain settings to determine regional myocardial echo amplitude. Left ventricular end diastolic and end systolic dimensions were increased above the normal 95% confidence interval in four patients, three of whom showed a depressed shortening fraction. Mitral regurgitation was present in six patients; this was severe enough to need valve replacement in two. Mean echo amplitude in both the septum and the posterior wall was significantly increased above normal by a mean (SD) of 4.87 (2.57) dB, suggesting the presence of myocardial fibrosis. There was no evidence of subendocardial involvement as there is in other hypereosinophilic syndromes. Mitral regurgitation is common in the Churg-Strauss syndrome. This cannot be ascribed to involvement of the cusps or chordae and it occurs even when ventricular function is well preserved. It is suggested that mitral regurgitation is caused by diffuse myocardial fibrosis.
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Affiliation(s)
- J M Morgan
- Cardiac Department, Brompton Hospital, London
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