Filipa Gerardo , Miguel Santos , Daniel Faria , Maura Nédio , Célia Monteiro , Sérgio Bravo Baptista , Pedro Farto e Abreu
{"title":"Economic evaluation of the impact of generic prasugrel widespread adoption at a national level","authors":"Filipa Gerardo , Miguel Santos , Daniel Faria , Maura Nédio , Célia Monteiro , Sérgio Bravo Baptista , Pedro Farto e Abreu","doi":"10.1016/j.repc.2025.03.004","DOIUrl":"10.1016/j.repc.2025.03.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 589-590"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effectiveness of a cardiac rehabilitation program in women with heart failure","authors":"Andreia Campinas , Cristine Schmidt , Maria Isilda Oliveira , Sandra Magalhães , Catarina Gomes , Rita Nogueira-Ferreira , Fernando Ribeiro , Mário Santos","doi":"10.1016/j.repc.2025.02.010","DOIUrl":"10.1016/j.repc.2025.02.010","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The effectiveness of cardiac rehabilitation (CR) in improving exercise capacity and quality of life (QoL) in heart failure (HF) is well established. However, it remains underutilized in women. We aimed to compare the adherence and effectiveness of a CR program in women and men with HF.</div></div><div><h3>Methods</h3><div>This was a prospective single-center study of consecutive 93 HF patients referred to a CR program between September 2019 and July 2021. We defined adherence as the percentage of sessions patients attended. Effectiveness outcomes were changes in peak oxygen uptake (VO<sub>2</sub> peak) and QoL measurements before (baseline) and after the CR program (12wk). VO<sub>2</sub> peak was assessed by a maximal effort cardiopulmonary exercise testing on a treadmill. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).</div></div><div><h3>Results</h3><div>Among 93 patients, 32.3% were female. Regarding adherence, 84% of patients completed the CR program, and no significant differences were found between groups (p=0.232). The increase in VO<sub>2</sub> peak did not differ between genders (p=0.938). A significant reduction in the total, physical and emotional MLHFQ scores in both genders was observed (all p<0.05). There were no significant differences in QoL effectiveness analysis between the groups (all p=NS).</div></div><div><h3>Conclusion</h3><div>Women with HF adhered to the CR program similarly to men and had a similar increase in VO<sub>2</sub> peak, a robust and validated prognostic marker for HF in this setting. Women benefited as much as men in all dimensions of QoL. Together, these data emphasize the need to increase the referral of women with HF to CR programs.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 525-532"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sofia Jacint, Guilherme Portugal, Hélder Santos, Pedro Silva Cunha, Bruno Valente, Ana Lousinha, Ana Sofia Delgado, Rui Cruz Ferreira, Mário Martins Oliveira
{"title":"Fluoroless cavotricuspid isthmus ablation of typical atrial flutter achieves success with shorter radiofrequency and procedural times","authors":"Sofia Jacint, Guilherme Portugal, Hélder Santos, Pedro Silva Cunha, Bruno Valente, Ana Lousinha, Ana Sofia Delgado, Rui Cruz Ferreira, Mário Martins Oliveira","doi":"10.1016/j.repc.2025.04.005","DOIUrl":"10.1016/j.repc.2025.04.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFL) has improved in recent years, especially with three-dimensional (3D) electroanatomic mapping systems. These tools allow a better understanding of the arrhythmia with higher ablation success rates while reducing radiation exposure. However, most ablation procedures still require varying amounts of fluoroscopy. Our aim was to examine whether fluoroless CTI ablation is effective and safe in reducing AFL recurrence, compared with CTI ablation using fluoroscopy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of CTI ablations performed at a tertiary center between December 2010 and December 2022. Patients were divided into two groups: fluoroless and fluoroscopic, according to the use of radiation. Procedural duration, fluoroscopy time (FT), radiofrequency time (RF), acute complications and recurrence rates at one year were analyzed.</div></div><div><h3>Results</h3><div>A total of 324 CTI ablations were performed. Mean age was 62.3±14.0 years, with 78.1% male patients. The FT was zero in the fluoroless group (n=31), and 7.0±7.0 minutes in the fluoroscopic group (n=293) (p<0.001). There was no statistically significant difference between the two groups, regarding AFL recurrence at one year. RF was shorter in the fluoroless group (8±4 vs. 14±11 minutes, p<0.001). Total time procedure duration was shorter in the fluoroless group (60±20 minutes vs. 99±45 minutes, p<0.001). There were no acute complications.</div></div><div><h3>Conclusion</h3><div>Fluoroless CTI ablation, avoiding any radiation exposure to the patient and operator, can be performed in patients with typical AFL, without compromising duration, safety or efficacy of the procedure.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 551-555"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rethinking the radiation: Toward a fluoroless future in electrophysiology","authors":"Renato Margato","doi":"10.1016/j.repc.2025.07.001","DOIUrl":"10.1016/j.repc.2025.07.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 557-559"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alicia Prieto-Lobato , Víctor Hidalgo Olivares , Manuel Gerónimo Pardo , Marta Cubells Pastor , Francisco Manuel Salmerón Martínez , Miguel José Corbí-Pascual
{"title":"One-year recurrence rate of new-onset atrial fibrillation after acute myocardial infarction","authors":"Alicia Prieto-Lobato , Víctor Hidalgo Olivares , Manuel Gerónimo Pardo , Marta Cubells Pastor , Francisco Manuel Salmerón Martínez , Miguel José Corbí-Pascual","doi":"10.1016/j.repc.2024.12.008","DOIUrl":"10.1016/j.repc.2024.12.008","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide, with a prevalence of up to 21% in the early phase of acute myocardial infarction (AMI). Data on new-onset AF in this context are limited, and long-term prognosis remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational cohort study from December 2011 to May 2021, including patients who experienced a first episode of paroxysmal AF during hospitalization for AMI. The primary outcome was the recurrence of AF within the first year post-discharge. Secondary outcomes included all-cause mortality, cardiovascular mortality, and a composite of major adverse cardiovascular events.</div></div><div><h3>Results</h3><div>A total of 209 patients were included. There was AF recurrence in 19 patients, 9.1% (95% CI 5.2–13.0%) with a median time to recurrence of 84 days (interquartile range 27.5–157.5). While mortality in the AF recurrence group was numerically higher than in the non-AF recurrence group, this difference did not achieve statistical significance (15.8% vs. 7.4%, p=0.19). Patients with AF recurrence had significantly worse prognosis (47.4% vs. 23.7%, p=0.04), primarily due to increased heart failure (HF) hospitalizations.</div></div><div><h3>Conclusions</h3><div>In patients with a first episode of paroxysmal AF during AMI, one-year recurrence is relatively low (9.1%); however, AF recurrence is associated with significantly worse prognosis, driven largely by HF hospitalizations.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 7","pages":"Pages 403-411"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Luísa Silva , Gonçalo Ferraz Costa , José Luís Martins , Luís Leite , Lino Gonçalves
{"title":"Surgical revascularization of chronic coronary total occlusions – A systematic review and meta-analysis","authors":"Ana Luísa Silva , Gonçalo Ferraz Costa , José Luís Martins , Luís Leite , Lino Gonçalves","doi":"10.1016/j.repc.2025.01.006","DOIUrl":"10.1016/j.repc.2025.01.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Chronic coronary total occlusion (CTO) optimal therapeutic management remains a topic of debate despite its association with adverse clinical outcomes. This study aimed to compare clinical outcomes of patients with CTOs treated with coronary artery bypass graft (CABG) versus medical therapy (MT), assessing the effect of CTO revascularization in patients with multivessel disease undergoing CABG.</div></div><div><h3>Methods</h3><div>In July 2023, PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for studies comparing CTOs treated with CABG versus MT. A sub-analysis of CABG patients, comparing complete surgical revascularization, including CTO bypass, to CABG without CTO bypass, was performed. A pooled odds ratio meta-analysis assessed four main outcomes: mortality, myocardial infarction (MI), stroke, and major adverse cardiovascular events (MACE). The primary outcome was all-cause mortality.</div></div><div><h3>Results</h3><div>Ten observational studies (6458 patients) comparing CABG-CTO with MT-CTO showed lower all-cause mortality in the CABG group (OR 0.31, 95% CI 0.24–0.40, p<0.001, I<sup>2</sup>=36%). Despite heterogeneity, CABG exhibited reduced CV mortality and MACE (OR 0.37, 95% CI 0.24–0.57, p<0.001, I<sup>2</sup>=59%; OR 0.37, 95% CI 0.15–0.92, p=0.03, I<sup>2</sup>=80%, respectively). The MI rate was lower in the CABG group (OR 0.41, 95% CI 0.30–0.56, p<0.001, I<sup>2</sup>=0%). Comparing bypassed to non-bypassed CTO groups (5 studies, 1949 patients), the bypassed-CTO group had considerably lower MACE (OR 0.49, 95% CI 0.30–0.81, p=0.005, I<sup>2</sup>=44%).</div></div><div><h3>Conclusion</h3><div>This study suggests a clinical benefit of bypassing a CTO in multivessel disease patients during CABG, with significantly lower MACE. The improved outcomes of CABG over MT further underscore these findings, warranting careful consideration by the Heart Team during their decision-making process.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 7","pages":"Pages 427-439"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dr. Fernando Matias dos Santos Silva","authors":"Mário Martins Oliveira","doi":"10.1016/j.repc.2025.06.004","DOIUrl":"10.1016/j.repc.2025.06.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 8","pages":"Page 523"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michele Galasso , Isidoro Pera , Martina Milani , Andrea Farina , Gianluca Tiberti , Silvia Massaro , Giuseppe Uccello
{"title":"Recurrent dissection of left coronary artery with extension to the left main and cardiogenic shock","authors":"Michele Galasso , Isidoro Pera , Martina Milani , Andrea Farina , Gianluca Tiberti , Silvia Massaro , Giuseppe Uccello","doi":"10.1016/j.repc.2025.02.006","DOIUrl":"10.1016/j.repc.2025.02.006","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 7","pages":"Pages 467-468"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}