Revista Portuguesa De Cardiologia最新文献

{"title":"Sex-related differences in ST-segment elevation myocardial infarction: A Portuguese multicenter national registry analysis.","authors":"Carolina Miguel Gonçalves, Mariana Carvalho, Adriana Vazão, Margarida Cabral, André Martins, Fátima Saraiva, João Morais","doi":"10.1016/j.repc.2024.06.005","DOIUrl":"10.1016/j.repc.2024.06.005","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Sex differences among patients with acute myocardial infarctions remain a matter of debate. Inequalities in presentation, diagnosis, treatment, and prognosis are frequently observed, contributing to a worse prognosis in women. The aim of this study was to investigate sex-related differences in Portuguese ST-segment elevation myocardial infarction (STEMI) patients.</p><p><strong>Methods: </strong>The authors conducted a retrospective analysis of STEMI patients included in the Portuguese Registry on Acute Coronary Syndromes, between October 2010 and 2022. The two co-primary endpoints were in-hospital and one-year mortality.</p><p><strong>Results: </strong>A total of 14470 STEMI patients were studied. Women were underrepresented with 3721 individuals (25.7%). They were significantly older (70 vs. 62 years, p<0.001), with higher prevalence of cardiovascular risk factors, and underwent less frequently coronary angiography (84.4% vs. 88.5%, p<0.001) and guideline-directed medical therapy (e.g., aspirin 92.5% vs. 95.4%, beta blockers 79.2% vs. 83%, p<0.001). Furthermore, they experienced more complications, such as congestive heart failure (23.4% vs. 14.6%), ischemic stroke (47% vs. 40%), and in-hospital mortality (8.5% vs. 4.1%) (p<0.001 for all comparisons). Similarly, they presented higher one-year mortality (11.5% vs. 6.3%, p<0.001). However, after a multivariate analysis testing significant clinical variables, female sex remained an independent predictor for in-hospital (odds ratio=1.633; 95% CI [1.065-2.504]; p=0.025), but not for one-year mortality.</p><p><strong>Conclusions: </strong>This analysis reveals sex-related disparities in Portuguese STEMI patients. Despite limitations inherent to registry-based analysis, women were significantly older, with increased cardiovascular risk, less treated, and with higher in-hospital mortality. These disparities should be a concern for clinicians to further improve outcomes and move toward equitable medical care.</p>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113886","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":"Atrial fibrillation ablation in patients with heart failure: Which patients are most likely to respond?","authors":"Diogo Cavaco","doi":"10.1016/j.repc.2024.08.006","DOIUrl":"10.1016/j.repc.2024.08.006","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 11","pages":"Pages 597-599"},"PeriodicalIF":1.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance and usefulness of SCORE2 in cardiovascular prevention","authors":"Luís Cotrim ,&nbsp;Carlos Rabaçal","doi":"10.1016/j.repc.2024.08.005","DOIUrl":"10.1016/j.repc.2024.08.005","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 11","pages":"Pages 611-612"},"PeriodicalIF":1.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health and cardiovascular healthcare professionals in Portugal: Current status, expectations and barriers to implementation","authors":"","doi":"10.1016/j.repc.2023.10.014","DOIUrl":"10.1016/j.repc.2023.10.014","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Digital health (DH) is a broad concept, bringing together technology and healthcare, that is playing an increasingly important role in the daily routine of healthcare professionals (HCPs) and promises to contribute to the prevention and treatment of cardiovascular disease. There are no solid data on the position of Portuguese HCPs toward the implementation of DH in cardiovascular medicine. This national cross-sectional study aims to provide a snapshot of DH implementation in Portuguese cardiovascular HCP routines and to identify both expectations and barriers to its adoption.</p></div><div><h3>Methods</h3><p>An 18-question survey was created specifically for this study and distributed to 1174 individuals on the Portuguese Society of Cardiology mailing list.</p></div><div><h3>Results</h3><p>We collected 117 valid responses (response rate 10%). Almost all participants had smartphones and laptops, and two-thirds had tablets. Electronic medical information systems were the most used DH tool (84% of respondents) and were considered the most important for improving cardiovascular care. Implantable technologies (sensors and devices), telemedicine and social media were used by more than two out of three respondents and considered «very important» or «extremely important» by most of them. Most participants showed positive expectations regarding the impact of DH in cardiovascular medicine: 78% agreed that DH could improve health outcomes, 64% that it promotes health literacy and 63% that it could decrease healthcare costs. The top-rated barriers were patients’ inability to use smartphones, limited access to electronic devices, and lack of legal regulation of DH.</p></div><div><h3>Conclusion</h3><p>Most Portuguese cardiovascular HCPs had at least three electronic devices (mainly smartphones, laptops and tablets) and showed positive expectations regarding DH's current and future impact on cardiovascular medicine. Patient DH literacy, technology adoption, and DH regulation were identified as the most important barriers to increasing the adoption of DH tools in cardiovascular medicine.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 8","pages":"Pages 459-467"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000738/pdfft?md5=546f53810f9b65c15622190e836cf5cd&pid=1-s2.0-S0870255124000738-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the cardiovascular risk SCORE2 globally valid and useful?","authors":"","doi":"10.1016/j.repc.2024.06.001","DOIUrl":"10.1016/j.repc.2024.06.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 8","pages":"Pages 445-447"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124001860/pdfft?md5=b3a43562e0ddafc4df29873441173043&pid=1-s2.0-S0870255124001860-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk assessment in Portugal's primary health care system: SCORE vs. SCORE2","authors":"","doi":"10.1016/j.repc.2023.10.012","DOIUrl":"10.1016/j.repc.2023.10.012","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>The 2021 European Society of Cardiology guidelines on cardiovascular disease (CVD) prevention introduced the more accurate SCORE2 risk model as a replacement for the earlier SCORE, which is still used in primary care software in Portugal. Our objective is to determine whether the difference between risk assessment using SCORE and SCORE2, in the same patient population, is statistically significant.</p></div><div><h3>Methods</h3><p>A total of 1642 patients aged 40–65 without previous CVD, from the medical records of two Family Health Units, were included in this cross-sectional study. SCORE and SCORE2 were calculated using the variables gender, age, smoking status, lipid profile and systolic blood pressure. A statistical analysis was performed on the results.</p></div><div><h3>Results</h3><p>Using SCORE, 98% of the patients were in the low–moderate risk categories and 2% in the high or very high risk categories. When using SCORE2, the corresponding percentages were 55% and 45%, respectively. Reclassification with SCORE2 into higher categories was more often observed in younger (under 50 years of age) and male patients. With SCORE, 38.61% of patients were within the LDL-C target range; this figure fell to 20.28% with SCORE2. These differences are statistically significant (p&lt;0.0001).</p></div><div><h3>Conclusion</h3><p>Our findings show that a significant number of patients in this cohort who were classified through SCORE at lower risk levels were reclassified into higher risk categories with SCORE2. Similarly, the number of patients within the LDL-C target range for LDL-C was also lower using SCORE2.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 8","pages":"Pages 449-455"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000672/pdfft?md5=19b002cfa36a786af4dd755fed16dd7d&pid=1-s2.0-S0870255124000672-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital cardiovascular healthcare: Current state and future perspectives","authors":"","doi":"10.1016/j.repc.2024.04.003","DOIUrl":"10.1016/j.repc.2024.04.003","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 8","pages":"Pages 469-470"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000830/pdfft?md5=932811507d36eb017b67d7de5a79a0cd&pid=1-s2.0-S0870255124000830-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal and neonatal cardiac mass: Difficulties in reaching the diagnosis","authors":"","doi":"10.1016/j.repc.2023.10.016","DOIUrl":"10.1016/j.repc.2023.10.016","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 8","pages":"Pages 475-476"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000775/pdfft?md5=f55814728d48583a19155dd7f0f6cba2&pid=1-s2.0-S0870255124000775-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the SCORE2 risk prediction algorithm in a Portuguese population: A new model to estimate 10-year cardiovascular disease incidence in Europe","authors":"","doi":"10.1016/j.repc.2023.10.011","DOIUrl":"10.1016/j.repc.2023.10.011","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Subjects without cardiovascular (CV) disease (CVD) may suffer from subclinical atherosclerosis, and are at increased risk for atherosclerotic CV events (ASCVE). The ESC/EAS risk SCORE was updated by SCORE2, which estimates 10-year risk of fatal and non-fatal CVD in European populations aged 40–69 years without established CVD or diabetes. Our aim was to compare the two ESC/EAS risk scores and to validate SCORE2 in our population.</p></div><div><h3>Methods</h3><p>A total of 1071 individuals (age 57.2±6.1 years; 75.2% male) without CVD or diabetes, from GENEMACOR study controls, were analyzed over 5.4±3.9 years. The population was stratified into risk categories according to the two scores, and the area under the ROC curve (AUC) and Harrell's C-index assessed the scores’ performance. Calibration was performed using the goodness-of-fit test, and occurrence of the first event assessed by Cox regression. Kaplan–Meier analysis estimated SCORE2 survival.</p></div><div><h3>Results</h3><p>SCORE stratified subjects into four risk categories: low (7.4%), moderate (46.5%), high (25.3%) and very high (20.8%), and SCORE2 into three: low-to-moderate (24.7%), high (59.0%) and very high (16.2%). SCORE presented good discrimination for CV mortality (AUC=0.838; C-index=0.834, 95% CI: 0.728–0.940), as did SCORE2 for total CV events (AUC=0.744; C-index=0.728, 95% CI: 0.648–0.808). Calibration did not show a disparity between observed and expected ASCVE. The probability of ASCVE was eight times higher in very-high-risk SCORE2 (p=0.001), and three times in the high-risk group (p=0.049). Event-free survival was 99%, 90% and 72% in the low-to-moderate, high and very-high-risk categories, respectively (p&lt;0.0001).</p></div><div><h3>Conclusions</h3><p>SCORE2 improved population stratification by identifying higher-risk patients, enabling early preventive measures. It showed good discriminative ability for all ASCVE.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 8","pages":"Pages 437-444"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000660/pdfft?md5=dbdab7da0b8a9d3fc7d831d0df3a5c86&pid=1-s2.0-S0870255124000660-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Replacing SCORE with SCORE2 in Portuguese primary care: News from the frontline of cardiovascular prevention","authors":"","doi":"10.1016/j.repc.2024.04.005","DOIUrl":"10.1016/j.repc.2024.04.005","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 8","pages":"Pages 457-458"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124001161/pdfft?md5=1641f39ce9befa2f39a12f2343cbdfc3&pid=1-s2.0-S0870255124001161-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}