Arquivos brasileiros de cardiologia最新文献

{"title":"Effectiveness of Implantable Cardioverter-Defibrillator Therapy for Primary Prevention in Patients with Nonischemic Heart Failure with Reduced Ejection Fraction.","authors":"Luis E Rohde, Leandro I Zimerman, Lídia Z Moura, Luis C Danzmann, Silvia M Martins, Verônica Colpani, Kelly Zucatti, José Albuquerque de Figueiredo-Neto, Fabiana G Marcondes-Braga, Ricardo Mourilhe-Rocha, Denilson Campos de Albuquerque, Mucio T de Oliveira-Júnior, Marcus V Simões","doi":"10.36660/abc.20250675","DOIUrl":"https://doi.org/10.36660/abc.20250675","url":null,"abstract":"<p><strong>Background: </strong>Primary prevention with an implantable cardioverter-defibrillator (ICD) has become an increasingly debated strategy, with its role in patients with nonischemic heart failure with reduced ejection fraction (HFrEF) undergoing continued reassessment.</p><p><strong>Objective: </strong>To summarize the available scientific evidence on the effectiveness of ICD therapy for primary prevention in patients with nonischemic HFrEF.</p><p><strong>Methods: </strong>A rapid systematic review and meta-analysis was conducted in accordance with the recommendations of the Cochrane Rapid Reviews Methods Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Statistical significance was defined as a two-sided p-value < 0.05. Searches were performed in the MEDLINE, Embase, and CENTRAL databases. Randomized controlled trials (RCTs) evaluating ICD implantation for primary prevention were included, with sudden cardiac death (SCD), cardiovascular mortality, and all-cause mortality as the primary outcomes.</p><p><strong>Results: </strong>A total of 18 publications reporting daata from six pivotal RCTs were included. ICD therapy was associated with a statistically significant reduction in SCD (relative risk [RR] 0.41; 95%CI 0.26-0.65; high-certainty evidence) and cardiovascular mortality (RR 0.75; 95%CI 0.59-0.95; high-certainty evidence). For all-cause mortality, the primary analysis showed no statistically significant difference between groups (RR 0.88; 95%CI 0.72-1.07; moderate-certainty evidence). In the subgroup analysis, studies with shorter follow-up (< 6.8 years) demonstrated a significant reduction in all-cause mortality (RR 0.69; 95%CI 0.52-0.92).</p><p><strong>Conclusion: </strong>In patients with nonischemic HFrEF, ICD therapy reduced SCD and cardiovascular mortality but did not significantly reduce all-cause mortality in the primary analysis. These findings support the use of ICD therapy when guided by individualized clinical assessment.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 7","pages":"20250675"},"PeriodicalIF":1.9,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149302483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Axillary Intra-Aortic Balloon Pump Implantation in Patients Hospitalized with Heart Failure: Initial Brazilian Experience.","authors":"Bruno Alves da Mota Rocha, Pedro H M C de Melo, Luis Mapa, Rafael Nunes Oliveira, Antônio Fernando Freire, Hernán Patricio García Mejía, Vanessa Corcioli Bellini, Liliane Kopel, Silvia Gelás Lage, Fabiana Goulart Marcondes-Braga, Sandrigo Mangini, Monica S Ávila, Iascara Wozniak de Campos, Fernando Bacal, Fábio Sândoli de Brito, Alexandre A Abizaid, Pedro Felipe Gomes Nicz","doi":"10.36660/abc.20250735","DOIUrl":"https://doi.org/10.36660/abc.20250735","url":null,"abstract":"<p><strong>Background: </strong>The intra-aortic balloon pump (IABP) is the most widely used mechanical circulatory support device for patients with advanced heart failure (HF) in our setting. However, femoral implantation restricts patient mobility during support.</p><p><strong>Objective: </strong>To report the initial experience of a Brazilian advanced HF referral center with percutaneous axillary IABP implantation.</p><p><strong>Methods: </strong>Consecutive patients hospitalized for HF who underwent percutaneous axillary IABP implantation at a tertiary cardiology referral center were included. A p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Between December 2020 and December 2023, 22 patients underwent percutaneous axillary IABP implantation. The mean age was 53 ± 10.7 years. All patients were hospitalized with refractory HF and were listed for heart transplantation. The procedure was successfully performed in all patients selected for the axillary approach. The median duration of support was 15 days (interquartile range: 7-28 days). Observed complications included device migration (18.2%), limb ischemia (9.1%), and isolated infectious and neurological events. Half of the patients either underwent heart transplantation or were successfully weaned from mechanical support.</p><p><strong>Conclusion: </strong>The initial experience with percutaneous axillary IABP implantation demonstrated that the technique is feasible, safe, and reproducible. Further studies are needed to establish the role of this strategy within the continuum of care for patients hospitalized with advanced HF while awaiting heart transplantation.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 8","pages":"e20250735"},"PeriodicalIF":1.9,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149302044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond LDL-Cholesterol: Can the Neutrophil-to-HDL-Cholesterol Ratio Capture Residual Inflammatory Risk?","authors":"Henrique Trombini Pinesi, Francisco Akira Malta Cardozo","doi":"10.36660/abc.20260670","DOIUrl":"https://doi.org/10.36660/abc.20260670","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 8","pages":"e20260670"},"PeriodicalIF":1.9,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149303097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the Inflammatory Atherosclerosis Index and Non-Alcoholic Fatty Liver Disease: NHANES 2017-2020.","authors":"Yun Jiang, Jingying Xie, Ying Dong","doi":"10.36660/abc.20260068","DOIUrl":"https://doi.org/10.36660/abc.20260068","url":null,"abstract":"<p><strong>Background: </strong>The Non-alcoholic fatty liver disease (NAFLD) prevalence is increasing globally and is closely associated with dysregulated lipid metabolism and inflammation. However, the relationship between NAFLD and the inflammatory atherosclerosis index (IAI), which reflects these processes, is unclear.</p><p><strong>Objectives: </strong>To investigate the association between IAI and NAFLD in a representative sample of U.S. adults.</p><p><strong>Methods: </strong>This cross-sectional study included 5,309 adults from the U.S. NHANES database. Multivariate weighted logistic regression was used to assess the association between IAI and NAFLD. Restricted cubic splines explored nonlinear relationships, and ROC analysis evaluated diagnostic performance.</p><p><strong>Results: </strong>A total of 5,309 participants were included, of whom 37.6% had NAFLD. Obesity and metabolic abnormalities were more pronounced in the NAFLD group, and IAI levels were significantly higher (P < 0.001). Multivariate analysis demonstrated that IAI was independently and positively associated with NAFLD (OR = 1.538, 95% CI: 1.421-1.665). RCS analysis indicated a nonlinear relationship (P for nonlinearity = 0.0473), with an inflection point at IAI = 0.145. When IAI < 0.145, the risk increased steeply (OR = 2.341, 95% CI: 2.037-2.690), whereas when IAI ≥ 0.145, the increase was attenuated (OR = 1.399, 95% CI: 1.263-1.548). Subgroup analyses showed consistent results, with no significant interactions across subgroups. ROC analysis showed that IAI exhibited the best diagnostic performance (AUC = 0.722), significantly outperforming other indicators (all P < 0.001).</p><p><strong>Conclusions: </strong>Among U.S. adults, IAI demonstrates a strong, positive, and nonlinear association with NAFLD. These findings suggest IAI is a promising population-level marker for NAFLD, though prospective studies are required for validation.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 9","pages":"e20260068"},"PeriodicalIF":1.9,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149302545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Policy on Congenital Heart Disease: Reflections and Proposals for Strengthening Care in Brazil.","authors":"Leonardo Miana, Bistra Zheleva, Juan Pedro Upegui Passos, Renata Mattos, Ana Paula Damiano, Jorge Yussef Afiune, Estela Suzana Kleiman Horowitz, Marcelo Biscegli Jatene","doi":"10.36660/abc.20260225","DOIUrl":"https://doi.org/10.36660/abc.20260225","url":null,"abstract":"<p><strong>Background: </strong>In Brazil, more than 20,000 children are born annually with congenital heart disease, and a significant proportion require surgical or interventional treatment within the first year of life. Despite advances in medical care, substantial inequalities persist in access to timely diagnosis and treatment.</p><p><strong>Objectives: </strong>To describe the evolution of national policies related to congenital heart disease care in Brazil and to discuss strategies for improving the organization and delivery of care within the national public health system.</p><p><strong>Methods: </strong>This is a narrative and documental review based on the analysis of publicly available data, official health policies, and previously published literature addressing congenital heart disease care and health system organization in Brazil.</p><p><strong>Results: </strong>The analysis identified that although multiple national initiatives have been implemented over time, they remain fragmented and have not fully addressed disparities in access to care. Key gaps include deficiencies in regionalization, data collection, workforce training, and system coordination.</p><p><strong>Conclusions: </strong>Congenital heart disease care in Brazil remains marked by structural inequalities and fragmentation of health policies. Strengthening regionalized networks, improving financing strategies, enhancing data systems, and optimizing referral pathways are essential to ensure timely and equitable access to diagnosis and treatment.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 8","pages":"e20260225"},"PeriodicalIF":1.9,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149303145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual Effects of Angiotensin II Receptor Blockers on Major Adverse Cardiovascular Events: A Systematic Review and Network Meta-Analysis.","authors":"Eurico Joaquim Lutucuta Ernesto, Ana Claudia Cavalcante Nogueira, Luis Gustavo Sedenho-Prado, Louise Buonalumi Tácito Yugar, Marília Paiva Martins, Daniel Campos Jesus, Jairo Lins Borges, Wilson Nadruz, Luiz Sérgio F Carvalho, Andrei C Sposito","doi":"10.36660/abc.20260274","DOIUrl":"https://doi.org/10.36660/abc.20260274","url":null,"abstract":"<p><strong>Background: </strong>Angiotensin II receptor blockers (ARBs) antagonize the AT1 receptor and are effective antihypertensives. Modest differences in blood pressure-lowering efficacy have been reported, reflecting variations in pharmacokinetics, receptor binding, duration of action, and potential pleiotropic effects. However, data on their comparative effects on cardiovascular outcomes in patients are scarce.</p><p><strong>Objective: </strong>To assess the effects of ARBs on MACE, hospitalization for heart failure (HHF), and all-cause mortality in randomized trials not primarily designed to evaluate heart failure (HF).</p><p><strong>Methods: </strong>MEDLINE/PubMed, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched until May 2025. Published RCTs reporting major adverse cardiovascular events (MACE), HHF or all-cause death, involving ARBs, with at least 100 individuals per arm and ≥12 months of follow-up, were included. Studies focusing primarily on patients with existing HF were excluded. Incidence rates of HHF, MACE, and all-cause death. A random-effects network meta-analysis including 27 RCTs and 702,584 patient-years was performed.</p><p><strong>Results: </strong>Candesartan reduced MACE versus placebo (OR 0.79; 95% CI, 0.63-0.97; SUCRA=0.85), ranking highest among ARBs, while telmisartan showed a smaller but significant reduction (OR 0.90; 95% CI, 0.80-0.99; SUCRA=0.61). The analysis relied on study-level data; included moderately sparse treatment networks with predominantly indirect comparisons between ARBs.</p><p><strong>Conclusion: </strong>This network meta-analysis in patients without baseline HF indicates that candesartan and telmisartan reduce MACE, suggesting clinically meaningful differences among ARBs. Given the predominantly indirect nature of several comparisons, these findings should be interpreted cautiously.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 9","pages":"e20260274"},"PeriodicalIF":1.9,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149302636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Disparities behind Brazil's Declining Cardiovascular Mortality.","authors":"Aline F Pedroso","doi":"10.36660/abc.20260615","DOIUrl":"https://doi.org/10.36660/abc.20260615","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 8","pages":"e20260615"},"PeriodicalIF":1.9,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149302480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Ejection Fraction: In Pacemaker-Induced Cardiomyopathy, are We Closer to Identifying At-Risk Patients Early?","authors":"Silvia Moreira Ayub-Ferreira, Mabely Teixeira","doi":"10.36660/abc.20260643","DOIUrl":"https://doi.org/10.36660/abc.20260643","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 7","pages":"e20260643"},"PeriodicalIF":1.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capsinoids in Obesity: A Cardiac Risk?","authors":"Leonardo Maciel","doi":"10.36660/abc.20260655","DOIUrl":"https://doi.org/10.36660/abc.20260655","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 6","pages":"e20260655"},"PeriodicalIF":1.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149248022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABC Cardiol 2018-2025: Identity, Impact, and Collective Achievement.","authors":"Carlos Eduardo Rochitte","doi":"10.36660/abc.20260582","DOIUrl":"10.36660/abc.20260582","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"123 9","pages":"e20260582"},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}