Cardiologia

Lições de um excelente estudo – Comentário sobre um estudo randomizado recente que testou a oclusão do apêndice atrial esquerdo durante cirurgias cardíacas para prevenir AVC.

9 Nov, 2021 | 12:04h

Lessons from a Superb Clinical Trial – by Dr. John Mandrola

Estudo original: #ACC21 – Practice Changing RCT: In patients with atrial fibrillation (75% maintained on anticoagulation), left atrial appendage occlusion during cardiac surgery reduces the incidence of stroke and systemic embolism (4.8 vs. 7.0%) in the following years.

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Miocardite após vacina de mRNA contra COVID-19: uma série de casos e a determinação das taxas de incidência.

8 Nov, 2021 | 12:41h

Myocarditis Following COVID-19 mRNA Vaccine: A Case Series and Incidence Rate Determination – Clinical Infectious Diseases

Conteúdos relacionados:

Heart-inflammation risk from Pfizer COVID vaccine is very low.

Large cohort study with over 2.5 million individuals showed the incidence of myocarditis after the Pfizer vaccine was 2.13 cases per 100,000 persons.

Study with over 5.1 million vaccinated individuals showed the incidence of myocarditis after the receipt of the Pfizer vaccine was low and more common after the second dose in young male recipients.

Large Observational study shows Pfizer Covid vaccine is mostly safe but is associated with increased risk of myocarditis, adenopathy, appendicitis, and herpes zoster.

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Estudo randomizado | Em pacientes com doença renal crônica avançada e hipertensão mal controlada, a clortalidona teve um impacto significativo no controle da pressão arterial (-11 mmHg vs. -0,5 mmHg no grupo placebo).

8 Nov, 2021 | 12:35h

Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease – New England Journal of Medicine (link para o resumo – $ para o texto completo)

Comentário: Cheap Diuretic, Chlorthalidone, Drops BP in Advanced Kidney Disease – Medscape (necessário cadastro gratuito)

 

Comentário no Twitter

In this placebo-controlled trial involving patients with advanced chronic kidney disease and poorly controlled hypertension, chlorthalidone therapy improved blood-pressure control at 12 weeks as compared with placebo. #KidneyWk https://t.co/iNZc2mYy2c pic.twitter.com/7svX4RVtPI

— NEJM (@NEJM) November 5, 2021

 

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Em pacientes com fibrilação atrial, os desfechos de 4 anos do estudo randomizado PRAGUE-17 mostraram que o fechamento do apêndice atrial esquerdo foi não inferior a anticoagulação oral para prevenir eventos isquêmicos e hemorrágicos.

8 Nov, 2021 | 12:30h

Left Atrial Appendage Closure versus Non-Warfarin Oral Anticoagulation in Atrial Fibrillation: 4-Year Outcomes of PRAGUE-17 – Journal of the American College of Cardiology (link para o resumo – $ para o texto completo)

Comentários:

PRAGUE-17: LAA Occlusion Noninferior to DOACs Over Longer Term – TCTMD

PRAGUE-17: LAAC Noninferior to NOACs For Major AFib-Related CV, Neurological Events Longer-Term – American College of Cardiology

Left Atrial Appendage Closure vs. Novel Anticoagulation Agents in High-Risk Atrial Fibrillation Patients – PRAGUE-17 – American College of Cardiology

 

Comentário no Twitter

📌 The PRAGUE-17 trial showed that left atrial appendage occlusion was noninferior to a #NOAC at preventing net ischemic & bleeding events. Check out ACC’s Visual Abstract from #TCT2021 to learn more here: https://t.co/NTVc4wpH6W pic.twitter.com/9EBWRvs72O

— American College of Cardiology (@ACCinTouch) November 6, 2021

 

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Novo estudo desafia a ideia de que um escore de cálcio de zero seja suficiente para descartar obstrução coronariana em pacientes sintomáticos, sobretudo em adultos jovens.

8 Nov, 2021 | 12:25h

Association of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients – JAMA Cardiology (link para o resumo – $ para o texto completo)

Comentário: Zero CAC Questionable for Ruling Out Obstructive CAD in Young Adults – TCTMD

 

Comentário do autor no Twitter (fio – clique para saber mais)

There has been a lot of discussion about our recent paper in JAMA Cardiology. In my opinion, much of the discussion is caused by a troublesome extrapolation of the results to the value of CAC in risk assessment in primary prevention. I will go through our findings in these tweets https://t.co/O0Rl12XYmV

— Martin Bødtker Mortensen (@MaBMortensen) November 1, 2021

 

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Estudo randomizado | Em pacientes com doença arterial coronariana de 3 vasos, uma estratégia de intervenção coronariana percutânea guiada por reserva de fluxo fracionada (fractional flow reserve – FFR) NÃO mostrou resultados comparáveis à cirurgia de revascularização do miocárdio – A incidência de 1 ano do desfecho primário composto (morte, infarto miocárdico ou AVC) foi de 7,3% no grupo de intervenção percutânea e de 5,2% no grupo cirúrgico.

5 Nov, 2021 | 17:11h

Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery – New England Journal of Medicine

Comentários:

FAME 3: PCI Fails to Demonstrate Noninferiority to Surgery in Three-Vessel CAD – TCTMD

FAME 3: FFR-Guided PCI vs. CABG in Patients With Three-Vessel CAD – American College of Cardiology

Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3 – FAME 3 – American College of Cardiology

 

Comentário no Twitter

In this trial, patients with three-vessel coronary artery disease, PCI guided by assessment of fractional flow reserve was not noninferior to CABG with respect to the composite end point of death, myocardial infarction, stroke, or repeat revascularization. https://t.co/uYZGZWub0T pic.twitter.com/zsghs2SlsA

— NEJM (@NEJM) November 4, 2021

 

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M-A | Denervação renal para hipertensão está associada com modesta redução no controle ambulatorial da pressão arterial (redução de 3,61 mmHg na pressão arterial sistólica e de 1,85 mmHg na pressão arterial diastólica).

5 Nov, 2021 | 17:07h

Renal Denervation for Hypertension: A Systematic Review and Meta-Analysis of Randomized, Blinded, Placebo-Controlled Trials – JACC: Cardiovascular Interventions

Comentários:

Meta-Analysis of Renal Denervation for Hypertension – American College of Cardiology

Is Renal Denervation a Useful Strategy in BP Management? – American College of Cardiology

Conteúdos relacionados:

#ACC21 – RCT: Among patients with resistant hypertension, ultrasound renal denervation resulted in a modest improvement in systolic BP (–4.5 mm Hg) vs. sham procedure.

Meta-Analysis: Sham-Controlled Randomized Trials of Catheter-Based Renal Denervation in Patients with Hypertension

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Dissecção espontânea de artéria coronária: princípios do tratamento.

4 Nov, 2021 | 11:52h

Spontaneous coronary artery dissection: Principles of management – Cleveland Clinic Journal of Medicine

Conteúdos relacionados:

Spontaneous Coronary Artery Dissection: Pitfalls of Angiographic Diagnosis and an Approach to Ambiguous Cases.

Spontaneous Coronary Artery Dissection: Clinical Considerations in Diagnosis and Treatment

Review: Spontaneous Coronary Artery Dissections and Associated Predisposing Factors

Study: Natural History of Spontaneous Coronary Artery Dissection

Spontaneous Coronary Artery Dissection: An Often Unrecognized Cause of Acute Coronary Syndrome

ESC position paper on spontaneous coronary artery dissection

Guideline: Spontaneous Coronary Artery Dissection

Study: Spontaneous Coronary Artery Dissection: Clinical Outcomes and Risk of Recurrence

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Revisão | Lesão cardíaca na Covid-19.

3 Nov, 2021 | 11:10h

Cardiac injury in COVID-19 – Intensive Care Medicine

 

Comentário no Twitter

Myocardial injury in #COVID19, many potential mechanisms:
🫀myocardial DO2/VO2 imbalance
🫀ARDS & MV
🫀cytokine storm
🫀direct viral lesion.
Variable clinical presentations, with high complications rates, mortality & risk of long-term cardiac impairment.https://t.co/wxPDDrtEoY pic.twitter.com/vOx1B4cwY2

— Intens Care Med (@yourICM) November 2, 2021

 

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Diretriz Científica AHA | Guia de orientação nutricional 2021 para melhorar a saúde cardiovascular.

3 Nov, 2021 | 11:09h

2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association – Circulation

Comunicado de imprensa: New look at nutrition research identifies 10 features of a heart-healthy eating pattern – American Heart Association

Principais tópicos a saber: 2021 Dietary Guidance to Improve Cardiovascular Health – American Heart Association

Comentários:

‘Balance’ is the key word in new dietary guidance for heart health – American Heart Association

The new American Heart Association dietary guidance to improve population-level cardiometabolic health: moving toward a heart-healthy food environment – American Heart Association

 

Comentário no Twitter

CHOOSE MINIMALLY PROCESSED FOODS INSTEAD OF ULTRA-PROCESSED FOODS is one of the 10 evidence-based dietary pattern recommendations in the new excellent 2021 American Heart Association Scientific Statement on Dietary Guidance to Improve Cardiovascular Healthhttps://t.co/YgtDKz05EP

— Carlos A. Monteiro (@CMonteiro_USP) November 2, 2021

 

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