Clinical impact of sex differences and procedural setting in transcatheter aortic valve implantation.

Background: Transcatheter aortic valve implantation (TAVI) is a well-established treatment for symptomatic patients with aortic stenosis. Yet, the impact of sex differences and public vs. private procedural setting on TAVI outcomes remain uncertain.

Learning Curve for In-Hospital Mortality of Transcatheter Aortic Valve Replacement: Insights from the Brazilian National Registry.

Background: Robust data on the learning curve (LC) of transcatheter aortic valve replacement (TAVR) are lacking in developing countries.

Objective: To assess TAVR's LC in Brazil over time.

Methods: We analyzed data from the Brazilian TAVR registry from 2008 to 2023.

In-Hospital influenza vaccination to prevent cardiorespiratory events in the first 45 days after acute coronary syndrome: A prespecified analysis of the VIP-ACS trial.

Background: Influenza vaccination prevents major cardiovascular events in individuals presenting a recent acute coronary syndrome (ACS), however the early effect of an in-hospital double-dose vaccination strategy remains uncertain.

Methods: The VIP-ACS was a randomized, pragmatic, multicenter, open-label trial with a blinded-adjudication endpoint. Patients with ACS ≤ 7 days of hospitalization were randomized to an in-hospital double-dose quadrivalent inactivated influenza vaccine (double-dose) or a standard-dose influenza vaccine at 30 days post-randomization.

Prognostic Assessment of Fractional Flow Reserve in Different Strata in Patients with Coronary Artery Disease.

Background: There are limited real-world data on the clinical course of untreated coronary lesions according to their functional severity.

Objective: To evaluate the 5-year clinical outcomes of patients with revascularized lesions with fractional flow reserve (FFR) ≤ 0.8 and patients with non-revascularized lesions with FFR > 0.

Coronary artery complications after left bundle branch area pacing: An increasingly reported issue in the era of physiologic pacing.

Coronary artery lesions related to pacemaker implantation are rare complications. With the increasing adoption of the technique of permanent transseptal pacing of the left bundle branch area pacing (LBBAP), an increase in the incidence of these complications may be expected. We report two cases of coronary lesions after permanent transeptal pacing of the LBBAP: the first with a small coronary artery fistula, and the second with an extrinsic coronary compression.

Influenza vaccination strategy in acute coronary syndromes: the VIP-ACS trial.

Aims: To evaluate whether a strategy of double-dose influenza vaccination during hospitalization for an acute coronary syndrome (ACS) compared with standard-dose outpatient vaccination (as recommended by current guidelines) would further reduce the risk of major cardiopulmonary events.

Methods And Results: Vaccination against Influenza to Prevent cardiovascular events after Acute Coronary Syndromes (VIP-ACS) was a pragmatic, randomized, multicentre, active-comparator, open-label trial with blinded outcome adjudication comparing two strategies of influenza vaccination following an ACS: double-dose quadrivalent inactivated vaccine before hospital discharge vs. standard-dose quadrivalent inactivated vaccine administered in the outpatient setting 30 days after randomization.

Performance of Prediction Models for Contrast-Induced Acute Kidney Injury after Transcutaneous Aortic Valve Replacement.

Background: Acute kidney injury (AKI) has shown to adversely affect outcomes in patients undergoing transcutaneous aortic valve replacement (TAVR), and its correct risk estimation may interfere in procedural planning and strategies. The aim of the study was to test and compare 6 scores in predicting AKI after TAVR.

Methods: We tested 6 scores (the contrast material limit score, volume-to-creatinine clearance ratio, ACEF, CR4EATME3AD3, Mehran model A, and Mehran model B) in a total of 559 consecutive patients included in the Brazilian TAVR registry.

Improvement of renal function after transcatheter aortic valve replacement in patients with chronic kidney disease.

Background: Chronic kidney disease is commonly found in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and has marked impact in their prognosis. It has been shown however that TAVR may improve renal function by alleviating the hemodynamic barrier imposed by AS. Nevertheless, the predictors of and clinical consequences of renal function improvement are not well established.

Emergency Percutaneous Treatment of Saphenous Vein Graft Perforation After Cardiac Surgery.

Immediately post coronary artery bypass graft surgery, a 58-year-old woman developed excessive bleeding through the chest drains and hemodynamic instability, followed by total atrioventricular block requiring use of temporary pacemaker, which precluded electrocardiographic interpretation. She was referred for urgent diagnostic coronary angiography, which demonstrated important contrast leakage from the distal body of the saphenous vein graft to the first marginal branch. Acute saphenous vein graft perforation following coronary artery bypass graft surgery is rare.

Permanent Pacing After Transcatheter Aortic Valve Implantation: Incidence, Predictors and Evolution of Left Ventricular Function.

Background: Transcatheter aortic valve implantation (TAVI) is a well-established procedure; however, atrioventricular block requiring permanent pacemaker implantation (PPI) is a common complication.

Objectives: To determine the incidence, predictors and clinical outcomes of PPI after TAVI, focusing on how PPI affects left ventricular ejection fraction (LVEF) after TAVI.

Methods: The Brazilian Multicenter TAVI Registry included 819 patients submitted to TAVI due to severe aortic stenosis from 22 centers from January/2008 to January/2015.

First results of the Brazilian Registry of Percutaneous Left Atrial Appendage Closure.

Background: Left atrial appendage closure (LAAC) is an effective alternative to oral anticoagulation (OA) for the prevention of stroke in patients with non-valvular atrial fibrillation (NVAF).

Objective: To present the immediate results and late outcomes of patients submitted to LAAC and included in the Brazilian Registry of Percutaneous Left Atrial Appendage Closure.

Methods: 91 patients with NVAF, high stroke risk (CHA2DS2VASc score = 4.

Association of alcohol consumption with coronary artery disease severity.

Background & Aims: The ingestion of small to moderate alcohol consumption amounts has been associated to cardiovascular protection. This study aimed to evaluate the association between alcohol consumption and coronary artery disease severity.

Material And Methods: Cross-sectional Study with patients undergoing coronary angiography.

Performance of surgical risk scores to predict mortality after transcatheter aortic valve implantation.

Background: Predicting mortality in patients undergoing transcatheter aortic valve implantation (TAVI) remains a challenge.

Objectives: To evaluate the performance of 5 risk scores for cardiac surgery in predicting the 30-day mortality among patients of the Brazilian Registry of TAVI.

Methods: The Brazilian Multicenter Registry prospectively enrolled 418 patients undergoing TAVI in 18 centers between 2008 and 2013.

Determining the influence of Itaipu Lake on thermal conditions for soybean development in adjacent lands.

Previous numerical simulations have suggested that the area adjacent to Itaipu Lake in Southern Brazil is significantly affecting the local thermal regime through development of a lake breeze. This has led to concerns that soybean growth and development, and consequently yield, has been affected by the creation of the artificial lake in this important agricultural region, but a systematic climatological study of the thermal effects of Itaipu Lake has not been conducted. The objectives of this study were to assess the spatial pattern of minimum and maximum air temperatures in a 10-km-wide area adjacent to Itaipu Lake as affected by distance from the water.

Very late outcomes of drug-eluting stents coated with biodegradable polymers: insights from the 5-year follow-up of the randomized PAINT trial.

Background: Few studies have examined the very long-term outcomes after implantation of drug-eluting stents (DES) coated with biodegradable polymers (BP). This report presents the 5-year clinical follow-up of patients treated with BP-DES in the randomized PAINT trial.

Methods: The PAINT study is a prospective, multicenter randomized controlled trial that allocated 274 patients for treatment with two BP-DES formulations [paclitaxel-eluting stents (PES) or sirolimus-eluting stents (SES)] or bare metal stents (BMS) in a 1:2:2 ratio, respectively.

Outcomes and predictors of mortality after transcatheter aortic valve implantation: results of the Brazilian registry.

Objective: The study sought to evaluate outcomes and predictors of mortality after transcatheter aortic valve implantation (TAVI).

Background: TAVI registries can reliably address outcomes and issues that adversely affect results in real-life.

Methods: All endpoints and complications were analyzed according to Valve Academic Research Consortium-2 criteria.

Efficacy and safety of drug-eluting stents in the real world: 8-year follow-up.

Background: Drug-eluting stents have been used in daily practice since 2002, with the clear advantages of reducing the risk of target vessel revascularization and an impressive reduction in restenosis rate by 50%-70%. However, the occurrence of a late thrombosis can compromise long-term results, particularly if the risks of this event were sustained. In this context, a registry of clinical cases gains special value.

Predictors of permanent pacemaker requirement after transcatheter aortic valve implantation: insights from a Brazilian registry.

Background: The aim of this study is to evaluate the predictors of permanent pacemaker (PPM) implantation after TAVI.

Methods: Between January 2008 and February 2012, 418 patients with severe aortic stenosis underwent TAVI and were enrolled in a Brazilian multicenter registry. After excluding patients who died during the procedure and those with a previous PPM, 353 patients were included in the analysis.

Egg consumption and coronary atherosclerotic burden.

Objective: To verify the association between egg consumption and coronary atherosclerotic burden.

Design: Observational study.

Setting: Cardiac catheterization laboratory.

Decrease in coronary flow after consecutive injections of contrast media during coronary angiography.

Background: TIMI frame count (TIMIfc) is widely used to assess coronary flow during angiography and there are studies showing the effects of contrast media on blood cells. In this study, we investigate changes in coronary flow and in red blood cells following contrast injections.

Methods And Results: Coronary flow was assessed by TIMIfc in the left anterior descending and circumflex coronary arteries of patients undergoing elective angiography.

Hydration with sodium bicarbonate does not prevent contrast nephropathy: a multicenter clinical trial.

Background: Radiographic contrast media exposition can cause acute renal function impairment. There is limited and conflicting evidence that hydration with sodium bicarbonate prevents contrast-induced nephropathy (CIN) in patients undergoing cardiac catheterization.

Objective: The present study was aimed at determining whether sodium bicarbonate is superior to hydration with saline to prevent nephropathy in patients at risk undergoing cardiac catheterization.

Association between self-reported oral health, tooth loss and atherosclerotic burden.

Previous studies have suggested that oral diseases may influence the development of atherosclerosis. The aim of this study was to test the hypothesis that poor self-reported oral health (SROH) and tooth loss are positively associated with coronary atherosclerotic burden (CAB). 382 consecutive subjects undergoing coronary angiography were included.

Intravascular ultrasound and pharmacological stress test to evaluate the anomalous origin of the right coronary artery.

The anomalous origin of the right coronary artery is a common finding. With its origin in the left coronary sinus, the right coronary artery can have a route between the aorta and pulmonary artery trunk and can cause myocardial ischemia and sudden death. The anomalous origin of the artery and its route may be diagnosed by coronary angiography or multislice computed tomography.