Publications by authors named "Joao Antonio Brum Silveira"
Impact of diabetes on epicardial reperfusion and mortality in a contemporary STEMI population undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry.
Nutr Metab Cardiovasc Dis
October 2024
Background And Aim: Diabetes has been shown in last decades to be associated with a significantly higher mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI (PPCI). Therefore, the aim of current study was to evaluate the impact of diabetes on times delays, reperfusion and mortality in a contemporary STEMI population undergoing PPCI, including treatment during the COVID pandemic.
Methods And Results: The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving PPCI centers from Europe, Latin America, South-East Asia and North-Africa, including patients treated from 1st of March until June 30, 2019 and 2020.
Impact of hypertension on mortality in patients with ST-elevation myocardial infarction undergoing primary angioplasty: insights from the international multicenter ISACS-STEMI registry.
J Hypertens
February 2025
Background: Hypertension is the most prevalent cardiovascular risk factor, with several detrimental effects on the cardiovascular system. Contrasting results have been reported so far on its prognostic role in patients admitted for ST-segment elevation myocardial infarction (STEMI). Therefore, we investigated the impact of hypertension on short-term mortality in a large multicenter contemporary registry of STEMI patients, including patients treated during COVID-19 pandemic.
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- * A study involving over 16,600 STEMI patients found a 16% reduction in PPCI procedures in 2020 compared to 2019, with the elderly experiencing the most significant delays.
- * Consequently, there was a notable increase in 30-day mortality rates during the pandemic, particularly among older patients, attributed to longer ischemia times and treatment delays.
Article Synopsis
- The COVID-19 pandemic significantly reduced the number of primary percutaneous coronary interventions (PPCIs) for ST-segment elevation myocardial infarction (STEMI) patients by 16% in 2020 compared to 2019.
- Despite this reduction affecting both genders equally, 30-day mortality rates increased notably for female patients during the pandemic, while male patients did not show a significant change.
- The analysis highlights the importance of addressing gender-specific outcomes in cardiac care during public health crises.
Article Synopsis
- The "smoking paradox" refers to lower mortality rates in smokers among STEMI patients, particularly in the context of modern primary PCI protocols during the COVID-19 pandemic.
- A large retrospective study revealed that among 16,083 STEMI patients, active smokers had better postprocedural blood flow and lower mortality rates compared to both non-smokers and previous smokers.
- The findings suggest that despite initial challenges in treatment, active smoking was linked to improved heart health outcomes in this patient population, indicating the need for further investigation into this unexpected relationship.
Article Synopsis
- - The study examined how SARS-CoV-2 positivity affects outcomes for patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI), using data from the ISACS-STEMI COVID-19 registry.
- - Results showed that SARS-CoV-2 positive patients were older, more likely to experience cardiogenic shock, and had worse post-procedural outcomes, including lower blood flow and increased need for thrombectomy.
- - Importantly, SARS-CoV-2 positivity was linked to higher in-hospital mortality (25.7% vs 7%) and significantly increased 30-day mortality rates (34.4% vs 8.5%), indicating that the virus
Background: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensin-converting-enzyme (ACE)2 and patient's susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment.
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- The study aimed to analyze how the COVID-19 pandemic impacted primary percutaneous coronary intervention (PPCI) procedures and patient outcomes for those with ST elevation myocardial infarction (STEMI) compared to the period before the pandemic.
- It involved a retrospective analysis of data from 16,674 patients across various regions, showing a significant decrease in PPCI procedures during the pandemic (16% reduction) along with increases in treatment delays and mortality rates.
- Findings highlight that older adults were particularly affected, and the increased time to treatment likely contributed to both in-hospital and 30-day mortality rates rising during the pandemic.
Performing elective cardiac invasive procedures during the COVID-19 outbreak: a position statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI).
EuroIntervention
February 2021
The rearrangement of healthcare services required to face the coronavirus disease 2019 (COVID-19) pandemic led to a drastic reduction in elective cardiac invasive procedures. We are already facing a "second wave" of infections and we might be dealing during the next months with a "third wave" and subsequently new waves. Therefore, during the different waves of the COVID-19 pandemic we have to face the problems of how to perform elective cardiac invasive procedures in non-COVID patients and which patients/procedures should be prioritised.
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