Initial experience with orbital atherectomy in a non-surgical center in Portugal.

Introduction And Objectives: Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with a higher risk of procedural complications, suboptimal stent expansion, and in-stent restenosis. Lesion preparation with orbital atherectomy (OA) in severely calcified lesions has been shown to increase procedural success and decrease reintervention rates. In this study, we sought to report the procedural safety and efficacy of our initial experience with OA in a non-surgical center in Portugal.

Ionizing radiation exposure in complex percutaneous coronary intervention: Defining local diagnostic reference levels in the catheterization laboratory.

Introduction And Objectives: Concerns regarding the consequences of ionizing radiation (IR) have been increasing in the field of interventional cardiology (IC). There is little information on reported national and local radiation diagnostic reference levels (DRLs) in catheterization laboratories in Portugal. This study was designed to assess the IR dose exposure during complex percutaneous coronary intervention (PCI), and to set the respective DRLs and future achievable doses (ADs).

Clinical results of percutaneous coronary intervention in chronic total occlusions of the right coronary artery.

Introduction And Objectives: Coronary chronic total occlusions (CTOs) of the right coronary artery (RCA) are a relatively common finding in the context of coronary angiography. However, the benefit of revascularization remains controversial.

Methods: A single-center retrospective cohort analysis prospectively collected outcomes of CTO patients undergoing percutaneous coronary intervention (PCI) in 2019 and 2020.

Clinical outcomes of percutaneous coronary intervention in chronic total occlusion in patients with type 2 diabetes mellitus.

Introduction And Objectives: Coronary chronic total occlusions (CTOs) are relatively common findings in patients with type 2 diabetes mellitus (T2DM). However, the indication for percutaneous coronary intervention (PCI) and its clinical benefit in these patients remain controversial.

Methods: A single-center retrospective cohort study with prospectively collected outcomes was carried out with CTO patients undergoing PCI in 2019 and 2020.

Pretreatment antithrombotic strategies in non-ST elevation acute coronary syndromes in contemporaneous clinical practice.

Background: Pretreatment antithrombotic strategies in non-ST elevation acute coronary syndromes (NSTE-ACS) during hospitalization is still a matter of contention within the cardiology community. Our aim was to analyze in-hospital and one-year follow-up outcomes of patients with NSTE-ACS pretreated with dual antiplatelet therapy (DAPT) versus single antiplatelet therapy (SAPT).

Methods: A retrospective study was carried out with NSTE-ACS patients who planned to undergo an invasive strategy and were included in the Portuguese Registry of ACS between 2018 and 2021.

Care of patients with ST-elevation myocardial infarction: an international analysis of quality indicators in the acute coronary syndrome STEMI Registry of the EURObservational Research Programme and ACVC and EAPCI Associations of the European Society of Cardiology in 11 462 patients.

Aims: To use quality indicators to study the management of ST-segment elevation myocardial infarction (STEMI) in different regions.

Methods And Results: Prospective cohort study of STEMI within 24 h of symptom onset (11 462 patients, 196 centres, 26 European Society of Cardiology members, and 3 affiliated countries). The median delay between arrival at a percutaneous cardiovascular intervention (PCI) centre and primary PCI was 40 min (interquartile range 20-74) with 65.

Premature acute coronary syndrome: understanding the early onset.

Introduction: Acute coronary syndrome (ACS) is less frequent in young adults, but it has become a significant health problem, associated with the increasing prevalence of modifiable risk factors.

Objectives: To characterize patients admitted with premature ACS, comparing with those with nonpremature ACS.

Methods: We performed a retrospective study encompassing patients of the Portuguese Registry (ProACS), comparing two groups: one composed of men less than 55 and women less than 65 years old; and other with men ≥55 and women ≥65 years old at the ACS admission.

Reperfusion therapies and in-hospital outcomes for ST-elevation myocardial infarction in Europe: the ACVC-EAPCI EORP STEMI Registry of the European Society of Cardiology.

Aims: The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI).

Methods And Results: Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset <24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.

P2Y inhibitor loading dose before catheterization in ST-segment elevation myocardial infarction: Is this the best strategy?

Introduction And Objectives: In ST-segment elevation myocardial infarction (STEMI) the benefit of dual antiplatelet therapy is unequivocal, but the optimal time to administer the loading dose (LD) of a P2Y inhibitor is the subject of debate and disagreement. The main aim of this study was characterize current practice in Portugal and to assess the prognostic impact of P2Y inhibitor LD administration strategy, before versus during or after primary percutaneous coronary intervention (PCI).

Methods: This multicenter retrospective study based on the Portuguese National Registry on Acute Coronary Syndromes included patients with STEMI and PCI performed between October 1, 2010 and September 19, 2017.

One aneurysm and two pseudoaneurysms, same patient.

Ventricular pseudoaneurysms are rare pathological entities that mainly arise in the context of myocardial infarction or post-cardiac surgery. The clinical presentation is usually non-specific, and at times patients are asymptomatic. Mortality is high even with timely surgical intervention.

CRUSADE: Is it still a good score to predict bleeding in acute coronary syndrome?

Introduction: Major bleeding is a serious complication of acute coronary syndrome (ACS) and is associated with a worse prognosis. The CRUSADE bleeding score is used to stratify the risk of major bleeding in ACS.

Objective: To assess the predictive ability of the CRUSADE score in a contemporary ACS population.

Portuguese Registry of Acute Coronary Syndromes (ProACS): 15 years of a continuous and prospective registry.

The Portuguese Registry of Acute Coronary Syndromes (ProACS) has completed 15 years of continuous and prospective activity. We present an overall picture of the data from this powerful tool. Up to 2016, 45 141 records were included, mostly male (71%), and with a mean age of 66 years.

Awareness of Fabry disease in cardiology: A gap to be filled.

Introduction: In adults, unexplained left ventricular hypertrophy is usually due to sarcomeric hypertrophic cardiomyopathy (HCM). Fabry disease (FD) is rare but may mimic sarcomeric HCM, and has an adverse prognosis in the absence of specific treatment. We aimed to assess cardiologists' awareness of FD based on data from the Portuguese Registry of Hypertrophic Cardiomyopathy.

Factors influencing patient delay before primary percutaneous coronary intervention in ST-segment elevation myocardial infarction: The Stent for life initiative in Portugal.

Introduction And Aims: Shorter patient delays are associated with a better prognosis for patients diagnosed with ST-segment elevation myocardial infarction (STEMI). This study aimed to identify predictors of patient delay in the Portuguese population.

Methods: Data on 994 patients with suspected STEMI of less than 12 hours' duration and referred for primary percutaneous coronary intervention (pPCI) and admitted to 18 Portuguese interventional cardiology centers were collected for a one-month period every year from 2011 to 2015.

Assessment of quality performance measures in patients with acute coronary syndromes: Data from the Portuguese Registry of Acute Coronary Syndromes (ProACS), a nationwide registry.

Rational, Aims, And Objectives: Registries are a powerful tool to assess specific performance measurements and quality of care in acute coronary syndromes (ACSs). In Portugal, ProACS is a nationwide registry of ACS that has been active for the past 15 years, and our objective was to assess specific quality indicators for the treatment of ACS.

Methods: Descriptive analysis of data from ProACS registry in specific quality indicators previously defined by international scientific societies.