Publications by authors named "M-A Lopes"
Electrophysiological Phenotype-Genotype Study of Sustained Monomorphic Ventricular Tachycardia in Inherited, High Arrhythmic Risk, Left Ventricular Cardiomyopathy.
Circ Arrhythm Electrophysiol
December 2024
Background: Among inherited cardiomyopathies involving the left ventricle, whether dilated or not, certain genotypes carry a well-established arrhythmic risk, notably manifested as sustained monomorphic ventricular tachycardia (SMVT). Nonetheless, the precise localization and electrophysiological profile of this substrate remain undisclosed across different genotypes.
Methods: Patients diagnosed with cardiomyopathy and left ventricle involvement due to high-risk genetic variants and SMVT treated by electrophysiological study were recruited from 18 European/US centers.
Background: In the ARTESiA trial (Apixaban for the Reduction of Thromboembolism in Patients With Device-Detected Subclinical Atrial Fibrillation), apixaban, compared with aspirin, reduced stroke or systemic embolism in patients with device-detected subclinical atrial fibrillation (SCAF). Clinical guidelines recommend considering SCAF episode duration when deciding whether to prescribe oral anticoagulation for this population.
Methods: We performed a retrospective cohort study in ARTESiA.
Background: Stroke prevention with direct-acting oral anticoagulant agents in patients with atrial fibrillation confers a risk of bleeding and limits their use. Asundexian, an activated factor XI (XIa) inhibitor, is an oral anticoagulant that may prevent strokes with less bleeding.
Methods: In a phase 3, international, double-blind trial, we randomly assigned high-risk patients with atrial fibrillation in a 1:1 ratio to receive asundexian at a dose of 50 mg once daily or standard-dose apixaban.
Background: The MINT trial (Myocardial Ischemia and Transfusion) raised concern for harm from a restrictive versus liberal transfusion strategy in patients with acute myocardial infarction (MI) and anemia. Type 1 and type 2 MI are distinct pathophysiologic entities that may respond differently to blood transfusion. This analysis sought to determine whether the effects of transfusion varied among patients with a type 1 or a type 2 MI and anemia.
View Article and Find Full Text PDFBackground: Results from the COORDINATE-Diabetes trial (Coordinating Cardiology Clinics Randomized Trial of Interventions to Improve Outcomes - Diabetes) demonstrated that a multifaceted, clinic-based intervention increased prescription of evidence-based medical therapies to participants with type 2 diabetes and atherosclerotic cardiovascular disease. This secondary analysis assessed whether intervention success was consistent across sex, race, and ethnicity.
Methods: COORDINATE-Diabetes, a cluster randomized trial, recruited participants from 43 US cardiology clinics (20 randomized to intervention and 23 randomized to usual care).
Targeted proteomic profiling of cardiogenic shock in the cardiac intensive care unit.
Eur Heart J Acute Cardiovasc Care
August 2024
Article Synopsis
- The study aimed to identify protein biomarkers linked to cardiogenic shock (CS) using advanced proteomic profiling techniques.
- It involved analyzing samples from 239 cardiac patients, determining that 63 biomarkers were significantly related to CS, with nine remaining consistent across different patient subsets.
- The researchers concluded that specific biomarkers could enhance the diagnosis of CS and proposed a multi-marker model incorporating key proteins for future use.
Article Synopsis
- Patients with chronic kidney disease (CKD) are at a higher risk of being hospitalized for heart failure, especially when treated with daprodustat compared to the conventional drug darbepoetin, although the difference isn't statistically significant.
- The study analyzed data from two trials, ASCEND-D and ASCEND-ND, focusing on how daprodustat impacts heart failure hospitalization rates among CKD patients with and without dialysis.
- Key risk factors for heart failure hospitalizations included a history of heart failure, diabetes, and higher blood pressure, but the increase in hospitalizations attributed to daprodustat compared to conventional treatments wasn't statistically conclusive.
Background: Device-detected atrial fibrillation (also known as subclinical atrial fibrillation or atrial high-rate episodes) is a common finding in patients with an implanted cardiac rhythm device and is associated with an increased risk of ischemic stroke. Whether oral anticoagulation is effective and safe in this patient population is unclear.
Methods: We performed a systematic review of MEDLINE and Embase for randomized trials comparing oral anticoagulation with antiplatelet or no antithrombotic therapy in adults with device-detected atrial fibrillation recorded by a pacemaker, implantable cardioverter defibrillator, cardiac resynchronization therapy device, or implanted cardiac monitor.
Article Synopsis
- A study compared two blood transfusion strategies for patients with myocardial infarction and low hemoglobin: a restrictive strategy (transfusion if hemoglobin <7 or 8 g/dL) and a liberal strategy (transfusion if hemoglobin <10 g/dL).
- Involving 3,504 patients, results showed that the liberal group received significantly more transfusions but did not experience a reduced risk of death or recurrent myocardial infarction at 30 days compared to the restrictive group.
- The findings suggest that while the liberal strategy may not improve outcomes, the potential risks of the restrictive strategy remain uncertain, indicating the need for further research.
Background: Subclinical atrial fibrillation is short-lasting and asymptomatic and can usually be detected only by long-term continuous monitoring with pacemakers or defibrillators. Subclinical atrial fibrillation is associated with an increased risk of stroke by a factor of 2.5; however, treatment with oral anticoagulation is of uncertain benefit.
View Article and Find Full Text PDFBackground: The incidence of lung cancer in the US has been decreasing but a bigger decline has been observed in men despite similar declines in tobacco use between men and women. Multiple theories have been proposed, including exposure to exogenous estrogens. Our study seeks to understand the relationship between hormone receptors (HR), gender, and the genomic landscape of non-small lung cancer (NSCLC).
View Article and Find Full Text PDFPrognostic significance of haemodynamic parameters in patients with cardiogenic shock.
Eur Heart J Acute Cardiovasc Care
October 2023
Article Synopsis
- Invasive haemodynamic assessment using a pulmonary artery catheter is important for managing patients with cardiogenic shock (CS) and understanding their prognosis.
- A study analyzed data from a multicenter registry involving patients with CS to find relationships between their haemodynamic parameters and outcomes like in-hospital mortality and end-organ dysfunction.
- Key findings indicated that lower mean arterial pressure, lower systolic blood pressure, and other specific haemodynamic metrics were linked to worse outcomes and higher serum lactate levels, suggesting severe circulatory issues.
Introduction And Hypothesis: Collagen is a protein that confers robustness and resilience to several tissues. In the female reproductive system, collagen plays a critical role in maintaining the health and function of the vaginal walls. Aging leads to collagen reduction, which may cause vaginal dryness, irritation, and prolapse.
View Article and Find Full Text PDFIn the context of relapsed and refractory childhood pre-B cell acute lymphoblastic leukemia (R/R B-ALL), CD19-targeting chimeric antigen receptor (CAR)-T cells often induce durable remissions, which requires the persistence of CAR-T cells. In this study, we systematically analyzed CD19 CAR-T cells of 10 children with R/R B-ALL enrolled in the CARPALL trial via high-throughput single-cell gene expression and T cell receptor sequencing of infusion products and serial blood and bone marrow samples up to 5 years after infusion. We show that long-lived CAR-T cells developed a CD4/CD8 double-negative phenotype with an exhausted-like memory state and distinct transcriptional signature.
View Article and Find Full Text PDFHilab System Device in an Oncological Hospital: A New Clinical Approach for Point of Care CBC Test, Supported by the Internet of Things and Machine Learning.
Diagnostics (Basel)
May 2023
The complete blood count (CBC) is a highly requested test that is generally restricted to centralized laboratories, which are limited by high cost, being maintenance-demanding, and requiring costly equipment. The Hilab System (HS) is a small, handheld hematological platform that uses microscopy and chromatography techniques, combined with machine learning (ML) and artificial intelligence (AI), to perform a CBC test. This platform uses ML and AI techniques to add higher accuracy and reliability to the results besides allowing for faster reporting.
View Article and Find Full Text PDFArticle Synopsis
- Atrial fibrillation (AF) is a major contributor to ischemic stroke, which greatly impacts health and mortality rates, especially as the aging population grows.
- There are various stroke prevention methods available, yet significant questions persist regarding the best strategies for both broader populations and individual patients in managing AF.
- The National Heart, Lung, and Blood Institute workshop highlighted research areas for improvement, including risk assessment tools, challenges related to oral anticoagulants, and the effectiveness of different left atrial appendage closure techniques in stroke prevention for AF patients.
Background: Iron content is increased in the substantia nigra of persons with Parkinson's disease and may contribute to the pathophysiology of the disorder. Early research suggests that the iron chelator deferiprone can reduce nigrostriatal iron content in persons with Parkinson's disease, but its effects on disease progression are unclear.
Methods: We conducted a multicenter, phase 2, randomized, double-blind trial involving participants with newly diagnosed Parkinson's disease who had never received levodopa.
Article Synopsis
- High-risk cardiac surgery often leads to low cardiac output syndrome (LCOS), which significantly increases mortality rates.
- The LEVO-CTS trial assessed the effectiveness of levosimendan compared to a placebo in patients with reduced heart function undergoing heart surgeries, identifying risk factors for LCOS and its impact on survival rates.
- Results showed that factors like lower pre-operative heart function and older age raise LCOS risk, while isolated CABG surgery and levosimendan use lower the risk; patients with LCOS faced much higher rates of complications and mortality.
Background: Thrombotic events are reduced with cangrelor, an intravenous P2Y inhibitor. We sought to characterize the timing, number, and type of early events (within 2 hours of randomization) in CHAMPION PHOENIX (A Clinical Trial Comparing Cangrelor to Clopidogrel Standard of Care Therapy in Subjects Who Require Percutaneous Coronary Intervention).
Methods: CHAMPION PHOENIX was a double-blind, placebo-controlled trial that randomized patients undergoing percutaneous coronary intervention to cangrelor or clopidogrel.
Multiple sodium glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to impart significant cardiovascular and kidney benefits, but are underused in clinical practice. Both SGLT-2i and GLP-1RA were first studied as glucose-lowering drugs, which may have impeded uptake by cardiologists in the wake of proven cardiovascular efficacy. Their significant effect on cardiovascular and kidney outcomes, which are largely independent of glucose-lowering effects, must drive a broader use of these drugs.
View Article and Find Full Text PDFClinically recognized atrial fibrillation (AF) is associated with higher risk of complications, including ischemic stroke, cognitive decline, heart failure, myocardial infarction, and death. It is increasingly recognized that AF frequently is undetected until complications such as stroke or heart failure occur. Hence, the public and clinicians have an intense interest in detecting AF earlier.
View Article and Find Full Text PDFBackground: The effects of rivaroxaban in patients with atrial fibrillation and a bioprosthetic mitral valve remain uncertain.
Methods: In this randomized trial, we compared rivaroxaban (20 mg once daily) with dose-adjusted warfarin (target international normalized ratio, 2.0 to 3.