Publications by authors named "Raposeiras Roubin Sergio"

Heart transplantation (HT) is the gold standard therapy for advanced heart failure (ADHF), and LVADs as destination therapy are an option in non-HT candidates. Most patients with ADHF never receive HT or an LVAD, so alternative strategies are needed. Intermittent levosimendan can reduce HF hospitalizations in ADHF patients in the short term.

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Introduction Y Objectives: Tako-tsubo syndrome (TTS) is a cardiac condition that mimics acute coronary syndrome, characterized by transient left ventricular dysfunction in the absence of culprit coronary artery stenosis. Although its etiology remains unknown, reversible microvascular dysfunction secondary to an adrenergic surge is thought to play a role. Treatment is empirical, although most patients receive beta-blockers (BB) in clinical practice.

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Amyloidosis is a rare disease that can affect genitourinary organs but the involvement of the prostate has been documented in a limited number of cases. We have reviewed morphologic and immunohistochemical features of prostate biopsies or surgical specimens in which an initial diagnosis of amyloidosis was made. Prostatic amyloidosis was diagnosed in 25 patients, 21 of them were needle biopsies (1.

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Aims: No study has analyzed the impact of guideline-directed medical therapy in preventing heart failure (HF) relapse in patients with arrhythmia-induced cardiomyopathy (AiCM) following left ventricular ejection fraction (LVEF) improvement.

Methods And Results: We analyzed data from a single-center cohort of 200 patients admitted for HF, LVEF <50% and cardiac arrhythmia considered by cardiologists to be the precipitating cause of the episode. The primary endpoint was time-to-HF relapse, defined as the composite of readmission for HF, Emergency Department (ED) visit for HF, or significant decline in LVEF.

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Background: Accurate bleeding risk stratification after percutaneous coronary intervention (PCI) is important for treatment individualization. However, there is still an unmet need for a more precise and standardized identification of high bleeding risk patients. We derived and validated a novel bleeding risk score by augmenting the PRECISE-DAPT score with the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria.

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Background: Cardiogenic shock (CS) complicates Takotsubo syndrome (TTS), significantly affecting patient outcomes. Since avoiding catecholamines, particularly inotropic agents, is recommended in TTS, temporary mechanical circulatory support (MCS) shows promise as a bridge to recovery. However, there is no prospective data on its use in TTS.

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Background: Patients with aortic stenosis may continue to have an increased risk of heart failure, arrhythmias, and death after successful transcatheter aortic valve implantation. Renin-angiotensin system inhibitors may be beneficial in this setting. We aimed to explore whether ramipril improves the outcomes of patients with aortic stenosis after transcatheter aortic valve implantation.

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Article Synopsis
  • Risk scores like MitraScore and COAPT help identify patients with mitral regurgitation (MR) who are at risk of adverse events but may still benefit from transcatheter edge-to-edge repair (TEER).
  • The study validated MitraScore in the COAPT trial with 614 patients and the COAPT risk score in the MIVNUT registry with 1007 patients, both focusing on predicting all-cause mortality over approximately 2 years.
  • Results indicated that both scores had fair to good predictive accuracy for mortality, with higher effectiveness seen in TEER patients, confirming the benefits of combining TEER with guideline-directed medical therapy (GDMT) across different risk levels.
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  • The study investigates whether early intensive lipid-lowering therapy can help achieve lower LDL cholesterol levels in patients who have suffered an acute myocardial infarction (AMI).
  • It evaluates the effectiveness of a combination therapy (high-potency statin, bempedoic acid, and ezetimibe) compared to standard guideline-recommended treatment on patients at risk for high LDL levels.
  • The primary goal is to see if this intensive treatment can lead to at least 33% of patients reaching LDL levels below 55 mg/dL within 8 weeks after their AMI.
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  • Malnutrition significantly impacts the prognosis of patients with secondary mitral regurgitation (SMR), with high rates of moderate to severe malnutrition detected among these patients undergoing transcatheter edge-to-edge repair (TEER).
  • A study involving 658 patients revealed that moderate-severe malnutrition was linked to a higher risk of all-cause mortality and hospitalization due to heart failure, demonstrating its harmful effects on clinical outcomes.
  • The findings suggest that nutritional status should be prioritized in the management and treatment of patients with SMR, as it remains an independent predictor of poor prognosis regardless of other factors.
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  • * Researchers analyzed data from the HOPE-2 registry, examining 2382 patients discharged alive and tracking their mortality and long-term COVID-19 symptoms.
  • * Findings reveal that patients with elevated troponin levels face higher mortality rates and are more likely to experience lasting cardiovascular issues, such as fatigue and dyspnea, after discharge.
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Background: Rate control is the most commonly employed first-line management strategy for atrial fibrillation (AF) in patients with chronic kidney disease (CKD). Principal agents used to control heart rate (HR) include beta-blockers (BB) and nondihydropyridine calcium channel blockers (ND-CCB). However, there is a paucity of published studies of the differences between those drugs in CKD patients.

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Background: Diabetes mellitus (DM) increases the probability of presenting atrial fibrillation (AF) and it is a predictor of its ischemic stroke. There is limited information of the association between glycated hemoglobin (HbA1c) levels and ischemic, embolic or bleeding events in patients with pre-DM and AF.

Methods: To investigate whether the presence of pre-DM in patients with AF predicts ischemic or bleeding events, myocardial infarction or mortality, we performed a retrospective study with a final cohort of 2993 non-diabetic patients with AF and data of glycated hemoglobin (HbA1c).

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Background: Recently, the direct oral anticoagulant (DOAC) score was developed and better predicted major bleeding in DOAC-treated patients with atrial fibrillation (AF) than HASBLED did. Little is known on the new score's performance regarding other bleeding risk in AF.

Methods: We studied 14,672 patients diagnosed with AF between 2014 and 2018.

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Introduction: Data on the association between kidney function and Takotsubo syndrome (TTS) outcomes are scarce and conflictive.

Objective: To assess the impact of chronic kidney disease (CKD) and acute renal failure (ARF) in patients with TTS.

Material And Methods: Patients from the prospective nation-wide (RETAKO) registry were included and divided into quartiles of maximum creatinine (Cr) level during hospitalization.

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Background: Cardiogenic shock (CS) is a significant complication of Takotsubo syndrome (TTS), contributing to heightened mortality and morbidity. Despite this, the Society for Cardiovascular Angiography and Interventions (SCAI) staging system for CS severity lacks validation in patients with TTS and CS. This study aimed to characterize a patient cohort with TTS using the SCAI staging system and assess its utility in cases of TTS complicated by CS.

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Article Synopsis
  • - Takotsubo syndrome (TTS) during the peripartum period is a significant health issue, with unclear prognosis compared to the general TTS population, prompting a study utilizing a nationwide registry.
  • - Analysis showed that peripartum TTS patients commonly experience atypical symptoms like dyspnea, have different echocardiographic findings, and less ST-segment elevation than other TTS patients.
  • - Despite presenting with higher Killip status upon admission, peripartum TTS patients often have good long-term prognoses, even though their conditions are mainly secondary and linked to physical stressors.
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  • The study evaluates the long-term impact of IntraVascular UltraSound (IVUS) on outcomes for patients with Unprotected Left Main (ULM) coronary artery disease undergoing Percutaneous Coronary Intervention (PCI).
  • Conducted across 13 European centers from 2002 to 2015, the research involved 627 patients, comparing those who received IVUS guidance to those who had traditional angiography.
  • Results showed that patients in the IVUS group experienced significantly fewer major adverse cardiovascular events (MACEs), all-cause death, and the need for further revascularization, suggesting that IVUS-guided PCI improves long-term patient outcomes.
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  • Long-term oral anticoagulation is standard for preventing thromboembolic events in patients with atrial fibrillation, but left atrial appendage occlusion (LAAO) may offer a safe alternative for those with very high stroke risk profiles.
  • This study aimed to compare the safety and effectiveness of LAAO versus direct oral anticoagulants (DOACs) in patients with a high CHADS-VASc score (≥ 5), which indicates a higher stroke risk.
  • Results showed that LAAO had a lower incidence of composite cardiovascular events and bleeding compared to DOACs, suggesting it might be a preferable option for high-risk patients.
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Background And Aims: Risk stratification for mitral valve transcatheter edge-to-edge repair (M-TEER) is paramount in the decision-making process to appropriately select patients with severe secondary mitral regurgitation (SMR). This study sought to develop and validate an artificial intelligence-derived risk score (EuroSMR score) to predict 1-year outcomes (survival or survival + clinical improvement) in patients with SMR undergoing M-TEER.

Methods: An artificial intelligence-derived risk score was developed from the EuroSMR cohort (4172 and 428 patients treated with M-TEER in the derivation and validation cohorts, respectively).

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  • The study investigates how gender affects heart remodeling and the risk of heart failure (HF) after acute coronary syndrome (ACS), using data from the CORALYS registry.
  • Among 14,699 patients, 31% were women, who had different health profiles compared to men, showing higher rates of hypertension and diabetes but lower rates of smoking and previous heart attacks.
  • Results indicated that women had a higher incidence of both HF hospitalizations and cardiovascular death, establishing female sex as an independent risk factor for these outcomes after ACS.
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