Publications by authors named "Sergio-Bravo Baptista"
Background: Age-related remodelling has the potential to affect the microvascular response to hyperemic stimuli. However, its precise effects on the vasodilatory response to adenosine and contrast medium, as well as its influence on fractional flow reserve (FFR) and contrast fractional flow reserve (cFFR), have not been previously investigated. We investigate the impact of age on these indices.
View Article and Find Full Text PDFAtherosclerotic cardiovascular disease (ASCVD) remains the major cause of premature death and disability; effective cardiovascular (CV) risk prevention is fundamental. The World Heart Federation (WHF) Cholesterol Roadmap provides a framework for national policy development and aims to achieve ASCVD prevention. At the invitation of the WHF, a group of experts from the Portuguese Society of Cardiology (SPC), addressed the cholesterol burden at nationally and discussed possible strategies to include in a Portuguese cholesterol roadmap.
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- Clinical events can occur after percutaneous coronary intervention (PCI), especially in complex cases, and using advanced intracoronary imaging and pressure guidewires may help reduce these risks.
- The OPTI-XIENCE study is an international, multicenter prospective observational study involving 1,064 patients with specific high-risk characteristics undergoing stent implantation, monitoring them for 12 months.
- The study aims to evaluate the effectiveness of using these intracoronary tools, with the primary focus on the rate of target lesion failure after one year, while also assessing additional cardiovascular outcomes.
Introduction And Objective: Several scoring systems have been developed for risk stratification in patients with acute pulmonary embolism (PE). The Pulmonary Embolism Severity Index (PESI) and its simplified version (sPESI) are among the most used, however the high number of variables hinder its application. Our aim was to derive an easy-to-perform score based on simple parameters obtained at admission to predict 30-day mortality in acute PE patients.
View Article and Find Full Text PDFGlobal warming is a result of the increased emission of greenhouse gases. The consequences of this climate change threaten society, biodiversity, food and resource availability. The consequences include an increased risk of cardiovascular (CV) disease and cardiovascular mortality.
View Article and Find Full Text PDFAir pollution is one of the main environmental risk factors for health and is linked to cardiovascular diseases, which are the leading cause of mortality worldwide. In this position paper, we discuss the main air pollutants and how they can promote the development of cardiovascular disease or cardiovascular events. We also summarise the main evidence supporting the association between air pollution and cardiovascular events, such as coronary events (acute coronary syndromes/myocardial infarction; chronic coronary syndromes), stroke, heart failure and mortality.
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- - Kounis syndrome is an acute coronary syndrome triggered by hypersensitivity reactions, leading to issues like coronary artery spasm and stent thrombosis due to mast-cell activation.
- - A case is presented of a man who experienced a heart attack 20 minutes after receiving the COVID-19 vaccine, which was linked to previous reactions after an influenza vaccine, both containing polysorbate 80.
- - This case highlights the importance of recognizing Kounis syndrome, especially as it can be life-threatening and often goes undiagnosed, emphasizing the need for proper diagnosis and future drug avoidance.
Introduction And Objectives: Use of invasive physiological assessment in patients with coronary artery disease varies widely and is perceived to be low. We aimed to examine adoption rates as well as patterns and determinants of use in an unselected population undergoing invasive coronary angiography over a long time frame.
Methods: We retrospectively determined the per-procedure prevalence of physiological assessment in 40821 coronary cases performed between 2007 and 2018 in two large-volume centers.
Introduction And Objectives: Use of invasive physiological assessment in patients with coronary artery disease varies widely and is perceived to be low. We aimed to examine adoption rates as well as patterns and determinants of use in an unselected population undergoing invasive coronary angiography over a long time frame.
Methods: We retrospectively determined the per-procedure prevalence of physiological assessment in 40821 coronary cases performed between 2007 and 2018 in two large-volume centers.
Background: The influence of age-dependent changes on fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) and the response to pharmacological hyperaemia has not been investigated.
Aims: We investigated the impact of age on these indices.
Methods: This is a post hoc analysis of the ADVISE II trial, including a total of 690 pressure recordings (in 591 patients).
The third generation of drug-eluting stents: Reassuring data while we wait for the next one.
Rev Port Cardiol (Engl Ed)
February 2021
Objective: To evaluate agreement between instantaneous wave free ratio (iFR) and fractional flow reserve (FFR) for the functional assessment of nonculprit coronary stenoses at staged follow-up after ST-segment elevation myocardial infarction (STEMI).
Results: We measured iFR and FFR at staged follow-up in 112 STEMI patients with 146 nonculprit stenoses. Median interval between STEMI and follow-up was 16 (interquartile range 5-32) days.
Eligibility for extended antithrombotic therapy for secondary prevention of acute coronary syndrome.
Rev Port Cardiol (Engl Ed)
September 2020
Introduction And Objectives: Recent randomized controlled trials have evaluated the benefit of extended antithrombotic therapy in secondary prevention of acute coronary syndrome (ACS). However, the numerous and strict enrollment criteria may limit the validity and reproducibility of the published results in clinical practice. Our goal was to estimate the eligibility for participation in two randomized clinical trials in a group of patients followed for ACS.
View Article and Find Full Text PDFBackground: Intracoronary physiology is increasingly used in nonculprit stenoses of patients with acute coronary syndromes (ACS). However, evidence regarding the safety of fractional flow reserve-based deferral in patients with ACS, compared with patients with stable angina pectoris (SAP), is scarce.
Objectives: The aim of this study was to evaluate the safety of revascularization deferral on the basis of fractional flow reserve interrogation of nonculprit lesions in patients with ACS.
Nonculprit lesions are frequently observed in patients with ST-segment elevation myocardial infarction. Results from recent randomized clinical trials suggest that complete revascularization after ST-segment elevation myocardial infarction improves outcomes. In this state-of-the-art paper, the authors review these trials and consider how best to determine which nonculprit lesions require revascularization and when this should be performed.
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- The study investigates different cutoff values for the instantaneous wave-free ratio (iFR) in assessing nonculprit stenoses in patients with ST-segment elevation myocardial infarction.
- It found that an iFR cutoff value of <0.90 is most effective for determining hemodynamic significance, showing high negative predictive value, especially at higher iFR thresholds.
- These results suggest that using iFR <0.90 provides the best classification agreement between acute and follow-up assessments of nonculprit stenoses in this patient population.
Importance: Approximately one-third of patients considered for coronary revascularization have diabetes, which is a major determinant of clinical outcomes, often influencing the choice of the revascularization strategy. The usefulness of fractional flow reserve (FFR) to guide treatment in this population is understudied and has been questioned.
Objective: To evaluate the usefulness and rate of major adverse cardiovascular events (MACE) of integrating FFR in management decisions for patients with diabetes who undergo coronary angiography.
Article Synopsis
- The study aims to identify factors that lead to differences between the instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) in patients undergoing coronary revascularization.
- Although iFR is generally comparable to the more established FFR, there is a 20% rate of discordance, prompting the need for further analysis of the causes.
- Key predictors of discordance include factors like the location and severity of stenosis, patient age, heart rate, and whether the patient is using beta-blockers, which should all be considered when evaluating iFR results.
Objectives: The aim of this study was to examine the level of agreement between acute instantaneous wave-free ratio (iFR) measured across nonculprit stenoses in patients with ST-segment elevation myocardial infarction (STEMI) and iFR measured at a staged follow-up procedure.
Background: Acute full revascularization of nonculprit stenoses in STEMI is debated and currently guided by angiography. Acute functional assessment of nonculprit stenoses may be considered.