Cineangiography – ABC CARDIOL

ABC

Case Report

COVID-19 and Acute Coronary Events – Collateral Damage. A Case Report.

Luiz Eduardo Fonteles Ritt et al. Mateus S. Viana Gustavo Freitas Feitosa Adriano Martins de Oliveira … Fabio Solano Souza Eduardo Sahade Darzé

Discussion

Considering the SARS-CoV-2 pandemic, quarantine periods have been declared in several cities in Brazil and worldwide, and people have been instructed to maintain social distancing in order to contain the rapid spread of the virus. Taken to the extreme, fear of becoming infected may result in typical symptoms of ACS being neglected or erroneously attributed to other less probable causes, delaying treatment and imposing avoidable risks to patients’ lives. We report a typical case of ACS in a patient with risk factors for atherosclerotic disease, who, driven by panic related to COVID-19, was unable to recognize the nature of his symptoms, thus delaying his trip to the emergency room until the moment that chest pain became unbearable. Furthermore, also due to concerns related to SARS-CoV-2 infection, the patient suspended use of angiotensin receptor blocker (ARB). In spite of a door-to-balloon time of 57 minutes, as a result of prolonged ischemia time, the patient developed left ventricular systolic dysfunction, albeit asymptomatic.

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IJCS

Original Article

Evaluation of Endothelial Function in Pre-Menopausal Women with Coronary Arterial Disease

Wilma Karlla dos Santos Farias et al. Tania Pavão Oliveira Rocha Jorgileia Braga de Melo Erika Joseth Nogueira da Cruz Fonseca … Darci Ramos Fernandes Leticia Prince Pontes Maria Valneide Gomes Andrade José Albuquerque de Figueiredo Neto

Abstract

Background:

The endothelium plays an important vascular regulatory function. Its dysfunction is an early marker of cardiovascular risk. However, there are few studies in our community that assess endothelial function in pre-menopausal women.

Objective:

To assess endothelial function in pre-menopausal women in the presence or absence of coronary artery disease, using a biophysical method (carotid intima media thickness) and a biochemical method (serum levels of hsCRP).

Methods:

Cross-sectional study that evaluated carotid intima-media thickness and serum levels of hsCRP of 31 pre-menopausal women undergoing coronary angiography at the Hemodynamics Service of Hospital Universitário da Universidade Federal do Maranhão from March 2012 to July 2013. The data were sent to statistical analysis and a statistical significance level of 5% was considered.

Results:

The sample was divided into two groups according to the presence of coronary artery disease (CAD): CAD group (n = 13) and group without CAD (n = 18). The average ages for the groups were 57.92 ± 5.17 and 51.72 ± 4.63 years, respectively (p = 0.001). CIMT was abnormal in 29.03% in the general population. Carotid intima-media thickness was 1.55 ± 0.78 mm in the general group, 1.92 ± 0.94 mm in the CAD group and 1.18 ± 0.71 mm in the group without CAD (p = 0.001). CAD patients had predominance of abnormal CMIT compared those without CAD: 36.46% vs. 22.22%, respectively. There was a sensitivity of 38%, specificity of 77% with a positive predictive value of 0.55 and a negative predictive value of 0.63 with likelihood ratio of 1.73. Patients with abnormal CIMT presented higher levels of hsCRP, but without statistical significance. CAD patients had higher levels of hsCRP, but without statistical significance.

Conclusion:

In the population studied, assessment of endothelial function using the CIMT method showed higher sensitivity and specificity for the diagnosis of CAD compared to the measurement of hsCRP levels in menopausal women.

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ABC

Original Article

Syntax Score and Major Adverse Cardiac Events in Patients with Suspected Coronary Artery Disease: Results from a Cohort Study in a University-Affiliated Hospital in Southern Brazil

Felipe C. Fuchs et al. Jorge P. Ribeiro Flávio D. Fuchs Marco V. Wainstein … Luis C. Bergoli Rodrigo V. Wainstein Vanessa Zen Alessandra C. Kerkhoff Leila B. Moreira Sandra C. Fuchs

Abstract

Background:

The importance of coronary anatomy in predicting cardiovascular events is well known. The use of traditional anatomical scores in routine angiography, however, has not been incorporated to clinical practice. SYNTAX score (SXscore) is a scoring system that estimates the anatomical extent of coronary artery disease (CAD). Its ability to predict outcomes based on a baseline diagnostic angiography has not been tested to date.

Objective:

To evaluate the performance of the SXscore in predicting major adverse cardiac events (MACE) in patients referred for diagnostic angiography.

Methods:

Prospective cohort of 895 patients with suspected CAD referred for elective diagnostic coronary angiography from 2008 to 2011, at a university-affiliated hospital in Brazil. They had their SXscores calculated and were stratified in three categories: no significant CAD (n = 495), SXscore_{LOW-INTERMEDIATE}: < 23 (n = 346), and SXscore_HIGH: ≥ 23 (n = 54). Primary outcome was a composite of cardiac death, myocardial infarction, and late revascularization. Secondary endpoints were the components of MACE and death from any cause.

Results:

On average, patients were followed up for 1.8 ± 1.4 years. The primary outcome occurred in 2.2%, 15.3%, and 20.4% in groups with no significant CAD, SXscore_{LOW-INTERMEDIATE}, and SXscore_HIGH, respectively (p < 0.001). All-cause death was significantly higher in the SXscore_HIGH compared with the ‘no significant CAD’ group, 16.7% and 3.8% (p < 0.001), respectively. After adjustment for confounding factors, all outcomes remained associated with the SXscore.

Conclusions:

SXscore independently predicts MACE in patients submitted to diagnostic coronary angiography. Its routine use in this setting could identify patients with worse prognosis.

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COVID-19 and Acute Coronary Events – Collateral Damage. A Case Report.

Discussion

Evaluation of Endothelial Function in Pre-Menopausal Women with Coronary Arterial Disease

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Syntax Score and Major Adverse Cardiac Events in Patients with Suspected Coronary Artery Disease: Results from a Cohort Study in a University-Affiliated Hospital in Southern Brazil

Abstract

Background:

Objective:

Methods:

Results:

Conclusions:

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