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  2. Keyword: Myocardial Ischemia / physiopathology
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Original Article

Creation and Implementation of a Prospective and Multicentric Database of Patients with Acute Myocardial Infarction: RIAM

Jacqueline Vaz et al. Anibal Pereira Abelin Marcia Moura Schmidt Pedro Piccaro de Oliveira … Carlos A. M. Gottschall Clarissa Garcia Rodrigues Alexandre Schaan de Quadros

Abstract

Background

Multicenter registries representing the real world can be a significant source of information, but few studies exist describing the methodology to implement these tools.

Objective

To describe the process of implementing a database of ST-segment elevation acute myocardial infarction (STEMI) at a reference hospital, and the application of this process to other centers by means of an online platform.

Methods

In 2009, our institution implemented an Registry of Acute Myocardial Infarction (RIAM), with the prospective and consecutive inclusion of every patient admitted to the institution who received a diagnosis of STEMI. From March 2014 to April 2016, the registries were uploaded to a web-based system using the REDCap software and the registry was expanded to other centers. Upon subscription, the REDCap platform is a noncommercial software made available by Vanderbilt University to institutions interested in research.

Results

The following steps were taken to improve and expand the registry: 1. Standardization of variables; 2. Implementation of institutional REDCap (Research Electronic Data Capture); 3. Development of data collection forms (Case Report Form – CRF); 4. Expansion of registry to other reference centers using the REDCap software; 5. Training of teams and participating centers following an SOP (Standard Operating Procedure).

Conclusion

The description of the methodology used to implement and expand the RIAM may help other centers and researchers to conduct similar studies, share information between institutions, develop new health technologies, and assist public policies regarding cardiovascular diseases. (Arq Bras Cardiol. 2020; 114(3):446-455)

  • Cardiovascular Diseases, mortality
  • Database
  • Multicenter Study
  • Myocardial Infarction/physiopathology
  • Myocardial Ischemia / physiopathology
  • Public Health Policy
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Creative Commons Attribution (CC BY) Creative Commons license
06/04/2020 DOI: 10.36660/abc.20190036
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Viewpoint

Downstream Change of the Primary Endpoint in the ISCHEMIA Trial: the Elephant in the Room

Luis Cláudio Lemos Correia et al. Anis Rassi Junior

Modification of the Trial Protocol

Recently we learned that the protocol of the ISCHEMIA trial published on ClinicalTrials.gov had a major modification in January 2018, only 11 months before the estimated completion of this 7-year trial. The primary endpoint was changed from the composite of cardiovascular death or nonfatal MI (2012 version) to a 5-component endpoint that also includes resuscitated cardiac arrest, hospitalization for unstable angina and hospitalization for heart failure (January 2018 version).,

Then, in February 2018, the full version of the 2012 ISCHEMIA protocol was published on ClinicalTrials.gov. This version of the protocol stated that if the incidence of the primary endpoint pooled across randomized groups is lower than expected, an independent advisory panel can decide to extend the follow-up period or change the primary endpoint.

[…]

  • Cardiac Catheterization
  • Evaluation Studies
  • Myocardial Ischemia / physiopathology
  • Myocardial Revascularization
  • Treatment Outcom
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Creative Commons Attribution (CC BY) Creative Commons license
01/08/2018 DOI: 10.5935/abc.20180145 Views 1
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Original Article

Applicability of Longitudinal Strain of Left Ventricle in Unstable Angina

Natasha Soares Simões dos Santos et al. Andrea de Andrade Vilela Rodrigo Bellio de Mattos Barretto Marcela Paganelli do Vale … Mariana Oliveira Rezende Murilo Castro Ferreira Alexandre José Aguiar Andrade Nelson Henrique Goes Scorsioni Olívia Ximenes de Queiroga David Le Bihan

Abstract

Background:

Unstable angina (UA) is a common cause of hospital admission; risk stratification helps determine strategies for treatment.

Objective:

To determine the applicability of two-dimensional longitudinal strain (SL2D) for the identification of myocardial ischemia in patients with UA.

Methods:

Cross-sectional, descriptive, observational study lasting 60 days. The sample consisted of 78 patients, of which fifteen (19.2%) were eligible for longitudinal strain analysis. The value of p < 0.05 was considered significant.

Results:

The group of ineligible patients presented: a lower proportion of women, a higher prevalence of diabetes mellitus (DM), use of ASA, statins and beta-blockers and larger cavity diameters. The main causes of non-applicability were: presence of previous infarction (56.4%), previous CTA (22.1%), previous MRI (11.5%) or both (16.7%) and the presence of specific electrocardiographic abnormalities (12.8%). SL2D assessment revealed a lower global strain value in those with stenosis greater than 70% in some epicardial coronary arteries (17.1 [3.1] versus 20.2 [6.7], with p = 0.014). Segmental strain assessment showed an association between severe CX and RD lesions with longitudinal strain reduction of lateral and inferior walls basal segments; (14 [5] versus 21 [10], with p = 0.04) and (12.5 [6] versus 19 [8], respectively).

Conclusion:

There was very low SL2D applicability to assess ischemia in the studied population. However, the global strain showed a correlation with the presence of significant coronary lesion, which could be included in the UA diagnostic arsenal in the future.

  • Angina, unstable / physiopathology
  • Echocardiography/methods
  • Myocardial Ischemia / physiopathology
  • Strain
  • Ventricular Dysfunction, Left
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Creative Commons Attribution (CC BY) Creative Commons license
01/04/2018 DOI: 10.5935/abc.20180062
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Viewpoint

Atypical Manifestation of Myocardial Ischemia in the Elderly

Marcelo E. Ochiai et al. Neusa Helena Lopes Carolina Giusti Buzo Humberto Pierri

Often, elderly patients have atypical clinical picture for myocardial ischemia, or are asymptomatic. This review intends to re-examine the pathophysiology of atypical manifestation in elderly persons, its prognostic and therapeutic implications.

The coronary atherosclerotic disease is an increasing public health problem, of particular importance in higher age groups. Its prevalence increases significantly at the sixth decade of life, becoming the leading cause of death in older people, as well as the greatest responsible for hospitalization and invasive procedures.

[…]

  • Aged
  • Angina Pectoris
  • Coronary Artery Disease
  • Heart Failure
  • Myocardial Ischemia / physiopathology
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Creative Commons Attribution (CC BY) Creative Commons license
01/03/2014 DOI: 10.5935/abc.20140025

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Vaz J, Abelin AP, Schmidt MM, Oliveira PP, Gottschall CAM, Rodrigues CG, Quadros AS, et al. Creation and Implementation of a Prospective and Multicentric Database of Patients with Acute Myocardial Infarction: RIAM. Arquivos Brasileiros de Cardiologia 2020;114(3):446-55.

Electronic Document Format (ABNT)

Vaz, Jacqueline; Abelin, Anibal Pereira; Schmidt, Marcia Moura; Oliveira, Pedro Piccaro de; Gottschall, Carlos A. M.; Rodrigues, Clarissa Garcia; Quadros, Alexandre Schaan de. Creation and Implementation of a Prospective and Multicentric Database of Patients with Acute Myocardial Infarction: RIAM. Arquivos Brasileiros de Cardiologia, v. 114, n. 3, p. 446-455, Apr. 2020.

Electronic Document Format (APA)

Vaz, J., Abelin, A. P., Schmidt, M. M., Oliveira, P. P. , Gottschall, C. A. M., Rodrigues, C. G., & Quadros, A. S. (2020). Creation and Implementation of a Prospective and Multicentric Database of Patients with Acute Myocardial Infarction: RIAM. Arquivos Brasileiros de Cardiologia, 114(3), 446-455.

Electronic Document Format (ISO)

Vaz, Jacqueline and Abelin, Anibal Pereira and Schmidt, Marcia Moura and Oliveira, Pedro Piccaro de and Gottschall, Carlos A. M. and Rodrigues, Clarissa Garcia and Quadros, Alexandre Schaan de. Creation and Implementation of a Prospective and Multicentric Database of Patients with Acute Myocardial Infarction: RIAM. Arquivos Brasileiros de Cardiologia [online]. 2020, vol. 114, n. 3, [cited 2026-10-14], pp. 446-455. Available from: <https://journals.cardiol.br/en/article/creation-and-implementation-of-a-prospective-and-multicentric-database-of-patients-with-acute-myocardial-infarction-riam/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Correia LCL, Rassi Junior A. Downstream Change of the Primary Endpoint in the ISCHEMIA Trial: the Elephant in the Room. Arquivos Brasileiros de Cardiologia 2018;111(2):213-4.

Electronic Document Format (ABNT)

Correia, Luis Cláudio Lemos; Rassi Junior, Anis. Downstream Change of the Primary Endpoint in the ISCHEMIA Trial: the Elephant in the Room. Arquivos Brasileiros de Cardiologia, v. 111, n. 2, p. 213-214, Jul. 2018.

Electronic Document Format (APA)

Correia, L. C. L., & Rassi Junior, A. (2018). Downstream Change of the Primary Endpoint in the ISCHEMIA Trial: the Elephant in the Room. Arquivos Brasileiros de Cardiologia, 111(2), 213-214.

Electronic Document Format (ISO)

Correia, Luis Cláudio Lemos and Rassi Junior, Anis. Downstream Change of the Primary Endpoint in the ISCHEMIA Trial: the Elephant in the Room. Arquivos Brasileiros de Cardiologia [online]. 2018, vol. 111, n. 2, [cited 2026-10-14], pp. 213-214. Available from: <https://journals.cardiol.br/en/article/downstream-change-of-the-primary-endpoint-in-the-ischemia-trial-the-elephant-in-the-room/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Santos NSS, Vilela AA, Barretto RBM, Vale MP, Rezende MO, Ferreira MC, Andrade AJA, et al. Applicability of Longitudinal Strain of Left Ventricle in Unstable Angina. Arquivos Brasileiros de Cardiologia 2018;110(4):354-61.

Electronic Document Format (ABNT)

Santos, Natasha Soares Simões dos; Vilela, Andrea de Andrade; Barretto, Rodrigo Bellio de Mattos; Vale, Marcela Paganelli do; Rezende, Mariana Oliveira; Ferreira, Murilo Castro; Andrade, Alexandre José Aguiar; Scorsioni, Nelson Henrique Goes; Queiroga, Olívia Ximenes de; Bihan, David Le. Applicability of Longitudinal Strain of Left Ventricle in Unstable Angina. Arquivos Brasileiros de Cardiologia, v. 110, n. 4, p. 354-361, Mar. 2018.

Electronic Document Format (APA)

Santos, N. S. S. , Vilela, A. A., Barretto, R. B. M., Vale, M. P. , Rezende, M. O., Ferreira, M. C., Andrade, A. J. A., Scorsioni, N. H. G., Queiroga, O. X. , & Bihan, D. L. (2018). Applicability of Longitudinal Strain of Left Ventricle in Unstable Angina. Arquivos Brasileiros de Cardiologia, 110(4), 354-361.

Electronic Document Format (ISO)

Santos, Natasha Soares Simões dos and Vilela, Andrea de Andrade and Barretto, Rodrigo Bellio de Mattos and Vale, Marcela Paganelli do and Rezende, Mariana Oliveira and Ferreira, Murilo Castro and Andrade, Alexandre José Aguiar and Scorsioni, Nelson Henrique Goes and Queiroga, Olívia Ximenes de and Bihan, David Le. Applicability of Longitudinal Strain of Left Ventricle in Unstable Angina. Arquivos Brasileiros de Cardiologia [online]. 2018, vol. 110, n. 4, [cited 2026-10-14], pp. 354-361. Available from: <https://journals.cardiol.br/en/article/applicability-of-longitudinal-strain-of-left-ventricle-in-unstable-angina/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Ochiai ME, Lopes NH, Buzo CG, Pierri H. Atypical Manifestation of Myocardial Ischemia in the Elderly. Arquivos Brasileiros de Cardiologia 2014;102(3):31.

Electronic Document Format (ABNT)

Ochiai, Marcelo E.; Lopes, Neusa Helena; Buzo, Carolina Giusti; Pierri, Humberto. Atypical Manifestation of Myocardial Ischemia in the Elderly. Arquivos Brasileiros de Cardiologia, v. 102, n. 3, 31, Feb. 2014.

Electronic Document Format (APA)

Ochiai, M. E., Lopes, N. H., Buzo, C. G., & Pierri, H. (2014). Atypical Manifestation of Myocardial Ischemia in the Elderly. Arquivos Brasileiros de Cardiologia, 102(3), 31.

Electronic Document Format (ISO)

Ochiai, Marcelo E. and Lopes, Neusa Helena and Buzo, Carolina Giusti and Pierri, Humberto. Atypical Manifestation of Myocardial Ischemia in the Elderly. Arquivos Brasileiros de Cardiologia [online]. 2014, vol. 102, n. 3, [cited 2026-10-14], 31. Available from: <https://journals.cardiol.br/en/article/atypical-manifestation-of-myocardial-ischemia-in-the-elderly/>. ISSN 0066-782X

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