Browsing by Author "Calisto, J"
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- Adjuvant antithrombotic therapy in ST-elevation myocardial infarction: Contemporaneous Portuguese cross-sectional dataPublication . Caldeira, D; Pereira, H; Marques, A; Alegria, S; Calisto, J; Silva, P; Ribeiro, V; Silva, JC; Seixo, F; Abreu, PF, et al.INTRODUCTION: The standard of care for acute ST-elevation myocardial infarction (STEMI) includes the activation of a STEMI care network, the administration of adjuvant medical therapy, and reperfusion through primary percutaneous coronary intervention (PCI). While primary PCI is nowadays the first option for the treatment of patients with STEMI, antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize their clinical outcomes. OBJECTIVE: The aim of this study was to describe contemporaneous real-world patterns of use of antithrombotic treatments in Portugal for STEMI patients undergoing primary PCI. METHODS: An observational, retrospective cross-sectional study was performed for the year 2016, based on data from two national registries: the Portuguese Registry on Acute Coronary Syndromes (ProACS) and the Portuguese Registry on Interventional Cardiology (PRIC). Data on oral antiplatelet and procedural intravenous antithrombotic drugs were retrieved. RESULTS: In 2016, the ProACS enrolled 534 STEMI patients treated with primary PCI, while the PRIC registry reported data on 2625 STEMI patients. Of these, 99.6% were treated with aspirin and 75.6% with dual antiplatelet therapy (mostly clopidogrel). GP IIb/IIIa inhibitors (mostly abciximab) were used in 11.6% of cases. Heparins were used in 80% of cases (78% unfractionated heparin [UFH] and 2% low molecular weight heparin). None of the patients included in the registry were treated with cangrelor, prasugrel or bivalirudin. Missing data are one of the main limitations of the registries. CONCLUSIONS: In 2016, according to data from these national registries, almost all patients with STEMI were treated with aspirin and 76% with dual antiplatelet agents, mostly clopidogrel. GP IIb/IIIa inhibitors were used in few patients, and UFH was the most prevalent parenteral anticoagulant drug.
- Angioplastia primária em Portugal entre 2002-2013. Atividade segundo o Registo Nacional de Cardiologia de IntervençãoPublication . Pereira, H; Teles, R; Costa, M; Silva, P; Ribeiro, V; Brandão, V; Martins, D; Matias, F; Pereira-Machado, F; Baptista, J; Abreu, PF; Santos, R; Drummond, A; Carvalho, H; Calisto, J; Silva, JC; Pipa, JL; Marques, J; Sousa, P; Fernandes, R; Ferreira, R; Ramos, S; Oliveira, E; Almeida, M; Registo Nacional de Cardiologia de IntervençãoIntrodução e objectivos: Foi nosso objectivo reportar a evolução da angioplastia coronária no tratamento do enfarte agudo do miocárdio com supradesnivelamento do segmento ST (EAMCST), entre 2002-2013. Métodos: Os dados prospectivos multicêntricos do Registo Nacional de Cardiologia de Intervenção (RNCI) e os dados oficiais da Direção Geral de Saúde (DGS) foram conjugados para estudar os procedimentos no EAMCST entre 2002 e 2013. Resultados: Em 2013 realizaram-se 3524 angioplastias primárias (ICP-P), representando um crescimento de 315% relativamente ao ano 2002. Em 2002 a ICP-P representava 16% do total de angioplastias coronárias, passando a representar 25% nos anos de 2012-2013. Entre 2002-2013 o número de procedimentos por milhão de habitantes aumentou de 106 de 338 e a angioplastia de recurso decresceu de 70,7 para 2%. Durante o período em análise, a utilização de stents eluidores de fármaco cresceu de 9,9 para 69,5%. Após 2008, observou-se uma utilização crescente de trombectomia de aspiração, atingindo 46,7% em 2013. Os inibidores das glicoproteínas IIb/IIIa registaram um decréscimo no seu uso, sendo de 73,2% em 2002 e de 23,6% em 2013. O acesso radial cresceu de 8,3% em 2008 até 54,6% em 2013. Conclusões: Durante o período em análise, a taxa de angioplastia coronária por milhão de habitantes triplicou. A angioplastia de recurso foi ultrapassada pela angioplastia primária a partir de 2006. Observaram-se novas tendências no tratamento do enfarte agudo do miocárdio com supradesnivelamento do segmento ST, salientando-se a utilização de stents eluidores de fármacos e o acesso radial.
- Evolução da intervenção coronária percutânea entre 2004‐2013. Atividade em Portugal segundo o Registo Nacional de Cardiologia de IntervençãoPublication . Pereira, H; Teles, R; Costa, M; Silva, P; Ferreira, R; Ribeiro, V; Santos, R; Abreu, PF; Carvalho, H; Marques, J; Fernandes, R; Brandão, V; Martins, D; Drummond, A; Pipa, J; Seca, L; Calisto, J; Baptista, J; Matias, F; Ramos, J; Pereira-Machado, F; Silva, J; Almeida, M; Registo Nacional de Cardiologia de IntervençãoINTRODUCTION AND OBJECTIVES: The aim of the present paper is to report trends in Portuguese interventional cardiology from 2004 to 2013 and to compare them with other European countries. METHODS: Based on the Portuguese National Registry of Interventional Cardiology and on official data from the Directorate-General of Health, we give an overview of developments in coronary interventions from 2004 to 2013. RESULTS: In 2013, 36 810 diagnostic catheterization procedures were performed, representing an increase of 34% compared to 2007 and a rate of 3529 coronary angiograms per million population. Coronary interventions increased by 65% in the decade from 2004 to 2013, with a total of 13 897 procedures and a rate of 1333 coronary interventions per million population in 2013. Primary percutaneous coronary intervention (PCI) increased by 265% from 2004 to 2013 (1328 vs. 3524), an adjusted rate of 338 primary PCIs per million, representing 25% of total angioplasties. Stents were the most frequently used devices, drug-eluting stents being used in 73% in 2013. Radial access increased from 4.1% in 2004 to 57.9% in 2013. CONCLUSION: Interventional cardiology in Portugal has been expanding since 2004. We would emphasize the fact that in 2013 all Portuguese interventional cardiology centers were participating in the National Registry of Interventional Cardiology, as well as the growth in primary PCI and increased use of radial access.
- Trends in primary angioplasty in Portugal from 2002 to 2013 according to the Portuguese National Registry of Interventional CardiologyPublication . Pereira, H; Teles, R; Costa, M; Silva, P; Ribeiro, V; Brandão, V; Martins, D; Matias, F; Pereira-Machado, F; Baptista, J; Abreu, PF; Santos, R; Drummond, A; Carvalho, H; Calisto, J; Silva, J; Pipa, J; Marques, J; Sousa, P; Fernandes, R; Ferreira, R; Ramos, S; Oliveira, E; Almeida, MIntroduction and Objectives: The aim of the present paper was to report trends in coronary angioplasty for the treatment of ST-elevation myocardial infarction (STEMI) in Portugal. Methods: Prospective multicenter data from the Portuguese National Registry of Interventional Cardiology (RNCI) and official data from the Directorate-General for Health (DGS) were studied to analyze percutaneous coronary intervention (PCI) procedures for STEMI from 2002 to 2013. Results: In 2013, 3524 primary percutaneous coronary intervention (p-PCI) procedures were performed (25% of all procedures), an increase of 315% in comparison to 2002 (16% of all interventions). Between 2002 and 2013 the rate increased from 106 to 338 p-PCIs per mil- lion population per year. Rescue angioplasty decreased from 70.7% in 2002 to 2% in 2013. During this period, the use of drug-eluting stents grew from 9.9% to 69.5%. After 2008, the use of aspiration thrombectomy increased, reaching 46.7% in 2013. Glycoprotein IIb-IIIa inhibitor use decreased from 73.2% in 2002 to 23.6% in the last year of the study. Use of a radial approach increased steadily from 8.3% in 2008 to 54.6% in 2013. Conclusion: During the reporting period there was a three-fold increase in primary angioplasty rates per million population. Rescue angioplasty has been overtaken by p-PCI as the predominant procedure since 2006. New trends in the treatment of STEMI were observed, notably the use of drug-eluting stents and radial access as the predominant approach.