Revista Portuguesa De Cardiologia最新文献

英文中文

Outcomes of ventricular tachycardia ablation in patients with ischemic and non-ischemic cardiomyopathy: A propensity-score matched analysis 缺血性和非缺血性心肌病患者室性心动过速消融术的疗效：倾向评分匹配分析

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.04.002

Daniel A. Gomes , Mariana Sousa Paiva , Daniel Matos , Ana Rita Bello , Gustavo Rodrigues , João Carmo , Jorge Ferreira , Francisco Moscoso Costa , Pedro Galvão Santos , Pedro Carmo , Diogo Cavaco , Francisco Bello Morgado , Pedro Adragão

Introduction and objectives

Catheter ablation (CA) is effective in the treatment of ventricular tachycardia (VT). Although some observational data suggest patients with non-ischemic cardiomyopathy (NICM) have less favorable outcomes when compared to those with an ischemic etiology (ICM), direct comparisons are rarely reported. We aimed to compare the outcomes of VT ablation in a propensity-score matched population of ICM or NICM patients.

Methods

Single-center retrospective study of consecutive patients undergoing VT ablation from 2012 to 2023. A propensity score (PS) was used to match ICM and NICM patients in a 1:1 fashion according to age, sex, left ventricular ejection fraction (LVEF), NYHA class, electrical storm (ES) at presentation, and previous endocardial ablation. The outcomes of interest were VT-free survival and all-cause mortality.

Results

The PS yielded two groups of 71 patients each (mean age 63±10 years, 92% male, mean LVEF 35±10%, 36% with ES at presentation, and 23% with previous ablation), well matched for baseline characteristics. During a median follow-up of 2.3 (interquartile range IQR 1.3–3.8) years, patients with NICM had a significantly lower VT-free survival (53.5% vs. 69.0%, log-rank p=0.037), although there were no differences regarding all-cause mortality (22.5% vs. 16.9%, log-rank p=0.245). Multivariate analysis identified NICM (HR 2.34 [95% CI 1.32–4.14], p=0.004), NYHA class III/IV (HR 2.11 [95% CI 1.11–4.04], p=0.024), and chronic kidney disease (HR 2.23 [95% CI 1.25–3.96], p=0.006), as independent predictors of VT recurrence.

Conclusion

Non-ischemic cardiomyopathy patients were at increased risk of VT recurrence after ablation, although long-term mortality did not differ.

导言和目的导管消融（CA）是治疗室性心动过速（VT）的有效方法。尽管一些观察性数据表明，非缺血性心肌病（NICM）患者的疗效不如缺血性病因（ICM）患者，但很少有直接比较的报道。我们的目的是比较 ICM 或 NICM 患者中倾向得分匹配人群的 VT 消融结果。根据年龄、性别、左心室射血分数 (LVEF)、NYHA 分级、发病时的电风暴 (ES) 和既往心内膜消融情况，采用倾向评分 (PS) 对 ICM 和 NICM 患者进行 1:1 匹配。结果 PS 两组各 71 例患者（平均年龄 63±10岁，92% 为男性，平均 LVEF 35±10%，36% 在发病时有 ES，23% 曾做过消融术），基线特征完全匹配。在中位随访 2.3 年（四分位间距 IQR 1.3-3.8）期间，NICM 患者的无 VT 生存率明显较低（53.5% 对 69.0%，log-rank p=0.037），尽管全因死亡率方面没有差异（22.5% 对 16.9%，log-rank p=0.245）。多变量分析发现，NICM（HR 2.34 [95% CI 1.32-4.14]，P=0.004）、NYHA III/IV 级（HR 2.11 [95% CI 1.11-4.04]，P=0.024）和慢性肾病（HR 2.23 [95% CI 1.25-3.96]，P=0.结论非缺血性心肌病患者消融术后VT复发风险增加，但长期死亡率并无差异。

{"title":"Outcomes of ventricular tachycardia ablation in patients with ischemic and non-ischemic cardiomyopathy: A propensity-score matched analysis","authors":"Daniel A. Gomes , Mariana Sousa Paiva , Daniel Matos , Ana Rita Bello , Gustavo Rodrigues , João Carmo , Jorge Ferreira , Francisco Moscoso Costa , Pedro Galvão Santos , Pedro Carmo , Diogo Cavaco , Francisco Bello Morgado , Pedro Adragão","doi":"10.1016/j.repc.2024.04.002","DOIUrl":"10.1016/j.repc.2024.04.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Catheter ablation (CA) is effective in the treatment of ventricular tachycardia (VT). Although some observational data suggest patients with non-ischemic cardiomyopathy (NICM) have less favorable outcomes when compared to those with an ischemic etiology (ICM), direct comparisons are rarely reported. We aimed to compare the outcomes of VT ablation in a propensity-score matched population of ICM or NICM patients.</p></div><div><h3>Methods</h3><p>Single-center retrospective study of consecutive patients undergoing VT ablation from 2012 to 2023. A propensity score (PS) was used to match ICM and NICM patients in a 1:1 fashion according to age, sex, left ventricular ejection fraction (LVEF), NYHA class, electrical storm (ES) at presentation, and previous endocardial ablation. The outcomes of interest were VT-free survival and all-cause mortality.</p></div><div><h3>Results</h3><p>The PS yielded two groups of 71 patients each (mean age 63±10 years, 92% male, mean LVEF 35±10%, 36% with ES at presentation, and 23% with previous ablation), well matched for baseline characteristics. During a median follow-up of 2.3 (interquartile range IQR 1.3–3.8) years, patients with NICM had a significantly lower VT-free survival (53.5% vs. 69.0%, log-rank p=0.037), although there were no differences regarding all-cause mortality (22.5% vs. 16.9%, log-rank p=0.245). Multivariate analysis identified NICM (HR 2.34 [95% CI 1.32–4.14], p=0.004), NYHA class III/IV (HR 2.11 [95% CI 1.11–4.04], p=0.024), and chronic kidney disease (HR 2.23 [95% CI 1.25–3.96], p=0.006), as independent predictors of VT recurrence.</p></div><div><h3>Conclusion</h3><p>Non-ischemic cardiomyopathy patients were at increased risk of VT recurrence after ablation, although long-term mortality did not differ.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000829/pdfft?md5=8f5f6df5645a6aa7b2fa9be1fb62bf84&pid=1-s2.0-S0870255124000829-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term prognosis of idiopathic ventricular fibrillation: An eighteen-year experience from a tertiary center 特发性心室颤动的长期预后：一家三级医疗中心十八年来的经验。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.04.001

Cátia Oliveira , Ana Pinho , Luís Santos , Ricardo Alves Pinto , Sílvia Oliveira , Helena Moreira , Miguel Rocha , Pedro Palma , Gonçalo Pestana , Marta Madeira , Ana Lebreiro , Luís Adão

Introduction and objectives

Idiopathic ventricular fibrillation (IVF) is diagnosed in patients who survive sudden cardiac arrest (SCA), preferably with documented ventricular fibrillation (VF), without any identifiable structural or electrical abnormality. Current evidence provides limited guidance on the diagnosis and follow-up of these patients. Our aim was to assess the clinical outcomes of survivors of an aborted SCA attributed to IVF.

Methods

We retrospectively collected clinical data from all patients who survived SCA and implanted a cardiac defibrillator (ICD) between 2005 and 2023.

Results

A total of 38 patients, 36.8% female, with a mean age of 44±14 years old were included. Median follow-up time was 8.7 years (interquartile range (IQR) 4.7–14.7 years). All patients underwent a comprehensive diagnostic evaluation that excluded structural and coronary disease. During follow-up, underlying diagnoses were established in 34.2% of the whole cohort. Genetic testing, performed in 37.2%, revealed underlying diagnoses in 57.1% of those tested, compared to only 26.3% of patients who did not undergo genetic testing [p=0.035, OR=5.1 (95% confidence interval (CI) 1.2–21.5)]. Mortality was 10.5% (due to non-arrhythmic causes) and 36.8% patients received appropriate therapies with a median time to first ICD therapy of 39 [5.4–47.3] months.

Conclusion(s)

Etiological diagnosis and recurrence prediction in patients with IVF remains challenging, even with extensive diagnostic evaluation and long-term follow-up. In our study, genetic testing enhanced diagnostic yield. Consistent with previous findings, our cohort experienced a notable arrhythmic recurrence, with no cardiac deaths, underlining the pivotal role of ICD implantation in these patients.

导言和目的特发性心室颤动（IVF）的诊断对象是心脏骤停（SCA）后存活的患者，最好是有记录的心室颤动（VF），但没有任何可识别的结构或电异常。目前的证据为这些患者的诊断和随访提供了有限的指导。我们的目的是评估因体外受精而流产的 SCA 幸存者的临床结局。方法我们回顾性地收集了 2005 年至 2023 年间所有 SCA 幸存者的临床数据，并植入了心脏除颤器（ICD）。中位随访时间为 8.7 年（四分位数间距 (IQR) 4.7-14.7 年）。所有患者都接受了全面的诊断评估，排除了结构性和冠状动脉疾病。在随访过程中，34.2%的患者确诊了潜在疾病。37.2%的患者接受了基因检测，其中57.1%的患者确诊了潜在疾病，而未接受基因检测的患者中只有26.3%确诊了潜在疾病[P=0.035，OR=5.1（95% 置信区间（CI）1.2-21.5）]。死亡率为 10.5%（非心律失常原因所致），36.8% 的患者接受了适当的治疗，首次 ICD 治疗的中位时间为 39 [5.4-47.3] 个月。在我们的研究中，基因检测提高了诊断率。与之前的研究结果一致，我们的研究队列中出现了明显的心律失常复发，但没有心脏性死亡，这凸显了 ICD 植入在这些患者中的关键作用。

{"title":"Long-term prognosis of idiopathic ventricular fibrillation: An eighteen-year experience from a tertiary center","authors":"Cátia Oliveira , Ana Pinho , Luís Santos , Ricardo Alves Pinto , Sílvia Oliveira , Helena Moreira , Miguel Rocha , Pedro Palma , Gonçalo Pestana , Marta Madeira , Ana Lebreiro , Luís Adão","doi":"10.1016/j.repc.2024.04.001","DOIUrl":"10.1016/j.repc.2024.04.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Idiopathic ventricular fibrillation (IVF) is diagnosed in patients who survive sudden cardiac arrest (SCA), preferably with documented ventricular fibrillation (VF), without any identifiable structural or electrical abnormality. Current evidence provides limited guidance on the diagnosis and follow-up of these patients. Our aim was to assess the clinical outcomes of survivors of an aborted SCA attributed to IVF.</p></div><div><h3>Methods</h3><p>We retrospectively collected clinical data from all patients who survived SCA and implanted a cardiac defibrillator (ICD) between 2005 and 2023.</p></div><div><h3>Results</h3><p>A total of 38 patients, 36.8% female, with a mean age of 44±14 years old were included. Median follow-up time was 8.7 years (interquartile range (IQR) 4.7–14.7 years). All patients underwent a comprehensive diagnostic evaluation that excluded structural and coronary disease. During follow-up, underlying diagnoses were established in 34.2% of the whole cohort. Genetic testing, performed in 37.2%, revealed underlying diagnoses in 57.1% of those tested, compared to only 26.3% of patients who did not undergo genetic testing [p=0.035, OR=5.1 (95% confidence interval (CI) 1.2–21.5)]. Mortality was 10.5% (due to non-arrhythmic causes) and 36.8% patients received appropriate therapies with a median time to first ICD therapy of 39 [5.4–47.3] months.</p></div><div><h3>Conclusion(s)</h3><p>Etiological diagnosis and recurrence prediction in patients with IVF remains challenging, even with extensive diagnostic evaluation and long-term follow-up. In our study, genetic testing enhanced diagnostic yield. Consistent with previous findings, our cohort experienced a notable arrhythmic recurrence, with no cardiac deaths, underlining the pivotal role of ICD implantation in these patients.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000805/pdfft?md5=b62746d7fe7f96fad299dfef4cd89c06&pid=1-s2.0-S0870255124000805-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Idiopathic ventricular fibrillation: A never ending “clinical” history 特发性心室颤动：永无止境的 "临床 "史

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.05.001

João Primo

引用次数: 0

The challenge of choosing the right prosthesis for the right patient – The devil is in the details "为合适的病人选择合适的假体所面临的挑战--细节决定成败"。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.05.004

Gonçalo F. Coutinho

引用次数: 0

The potential for health education to target cardiovascular risk factors at an age when it really matters 健康教育有可能在真正重要的年龄段针对心血管风险因素开展教育。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.02.001

António Manuel Pires

引用次数: 0

Surgical aortic valve replacement in octogenarians: Single-center perioperative outcomes and five-year survival 八旬老人主动脉瓣置换手术：单中心围手术期疗效和 5 年生存率。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.02.003

Tiago R. Velho , João Gonçalves , Rafael Maniés Pereira , Ricardo Ferreira , André Sena , Nádia Junqueira , Eurídice Ângelo , Nuno Carvalho Guerra , Mário Mendes , Ricardo Arruda Pereira , Ângelo Nobre

Introduction and objectives

Aortic stenosis is the most common valvular heart disease. The number of octogenarians proposed for intervention is growing due to increased lifespan. In this manuscript we aim to evaluate perioperative outcome and long-term survival after surgical aortic valve replacement (SAVR) in octogenarians, comparing patients with low surgical risk (EuroscoreII <4%) with intermediate-high risk (EuroscoreII ≥4%).

Methods

A retrospective observational single-center cohort study with 195 patients aged ≥80 years old, who underwent SAVR between 2017 and 2021, was conducted. Patients were divided into two groups according to EuroscoreII: (1) Low risk (EuroscoreII <4%) with intermediate-high risk (EuroscoreII ≥4%). Continuous variables are presented in median (IQR), analyzed using Wilcoxon rank sum test; categorical variables in percentages, analyzed using chi-squared test; and survival was analyzed by Kaplan–Meier, open cohort, and the log-rank test was performed.

Results

The overall median age was 82 (IQR 81–83), with 4.6% of the patients ≥85 years old. 23.6% of the patients presented EuroscoreII ≥4%. No complications were observed in 26.2%, with a significantly higher rate in intermediate-high risk patients. Postoperative need for hemodynamic support was the most frequent complication, followed by postoperative acute kidney injury and the use of blood products. Overall median ICU stay was three days (2–4) and hospital length of stay (LOS) six days (5–8). Patients with intermediate-high risk and those with complications had longer ICU LOS. At 12 months, overall survival was 96.4%, at three years 94.1% and 5 years 75.4%. Patients with low surgical risk had higher survival proportions up to 5 years.

Conclusion

SAVR in patients ≥80 years is associated with low in-hospital mortality, although a significant proportion of patients develop complications. Long-term follow-up up to five years after surgery is acceptable in octogenarians with low surgical risk.

导言和目标：主动脉瓣狭窄是最常见的瓣膜性心脏病。由于寿命的延长，建议进行介入治疗的八旬老人越来越多。在这篇手稿中，我们旨在评估八旬老人主动脉瓣置换术（SAVR）后的围手术期结果和长期存活率，并对手术风险低（EuroscoreII 方法）的患者进行比较：一项回顾性观察性单中心队列研究，研究对象为2017-2021年间接受SAVR的195名年龄≥80岁的患者。根据EuroscoreII将患者分为两组：1）低风险（EuroscoreIIResults：总体中位年龄为82岁（IQR 81-83），4.6%的患者年龄≥85岁。23.6%的患者欧洲评分II≥4%。26.2%的患者未出现并发症，中高风险患者的并发症发生率明显更高。术后需要血流动力学支持是最常见的并发症，其次是术后急性肾损伤和使用血制品。重症监护室总住院时间中位数为 3 天（2-4 天），住院时间中位数为 6 天（5-8 天）。中高风险患者和有并发症的患者的重症监护室住院时间更长。12个月的总生存率为96.4%，3年为94.1%，5年为75.4%。手术风险低的患者5年生存率更高：结论：对年龄≥80岁的患者进行SAVR手术的院内死亡率较低，但有相当一部分患者会出现并发症。对于手术风险较低的八旬老人，术后5年的长期随访是可以接受的。

{"title":"Surgical aortic valve replacement in octogenarians: Single-center perioperative outcomes and five-year survival","authors":"Tiago R. Velho , João Gonçalves , Rafael Maniés Pereira , Ricardo Ferreira , André Sena , Nádia Junqueira , Eurídice Ângelo , Nuno Carvalho Guerra , Mário Mendes , Ricardo Arruda Pereira , Ângelo Nobre","doi":"10.1016/j.repc.2024.02.003","DOIUrl":"10.1016/j.repc.2024.02.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Aortic stenosis is the most common valvular heart disease. The number of octogenarians proposed for intervention is growing due to increased lifespan. In this manuscript we aim to evaluate perioperative outcome and long-term survival after surgical aortic valve replacement (SAVR) in octogenarians, comparing patients with low surgical risk (EuroscoreII <4%) with intermediate-high risk (EuroscoreII ≥4%).</p></div><div><h3>Methods</h3><p>A retrospective observational single-center cohort study with 195 patients aged ≥80 years old, who underwent SAVR between 2017 and 2021, was conducted. Patients were divided into two groups according to EuroscoreII: (1) Low risk (EuroscoreII <4%) with intermediate-high risk (EuroscoreII ≥4%). Continuous variables are presented in median (IQR), analyzed using Wilcoxon rank sum test; categorical variables in percentages, analyzed using chi-squared test; and survival was analyzed by Kaplan–Meier, open cohort, and the log-rank test was performed.</p></div><div><h3>Results</h3><p>The overall median age was 82 (IQR 81–83), with 4.6% of the patients ≥85 years old. 23.6% of the patients presented EuroscoreII ≥4%. No complications were observed in 26.2%, with a significantly higher rate in intermediate-high risk patients. Postoperative need for hemodynamic support was the most frequent complication, followed by postoperative acute kidney injury and the use of blood products. Overall median ICU stay was three days (2–4) and hospital length of stay (LOS) six days (5–8). Patients with intermediate-high risk and those with complications had longer ICU LOS. At 12 months, overall survival was 96.4%, at three years 94.1% and 5 years 75.4%. Patients with low surgical risk had higher survival proportions up to 5 years.</p></div><div><h3>Conclusion</h3><p>SAVR in patients ≥80 years is associated with low in-hospital mortality, although a significant proportion of patients develop complications. Long-term follow-up up to five years after surgery is acceptable in octogenarians with low surgical risk.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000696/pdfft?md5=18df2bcc522b97bb00032405dec1fc04&pid=1-s2.0-S0870255124000696-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ventricular tachycardia ablation in non-ischemic cardiomyopathy: A Sisyphean task? 非缺血性心肌病的室性心动过速消融术：一项艰巨的任务？

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.05.006

Guilherme Portugal

引用次数: 0

Ghost in the heart: A case of post ischemia left ventricular false tendon rupture 心脏里的幽灵一例缺血后左心室假腱断裂。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2023.10.008

Mostafa Yahyazadeh Andevari, Reza Hali

引用次数: 0

Are we missing an opportunity? Prehospital delay in patients with acute ischemic stroke and known atrial fibrillation 我们是否错失良机？急性缺血性脑卒中和已知心房颤动患者的院前延误。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2023.11.005

Marta Magriço , Miguel Serôdio , João Nuno Ramos , Rita Ventura , André Sobral-Pinho , João Pedro Marto , Miguel Viana-Baptista

Introduction and Objectives

The follow-up of patients with atrial fibrillation (AF) presents an opportunity to alert patients and their families on how to recognize and act in the event of stroke. Our aim was to compare stroke recognition-to-door time and prehospital stroke code activation in patients with known AF (KAF) and AF detected after stroke (AFDAS).

Methods

We performed a retrospective cohort study of consecutive patients receiving acute recanalization treatment for acute ischemic stroke between January 2016 and August 2022, with AF as a potential stroke cause. Patients were divided into KAF and AFDAS, and stroke recognition-to-door time and prehospital stroke code activation were compared. In the KAF subgroup, we assessed whether the use of preadmission anticoagulation was associated with the studied prehospital parameters.

Results

We included 438 patients, 290 female (66.2%), mean age 79.3±9.4 years. In total, 238 patients had KAF (54.3%) and 200 (45.7%) had AFDAS. Of those with KAF, 114 (48.1%) were pretreated with anticoagulation. Patients with KAF and AFDAS had no differences in stroke recognition-to-door time (74.0 [55.0–101.0] vs. 78.0 [60.0–112.0] min; p=0.097) or prehospital stroke code activation [148 (64.6%) vs. 128 (65.3%); p=0.965]. In the KAF subgroup, preadmission anticoagulation did not influence stroke recognition-to-door time or mode of hospital admission.

Conclusion

Stroke recognition-to-door time and prehospital stroke code activation were similar between patients with known or newly diagnosed AF. Preadmission anticoagulation treatment also did not affect the studied parameters. Our findings highlight a missed opportunity to promote stroke knowledge in patients followed due to AF.

导言和目标：对心房颤动（AF）患者的随访为提醒患者及其家属在发生卒中时如何识别和采取行动提供了机会。我们的目的是比较已知心房颤动患者（KAF）和中风后发现心房颤动患者（AFDAS）的中风识别到门时间和院前中风代码激活情况：我们对 2016 年 1 月至 2022 年 8 月间因急性缺血性卒中接受急性再通治疗的连续患者进行了回顾性队列研究，房颤是卒中的潜在原因。研究人员将患者分为 KAF 和 AFDAS 两组，并比较了卒中识别到门时间和院前卒中代码激活情况。在 KAF 亚组中，我们评估了入院前抗凝药的使用是否与所研究的院前参数相关：我们共纳入了 438 名患者，其中 290 名女性（66.2%），平均年龄为 79.3±9.4 岁。共有 238 名患者患有 KAF（54.3%），200 名患者患有 AFDAS（45.7%）。在 KAF 患者中，114 人（48.1%）接受了抗凝治疗。KAF 患者和 AFDAS 患者的卒中识别到门时间（74.0 [55.0-101.0] 分钟 vs. 78.0 [60.0-112.0] 分钟；p=0.097）或院前卒中代码激活时间（148 (64.6%) vs. 128 (65.3%)；p=0.965）无差异。在 KAF 亚组中，入院前的抗凝治疗并不影响卒中识别到入院的时间或入院方式：结论：已知心房颤动或新诊断心房颤动的患者的卒中识别至入院时间和院前卒中代码激活时间相似。入院前的抗凝治疗也不会影响研究参数。我们的研究结果凸显了在心房颤动患者中宣传卒中知识所错失的良机。

{"title":"Are we missing an opportunity? Prehospital delay in patients with acute ischemic stroke and known atrial fibrillation","authors":"Marta Magriço , Miguel Serôdio , João Nuno Ramos , Rita Ventura , André Sobral-Pinho , João Pedro Marto , Miguel Viana-Baptista","doi":"10.1016/j.repc.2023.11.005","DOIUrl":"10.1016/j.repc.2023.11.005","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>The follow-up of patients with atrial fibrillation (AF) presents an opportunity to alert patients and their families on how to recognize and act in the event of stroke. Our aim was to compare stroke recognition-to-door time and prehospital stroke code activation in patients with known AF (KAF) and AF detected after stroke (AFDAS).</p></div><div><h3>Methods</h3><p>We performed a retrospective cohort study of consecutive patients receiving acute recanalization treatment for acute ischemic stroke between January 2016 and August 2022, with AF as a potential stroke cause. Patients were divided into KAF and AFDAS, and stroke recognition-to-door time and prehospital stroke code activation were compared. In the KAF subgroup, we assessed whether the use of preadmission anticoagulation was associated with the studied prehospital parameters.</p></div><div><h3>Results</h3><p>We included 438 patients, 290 female (66.2%), mean age 79.3±9.4 years. In total, 238 patients had KAF (54.3%) and 200 (45.7%) had AFDAS. Of those with KAF, 114 (48.1%) were pretreated with anticoagulation. Patients with KAF and AFDAS had no differences in stroke recognition-to-door time (74.0 [55.0–101.0] vs. 78.0 [60.0–112.0] min; p=0.097) or prehospital stroke code activation [148 (64.6%) vs. 128 (65.3%); p=0.965]. In the KAF subgroup, preadmission anticoagulation did not influence stroke recognition-to-door time or mode of hospital admission.</p></div><div><h3>Conclusion</h3><p>Stroke recognition-to-door time and prehospital stroke code activation were similar between patients with known or newly diagnosed AF. Preadmission anticoagulation treatment also did not affect the studied parameters. Our findings highlight a missed opportunity to promote stroke knowledge in patients followed due to AF.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000659/pdfft?md5=7cde4552f871f628f9d46e840a1b7704&pid=1-s2.0-S0870255124000659-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current and future challenges: Exploring new opportunities in stroke education for atrial fibrillation patients 当前和未来的挑战：探索心房颤动患者卒中教育的新机遇。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.04.004

Alexandre Amaral e Silva

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Revista Portuguesa De Cardiologia

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀