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  1. Article ; Online: Prevalência de aterosclerose subclínica e reclassificação de risco cardiovascular pela medida da espessura íntimo-medial carotídea em pacientes hipertensos ambulatoriais.

    Monteiro Júnior, Francisco das Chagas / Pereira da Cunha Júnior, Cacionor / Muniz Ferreira, Pedro Antônio / Teixeira Nunes, José Aldemir / Lopes Brito, Ronald / Barbosa, José Bonifácio / Ribeiro Mandarino, Natália / Santos Lages, Joyce / Salgado Filho, Natalino / Correia de Lima, Valter

    Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology

    2013  Volume 32, Issue 12, Page(s) 975–980

    Abstract: Introduction and objectives: Although carotid intima-media thickness (CIMT) is considered a surrogate marker of subclinical atherosclerosis, with known value in risk stratification, its routine use in hypertensive patients is not recommended. The aim of ...

    Title translation Prevalence of subclinical atherosclerosis and cardiovascular risk reclassification by measure of carotid intima-media thickness in ambulatory hypertensive patients.
    Abstract Introduction and objectives: Although carotid intima-media thickness (CIMT) is considered a surrogate marker of subclinical atherosclerosis, with known value in risk stratification, its routine use in hypertensive patients is not recommended. The aim of this study was to determine the prevalence of subclinical atherosclerosis through measurement of CIMT and its impact on reclassification of risk in hypertensive patients.
    Methods: This was a cross-sectional study of 94 middle-aged (56.99±11.89 years) hypertensive outpatients without overt cardiovascular disease, 68.1% female. All participants underwent clinical examination, biochemical tests, echocardiogram and measurement of CIMT by high-resolution ultrasound.
    Results: Although the majority of patients were stratified as low (63.5%) or intermediate risk (23%) according to their Framingham score, a high prevalence (75.3%) of increased CIMT was observed in the overall sample, including in the low (61%) and intermediate risk groups (93.8%). CIMT measurement resulted in risk reclassification of 70.31% of the patients, 61% of those at low risk being reclassified as intermediate risk and 93.8% of those at intermediate risk being reclassified as high risk.
    Conclusion: In these hypertensive outpatients, predominantly middle-aged and female, CIMT measurement revealed a high prevalence of subclinical atherosclerosis and resulted in risk reclassification in the majority of cases.
    MeSH term(s) Ambulatory Care ; Atherosclerosis/complications ; Atherosclerosis/epidemiology ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/epidemiology ; Carotid Intima-Media Thickness ; Cross-Sectional Studies ; Female ; Humans ; Hypertension/complications ; Male ; Middle Aged ; Prevalence ; Risk Assessment
    Language Portuguese
    Publishing date 2013-12
    Publishing country Portugal
    Document type English Abstract ; Journal Article
    ZDB-ID 632718-7
    ISSN 2174-2030 ; 0870-2551 ; 0304-4750
    ISSN (online) 2174-2030
    ISSN 0870-2551 ; 0304-4750
    DOI 10.1016/j.repc.2013.04.016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Surgical Treatment of Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation.

    Mangner, Norman / del Val, David / Abdel-Wahab, Mohamed / Crusius, Lisa / Durand, Eric / Ihlemann, Nikolaj / Urena, Marina / Pellegrini, Costanza / Giannini, Francesco / Gasior, Tomasz / Wojakowski, Wojtek / Landt, Martin / Auffret, Vincent / Sinning, Jan Malte / Cheema, Asim N / Nombela-Franco, Luis / Chamandi, Chekrallah / Campelo-Parada, Francisco / Munoz-Garcia, Erika /
    Herrmann, Howard C / Testa, Luca / Kim, Won-Keun / Castillo, Juan Carlos / Alperi, Alberto / Tchetche, Didier / Bartorelli, Antonio L / Kapadia, Samir / Stortecky, Stefan / Amat-Santos, Ignacio / Wijeysundera, Harindra C / Lisko, John / Gutiérrez-Ibanes, Enrique / Serra, Vicenç / Salido, Luisa / Alkhodair, Abdullah / Livi, Ugolino / Chakravarty, Tarun / Lerakis, Stamatios / Vilalta, Victoria / Regueiro, Ander / Romaguera, Rafael / Kappert, Utz / Barbanti, Marco / Masson, Jean-Bernard / Maes, Frédéric / Fiorina, Claudia / Miceli, Antonio / Kodali, Susheel / Ribeiro, Henrique B / Mangione, Jose Armando / Sandoli de Brito, Fabio / Actis Dato, Guglielmo Mario / Rosato, Francesco / Ferreira, Maria-Cristina / Correia de Lima, Valter / Colafranceschi, Alexandre Siciliano / Abizaid, Alexandre / Marino, Marcos Antonio / Esteves, Vinicius / Andrea, Julio / Godinho, Roger R / Alfonso, Fernando / Eltchaninoff, Helene / Søndergaard, Lars / Himbert, Dominique / Husser, Oliver / Latib, Azeem / Le Breton, Hervé / Servoz, Clement / Pascual, Isaac / Siddiqui, Saif / Olivares, Paolo / Hernandez-Antolin, Rosana / Webb, John G / Sponga, Sandro / Makkar, Raj / Kini, Annapoorna S / Boukhris, Marouane / Gervais, Philippe / Côté, Mélanie / Holzhey, David / Linke, Axel / Rodés-Cabau, Josep

    Journal of the American College of Cardiology

    2022  Volume 79, Issue 8, Page(s) 772–785

    Abstract: Background: The optimal treatment of patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is uncertain.: Objectives: The goal of this study was to investigate the clinical characteristics and outcomes ... ...

    Abstract Background: The optimal treatment of patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is uncertain.
    Objectives: The goal of this study was to investigate the clinical characteristics and outcomes of patients with TAVI-IE treated with cardiac surgery and antibiotics (IE-CS) compared with patients treated with antibiotics alone (IE-AB).
    Methods: Crude and inverse probability of treatment weighting analyses were applied for the treatment effect of cardiac surgery vs medical therapy on 1-year all-cause mortality in patients with definite TAVI-IE. The study used data from the Infectious Endocarditis after TAVI International Registry.
    Results: Among 584 patients, 111 patients (19%) were treated with IE-CS and 473 patients (81%) with IE-AB. Compared with IE-AB, IE-CS was not associated with a lower in-hospital mortality (HR
    Conclusions: In this registry, the majority of patients with TAVI-IE were treated with antibiotics alone. Cardiac surgery was not associated with an improved all-cause in-hospital or 1-year mortality. The high mortality of patients with TAVI-IE was strongly linked to patients' characteristics, pathogen, and IE-related complications.
    MeSH term(s) Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Cardiac Surgical Procedures ; Combined Modality Therapy ; Endocarditis, Bacterial/drug therapy ; Endocarditis, Bacterial/etiology ; Endocarditis, Bacterial/surgery ; Female ; Humans ; Male ; Prosthesis-Related Infections/drug therapy ; Prosthesis-Related Infections/etiology ; Prosthesis-Related Infections/surgery ; Staphylococcal Infections/drug therapy ; Staphylococcal Infections/etiology ; Staphylococcal Infections/surgery ; Transcatheter Aortic Valve Replacement/adverse effects
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-02-21
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2021.11.056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement.

    Panagides, Vassili / Del Val, David / Abdel-Wahab, Mohamed / Mangner, Norman / Durand, Eric / Ihlemann, Nikolaj / Urena, Marina / Pellegrini, Costanza / Giannini, Francesco / Gasior, Tomasz / Wojakowski, Wojtek / Landt, Martin / Auffret, Vincent / Sinning, Jan Malte / Cheema, Asim N / Nombela-Franco, Luis / Chamandi, Chekrallah / Campelo-Parada, Francisco / Munoz-Garcia, Erika /
    Herrmann, Howard C / Testa, Luca / Kim, Won Keun / Castillo, Juan Carlos / Alperi, Alberto / Tchetche, Didier / Bartorelli, Antonio L / Kapadia, Samir / Stortecky, Stefan / Amat-Santos, Ignacio / Wijeysundera, Harindra C / Lisko, John / Gutiérrez-Ibanes, Enrique / Serra, Vicenç / Salido, Luisa / Alkhodair, Abdullah / Livi, Ugolino / Chakravarty, Tarun / Lerakis, Stamatios / Vilalta, Victoria / Regueiro, Ander / Romaguera, Rafael / Kappert, Utz / Barbanti, Marco / Masson, Jean Bernard / Maes, Frédéric / Fiorina, Claudia / Miceli, Antonio / Kodali, Susheel / Ribeiro, Henrique B / Mangione, Jose Armando / Sandoli de Brito, Fabio / Actis Dato, Guglielmo Mario / Rosato, Francesco / Ferreira, Maria Cristina / Correia de Lima, Valter / Colafranceschi, Alexandre Siciliano / Abizaid, Alexandre / Marino, Marcos Antonio / Esteves, Vinicius / Andrea, Julio / Godinho, Roger R / Alfonso, Fernando / Eltchaninoff, Helene / Søndergaard, Lars / Himbert, Dominique / Husser, Oliver / Latib, Azeem / Le Breton, Hervé / Servoz, Clement / Pascual, Isaac / Siddiqui, Saif / Olivares, Paolo / Hernandez-Antolin, Rosana / Webb, John G / Sponga, Sandro / Makkar, Raj / Kini, Annapoorna S / Boukhris, Marouane / Gervais, Philippe / Linke, Axel / Crusius, Lisa / Holzhey, David / Rodés-Cabau, Josep

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2021  Volume 75, Issue 4, Page(s) 638–646

    Abstract: Background: Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients.: Methods: This multicenter ... ...

    Abstract Background: Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients.
    Methods: This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53-421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm, or fistula.
    Results: A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (adjusted odds ratio [ORadj], 2.08; 95% confidence interval [CI]: 1.27-3.41; P = .003) and IE secondary to coagulase-negative staphylococci (ORadj, 2.71; 95% CI: 1.57-4.69; P < .001) were associated with an increased risk of PEE. Surgery was performed at index IE episode in 34 patients (32.4%) with PEE (vs 15.2% in patients without PEE, P < .001). In-hospital and 2-year mortality rates among PEE-IE patients were 36.5% and 69.4%, respectively. Factors independently associated with an increased mortality were the occurrence of other complications (stroke post-TAVR, acute renal failure, septic shock) and the lack of surgery at index IE hospitalization (padj < 0.05 for all).
    Conclusions: PEE occurred in about one-fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.
    MeSH term(s) Abscess ; Aneurysm, False/complications ; Aneurysm, False/surgery ; Coagulase ; Endocarditis/epidemiology ; Endocarditis/etiology ; Endocarditis/surgery ; Endocarditis, Bacterial/epidemiology ; Endocarditis, Bacterial/etiology ; Endocarditis, Bacterial/surgery ; Humans ; Renal Insufficiency, Chronic/complications ; Risk Factors ; Transcatheter Aortic Valve Replacement/adverse effects
    Chemical Substances Coagulase
    Language English
    Publishing date 2021-12-10
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciab1004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Stroke Complicating Infective Endocarditis After Transcatheter Aortic Valve Replacement.

    Del Val, David / Abdel-Wahab, Mohamed / Mangner, Norman / Durand, Eric / Ihlemann, Nikolaj / Urena, Marina / Pellegrini, Costanza / Giannini, Francesco / Gasior, Tomasz / Wojakowski, Wojtek / Landt, Martin / Auffret, Vincent / Sinning, Jan Malte / Cheema, Asim N / Nombela-Franco, Luis / Chamandi, Chekrallah / Campelo-Parada, Francisco / Munoz-Garcia, Erika / Herrmann, Howard C /
    Testa, Luca / Won-Keun, Kim / Castillo, Juan Carlos / Alperi, Alberto / Tchetche, Didier / Bartorelli, Antonio L / Kapadia, Samir / Stortecky, Stefan / Amat-Santos, Ignacio / Wijeysundera, Harindra C / Lisko, John / Gutiérrez-Ibanes, Enrique / Serra, Vicenç / Salido, Luisa / Alkhodair, Abdullah / Livi, Ugolino / Chakravarty, Tarun / Lerakis, Stamatios / Vilalta, Victoria / Regueiro, Ander / Romaguera, Rafael / Kappert, Utz / Barbanti, Marco / Masson, Jean-Bernard / Maes, Frédéric / Fiorina, Claudia / Miceli, Antonio / Kodali, Susheel / Ribeiro, Henrique B / Mangione, Jose Armando / Sandoli de Brito, Fabio / Actis Dato, Guglielmo Mario / Rosato, Francesco / Ferreira, Maria-Cristina / Correia de Lima, Valter / Colafranceschi, Alexandre Siciliano / Abizaid, Alexandre / Marino, Marcos Antonio / Esteves, Vinicius / Andrea, Julio / Godinho, Roger R / Alfonso, Fernando / Eltchaninoff, Helene / Søndergaard, Lars / Himbert, Dominique / Husser, Oliver / Latib, Azeem / Le Breton, Hervé / Servoz, Clement / Pascual, Isaac / Siddiqui, Saif / Olivares, Paolo / Hernandez-Antolin, Rosana / Webb, John G / Sponga, Sandro / Makkar, Raj / Kini, Annapoorna S / Boukhris, Marouane / Gervais, Philippe / Linke, Axel / Crusius, Lisa / Holzhey, David / Rodés-Cabau, Josep

    Journal of the American College of Cardiology

    2021  Volume 77, Issue 18, Page(s) 2276–2287

    Abstract: Background: Stroke is one of the most common and potentially disabling complications of infective endocarditis (IE). However, scarce data exist about stroke complicating IE after transcatheter aortic valve replacement (TAVR).: Objectives: The purpose ...

    Abstract Background: Stroke is one of the most common and potentially disabling complications of infective endocarditis (IE). However, scarce data exist about stroke complicating IE after transcatheter aortic valve replacement (TAVR).
    Objectives: The purpose of this study was to determine the incidence, risk factors, clinical characteristics, management, and outcomes of patients with definite IE after TAVR complicated by stroke during index IE hospitalization.
    Methods: Data from the Infectious Endocarditis after TAVR International Registry (including 569 patients who developed definite IE following TAVR from 59 centers in 11 countries) was analyzed. Patients were divided into two groups according to stroke occurrence during IE admission (stroke [S-IE] vs. no stroke [NS-IE]).
    Results: A total of 57 (10%) patients had a stroke during IE hospitalization, with no differences in causative microorganism between groups. S-IE patients exhibited higher rates of acute renal failure, systemic embolization, and persistent bacteremia (p < 0.05 for all). Previous stroke before IE, residual aortic regurgitation ≥moderate after TAVR, balloon-expandable valves, IE within 30 days after TAVR, and vegetation size >8 mm were associated with a higher risk of stroke during the index IE hospitalization (p < 0.05 for all). Stroke rate in patients with no risk factors was 3.1% and increased up to 60% in the presence of >3 risk factors. S-IE patients had higher rates of in-hospital mortality (54.4% vs. 28.7%; p < 0.001) and overall mortality at 1 year (66.3% vs. 45.6%; p < 0.001). Surgical treatment was not associated with improved outcomes in S-IE patients (in-hospital mortality: 46.2% in surgical vs. 58.1% in no surgical treatment; p = 0.47).
    Conclusions: Stroke occurred in 1 of 10 patients with IE post-TAVR. A history of stroke, short time between TAVR and IE, vegetation size, valve prosthesis type, and residual aortic regurgitation determined an increased risk. The occurrence of stroke was associated with increased in-hospital and 1-year mortality rates, and surgical treatment failed to improve clinical outcomes.
    MeSH term(s) Aged ; Aged, 80 and over ; Endocarditis, Bacterial/complications ; Female ; Humans ; Incidence ; Male ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Postoperative Complications/therapy ; Retrospective Studies ; Risk Factors ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/etiology ; Stroke/therapy ; Transcatheter Aortic Valve Replacement
    Language English
    Publishing date 2021-06-01
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2021.03.233
    Database MEDical Literature Analysis and Retrieval System OnLINE

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