Daniel Medeiros Moreira

Introduction Coronary artery disease is the leading cause of death worldwide and presents a great social and financial burden for healthcare systems. Although the entire process of atherosclerotic plaque formation and progression to myocardial infarction is driven by inflammation, few therapies targeting this mechanism are available (e.g., colchicine)., In this context, foods with bioactive properties, such as chocolate, have drawn interest for their potential cardiovascular benefits. Prospective studies and meta-analyses have demonstrated that chocolate consumption may reduce the incidence of [...] Introduction Coronary artery disease is the leading cause of death worldwide and presents a great social and financial burden for healthcare systems. Although the entire process of atherosclerotic plaque formation and progression to myocardial infarction is driven by inflammation, few therapies targeting this mechanism are available (e.g., colchicine)., In this context, foods with bioactive properties, such as chocolate, have drawn interest for their potential cardiovascular benefits. Prospective studies and meta-analyses have demonstrated that chocolate consumption may reduce the incidence of

Background: Cardiovascular diseases are the leading cause of mortality worldwide. Wine consumption has been associated with cardiovascular benefits, which are attributed to the presence of flavonoids. Objectives: To assess the effects of alcoholic and non-alcoholic red wine on endothelial function by measuring variations in brachial artery flow-mediated dilation (FMD) and analyzing changes in arterial diameter, heart rate, and blood pressure. Methods: A randomized, parallel, controlled clinical trial was conducted with 22 participants assessed at 2 distinct time points. Participants [...] Abstract Background: Cardiovascular diseases are the leading cause of mortality worldwide. Wine consumption has been associated with cardiovascular benefits, which are attributed to the presence of flavonoids. Objectives: To assess the effects of alcoholic and non-alcoholic red wine on endothelial function by measuring variations in brachial artery flow-mediated dilation (FMD) and analyzing changes in arterial diameter, heart rate, and blood pressure. Methods: A randomized, parallel, controlled clinical trial was conducted with 22 participants assessed at 2 distinct time points. Participants

The aim is to estimate the overall one-year survival rate and readmission rate after the first myocardial infarction. A cohort study involving 689 patients followed up between August 2016 and March 2022. The Kaplan-Meier estimator and the log-rank test were used. Cox semiparametric model was used to estimate death and readmission risk. The mean age was 60.0 (SD 11.0) years old, 67.9% men and 50.7% with ST-elevation myocardial infarction. The overall survival rate was 96.3%, with median time of death of 41.5 days. The readmission-free survival rate was 83.4%, with median time of readmission of 54 days. Age of 60 years and over increased death risk by 10.01 and the presence of systemic arterial hypertension increased readmission risk by 1.52. The overall survival rate was 96.2% with difference in age groups. The readmission-free survival rate was 83.4%, with difference by the presence of systemic arterial hypertension. As these events are quite prevalent, a better assessment of the effectiveness of the health care provided and the actions that must be taken to reduce the incidence and consequent morbidity and mortality is necessary.

Resumo Fundamento As doenças cardiovasculares constituem a principal causa de mortalidade no mundo, gerando impactos sociais e econômicos significativos. Essas condições frequentemente coexistem com comorbidades, como a disfunção renal. Objetivos Avaliar a associação entre a depuração de creatinina e a incidência de desfechos cardiovasculares no período de 1 ano em pacientes com diagnóstico de infarto agudo do miocárdio (IAM). Métodos Este estudo de coorte prospectivo incluiu pacientes hospitalizados em decorrência do primeiro episódio de IAM. A depuração de creatinina foi analisada em relação aos desfechos cardiovasculares, incluindo recidiva de IAM, acidente vascular cerebral e óbito de causa cardiovascular. Valores de p <0,05 foram considerados estatisticamente significativos. Resultados Foram analisados 1.324 pacientes, com idade média de 60,9 ± 11,4 anos, dos quais 67,4% do sexo masculino. Depuração de creatinina inferior a 60 ml/min apresentou associação significativa com hipertensão arterial sistêmica (79,6% vs. 55,1%; p<0,001), diabetes mellitus (40,8% vs. 24,5%; p<0,001) e dislipidemia (38,8% vs. 31,4%; p=0,043). Valores mais elevados de depuração de creatinina associaram-se a menor risco de eventos adversos cardiovasculares maiores (MACEs) em 1 ano (HR: 0,992; IC 95%: 0,984-0,999; p=0,030). Ademais, verificou-se associação com menor mortalidade geral (HR: 0,984; IC 95%: 0,970-0,998; p=0,021). Conclusão Valores mais elevados de depuração de creatinina associaram-se a menores razões de risco para MACEs e mortalidade geral no período de 1 ano após o IAM.

Background Cardiovascular diseases are the leading cause of death worldwide, with substantial social and economic impacts. These conditions are frequently associated with comorbidities, including renal dysfunction. Objectives To evaluate the association between creatinine clearance and the incidence of cardiovascular outcomes within 1 year in patients diagnosed with acute myocardial infarction (AMI). Methods This prospective cohort study included patients hospitalized for their first AMI. Creatinine clearance was assessed in relation to cardiovascular outcomes, including recurrent AMI, stroke, and cardiovascular death. A p-value of <0.05 was considered statistically significant. Results A total of 1,324 patients were analyzed, with a mean age of 60.9 ± 11.4 years; 67.4% were male. Creatinine clearance <60 mL/min was significantly associated with systemic arterial hypertension (79.6% vs. 55.1%, p<0.001), diabetes mellitus (40.8% vs. 24.5%, p<0.001), and dyslipidemia (38.8% vs. 31.4%, p=0.043). Higher creatinine clearance values were associated with a reduced risk of major adverse cardiovascular events (MACE) at 1 year (HR: 0.992; 95% CI: 0.984-0.999; p=0.030). Additionally, higher clearance was linked to lower overall mortality (HR: 0.984; 95% CI: 0.970-0.998; p=0.021). Conclusion Higher creatinine clearance values are associated with a lower hazard ratio for MACE and overall mortality within 1 year following AMI.

A Esclerose Sistêmica é uma doença multissistêmica rara caracterizada pelo Fenômeno de Raynaud, vasculopatias, fibrose de pele, entre outros. É uma doença devastadora de alta mortalidade, custo e impacto na qualidade de vida. Ademais, é uma doença autoimune heterogênea de grande complexidade diagnóstica, principalmente quando associada a outras síndromes autoimunes. O relato a seguir tem como objetivo demonstrar a complexidade diagnóstica de uma provável associação entre Esclerose Sistêmica e Síndrome de Sjogren, com múltiplos achados clínicos e em exames complementares.

Resumo Fundamento: A síndrome de Brugada é um distúrbio arritmogênico hereditário caracterizado pela presença de características eletrocardiográficas específicas com ou sem sintomas. Os pacientes apresentam risco aumentado de morte súbita por fibrilação ventricular. A prevalência desse padrão eletrocardiográfico difere de acordo com a região estudada. Porém, informações epidemiológicas, incluindo a população brasileira, são escassas. Objetivo: Avaliar a prevalência do padrão eletrocardiográfico da síndrome de Brugada e o perfil epidemiológico associado a ela. Métodos: Estudo transversal que incluiu 846.533 registros ECG [...] Resumo Fundamento: A síndrome de Brugada é um distúrbio arritmogênico hereditário caracterizado pela presença de características eletrocardiográficas específicas com ou sem sintomas. Os pacientes apresentam risco aumentado de morte súbita por fibrilação ventricular. A prevalência desse padrão eletrocardiográfico difere de acordo com a região estudada. Porém, informações epidemiológicas, incluindo a população brasileira, são escassas. Objetivo: Avaliar a prevalência do padrão eletrocardiográfico da síndrome de Brugada e o perfil epidemiológico associado a ela. Métodos: Estudo transversal que incluiu 846.533 registros ECG

Background: In ST-segment elevation myocardial infarction, the main therapy is early arterial reperfusion, performed by primary percutaneous coronary intervention. The recommended door-to-balloon time is