Abstract:
BACKGROUND:Behavioral scientists consistently point out that knowledge does not influence decisions as expected. GRACE Score is a well validated risk model for predicting death of patients with acute coronary syndromes (ACS). However, whether prognostic assessment by this Score modulates medical decision is not known. OBJECTIVE:To test the hypothesis that the use of a validated risk score rationalizes the choice of invasive strategies for higher risk patients with non-ST-elevation ACS. METHODS:ACS patients were consecutively included in this prospective registry. GRACE Score was routinely used by cardiologists as the prognostic risk model. An invasive strategy was defined as an immediate decision of the coronary angiography, which in the selective strategy was only indicated in case of positive non-invasive test or unstable course. Firstly, we evaluated the association between GRACE and invasiviness; secondly, in order to find out the actual determinants of the invasive strategy, we built a propensity model for invasive decision. For this analysis, a p-value < 0.05 was considered as significant. RESULTS:In a sample of 570 patients, an invasive strategy was adopted for 394 (69%). GRACE Score was 118 ± 38 for the invasive group, similar to 116 ± 38 for the selective group (p = 0.64). A propensity score for the invasive strategy was derived from logistic regression: positive troponin and ST-deviation (positive associations) and hemoglobin (negative association). This score predicted an invasive strategy with c-statistics of 0.68 (95%CI: 0.63-0.73), opposed to GRACE Score (AUC 0.51; 95%CI: 0.47-0.57). CONCLUSION:The dissociation between GRACE Score and invasive decision in ACS suggests that the knowledge of prognostic probabilities might not determine medical decision.
journal_name
Arq Bras Cardioljournal_title
Arquivos brasileiros de cardiologiaauthors
Carvalhal MC,Souza TMB,Suerdieck J,Lopes F,Correia VCA,Lacerda YF,Sá N,Sodré GS,Rabelo MMN,Correia LCLdoi
10.5935/abc.20190046subject
Has Abstractpub_date
2019-06-01 00:00:00pages
721-726issue
6eissn
0066-782Xissn
1678-4170pii
S0066-782X2019005005103journal_volume
112pub_type
杂志文章abstract:BACKGROUND:Percutaneous intervention in patients with bioprosthetic mitral valve dysfunction is an alternative to conventional surgical treatment. OBJECTIVES:To report the first Brazilian experience with transseptal transcatheter bioprosthetic mitral valve-in-valve implantation (transseptal-TMVIV). METHODS:Patients w...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章,多中心研究
doi:10.36660/abc.20190252
更新日期:2020-09-01 00:00:00
abstract::The assessment of left atrial (LA) function is used in various cardiovascular diseases. LA plays a complementary role in cardiac performance by modulating left ventricular (LV) function. Transthoracic two-dimensional (2D) phasic volumes and Doppler echocardiography can measure LA function non‑invasively. However, eval...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章,评审
doi:10.5935/abc.20150144
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Cardiac magnetic resonance imaging is considered the gold-standard method for the calculation of cardiac volumes. Transthoracic impedance cardiography assesses the cardiac output. No studies validating this measurement, in comparison to that obtained by magnetic resonance imaging, are available. OBJECTIVE:T...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2012005000104
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To investigate a group of patients that have a significant lesion in a single-vessel and to demonstrate whether or not the sensitivity and specificity of a dobutamine stress echocardiography (DSE) was valuable in the evaluation of myocardial viability for these patients. METHODS:Twenty patients who had under...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2005001900005
更新日期:2005-12-01 00:00:00
abstract:PURPOSE:To analyze, by cross-sectional echocardiography, morphological features of the atrial atrioventricular and ventricular septum potentially involved in the genesis of fixed subaortic stenosis. METHODS:Forty three children with fixed subaortic stenosis were compared with 86 normal children, matched by age, sex an...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract::The origin of the right pulmonary artery from the ascending aorta is a rare cogenital anomaly, with very few reports in the literature. We describe two cases of this rare malformation, one of them, associated with interruption of the aortic arch (type B). In both cases, the diagnosis was made by two-dimensional echoca...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x1998000500007
更新日期:1998-05-01 00:00:00
abstract::Anticoagulation is the chief problem during pregnancy of women with mechanical prosthetic valves. Many studies have investigated a nonthrombogenic valve. Since 1978 we have used a biological porcine prosthetic valves in 16 pregnancies, 11 patients with regular clinical electrocardiographic, echocardiographic and chest...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract:OBJECTIVE:Compare the therapeutic response of symptomatic, hypertensive patients to symptomatic medication or anti-hypertensive drugs at the Emergency Unit. METHODS:A randomized, blind clinical trial involving 100 (one hundred) patients assisted at the Cardiology Emergency Unit at Oswaldo Cruz University Hospital (HUO...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章,随机对照试验
doi:10.1590/s0066-782x2005001500008
更新日期:2005-08-01 00:00:00
abstract::The risk scores used as assistance agents in valve diseases are validated worldwide; however, the data are not homogeneous. The epidemiological characteristics of each population require local validation of these risk tools. The percutaneous valve replacement, which is a reality in valvular diseases (especially aortic...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2012000500018
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Heart failure is a severe complication associated with doxorubicin (DOX) use. Strain, assessed by two-dimensional speckle tracking (2D-STE), has been shown to be useful in identifying subclinical ventricular dysfunction. OBJECTIVES:a) To investigate the role of strain in the identification of subclinical ve...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.5935/abc.20140209
更新日期:2015-04-01 00:00:00
abstract::For purposes of studying left ventricular mechanics, 184 chronic chagasic and 85 primary cardiomyopathy patients were submitted to an extensive invasive (LV cine, right and left cardiac catheterization and coronarography) and non-invasive protocol. The afterload, (mean wall stress), the contractile status (ejection fr...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Effective interventions to improve medication adherence are usually complex and expensive. OBJECTIVE:To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD. METHOD:A pilot RCT was conducted at a teaching hospital. I...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章,随机对照试验
doi:10.5935/abc.20140151
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Heart rate recovery after treadmill electrocardiographic exercise stress test is modulated by the autonomic nervous system. Analysis of heart rate variability can provide useful information about autonomic control of the cardiovascular system. OBJECTIVE:The aim of the study was to test the hypothesis of ass...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2008000600005
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:The Stroop test requires the individual to respond to specific elements of a stimulus, whereas inhibiting more automated processes. OBJECTIVE:To compare the cardiovascular reactivity induced by the computerized version of the Stroop word-color test TESTINPACS with the traditional version based on the readin...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2010005000006
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is the most common arrhythmia in adults, and is encountered in 10-15% of the patients with hyperthyroidism. Unless euthyroidism is restored, pharmacological or electrical cardioversion is controversial in patients with AF who remain hyperthyroid. OBJECTIVE:The aim of this study was ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.5935/abc.20160013
更新日期:2016-02-01 00:00:00
abstract::Six days old neonate with pulmonary atresia and intact ventricular septum is reported in which a communication was established between the right ventricle and the pulmonary artery. The membraneous atresia was perforated with a special radiofrequency catheter 2F connected to a Hat 200S radiofrequency generator (Osypka)...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract::This is the report of a 74-year-old female patient with a history of systemic hypertension and peripheral vascular disease who presented acute coronary syndrome symptoms. Coronary angiography showed coronary arteries with no significant obstructions. Ventriculography and echocardiography showed akinesia in mid and api...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2008000300013
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Few data are available on diastolic function in patients with aortic stenosis (AOS) with indication of surgical treatment. A potential correlation between biomarkers and diastolic function has not been established. OBJECTIVE:The aim of our study was to evaluate diastolic function in patients with AOS waitin...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.5935/abc.20130076
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To compare blood pressure, lipid profile, food intake, and anthropometric data of adolescents with or without a familial history of hypertension. METHODS:Forty-three adolescents from both sexes were assessed, with ages ranging from 11 to 18 years old. Twenty had hypertensive parents, and 23 had normotensive ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2004000200005
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:The analysis of immediate and long-term results of mitral valvoplasty by balloon catheter (MVRBC) are still lacking in literature, mainly in the national context. OBJECTIVE:To assess the immediate and late results of patients submitted to mitral valve repair by balloon catheter. METHOD:A total of 330 conse...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2010000300020
更新日期:2010-03-01 00:00:00
abstract::We describe the treatment of a patient presenting with very-late stent thrombosis with the use of a drug-coated balloon. In this patient, optical coherence tomography disclosed that ruptured and complicated neoatherosclerosis was the underlying substrate responsible for the episode of very-late stent thrombosis. The p...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.5935/abc.20160089
更新日期:2016-06-01 00:00:00
abstract:PURPOSE:To evaluate the influence of age on response to pravastatin treatment in patients treated by community physicians. METHODS:According to age, 873 patients were divided in three groups: group A with ages ranging from 45 to 59 years (n = 55), group B with ages from 60 to 64 years (n = 182) and group C with ages f...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To study the factors associated with the risk of in-hospital death in acute myocardial infarction in the Brazilian public health system in Rio de Janeiro, Brazil. METHODS:Sectional study of a sample with 391 randomly drawn medical records of the hospitalizations due to acute myocardial infarction recorded in...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2003000600003
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the effectiveness of acute ischemic preconditioning (IP), based on somatosensory evoked potentials (SSEP) monitoring, as a method of spinal cord protection and to asses SSEP importance in spinal cord neuromonitoring. METHODS:Twenty-eight dogs were submitted to spinal cord ischemic injury attaine...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2007000300007
更新日期:2007-03-01 00:00:00
abstract::The management of cardiac implantable electronic devices after death has become a source of controversy. There are no uniform recommendations for such management in Brazil; practices rely exclusively on institutional protocols and regional custom. When the cadaver is sent for cremation, it is recommended to remove the...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 信件
doi:10.36660/abc.20200447
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:To evaluate the results with the use of an automatic antitachycardia pacemaker in patients with refractory paroxysmal supraventricular tachycardia. PATIENTS AND METHODS:Nine patients aged 32 to 63 years with symptoms from 2 to more than 40 years and prophylactic treatment with several antiarrhythmic drugs that...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:The new European Society of Cardiology guidelines for hypertrophic cardiomyopathy (HCM) define the estimation of sudden cardiac death (SCD) risk as an integral part of clinical management. An implantable cardioverter defibrillator (ICD) is recommended (class IIa) when the risk is ≥ 6%. OBJECTIVES:To compare...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.5935/abc.20180099
更新日期:2018-06-01 00:00:00
abstract::Two male black patients, 18 and 12-year-old, with mental retardation and typical elfin face, presented with severe supravalvular aortic stenosis, thus characterizing Williams's or aortic supravalvular stenosis syndrome. Both were submitted to surgical treatment of the stenosis, and are asymptomatic after a one and fou...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::Percutaneous mitral and tricuspid balloon valvuloplasty was realized in the same procedure using a double lumen exchange catheter that could accommodate two guide wires and two balloons (19 mm and Trefoil 3 c 10 mm--Schneider) with simultaneous insufflation. Hemodynamically successful was accomplished as evidenced by ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract::This report describes a case of a 62 year-old man admitted for recurrent myocardial infarction and normal coronary arteries, caused by coronary embolism from aortic papillary fibroelastoma. Other conditions causing acute coronary syndrome and normal coronary arteries are discussed. A careful evaluation by transthoraci...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2012000100018
更新日期:2012-01-01 00:00:00