que se leu este artigo
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"Glória" "apellidos" => "Abreu" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255118307297?idApp=UINPBA00004E" "url" => "/08702551/0000003700000011/v4_201911280953/S0870255118307297/v4_201911280953/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0870255118306218" "issn" => "08702551" "doi" => "10.1016/j.repc.2018.09.007" "estado" => "S300" "fechaPublicacion" => "2018-11-01" "aid" => "1311" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2018;37:951" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 643 "formatos" => array:3 [ "EPUB" => 79 "HTML" => 319 "PDF" => 245 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Turner syndrome and pregnancy: A multidisciplinary approach" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "951" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Síndrome de Turner e gravidez: uma abordagem multidisciplinar" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ruth Alvarez, María Luisa Rodríguez, María Martín" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ruth" "apellidos" => "Alvarez" ] 1 => array:2 [ "nombre" => "María Luisa" "apellidos" => "Rodríguez" ] 2 => array:2 [ "nombre" => "María" "apellidos" => "Martín" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255118306218?idApp=UINPBA00004E" "url" => "/08702551/0000003700000011/v4_201911280953/S0870255118306218/v4_201911280953/en/main.assets" ] "asociados" => array:2 [ 0 => array:19 [ "pii" => "S0870255117303840" "issn" => "08702551" "doi" => "10.1016/j.repc.2017.07.019" "estado" => "S300" "fechaPublicacion" => "2018-08-01" "aid" => "1253" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Rev Port Cardiol. 2018;37:707-13" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1756 "formatos" => array:3 [ "EPUB" => 123 "HTML" => 1220 "PDF" => 413 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>" "titulo" => "Spontaneous coronary artery dissection: A single-center case series and literature review" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "707" "paginaFinal" => "713" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Disseção coronária espontânea – Uma série de casos de um centro e revisão da literatura" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3142 "Ancho" => 2500 "Tamanyo" => 686335 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Panel A:</span> Coronary angiography from patient 8 – spontaneous coronary artery dissection (SCAD) type 1, extending from left main coronary artery to left anterior descending artery (LAD). <span class="elsevierStyleBold">Panel B:</span> Coronary angiography from patient 8 showing the result obtained after guidewire advancement to the true LAD lumen. <span class="elsevierStyleBold">Panel C:</span> Coronary angiography from patient 11 showing diffuse lumen narrowing involving the proximal and mid segments of right coronary artery – SCAD type 2. <span class="elsevierStyleBold">Panel D:</span> Coronary angiography from patient 11 showing the angiographic result after stent implantation. <span class="elsevierStyleBold">Panels E-F</span>: Optical coherence tomography from patient 22 of distal segment of right coronary artery, depicting intramural hematoma (asterisk). <span class="elsevierStyleBold">Panels G-H:</span> Cross-sectional intravenous ultrasound views from patient 9 depicting intramural hematoma (asterisk) causing luminal stenosis in the mid-LAD.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Glória Abreu, Carlos Galvão Braga, João Costa, Pedro Azevedo, Jorge Marques" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Glória" "apellidos" => "Abreu" ] 1 => array:2 [ "nombre" => "Carlos" "apellidos" => "Galvão Braga" ] 2 => array:2 [ "nombre" => "João" "apellidos" => "Costa" ] 3 => array:2 [ "nombre" => "Pedro" "apellidos" => "Azevedo" ] 4 => array:2 [ "nombre" => "Jorge" "apellidos" => "Marques" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117303840?idApp=UINPBA00004E" "url" => "/08702551/0000003700000008/v1_201808050413/S0870255117303840/v1_201808050413/en/main.assets" ] 1 => array:19 [ "pii" => "S0870255118307297" "issn" => "08702551" "doi" => "10.1016/j.repc.2018.10.006" "estado" => "S300" "fechaPublicacion" => "2018-11-01" "aid" => "1313" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2018;37:957-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 679 "formatos" => array:3 [ "EPUB" => 90 "HTML" => 423 "PDF" => 166 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reply to Letter to the Editor “Focus on spontaneous coronary artery dissection: Where are we now?”" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "957" "paginaFinal" => "958" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Resposta à Carta ao Editor «Foco na disseção espontânea da artéria coronária: Onde estamos agora?»" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Glória Abreu" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Glória" "apellidos" => "Abreu" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255118307297?idApp=UINPBA00004E" "url" => "/08702551/0000003700000011/v4_201911280953/S0870255118307297/v4_201911280953/en/main.assets" ] ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Focus on spontaneous coronary artery dissection: Where are we now?" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "953" "paginaFinal" => "955" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Dario Buccheri" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Dario" "apellidos" => "Buccheri" "email" => array:1 [ 0 => "dariobuccheri@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Interventional Cardiology, “S. Antonio Abate” Hospital, Via Cosenza, 80, 91016 Erice (TP), Italy" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Foco na disseção espontânea da artéria coronária: Onde estamos agora?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2589 "Ancho" => 3000 "Tamanyo" => 604470 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flowchart for the diagnosis and management of spontaneous coronary artery dissection.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a></p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">I read with great interest the single-center experience on spontaneous coronary artery dissection (SCAD) recently published by Abreu and colleagues in this journal.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> The authors reported a case series consisting of 27 patients, admitted to the cardiology department between January 2010 and December 2016, with a diagnosis of acute coronary syndrome (ACS) due to ongoing SCAD.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The prevalence of SCAD was 0.5% among patients who underwent catheterization for suspected ACS (15 NSTEMI, 10 STEMI and two sudden cardiac arrest). Most were women (22 F:5 M) and the cohort's median age was 56±11 years.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Patient characteristics and clinical presentation with predisposing factors were reported in Table 1 of the article. They were managed mainly in a conservative manner (15 medical therapy vs. 12 PCI). It is not insignificant that four of the 15 patients managed conservatively had a myocardial infarction on follow-up and in two of these the initial treatment was modified, requiring a switch to coronary angioplasty, with no cases of stent thrombosis at follow-up. A close clinical follow-up with optical coherence tomography (OCT) for PCI-managed cases was recommended. Prognosis was good despite the high prevalence of reinfarction in-hospital or during follow-up.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Considering the high level of interest in this subject, the European Society of Cardiology, in partnership with the Acute Cardiovascular Care Association, has established a European SCAD registry as a platform for collaborative research with the aim of improving awareness of the condition for better management.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Here I would like to put forward some food for thought that could be useful and interesting for the <span class="elsevierStyleItalic">Journal</span>'s readers.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Of note, Abreu et al. remarked that SCAD is still an underestimated entity due to the challenging diagnosis, in which a high degree of clinical suspicion plays a key role. In this regard, I would like to underline that emerging evidence shows that this underestimation is mainly due to the absence of the classic angiographic hallmarks, which are lacking in >70% of angiographies<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a> and may be discovered only by intravascular imaging, namely OCT and intravascular ultrasound (IVUS).<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Considering the high rate of misdiagnosed SCAD,<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">2–6</span></a> an interesting and useful score system (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>) was previously published and tested<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">6–8</span></a> allowing interventionists to select suspected cases in which intravascular imaging, particularly OCT, as the first choice, thanks to its higher spatial resolution (about 10 times greater than IVUS, which represents the second line) could identify the presence of SCAD, thus reducing the time to obtain the correct diagnosis and initiate appropriate therapy. The score is in the process of statistical validation on a larger cohort.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Moreover, SCAD management remains challenging because of the lack of evidence supporting standard medical therapy, and the role of percutaneous or surgical revascularization is strongly debated.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">4,5,9</span></a> Abreu et al. state that, when necessary, a long stent or two stents were implanted, preventing the extension of intramural hematoma caused by stent compression against the vessel wall.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Conservative management (medical therapy) with aspirin, P2Y<span class="elsevierStyleInf">12</span> inhibitors, beta-blockers and statins is the preferred option according to a recently published experience-based survey. Alternatively, our group suggested invasive treatment with implantation of a drug-eluting stent or a bioresorbable scaffold (BRS) in cases of dissection involving vessels of ≥3 mm diameter or proximal vessel segments.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In my opinion, and following our experience<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">6–8,10,11</span></a> and the recent literature,<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">12,13</span></a> these patients are eligible for bioresorbable scaffolding that allows vessel sealing, in consideration of the typical absence of atherosclerotic plaque rupture and the young age of most subjects affected, as in the cases reported, thus avoiding a permanent metal prosthesis.</p><p id="par0055" class="elsevierStylePara elsevierViewall">In conclusion, our clinical-angiographic score could have helped provide the correct diagnosis, especially in challenging cases, thus allowing effective therapy that in my opinion should have been invasive, preferably with BRS implantation, considering the clinical presentation of ACS and for lesions longer than 3 mm or involving the proximal segment of coronary arteries, in view of the risk of potentially life-threatening complications that could have occurred in young people like the patients of the case series reported.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2589 "Ancho" => 3000 "Tamanyo" => 604470 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flowchart for the diagnosis and management of spontaneous coronary artery dissection.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a></p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0070" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous coronary artery dissection: a single-center case series and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G. 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Ano/Mês | Html | Total | |
---|---|---|---|
2024 Novembro | 8 | 4 | 12 |
2024 Outubro | 40 | 28 | 68 |
2024 Setembro | 34 | 30 | 64 |
2024 Agosto | 41 | 29 | 70 |
2024 Julho | 33 | 48 | 81 |
2024 Junho | 34 | 23 | 57 |
2024 Maio | 40 | 16 | 56 |
2024 Abril | 26 | 23 | 49 |
2024 Maro | 30 | 28 | 58 |
2024 Fevereiro | 31 | 21 | 52 |
2024 Janeiro | 26 | 21 | 47 |
2023 Dezembro | 17 | 18 | 35 |
2023 Novembro | 22 | 29 | 51 |
2023 Outubro | 20 | 14 | 34 |
2023 Setembro | 18 | 22 | 40 |
2023 Agosto | 19 | 18 | 37 |
2023 Julho | 24 | 24 | 48 |
2023 Junho | 22 | 16 | 38 |
2023 Maio | 38 | 29 | 67 |
2023 Abril | 20 | 2 | 22 |
2023 Maro | 31 | 24 | 55 |
2023 Fevereiro | 32 | 18 | 50 |
2023 Janeiro | 17 | 12 | 29 |
2022 Dezembro | 34 | 23 | 57 |
2022 Novembro | 37 | 29 | 66 |
2022 Outubro | 30 | 23 | 53 |
2022 Setembro | 49 | 39 | 88 |
2022 Agosto | 25 | 28 | 53 |
2022 Julho | 20 | 38 | 58 |
2022 Junho | 25 | 29 | 54 |
2022 Maio | 20 | 24 | 44 |
2022 Abril | 24 | 38 | 62 |
2022 Maro | 30 | 44 | 74 |
2022 Fevereiro | 22 | 24 | 46 |
2022 Janeiro | 26 | 30 | 56 |
2021 Dezembro | 25 | 31 | 56 |
2021 Novembro | 29 | 41 | 70 |
2021 Outubro | 30 | 51 | 81 |
2021 Setembro | 29 | 31 | 60 |
2021 Agosto | 24 | 24 | 48 |
2021 Julho | 16 | 20 | 36 |
2021 Junho | 17 | 19 | 36 |
2021 Maio | 34 | 26 | 60 |
2021 Abril | 23 | 49 | 72 |
2021 Maro | 44 | 14 | 58 |
2021 Fevereiro | 50 | 15 | 65 |
2021 Janeiro | 27 | 10 | 37 |
2020 Dezembro | 30 | 6 | 36 |
2020 Novembro | 14 | 21 | 35 |
2020 Outubro | 17 | 10 | 27 |
2020 Setembro | 15 | 14 | 29 |
2020 Agosto | 13 | 6 | 19 |
2020 Julho | 27 | 18 | 45 |
2020 Junho | 22 | 9 | 31 |
2020 Maio | 19 | 7 | 26 |
2020 Abril | 20 | 26 | 46 |
2020 Maro | 19 | 10 | 29 |
2020 Fevereiro | 81 | 19 | 100 |
2020 Janeiro | 20 | 12 | 32 |
2019 Dezembro | 45 | 9 | 54 |
2019 Novembro | 16 | 6 | 22 |
2019 Outubro | 18 | 3 | 21 |
2019 Setembro | 96 | 10 | 106 |
2019 Agosto | 10 | 3 | 13 |
2019 Julho | 19 | 12 | 31 |
2019 Junho | 18 | 9 | 27 |
2019 Maio | 15 | 9 | 24 |
2019 Abril | 15 | 10 | 25 |
2019 Maro | 12 | 11 | 23 |
2019 Fevereiro | 12 | 9 | 21 |
2019 Janeiro | 26 | 12 | 38 |
2018 Dezembro | 45 | 33 | 78 |
2018 Novembro | 11 | 17 | 28 |