array:25 [
  "pii" => "S0870255118307285"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2018.10.005"
  "estado" => "S300"
  "fechaPublicacion" => "2018-11-01"
  "aid" => "1310"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2018;37:909-10"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 860
    "formatos" => array:3 [
      "EPUB" => 95
      "HTML" => 540
      "PDF" => 225
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0870255117308004"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2018.03.016"
    "estado" => "S300"
    "fechaPublicacion" => "2018-11-01"
    "aid" => "1305"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2018;37:911-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 767
      "formatos" => array:3 [
        "EPUB" => 86
        "HTML" => 445
        "PDF" => 236
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Left main and&#47;or three-vessel disease in patients with non-ST-segment elevation myocardial infarction and low-risk GRACE score&#58; Prevalence&#44; clinical outcomes and predictors"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "911"
          "paginaFinal" => "919"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Doen&#231;a do tronco comum e&#47;ou doen&#231;a arterial coron&#225;ria de tr&#234;s vasos em doentes com enfarte agudo do mioc&#225;rdio sem eleva&#231;&#227;o do segmento ST e <span class="elsevierStyleItalic">Score</span> Grace de baixo risco&#58; preval&#234;ncia&#44; progn&#243;stico cl&#237;nico e preditores"
        ]
      ]
      "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" => 2214
              "Ancho" => 2167
              "Tamanyo" => 283739
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart of patient selection&#46; ACS&#58; acute coronary syndrome&#59; GRACE&#58; Global Registry of Acute Coronary Events&#59; LM&#47;3VD&#58; left main and&#47;or three-vessel disease&#59; MI&#58; myocardial infarction&#59; NSTE-ACS&#58; non-ST-segment elevation acute coronary syndrome&#59; NSTEMI&#58; non-ST-segment elevation acute myocardial infarction&#59; STEMI&#58; ST-segment elevation myocardial infarction&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jo&#227;o Filipe Carvalho, Adriana Belo, Kisa Congo, David Neves, Ana Rita Santos, Bruno Pi&#231;arra, Ana Filipa Dam&#225;sio, Jos&#233; Aguiar"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Jo&#227;o Filipe"
              "apellidos" => "Carvalho"
            ]
            1 => array:2 [
              "nombre" => "Adriana"
              "apellidos" => "Belo"
            ]
            2 => array:2 [
              "nombre" => "Kisa"
              "apellidos" => "Congo"
            ]
            3 => array:2 [
              "nombre" => "David"
              "apellidos" => "Neves"
            ]
            4 => array:2 [
              "nombre" => "Ana Rita"
              "apellidos" => "Santos"
            ]
            5 => array:2 [
              "nombre" => "Bruno"
              "apellidos" => "Pi&#231;arra"
            ]
            6 => array:2 [
              "nombre" => "Ana Filipa"
              "apellidos" => "Dam&#225;sio"
            ]
            7 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Aguiar"
            ]
            8 => array:1 [
              "colaborador" => "on behalf of the investigators of the Portuguese Registry on Acute Coronary Syndromes &#40;ProACS&#41;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117308004?idApp=UINPBA00004E"
    "url" => "/08702551/0000003700000011/v4_201911280953/S0870255117308004/v4_201911280953/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S087025511730776X"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2017.11.016"
    "estado" => "S300"
    "fechaPublicacion" => "2018-11-01"
    "aid" => "1306"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2018;37:901-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 938
      "formatos" => array:3 [
        "EPUB" => 100
        "HTML" => 531
        "PDF" => 307
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome&#63; A propensity-score matching analysis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "901"
          "paginaFinal" => "908"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Qual o papel dos bloqueadores-beta numa coorte de tratamento contempor&#226;nea de doentes com s&#237;ndrome coron&#225;ria aguda&#63; An&#225;lise de emparelhamento de <span class="elsevierStyleItalic">score</span> de propens&#227;o"
        ]
      ]
      "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" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 981
              "Ancho" => 2500
              "Tamanyo" => 147265
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Subgroup analysis&#46; CI&#58; confidence interval&#59; HR&#58; hazard ratio&#59; LVEF&#58; left ventricular ejection fraction&#59; NSTE-ACS&#58; non-ST-elevation acute coronary syndrome&#59; STEMI&#58; ST-elevation myocardial infarction&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Teresa Tim&#243;teo, S&#237;lvia Aguiar Rosa, Madalena Cruz, Rita Ilh&#227;o Moreira, Ramiro Carvalho, Maria Lurdes Ferreira, Rui Cruz Ferreira"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Ana Teresa"
              "apellidos" => "Tim&#243;teo"
            ]
            1 => array:2 [
              "nombre" => "S&#237;lvia Aguiar"
              "apellidos" => "Rosa"
            ]
            2 => array:2 [
              "nombre" => "Madalena"
              "apellidos" => "Cruz"
            ]
            3 => array:2 [
              "nombre" => "Rita Ilh&#227;o"
              "apellidos" => "Moreira"
            ]
            4 => array:2 [
              "nombre" => "Ramiro"
              "apellidos" => "Carvalho"
            ]
            5 => array:2 [
              "nombre" => "Maria Lurdes"
              "apellidos" => "Ferreira"
            ]
            6 => array:2 [
              "nombre" => "Rui Cruz"
              "apellidos" => "Ferreira"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730776X?idApp=UINPBA00004E"
    "url" => "/08702551/0000003700000011/v4_201911280953/S087025511730776X/v4_201911280953/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S087025511730776X"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2017.11.016"
      "estado" => "S300"
      "fechaPublicacion" => "2018-11-01"
      "aid" => "1306"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Cardiol. 2018;37:901-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 938
        "formatos" => array:3 [
          "EPUB" => 100
          "HTML" => 531
          "PDF" => 307
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome&#63; A propensity-score matching analysis"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "901"
            "paginaFinal" => "908"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Qual o papel dos bloqueadores-beta numa coorte de tratamento contempor&#226;nea de doentes com s&#237;ndrome coron&#225;ria aguda&#63; An&#225;lise de emparelhamento de <span class="elsevierStyleItalic">score</span> de propens&#227;o"
          ]
        ]
        "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" => "fig0010"
            "etiqueta" => "Figure 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 981
                "Ancho" => 2500
                "Tamanyo" => 147265
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Subgroup analysis&#46; CI&#58; confidence interval&#59; HR&#58; hazard ratio&#59; LVEF&#58; left ventricular ejection fraction&#59; NSTE-ACS&#58; non-ST-elevation acute coronary syndrome&#59; STEMI&#58; ST-elevation myocardial infarction&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Ana Teresa Tim&#243;teo, S&#237;lvia Aguiar Rosa, Madalena Cruz, Rita Ilh&#227;o Moreira, Ramiro Carvalho, Maria Lurdes Ferreira, Rui Cruz Ferreira"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Ana Teresa"
                "apellidos" => "Tim&#243;teo"
              ]
              1 => array:2 [
                "nombre" => "S&#237;lvia Aguiar"
                "apellidos" => "Rosa"
              ]
              2 => array:2 [
                "nombre" => "Madalena"
                "apellidos" => "Cruz"
              ]
              3 => array:2 [
                "nombre" => "Rita Ilh&#227;o"
                "apellidos" => "Moreira"
              ]
              4 => array:2 [
                "nombre" => "Ramiro"
                "apellidos" => "Carvalho"
              ]
              5 => array:2 [
                "nombre" => "Maria Lurdes"
                "apellidos" => "Ferreira"
              ]
              6 => array:2 [
                "nombre" => "Rui Cruz"
                "apellidos" => "Ferreira"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730776X?idApp=UINPBA00004E"
      "url" => "/08702551/0000003700000011/v4_201911280953/S087025511730776X/v4_201911280953/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "The dilemma of beta-blocker use after acute coronary syndrome&#58; To support the dogma or to embrace the paradigm shift&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "909"
        "paginaFinal" => "910"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Daniel Ferreira"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Daniel"
            "apellidos" => "Ferreira"
            "email" => array:1 [
              0 => "dferreira@hospitaldaluz.pt"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Cardiovascular Centre&#44; Hospital da Luz Lisboa&#44; Lisbon&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "O dilema do uso de bloqueadores beta ap&#243;s uma s&#237;ndroma coron&#225;ria aguda&#58; manter o dogma ou abra&#231;ar a mudan&#231;a de paradigma&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">The old evidence</span><p id="par0005" class="elsevierStylePara elsevierViewall">Since the last quarter of the 20th century&#44; beta-blockers have been considered a cornerstone therapy after acute coronary syndrome &#40;ACS&#41;&#44; alongside reperfusion therapy&#44; antiplatelet agents&#44; statins and angiotensin-converting enzyme inhibitors&#47;angiotensin receptor blockers&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Together&#44; these therapies have led to striking improvements in the outcome of these syndromes&#44; in terms of both mortality and morbidity&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">More recent advances in organizational models of response to ACS and in reperfusion therapy&#44; with wider availability of percutaneous coronary intervention &#40;PCI&#41; replacing pharmacological reperfusion therapy&#44; have led to further significant reductions in mortality and morbidity&#44; particularly in terms of heart failure and mechanical complications following myocardial infarction &#40;MI&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">With every new advance in this field&#44; researchers should question old dogmas and reassess previous strategies&#44; procedures and drug indications&#46; Current guidelines should be seen as such&#44; as current&#44; and should be periodically revised&#46; This is regularly done by the major cardiological societies&#44; at the national and continental &#40;and even international&#41; level&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In the latest updates of the American and European guidelines on MI&#44; beta-blocker use is still a class I or IIa indication for patients after both ST-elevation MI<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#44;2</span></a> and non-ST-elevation ACS&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">3&#44;4</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">The new evidence</span><p id="par0030" class="elsevierStylePara elsevierViewall">However&#44; several authors have questioned this indication&#44; especially in patients without left ventricular dysfunction&#44; in most cases on the basis of registries<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#8211;8</span></a> and&#47;or meta-analyses of real-world population-based studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">9&#8211;11</span></a> These authors all suggest that a paradigm shift is needed and that the guidelines&#8217; indication for beta-blocker use after MI should be challenged&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; another piece of evidence is published that keeps this discussion wide open&#46; In their interesting article&#44; Tim&#243;teo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> present a single-center study that again supports the use of beta-blockers after ACS&#44; as this strategy showed a significant reduction in all-cause mortality&#44; irrespective of residual left ventricular function&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The potential limitations of the study being based on a single center were overcome by a robust statistical analysis with the use of propensity-score matching&#44; a large number of patients&#44; and an impressive 99&#46;8&#37; of successful one-year follow-up&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">One of the limitations acknowledged by the authors is the lack of information regarding the type and dose of the beta-blockers used&#44; but the same limitation also applies to similar studies and meta-analyses&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">The dilemma</span><p id="par0050" class="elsevierStylePara elsevierViewall">So we are faced with a significant dilemma&#46; Should we support the dogmatic approach and continue to prescribe beta-blockers for our post-ACS patients&#44; based on indications in the current guidelines and on studies like that of Tim&#243;teo et al&#46;&#63;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">12&#8211;15</span></a> Or should we follow Thomas Kuhn&#39;s view that science is based on paradigm shifts and challenge these indications&#44; as advocated by the above more recent meta-analyses&#63;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">9&#8211;11</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">I&#44; for one&#44; as a man of science&#44; would like to have as much robust data as possible&#44; which means that I would like to see contemporary randomized clinical trials &#40;RCTs&#41; that study the results of prescribing beta-blockers after ACS alongside the more recent strategies of care &#40;including modern reperfusion therapies&#41; recommended for these syndromes&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The question&#44; of course&#44; is whether the pharmaceutical industry would support RCTs that question the continued use of old and cheap drugs&#46; This is a clear case for investigator-driven studies&#44; supported by their institutions and&#47;or medical societies&#44; such as the recent article by Watanabe et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> which published the results of the CAPITAL-RCT study&#44; showing no benefit from the use of carvedilol in patients with ST-elevation MI treated with primary PCI&#46; Similar studies are needed in order to clarify this important clinical question&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">To the quote attributed to W&#46; Edwards Deming&#44; &#8220;In God we trust&#59; all others must bring data&#44;&#8221; I would add&#58; &#8220;&#8230; robust data&#8221;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">Daniel Ferreira has received honoraria &#40;advisory board member and&#47;or invited speaker&#41; from Astellas&#44; Astra-Zeneca&#44; Bayer&#44; BMS&#47;Pfizer&#44; Boehringer-Ingelheim&#44; Novartis&#44; and Sanofi-Aventis&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:5 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "The old evidence"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "The new evidence"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "The dilemma"
        ]
        3 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Conflicts of interest"
        ]
        4 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:16 [
            0 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2013 ACCF&#47;AHA guideline for the management of ST-elevation myocardial infarction&#58; a report of the American College of Cardiology Foundation&#47;American Heart Association Task Force on Practice Guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;T&#46; O&#8217;Gara"
                            1 => "D&#46;D&#46; Ascheim"
                            2 => "D&#46;E&#46; Casey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2012.11.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2013"
                        "volumen" => "61"
                        "paginaInicial" => "e78"
                        "paginaFinal" => "e140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23256914"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation&#58; the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology &#40;ESC&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46; Ibanez"
                            1 => "S&#46; James"
                            2 => "S&#46; Agewall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehx393"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2018"
                        "volumen" => "39"
                        "paginaInicial" => "119"
                        "paginaFinal" => "177"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28886621"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2014 AHA&#47;ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes&#58; a report of the American College of Cardiology&#47;American Heart Association Task Force on Practice Guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46;A&#46; Amsterdam"
                            1 => "N&#46;K&#46; Wenger"
                            2 => "R&#46;G&#46; Brindis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2014.09.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2014"
                        "volumen" => "64"
                        "paginaInicial" => "e139"
                        "paginaFinal" => "e228"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25260718"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Roffi"
                            1 => "C&#46; Patrono"
                            2 => "J&#46;-P&#46; Collet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehv320"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2016"
                        "volumen" => "37"
                        "paginaInicial" => "267"
                        "paginaFinal" => "315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26320110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lack of effect of oral beta-blocker therapy at discharge on long-term clinical outcomes of ST-segment elevation acute myocardial infarction after primary percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Ozasa"
                            1 => "T&#46; Kimura"
                            2 => "T&#46; Morimoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2010.06.048"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2010"
                        "volumen" => "106"
                        "paginaInicial" => "1225"
                        "paginaFinal" => "1233"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21029817"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of beta-blocker dose on survival after acute myocardial infarction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; Goldberger"
                            1 => "R&#46;O&#46; Bonow"
                            2 => "M&#46; Cuffe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2015.07.047"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2015"
                        "volumen" => "66"
                        "paginaInicial" => "1431"
                        "paginaFinal" => "1441"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26403339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#946; blockers and mortality after myocardial infarction in patients without heart failure&#58; multicentre prospective cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Puymirat"
                            1 => "E&#46; Riant"
                            2 => "N&#46; Aissaoui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.i4801"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2016"
                        "volumen" => "354"
                        "paginaInicial" => "i4801"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27650822"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#946;-Blockers and mortality after acute myocardial infarction in patients without heart failure or ventricular dysfunction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;B&#46; Dondo"
                            1 => "M&#46; Hall"
                            2 => "R&#46;M&#46; West"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2017.03.578"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2017"
                        "volumen" => "69"
                        "paginaInicial" => "2710"
                        "paginaFinal" => "2720"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28571635"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-analysis of relation between oral &#946;-blocker therapy and outcomes in patients with acute myocardial infarction who underwent percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46;T&#46; Huang"
                            1 => "F&#46;Y&#46; Huang"
                            2 => "Z&#46;L&#46; Zuo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2015.02.057"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2015"
                        "volumen" => "115"
                        "paginaInicial" => "1529"
                        "paginaFinal" => "1538"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25862157"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical outcomes with &#946;-blockers for myocardial infarction&#58; a meta-analysis of randomized trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Bangalore"
                            1 => "H&#46; Makani"
                            2 => "M&#46; Radford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjmed.2014.05.032"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2014"
                        "volumen" => "127"
                        "paginaInicial" => "939"
                        "paginaFinal" => "953"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24927909"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of oral &#946;-blocker treatment on mortality in contemporary post-myocardial infarction patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Dahl Aarvik"
                            1 => "I&#46; Sandven"
                            2 => "T&#46;B&#46; Dondo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ehjcvp/pvy034. [Epub ahead of print]"
                      "Revista" => array:2 [
                        "tituloSerie" => "Eur Heart J Cardiovasc Pharmacother"
                        "fecha" => "2018"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndromes&#63; A propensity-score matching analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;T&#46; Tim&#243;teo"
                            1 => "S&#46;A&#46; Rosa"
                            2 => "M&#46; Cruz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2017.11.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2018"
                        "volumen" => "37"
                        "paginaInicial" => "901"
                        "paginaFinal" => "908"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30454912"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing oral beta-blocker therapy after percutaneous coronary intervention for ST-segment elevation myocardial infarction&#58; the role of observational data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;B&#46; Granger"
                            1 => "M&#46;P&#46; Rao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcin.2014.04.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Cardiovasc Interv"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "602"
                        "paginaFinal" => "603"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24947718"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of beta-blocker therapy at discharge with clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;H&#46; Yang"
                            1 => "J&#46;-Y&#46; Hahn"
                            2 => "Y&#46;B&#46; Song"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcin.2013.12.206"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Cardiovasc Interv"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "592"
                        "paginaFinal" => "601"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24947717"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship between &#946;-blocker therapy at discharge and clinical outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Li"
                            1 => "Y&#46; Sun"
                            2 => "X&#46; Shen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/JAHA.116.004148"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Am Heart Assoc"
                        "fecha" => "2016"
                        "volumen" => "5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27912209"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term use of carvedilol in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46; Watanabe"
                            1 => "N&#46; Ozasa"
                            2 => "T&#46; Morimoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0199347"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2018"
                        "volumen" => "13"
                        "paginaInicial" => "e0199347"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30153268"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000003700000011/v4_201911280953/S0870255118307285/v4_201911280953/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "29261"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Artigos Originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003700000011/v4_201911280953/S0870255118307285/v4_201911280953/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255118307285?idApp=UINPBA00004E"
]
Partilhar
Informação da revista

Estatísticas

Siga este link para acessar o texto completo do artigo

Editorial comment
The dilemma of beta-blocker use after acute coronary syndrome: To support the dogma or to embrace the paradigm shift?
O dilema do uso de bloqueadores beta após uma síndroma coronária aguda: manter o dogma ou abraçar a mudança de paradigma?
Daniel Ferreira
Cardiovascular Centre, Hospital da Luz Lisboa, Lisbon, Portugal
Lido
4948
Vezes
que se leu este artigo
1641
Total PDF
3307
Total HTML
Compartilhar estatísticas
 array:25 [
  "pii" => "S0870255118307285"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2018.10.005"
  "estado" => "S300"
  "fechaPublicacion" => "2018-11-01"
  "aid" => "1310"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2018;37:909-10"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 860
    "formatos" => array:3 [
      "EPUB" => 95
      "HTML" => 540
      "PDF" => 225
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0870255117308004"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2018.03.016"
    "estado" => "S300"
    "fechaPublicacion" => "2018-11-01"
    "aid" => "1305"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2018;37:911-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 767
      "formatos" => array:3 [
        "EPUB" => 86
        "HTML" => 445
        "PDF" => 236
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Left main and&#47;or three-vessel disease in patients with non-ST-segment elevation myocardial infarction and low-risk GRACE score&#58; Prevalence&#44; clinical outcomes and predictors"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "911"
          "paginaFinal" => "919"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Doen&#231;a do tronco comum e&#47;ou doen&#231;a arterial coron&#225;ria de tr&#234;s vasos em doentes com enfarte agudo do mioc&#225;rdio sem eleva&#231;&#227;o do segmento ST e <span class="elsevierStyleItalic">Score</span> Grace de baixo risco&#58; preval&#234;ncia&#44; progn&#243;stico cl&#237;nico e preditores"
        ]
      ]
      "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" => 2214
              "Ancho" => 2167
              "Tamanyo" => 283739
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart of patient selection&#46; ACS&#58; acute coronary syndrome&#59; GRACE&#58; Global Registry of Acute Coronary Events&#59; LM&#47;3VD&#58; left main and&#47;or three-vessel disease&#59; MI&#58; myocardial infarction&#59; NSTE-ACS&#58; non-ST-segment elevation acute coronary syndrome&#59; NSTEMI&#58; non-ST-segment elevation acute myocardial infarction&#59; STEMI&#58; ST-segment elevation myocardial infarction&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jo&#227;o Filipe Carvalho, Adriana Belo, Kisa Congo, David Neves, Ana Rita Santos, Bruno Pi&#231;arra, Ana Filipa Dam&#225;sio, Jos&#233; Aguiar"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Jo&#227;o Filipe"
              "apellidos" => "Carvalho"
            ]
            1 => array:2 [
              "nombre" => "Adriana"
              "apellidos" => "Belo"
            ]
            2 => array:2 [
              "nombre" => "Kisa"
              "apellidos" => "Congo"
            ]
            3 => array:2 [
              "nombre" => "David"
              "apellidos" => "Neves"
            ]
            4 => array:2 [
              "nombre" => "Ana Rita"
              "apellidos" => "Santos"
            ]
            5 => array:2 [
              "nombre" => "Bruno"
              "apellidos" => "Pi&#231;arra"
            ]
            6 => array:2 [
              "nombre" => "Ana Filipa"
              "apellidos" => "Dam&#225;sio"
            ]
            7 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Aguiar"
            ]
            8 => array:1 [
              "colaborador" => "on behalf of the investigators of the Portuguese Registry on Acute Coronary Syndromes &#40;ProACS&#41;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117308004?idApp=UINPBA00004E"
    "url" => "/08702551/0000003700000011/v4_201911280953/S0870255117308004/v4_201911280953/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S087025511730776X"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2017.11.016"
    "estado" => "S300"
    "fechaPublicacion" => "2018-11-01"
    "aid" => "1306"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2018;37:901-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 938
      "formatos" => array:3 [
        "EPUB" => 100
        "HTML" => 531
        "PDF" => 307
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome&#63; A propensity-score matching analysis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "901"
          "paginaFinal" => "908"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Qual o papel dos bloqueadores-beta numa coorte de tratamento contempor&#226;nea de doentes com s&#237;ndrome coron&#225;ria aguda&#63; An&#225;lise de emparelhamento de <span class="elsevierStyleItalic">score</span> de propens&#227;o"
        ]
      ]
      "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" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 981
              "Ancho" => 2500
              "Tamanyo" => 147265
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Subgroup analysis&#46; CI&#58; confidence interval&#59; HR&#58; hazard ratio&#59; LVEF&#58; left ventricular ejection fraction&#59; NSTE-ACS&#58; non-ST-elevation acute coronary syndrome&#59; STEMI&#58; ST-elevation myocardial infarction&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Teresa Tim&#243;teo, S&#237;lvia Aguiar Rosa, Madalena Cruz, Rita Ilh&#227;o Moreira, Ramiro Carvalho, Maria Lurdes Ferreira, Rui Cruz Ferreira"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Ana Teresa"
              "apellidos" => "Tim&#243;teo"
            ]
            1 => array:2 [
              "nombre" => "S&#237;lvia Aguiar"
              "apellidos" => "Rosa"
            ]
            2 => array:2 [
              "nombre" => "Madalena"
              "apellidos" => "Cruz"
            ]
            3 => array:2 [
              "nombre" => "Rita Ilh&#227;o"
              "apellidos" => "Moreira"
            ]
            4 => array:2 [
              "nombre" => "Ramiro"
              "apellidos" => "Carvalho"
            ]
            5 => array:2 [
              "nombre" => "Maria Lurdes"
              "apellidos" => "Ferreira"
            ]
            6 => array:2 [
              "nombre" => "Rui Cruz"
              "apellidos" => "Ferreira"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730776X?idApp=UINPBA00004E"
    "url" => "/08702551/0000003700000011/v4_201911280953/S087025511730776X/v4_201911280953/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S087025511730776X"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2017.11.016"
      "estado" => "S300"
      "fechaPublicacion" => "2018-11-01"
      "aid" => "1306"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Cardiol. 2018;37:901-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 938
        "formatos" => array:3 [
          "EPUB" => 100
          "HTML" => 531
          "PDF" => 307
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome&#63; A propensity-score matching analysis"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "901"
            "paginaFinal" => "908"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Qual o papel dos bloqueadores-beta numa coorte de tratamento contempor&#226;nea de doentes com s&#237;ndrome coron&#225;ria aguda&#63; An&#225;lise de emparelhamento de <span class="elsevierStyleItalic">score</span> de propens&#227;o"
          ]
        ]
        "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" => "fig0010"
            "etiqueta" => "Figure 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 981
                "Ancho" => 2500
                "Tamanyo" => 147265
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Subgroup analysis&#46; CI&#58; confidence interval&#59; HR&#58; hazard ratio&#59; LVEF&#58; left ventricular ejection fraction&#59; NSTE-ACS&#58; non-ST-elevation acute coronary syndrome&#59; STEMI&#58; ST-elevation myocardial infarction&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Ana Teresa Tim&#243;teo, S&#237;lvia Aguiar Rosa, Madalena Cruz, Rita Ilh&#227;o Moreira, Ramiro Carvalho, Maria Lurdes Ferreira, Rui Cruz Ferreira"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Ana Teresa"
                "apellidos" => "Tim&#243;teo"
              ]
              1 => array:2 [
                "nombre" => "S&#237;lvia Aguiar"
                "apellidos" => "Rosa"
              ]
              2 => array:2 [
                "nombre" => "Madalena"
                "apellidos" => "Cruz"
              ]
              3 => array:2 [
                "nombre" => "Rita Ilh&#227;o"
                "apellidos" => "Moreira"
              ]
              4 => array:2 [
                "nombre" => "Ramiro"
                "apellidos" => "Carvalho"
              ]
              5 => array:2 [
                "nombre" => "Maria Lurdes"
                "apellidos" => "Ferreira"
              ]
              6 => array:2 [
                "nombre" => "Rui Cruz"
                "apellidos" => "Ferreira"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730776X?idApp=UINPBA00004E"
      "url" => "/08702551/0000003700000011/v4_201911280953/S087025511730776X/v4_201911280953/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "The dilemma of beta-blocker use after acute coronary syndrome&#58; To support the dogma or to embrace the paradigm shift&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "909"
        "paginaFinal" => "910"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Daniel Ferreira"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Daniel"
            "apellidos" => "Ferreira"
            "email" => array:1 [
              0 => "dferreira@hospitaldaluz.pt"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Cardiovascular Centre&#44; Hospital da Luz Lisboa&#44; Lisbon&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "O dilema do uso de bloqueadores beta ap&#243;s uma s&#237;ndroma coron&#225;ria aguda&#58; manter o dogma ou abra&#231;ar a mudan&#231;a de paradigma&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">The old evidence</span><p id="par0005" class="elsevierStylePara elsevierViewall">Since the last quarter of the 20th century&#44; beta-blockers have been considered a cornerstone therapy after acute coronary syndrome &#40;ACS&#41;&#44; alongside reperfusion therapy&#44; antiplatelet agents&#44; statins and angiotensin-converting enzyme inhibitors&#47;angiotensin receptor blockers&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Together&#44; these therapies have led to striking improvements in the outcome of these syndromes&#44; in terms of both mortality and morbidity&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">More recent advances in organizational models of response to ACS and in reperfusion therapy&#44; with wider availability of percutaneous coronary intervention &#40;PCI&#41; replacing pharmacological reperfusion therapy&#44; have led to further significant reductions in mortality and morbidity&#44; particularly in terms of heart failure and mechanical complications following myocardial infarction &#40;MI&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">With every new advance in this field&#44; researchers should question old dogmas and reassess previous strategies&#44; procedures and drug indications&#46; Current guidelines should be seen as such&#44; as current&#44; and should be periodically revised&#46; This is regularly done by the major cardiological societies&#44; at the national and continental &#40;and even international&#41; level&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In the latest updates of the American and European guidelines on MI&#44; beta-blocker use is still a class I or IIa indication for patients after both ST-elevation MI<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#44;2</span></a> and non-ST-elevation ACS&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">3&#44;4</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">The new evidence</span><p id="par0030" class="elsevierStylePara elsevierViewall">However&#44; several authors have questioned this indication&#44; especially in patients without left ventricular dysfunction&#44; in most cases on the basis of registries<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#8211;8</span></a> and&#47;or meta-analyses of real-world population-based studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">9&#8211;11</span></a> These authors all suggest that a paradigm shift is needed and that the guidelines&#8217; indication for beta-blocker use after MI should be challenged&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; another piece of evidence is published that keeps this discussion wide open&#46; In their interesting article&#44; Tim&#243;teo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> present a single-center study that again supports the use of beta-blockers after ACS&#44; as this strategy showed a significant reduction in all-cause mortality&#44; irrespective of residual left ventricular function&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The potential limitations of the study being based on a single center were overcome by a robust statistical analysis with the use of propensity-score matching&#44; a large number of patients&#44; and an impressive 99&#46;8&#37; of successful one-year follow-up&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">One of the limitations acknowledged by the authors is the lack of information regarding the type and dose of the beta-blockers used&#44; but the same limitation also applies to similar studies and meta-analyses&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">The dilemma</span><p id="par0050" class="elsevierStylePara elsevierViewall">So we are faced with a significant dilemma&#46; Should we support the dogmatic approach and continue to prescribe beta-blockers for our post-ACS patients&#44; based on indications in the current guidelines and on studies like that of Tim&#243;teo et al&#46;&#63;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">12&#8211;15</span></a> Or should we follow Thomas Kuhn&#39;s view that science is based on paradigm shifts and challenge these indications&#44; as advocated by the above more recent meta-analyses&#63;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">9&#8211;11</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">I&#44; for one&#44; as a man of science&#44; would like to have as much robust data as possible&#44; which means that I would like to see contemporary randomized clinical trials &#40;RCTs&#41; that study the results of prescribing beta-blockers after ACS alongside the more recent strategies of care &#40;including modern reperfusion therapies&#41; recommended for these syndromes&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The question&#44; of course&#44; is whether the pharmaceutical industry would support RCTs that question the continued use of old and cheap drugs&#46; This is a clear case for investigator-driven studies&#44; supported by their institutions and&#47;or medical societies&#44; such as the recent article by Watanabe et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> which published the results of the CAPITAL-RCT study&#44; showing no benefit from the use of carvedilol in patients with ST-elevation MI treated with primary PCI&#46; Similar studies are needed in order to clarify this important clinical question&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">To the quote attributed to W&#46; Edwards Deming&#44; &#8220;In God we trust&#59; all others must bring data&#44;&#8221; I would add&#58; &#8220;&#8230; robust data&#8221;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">Daniel Ferreira has received honoraria &#40;advisory board member and&#47;or invited speaker&#41; from Astellas&#44; Astra-Zeneca&#44; Bayer&#44; BMS&#47;Pfizer&#44; Boehringer-Ingelheim&#44; Novartis&#44; and Sanofi-Aventis&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:5 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "The old evidence"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "The new evidence"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "The dilemma"
        ]
        3 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Conflicts of interest"
        ]
        4 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:16 [
            0 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2013 ACCF&#47;AHA guideline for the management of ST-elevation myocardial infarction&#58; a report of the American College of Cardiology Foundation&#47;American Heart Association Task Force on Practice Guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;T&#46; O&#8217;Gara"
                            1 => "D&#46;D&#46; Ascheim"
                            2 => "D&#46;E&#46; Casey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2012.11.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2013"
                        "volumen" => "61"
                        "paginaInicial" => "e78"
                        "paginaFinal" => "e140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23256914"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation&#58; the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology &#40;ESC&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46; Ibanez"
                            1 => "S&#46; James"
                            2 => "S&#46; Agewall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehx393"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2018"
                        "volumen" => "39"
                        "paginaInicial" => "119"
                        "paginaFinal" => "177"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28886621"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2014 AHA&#47;ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes&#58; a report of the American College of Cardiology&#47;American Heart Association Task Force on Practice Guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46;A&#46; Amsterdam"
                            1 => "N&#46;K&#46; Wenger"
                            2 => "R&#46;G&#46; Brindis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2014.09.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2014"
                        "volumen" => "64"
                        "paginaInicial" => "e139"
                        "paginaFinal" => "e228"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25260718"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Roffi"
                            1 => "C&#46; Patrono"
                            2 => "J&#46;-P&#46; Collet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehv320"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2016"
                        "volumen" => "37"
                        "paginaInicial" => "267"
                        "paginaFinal" => "315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26320110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lack of effect of oral beta-blocker therapy at discharge on long-term clinical outcomes of ST-segment elevation acute myocardial infarction after primary percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Ozasa"
                            1 => "T&#46; Kimura"
                            2 => "T&#46; Morimoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2010.06.048"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2010"
                        "volumen" => "106"
                        "paginaInicial" => "1225"
                        "paginaFinal" => "1233"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21029817"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of beta-blocker dose on survival after acute myocardial infarction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; Goldberger"
                            1 => "R&#46;O&#46; Bonow"
                            2 => "M&#46; Cuffe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2015.07.047"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2015"
                        "volumen" => "66"
                        "paginaInicial" => "1431"
                        "paginaFinal" => "1441"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26403339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#946; blockers and mortality after myocardial infarction in patients without heart failure&#58; multicentre prospective cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Puymirat"
                            1 => "E&#46; Riant"
                            2 => "N&#46; Aissaoui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.i4801"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2016"
                        "volumen" => "354"
                        "paginaInicial" => "i4801"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27650822"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#946;-Blockers and mortality after acute myocardial infarction in patients without heart failure or ventricular dysfunction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;B&#46; Dondo"
                            1 => "M&#46; Hall"
                            2 => "R&#46;M&#46; West"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2017.03.578"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2017"
                        "volumen" => "69"
                        "paginaInicial" => "2710"
                        "paginaFinal" => "2720"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28571635"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-analysis of relation between oral &#946;-blocker therapy and outcomes in patients with acute myocardial infarction who underwent percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46;T&#46; Huang"
                            1 => "F&#46;Y&#46; Huang"
                            2 => "Z&#46;L&#46; Zuo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2015.02.057"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2015"
                        "volumen" => "115"
                        "paginaInicial" => "1529"
                        "paginaFinal" => "1538"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25862157"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical outcomes with &#946;-blockers for myocardial infarction&#58; a meta-analysis of randomized trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Bangalore"
                            1 => "H&#46; Makani"
                            2 => "M&#46; Radford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjmed.2014.05.032"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2014"
                        "volumen" => "127"
                        "paginaInicial" => "939"
                        "paginaFinal" => "953"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24927909"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of oral &#946;-blocker treatment on mortality in contemporary post-myocardial infarction patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Dahl Aarvik"
                            1 => "I&#46; Sandven"
                            2 => "T&#46;B&#46; Dondo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ehjcvp/pvy034. [Epub ahead of print]"
                      "Revista" => array:2 [
                        "tituloSerie" => "Eur Heart J Cardiovasc Pharmacother"
                        "fecha" => "2018"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndromes&#63; A propensity-score matching analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;T&#46; Tim&#243;teo"
                            1 => "S&#46;A&#46; Rosa"
                            2 => "M&#46; Cruz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2017.11.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2018"
                        "volumen" => "37"
                        "paginaInicial" => "901"
                        "paginaFinal" => "908"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30454912"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing oral beta-blocker therapy after percutaneous coronary intervention for ST-segment elevation myocardial infarction&#58; the role of observational data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;B&#46; Granger"
                            1 => "M&#46;P&#46; Rao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcin.2014.04.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Cardiovasc Interv"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "602"
                        "paginaFinal" => "603"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24947718"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of beta-blocker therapy at discharge with clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;H&#46; Yang"
                            1 => "J&#46;-Y&#46; Hahn"
                            2 => "Y&#46;B&#46; Song"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcin.2013.12.206"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Cardiovasc Interv"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "592"
                        "paginaFinal" => "601"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24947717"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship between &#946;-blocker therapy at discharge and clinical outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Li"
                            1 => "Y&#46; Sun"
                            2 => "X&#46; Shen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/JAHA.116.004148"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Am Heart Assoc"
                        "fecha" => "2016"
                        "volumen" => "5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27912209"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term use of carvedilol in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46; Watanabe"
                            1 => "N&#46; Ozasa"
                            2 => "T&#46; Morimoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0199347"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2018"
                        "volumen" => "13"
                        "paginaInicial" => "e0199347"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30153268"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000003700000011/v4_201911280953/S0870255118307285/v4_201911280953/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "29261"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Artigos Originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003700000011/v4_201911280953/S0870255118307285/v4_201911280953/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255118307285?idApp=UINPBA00004E"
]
Informação do artigo
ISSN: 08702551
Idioma original: Inglês
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Novembro 8 3 11
2024 Outubro 50 29 79
2024 Setembro 51 26 77
2024 Agosto 44 25 69
2024 Julho 44 27 71
2024 Junho 39 20 59
2024 Maio 40 22 62
2024 Abril 37 31 68
2024 Maro 52 25 77
2024 Fevereiro 51 19 70
2024 Janeiro 52 30 82
2023 Dezembro 43 20 63
2023 Novembro 59 31 90
2023 Outubro 39 17 56
2023 Setembro 32 25 57
2023 Agosto 32 22 54
2023 Julho 30 11 41
2023 Junho 31 12 43
2023 Maio 42 25 67
2023 Abril 24 7 31
2023 Maro 45 26 71
2023 Fevereiro 42 26 68
2023 Janeiro 33 16 49
2022 Dezembro 40 29 69
2022 Novembro 42 22 64
2022 Outubro 72 30 102
2022 Setembro 54 34 88
2022 Agosto 98 38 136
2022 Julho 96 36 132
2022 Junho 44 23 67
2022 Maio 31 30 61
2022 Abril 36 34 70
2022 Maro 38 43 81
2022 Fevereiro 39 23 62
2022 Janeiro 37 30 67
2021 Dezembro 30 32 62
2021 Novembro 43 35 78
2021 Outubro 141 48 189
2021 Setembro 38 28 66
2021 Agosto 43 32 75
2021 Julho 27 16 43
2021 Junho 47 25 72
2021 Maio 68 35 103
2021 Abril 118 68 186
2021 Maro 82 31 113
2021 Fevereiro 68 24 92
2021 Janeiro 64 17 81
2020 Dezembro 46 11 57
2020 Novembro 60 25 85
2020 Outubro 43 22 65
2020 Setembro 33 15 48
2020 Agosto 38 13 51
2020 Julho 51 13 64
2020 Junho 31 20 51
2020 Maio 36 11 47
2020 Abril 43 9 52
2020 Maro 51 11 62
2020 Fevereiro 98 20 118
2020 Janeiro 34 12 46
2019 Dezembro 32 5 37
2019 Novembro 25 11 36
2019 Outubro 22 9 31
2019 Setembro 22 11 33
2019 Agosto 21 4 25
2019 Julho 54 12 66
2019 Junho 91 20 111
2019 Maio 31 13 44
2019 Abril 23 15 38
2019 Maro 12 17 29
2019 Fevereiro 14 9 23
2019 Janeiro 22 12 34
2018 Dezembro 42 40 82
2018 Novembro 16 23 39
Mostrar tudo

Siga este link para acessar o texto completo do artigo

Idiomas
Revista Portuguesa de Cardiologia
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.