que se leu este artigo
array:23 [ "pii" => "S0870255122000695" "issn" => "08702551" "doi" => "10.1016/j.repc.2022.02.002" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1915" "copyrightAnyo" => "2022" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "dis" "cita" => "Rev Port Cardiol. 2022;41:453-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S087025512200066X" "issn" => "08702551" "doi" => "10.1016/j.repc.2021.03.014" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1912" "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. 2022;41:455-61" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Evaluation of myocardial performance index in patients with COVID-19: An echocardiographic follow-up study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "455" "paginaFinal" => "461" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Avaliação do índice de performance miocárdico em doentes com COVID-19: um estudo de seguimento ecocardiográfico" ] ] "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" => 1341 "Ancho" => 1508 "Tamanyo" => 266358 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Calculation of tissue Doppler-derived left ventricular myocardial performance index. ET: ejection time; ICT: isovolumic contraction time; IRT: isovolumic relaxation time.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Hakan Kaya, Ramazan Asoglu, Abdulmecit Afsin, Hakan Tibilli, Ercan Kurt, Safiye Kafadar, Umut Gulacti, Huseyin Kafadar" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Hakan" "apellidos" => "Kaya" ] 1 => array:2 [ "nombre" => "Ramazan" "apellidos" => "Asoglu" ] 2 => array:2 [ "nombre" => "Abdulmecit" "apellidos" => "Afsin" ] 3 => array:2 [ "nombre" => "Hakan" "apellidos" => "Tibilli" ] 4 => array:2 [ "nombre" => "Ercan" "apellidos" => "Kurt" ] 5 => array:2 [ "nombre" => "Safiye" "apellidos" => "Kafadar" ] 6 => array:2 [ "nombre" => "Umut" "apellidos" => "Gulacti" ] 7 => array:2 [ "nombre" => "Huseyin" "apellidos" => "Kafadar" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025512200066X?idApp=UINPBA00004E" "url" => "/08702551/0000004100000006/v3_202206160259/S087025512200066X/v3_202206160259/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0870255122000683" "issn" => "08702551" "doi" => "10.1016/j.repc.2021.03.016" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1914" "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. 2022;41:445-52" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "The updated pre-test probability model of the 2019 ESC guidelines improves prediction of obstructive coronary artery disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "445" "paginaFinal" => "452" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Probabilidade pré-teste de doença arterial coronária obstrutiva nas novas recomendações de síndromes coronárias crónicas" ] ] "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" => 1632 "Ancho" => 1293 "Tamanyo" => 201762 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Comparison of observed vs. expected prevalence according to the two pre-test probability (PTP) prediction models. The 2013 European Society of Cardiology (ESC) prediction model significantly overestimated the observed prevalence of CAD across all quartiles of PTP, whereas the new 2019 ESC prediction model showed good calibration for predicting the likelihood of coronary artery disease. Abbreviations as in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro M. Lopes, Francisco Albuquerque, Pedro Freitas, Bruno M.L. Rocha, Gonçalo J.L. Cunha, Ana Coutinho Santos, João Abecasis, Sara Guerreiro, Carla Saraiva, Miguel Mendes, António M. Ferreira" "autores" => array:11 [ 0 => array:2 [ "nombre" => "Pedro M." "apellidos" => "Lopes" ] 1 => array:2 [ "nombre" => "Francisco" "apellidos" => "Albuquerque" ] 2 => array:2 [ "nombre" => "Pedro" "apellidos" => "Freitas" ] 3 => array:2 [ "nombre" => "Bruno M.L." "apellidos" => "Rocha" ] 4 => array:2 [ "nombre" => "Gonçalo J.L." "apellidos" => "Cunha" ] 5 => array:2 [ "nombre" => "Ana Coutinho" "apellidos" => "Santos" ] 6 => array:2 [ "nombre" => "João" "apellidos" => "Abecasis" ] 7 => array:2 [ "nombre" => "Sara" "apellidos" => "Guerreiro" ] 8 => array:2 [ "nombre" => "Carla" "apellidos" => "Saraiva" ] 9 => array:2 [ "nombre" => "Miguel" "apellidos" => "Mendes" ] 10 => array:2 [ "nombre" => "António M." "apellidos" => "Ferreira" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255122000683?idApp=UINPBA00004E" "url" => "/08702551/0000004100000006/v3_202206160259/S0870255122000683/v3_202206160259/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>" "titulo" => "Estimating the pre-test probability of coronary artery disease according to the ESC guidelines: Are we getting there?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "453" "paginaFinal" => "454" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Nuno Bettencourt" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Nuno" "apellidos" => "Bettencourt" "email" => array:1 [ 0 => "bettencourt.n@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Probabilidade pré-teste de doença coronária obstrutiva: o ajustar da mira!" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In 2019 the European Society of Cardiology (ESC) updated its method for estimating the pre-test probability (PTP) of obstructive coronary artery disease (CAD) in the guidelines on chronic coronary syndromes.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> In this issue of the <span class="elsevierStyleItalic">Journal</span>, Lopes et al. present a single-center cross-sectional study enrolling 320 consecutive patients with stable chest pain undergoing coronary computed tomography angiography (CCTA) for suspected CAD, aiming to compare the performance of the new PTP method with the prediction model in the 2013 guidelines.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Using as reference standard the presence of obstructive coronary disease, defined as ≥50% stenosis on CCTA (or invasive coronary angiography when it was performed subsequently), the authors compared the two prediction models in terms of calibration, discrimination and the ability to change the downstream diagnostic pathway.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Despite the important limitations of the study, particularly the absence of coronary angiography (and so of the defined gold standard) in a proportion of patients with calcium score >400 – in which the presence of obstructive CAD was directly assumed or confirmed according to subsequent functional tests, if performed – this article further supports the adoption of the 2019 PTP estimation method. According to the study results, the updated 2019 prediction model provides a more accurate estimation of the PTP of obstructive CAD than the previous model: while the 2013 model significantly overestimated the likelihood of obstructive CAD, the updated 2019 method showed good calibration, with a net reclassification improvement of 10%, and similar discriminative power. Another potential advantage of the new PTP model – which was not addressed in this publication – is the incorporation of dyspnea as a discriminatory symptom of CAD, enabling assessment of PTP in previously excluded patients.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Besides improving disease prediction, adoption of the 2019 ESC guidelines will most certainly have a significant impact on the appropriate selection of non-invasive testing for the diagnosis of CAD. As the authors correctly state, the new guidelines not only updated the PTP model but have simultaneously lowered the threshold for testing, aiming to keep false negatives below 5%. Taken together, these new recommendations tend to emphasize the unique role of CCTA in CAD assessment, based on its superior performance in ruling out CAD in populations with lower PTP. It is now clear that a diagnosis of CAD should no longer be based solely on treadmill testing and catheterization or on other functional testing but should rather take advantage of the different methods available, according to the different pre-test probabilities under study. Technical developments and evidence accumulated in recent decades have supplied the necessary tools for a much more precise and personalized medicine and pushed guidelines forward. However, the bottleneck for guideline-driven quality medicine in CAD diagnosis, at least in some European countries like Portugal, seems to be the lack of availability and/or reimbursement for the correct test. In the name of quality of care, current efforts should focus on removing these constraints, in order to guide the appropriate management of patients with suspected CAD, while avoiding exposure to unnecessary procedures and costs.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Quality studies like the one presented in this issue of the <span class="elsevierStyleItalic">Journal</span> by Lopes et al. may provide a much-needed perspective on the real-world clinical impact of guideline changes and are therefore very welcome. The authors should be congratulated for their work, while readers and the medical community in general should feel encouraged to act in order to break down all the barriers that block the application of current guidelines.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Knuuti" 1 => "W. Wijns" 2 => "S. Achenbach" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehz425" "Revista" => array:7 [ "tituloSerie" => "Eur Heart J" "fecha" => "2020" "volumen" => "41" "paginaInicial" => "407" "paginaFinal" => "477" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31504439" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022347616312628" "estado" => "S300" "issn" => "00223476" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The updated pre-test probability model of the 2019 ESC guidelines improves prediction of obstructive coronary artery disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P.M. Lopes" 1 => "L. Mendes" 2 => "J.P. Fontes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2022" "volumen" => "41" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Documento de Consenso sobre Estratificação de Risco Cardiovascular e estudo da doença coronária em Portugal: a posição dos Grupos de Estudo de Cardiologia Nuclear Ressonância Magnética e Tomografia Computorizada Cardíaca, de Ecocardiografia e de Fisiopatologia do Esforço e Reabilitação Cardíaca" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "N. Bettencourt" 1 => "L. Mendes" 2 => "J.P. Fontes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2020.10.009" "Revista" => array:5 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2022" "volumen" => "41" "paginaInicial" => "241" "paginaFinal" => "251" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000004100000006/v3_202206160259/S0870255122000695/v3_202206160259/en/main.assets" "Apartado" => array:4 [ "identificador" => "92834" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004100000006/v3_202206160259/S0870255122000695/v3_202206160259/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255122000695?idApp=UINPBA00004E" ]
Ano/Mês | Html | Total | |
---|---|---|---|
2024 Novembro | 10 | 5 | 15 |
2024 Outubro | 60 | 43 | 103 |
2024 Setembro | 68 | 29 | 97 |
2024 Agosto | 47 | 27 | 74 |
2024 Julho | 61 | 37 | 98 |
2024 Junho | 43 | 36 | 79 |
2024 Maio | 45 | 30 | 75 |
2024 Abril | 43 | 41 | 84 |
2024 Maro | 56 | 24 | 80 |
2024 Fevereiro | 84 | 22 | 106 |
2024 Janeiro | 57 | 33 | 90 |
2023 Dezembro | 44 | 32 | 76 |
2023 Novembro | 71 | 64 | 135 |
2023 Outubro | 49 | 29 | 78 |
2023 Setembro | 51 | 33 | 84 |
2023 Agosto | 47 | 16 | 63 |
2023 Julho | 59 | 6 | 65 |
2023 Junho | 33 | 17 | 50 |
2023 Maio | 54 | 29 | 83 |
2023 Abril | 24 | 12 | 36 |
2023 Maro | 36 | 37 | 73 |
2023 Fevereiro | 44 | 26 | 70 |
2023 Janeiro | 27 | 22 | 49 |
2022 Dezembro | 40 | 35 | 75 |
2022 Novembro | 48 | 39 | 87 |
2022 Outubro | 51 | 39 | 90 |
2022 Setembro | 42 | 52 | 94 |
2022 Agosto | 35 | 54 | 89 |
2022 Julho | 50 | 46 | 96 |
2022 Junho | 129 | 75 | 204 |
2022 Maio | 40 | 36 | 76 |