bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral Presentation No. 48 Sex-based differences in patients with peripheral arterial disease admitted for acute coronary syndrome - Insights from a multicentre national registry
Authors: Cabral Margarida , Gonçalves Carolina , Fernandes Sara , Carvalho Mariana , Ruivo Catarina , Pernencar Sidarth , Loureiro Maria Fátima , Morais João 
Published: October 2022

Abstract
Atherosclerosis represents a systemic disease that can involve multiple vascular beds, including coronary artery disease and peripheral artery disease (PAD). Acute coronary syndrome (ACS) with concomitant PAD represents a high-risk subgroup that deserves special attention. In particular, sex-based differences in PAD treatment and outcomes have been discussed.
This study aimed to clarify the main differences in clinical outcomes between women and men with PAD admitted for ACS. The authors performed a retrospective analysis of adult patients with PAD, included in the Portuguese Registry on Acute Coronary Syndromes (ProACS) between October 2010 and July 2022. A P-value &lt; 0.05 is statistically significant.
Of the total of 32 251 hospitalized patients admitted for ACS, 1588 (4.9%) had known PAD, of which 320 were women and 1268 men. Table 1 shows the most important baseline characteristics and differences between groups. After propensity score matching, with 640 patients, female gender appeared to be an independent factor for acute heart failure (OR 0.68, 95% CI [0.48, 0.96], P-value = 0.03) and in-hospital mortality (OR 0.36, 95% CI [0.17, 0.73], P-value &lt; 0.01). However, there are no differences between sex for 1-year mortality (P-value = 0.70).
In conclusion, in this group of patients, PAD is less prevalent among women, and probably underdiagnosed. In addition, there is a significant difference in medication with fewer women taking acetylsalicylic acid, probably undertreated. Finally, women have more in-hospital complications, including mortality. Hence, additional efforts are needed in order to better understand sex-based differences in PAD and increase awareness of this condition in women.
Oral Presentation No. 006 Postoperative Myocardial Injury due to Platelet Reactivity in Patients undergoing Vascular Surgery
Authors: Zheng K L 
Published: October 2022

Abstract

Background
Postoperative myocardial injury (PMI) after major vascular surgery, detected by elevated cardiac troponin (cTn), has been associated with morbidity and mortality. It is unclear whether the pathophysiology of PMI is determined by increased platelet activity.

Objective
To examine the relationship between platelet activation (P-selectin expression) and PMI(cTn release as continuum) in patients undergoing elective open abdominal aortic surgery in the early post-operative period.

Methods
This prospective, single-centre, observational, cohort study included 33 patients undergoing elective open abdominal aortic surgery between March 2018 and April 2021. Patients were routinely treated with aspirin. Unstimulated platelet activation was measured by platelet bound P-selectin expression (range 0–100%). Explorative coagulation measurements were: stimulated platelet aggregation measured with the VerifyNow® assay (aspirin cartridge), with the Multiplate® analyzer (ASPI, ADP and TRAP) and stimulated coagulation status evaluated by the TEG® Haemostasis Analyzer System (global haemostasis cartridge). The primary outcome was cTn release assessed by the fifth generation high-sensitive cTn assay. Multivariable generalized linear mixed models were used to evaluate the association between platelet function and cTn concentrations over time.

Results
Ten patients (29.4%) developed PMI. Increased P-selectin expression directly after surgery was associated with the cTn concentrations over 48 h (β = 1.39(1.1–1.75), P = 0.0064). No association was found between P-selectin measured later (at 24 h or 48 h) after surgery and cTn concentrations. Furthermore, there was no association between the explorative coagulation parameters and cTn release.

Conclusion
Increased P-selectin expression measured directly after surgery is associated with elevated cTn concentrations in the early postoperative period in patients undergoing elective open abdominal aortic surgery.
Poster No. 009 In-hospital bleeding in acute coronary syndrome: new antithrombotics, old problems
Authors: Lopes Vanessa , Moreira Nádia , Fernandes Rafaela , Cunha Gil , Sousa José Pedro , Lopes João , Milner James , Marinho Vera , Monteiro Sílvia , Monteiro Pedro , Gonçalves Francisco , Gonçalves Lino 
Published: October 2022

Abstract

Background
Progress in decreasing ischemic complications in acute coronary syndrome (ACS) has come at the expense of increased risk of bleeding. This study sought to determine the incidence, predictors, and prognosis of in-hospital bleeding (IHB) in ACS patients.

Material and methods
We retrospectively analyzed patients consecutively admitted to the coronary care unit (CCU) with ACS. Patients who suffered clinically significant IHB were compared to the remaining ACS patients. The primary endpoint was all-cause in-hospital death.

Results and conclusions
From a total of 1032 ACS patients, clinically significant IHB was identified in 5.6% (n = 58) of patients, of whom 13 patients presented serious bleeding. Patients with IHB were older (P = 0.003), more often female (P = 0.012), were more likely to have prior heart failure (P = 0.007) and chronic kidney disease (P = 0.001). At admission, they presented more often with Killip-Kimball class &gt; I (P = 0.001), lower hemoglobin (P = 0.013), lower eGFR (P = 0.005), and a higher CRUSADE score (P &lt; 0.001). In multivariate logistic regression, female sex (OR = 2.26, 1.17–4–38, P = 0.023), acute kidney injury (OR = 2.23, 1.12–4.45, P = 0.028), and non-radial access in coronary angiography (OR = 2.04, 1.08–3.87, P = 0.028), were identified as independent predictors of IHB.
The primary endpoint occurred in 5.8% of ACS patients. Patients who suffered IHB were at higher risk of death during hospitalization (OR = 2.39, 95% CI 1.03–5.51, P = 0.042), but not during the 2-year follow-up (P = 0.429).
In conclusion, IHB is not an uncommon complication in ACS patients and is associated with an increased risk of in-hospital mortality.
Poster No. 043 A Case of Post Thrombotic Syndrome and AV Fistula arising from Recurrent DVT Secondary to May – Thurner Syndrome (MTS) in an Elderly Woman
Authors: Lim Angeline U Y , de Jesus Marilou , Posas Fabio Enrique , Martinez Marvin 
Published: October 2022

Abstract
May-Thurner Syndrome (MTS) remains to be an overlooked condition wherein the right common iliac artery compresses the left common iliac vein. Rarely reported, MTS has other different variants with the iliac vein being compressed by an ipsilateral artery. Iliofemoral DVT poses a significant impact because of venous claudication and DVT recurrence. MTS usually occurs in women, ages 20–40 y/o, and is thus rarely included in differential diagnosis of DVT in elderly patients presenting with persistent unilateral leg swelling. Treatment of DVT alone with anticoagulation is insufficient to address thrombotic MTS. Failure to address the mechanical compression leads to poor quality of life due to high predisposition to recurrent DVT, and at times to other complications such as post-thrombotic syndrome and formation of AV fistulas.
We present a case of an 89 year old woman, hypertensive, non-smoker, no history of cancer, presenting with progressive left lower extremity swelling with erythema, violaceous discoloration, varicosities, telangiectatic skin lesions, hyperpigmentation and calf tenderness. Ultrasound revealed DVT at common iliac vein extending to the popliteal veins. CT studies showed a left common iliac artery compressing the left common iliac vein with early enhancement of the common femoral vein, indicating presence of fistula. Peripheral angiography and venography findings were consistent with CT scan findings, with incidental findings of multiple small AV fistulas.
Anti-coagulation was given and IVC filter was inserted. An attempt to do catheter-directed thrombolysis was unsuccessful. Subsequently, she underwent Palma's surgery which provided significant improvement and was sent home ambulatory.
Poster No. 047 A comparative study of high-intensity statin therapy in post-acute coronary syndrome patients undergoing a cardiac rehabilitation program
Authors: Cabral Margarida , Carvalho Mariana , Santos Rita , Ferreira José Bernardo , Ruivo Catarina , Januário Filipa , Antunes Alexandre , Morais João 
Published: October 2022

Abstract
Aggressive lipid lowering has been shown to be a crucial part of secondary prevention after acute coronary syndrome (ACS). The selection of the best lipid-lowering agents is controversial, with some trials showing rosuvastatin as more efficacious in improving lipid profile compared to atorvastatin, others showing no difference. Another concern is the impact of statin therapy on the reduction of muscle oxidative capacity, and, consequently, on functional capacity.
This study aimed to analyse the differences in lipid profile and physical capacity in post-ACS patients undergoing a cardiac rehabilitation program (CPR), medicated with rosuvastatin versus atorvastatin.
A retrospective analysis of patients in phase 2 of CRP between 2017 and 2020 was performed. Two groups were created: group 1 for patients under atorvastatin 40 mg and group 2 under rosuvastatin 20 mg. Variables were analysed at the beginning and the end of phase 2, 12 weeks later. A P-value &lt; 0.05 is statistically significant.
A total of 98 patients completed phase 2 of CRP, of which 14 are part of group 1, 67 of group 2, and 17 users of other lipid-lowering drugs. Table 1 shows the main characteristics. Univariate (table 2) and multivariate analyses show no differences regarding lipid profile or functional activity between groups.
In conclusion, in this group of patients, high-intensity rosuvastatin and atorvastatin in secondary prevention post-ACS had a comparable impact on lipidic profile, without a significant difference in functional activity, independently of age, sex or comorbidities. Larger randomized prospective trials, including phase 3 of CRP, are needed to confirm these results.
Poster No. 050 Klotho protein supports mechanical function and prevents MMP-mediated injury of heart during ischemia/reperfusion
Authors: Olejnik Agnieszka , Krzywonos-Zawadzka Anna , Banaszkiewicz Marta , Bil-Lula Iwona 
Published: October 2022

Abstract

Background
The injury of the myocardium during ischemia/reperfusion (IRI) involves metabolic, morphological, and contractile disorders. Klotho is a membrane or soluble anti-aging protein. Recent studies have proven the correlation between Klotho deficiency and the occurrence and development of cardiovascular diseases. The study aimed to evaluate the effect of Klotho protein on hearts subjected to IRI.

Material and methods
Isolated Wistar rat hearts perfused with the Langendorff method were subjected to ischemia, followed by reperfusion, in the presence or absence of Klotho protein. Hemodynamic parameters and the levels of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-Κb), nitrate/nitrite, inducible nitric oxide synthase (iNOS), asymmetric dimethylarginine (ADMA), matrix metalloproteinase 2 (MMP-2), MMP-9 and tissue inhibitor of MMP type 4 (TIMP-4) were evaluated.

Results
Infusion supply of Klotho during IRI resulted in the recovery of contractile function (P = 0.031) and heart rate (P = 0.02). IRI activated MMP-2 (P = 0.042) and MMP-9 (P = 0.041) in hearts, as compared to aerobic control. Klotho contributed to increase in iNOS level (P = 0.02), and decreased levels of NF-Κb (P = 0.006), ADMA (P = 0.007), nitrate/nitrite (P = 0.022), MMP-2 (P = 0.024) and MMP-9 (P &lt; 0.001), as compared to IRI group.

Conclusions
Klotho protein preserved heart mechanical function and reduced the level of proteolytic enzymes in the heart. Thus, Klotho can be recognized as a novel cardiopreventive/cardioprotective agent in ischemic damage.
This work was supported by the National Science Centre, Poland [grant number 2019/33/N/NZ3/01649].
Poster No. 080 Relationship between triglyceride glucose index, MACE and nephropathy in type 2 diabetes
Authors: Delia Mercea , Mihaela Mociran , Raluca Ianos , Adela Sitar-Taut , Sporis D , Ganea A , Lazar A , Malinescu V , Cozma A 
Published: October 2022

Abstract

Background
The triglyceride glucose (TyG) index, a simple surrogate estimate of insulin resistance, has been demonstrated to predict cardiovascular disease morbidity and mortality in the general population. To explore the relationship between TyG index, MACE (major adverse cardiovascular events) and diabetic nephropathy in type 2 diabetes, we evaluated TyG index for 3 consecutive years.

Material and methods
This was a cross-sectional observational study that examined 172 subjects with T2DM. The mean age of the study participants was 61.71 ± 13.16 years, and 90 were female. The primary outcomes included the occurrence of MACE, defined as all-cause death, non-fatal myocardial infarction and non-fatal stroke. Subjects underwent a detailed standard evaluation to detect diabetic nephropathy (defined as urinary albumin excretion ≥ 30 mg/24 h). The TyG index was calculated as ln (fasting triglycerides × fasting glucose/2) and stratified into 4 quartiles (TyG-Q). The baseline characteristics of the study population in the four TyG-Q (Q1 (≤ 8.95) n = 43, Q2 (&gt; 8.95 to ≤ 9.27) n = 43, Q3 (&gt; 9.27 to ≤ 9.7) n = 43, and Q4 (&gt; 9.7) n = 43) were analysed.

Results and conclusions
Higher TyG-Q correlated with the presence of nephropathy (p = 0.028), age (p = 0.0172), HbA1c levels (p = 0.001) and the presence of arterial hypertension (p = 0.032). The optimal TyG index cut-off for predicting MACE was 9.271 (sensitivity 54.0%; specificity 54%; area under the curve 0.532).The TyG index was significantly associated with MACE, suggesting that the TyG index may be a valid marker for risk stratification and prognosis in patients with T2DM.
Oral Presentation No. 096 Impact of Inflammatory and Hematological Factors to The Left Ventricule Function, Remodeling, and Clinical Outcomes after The First Myocardial Infarction
Authors: Korac Nina , Dekleva Milica 
Published: October 2022

Abstract

Background
It is known that hematological and inflammatory factors can affect the prognosis of patients with AMI, but the interpretations are different.

Material and methods
The study included 182 patients with their first AMI age &lt; 70 years. Inflammatory (CRP, Sedimentation and Leukocytes), hematological factors (Platelets, Iron, Hct) and coronary status were obtained at admission. Doppler echocardiography was performed two days after admission and after 6 months.The degree of heart failure was assessed by clinical examination.

Results and conclusions
Remodeling of LV, measured by LV volume increase and Sphericity index was closely related to Sedimentation level (P = 0.013; P = 0.028). Sedimenation was related to systolic function measured by LVEF (P = 0.011) and with diastolic dysfunction measured by E/e ratio (P &lt; 0.001). A significant impact of CRP on LVEF (P = 0.028) and degree of diastolic dysfunction (P = 0.024) was estimated. Iron level had an effect on LVEF (P = 0.017), while E/e was negatively correlated with Iron (P = 0.005). The degree of heart failure was positively correlated with the level of Iron and Sedimentation. Sedimentation level of 22.5 cut off had a sensitivity of 75%, a specificity of 52% in predicting NYHA III and IV. Iron level of 8.1 has a sensitivity of 72.4%, specificity of 57.9% in predicting NYHA III and IV. There were no significant correlations between coronary status and inflammation parameters .Inflammatory hematological status of patients is associated with changes in the morphology and function of the LV after the first MI. The sedimentation level and CRP contribute to a better risk stratification for the severity of heart failure.
Poster No. 098 SGLT2-inhibitors as add-on therapy in cardiac amyloidosis: our experience
Authors: Fazio Giovanni 
Published: October 2022

Abstract

Background
Cardiac amyloidosis (CA) is a severe and progressive infiltrative disease caused by physiological, inherited or acquired abnormalities, which lead to the accumulation of amyloid fibrils in the cardiac interstitium. Despite recent evidence support the use of SGLT2-inhibitors in heart failure, including HFpEF for empagliflozin and dapagliflozin, there are no studies on the use of these drugs for the treatment of CA.

Methods
We enrolled 5 consecutive patients with symptomatic CA (II or II NYHA). The diagnosis of was based on non-invasive criteria: echocardiographic criteria + grade 2 or 3 cardiac uptake at diphosponate scintigraphy + negative serum light chains and negative serum and urine immunofixation. Mean age was 66,52 years, all male. Despite optimal therapy, they had symptoms of pulmonary and peripheral congestion. We added 10 mg of dapagliflozin daily to therapy and reassessed patients after 7 days.

Results
Dapagliflozin was effective as add-on therapy in CA. All treated patients reported an improvement in symptoms and signs. After7 days, dyspnea improved, exercise tolerance evaluated in six minutes walking test increased (from a mean of 123 meters to a mean of212 meters), and oedema decreased. Therapy was well tolerated, and no side effects were reported.

Conclusions
Our initial experience with dapagliflozin suggests that SGLT2-inhibitors may play a role in the treatment of cardiac amyloidosis. In our opinion, the growing evidence of this class of drugs in heart failure therapy justifies clinical trials on amyloidosis.
Poster No. 104 Impact of pre-treatment with a P2Y12 receptor inhibitor on delay to CABG surgery in a real-world population with non-ST segment elevation acute coronary syndrome
Authors: Gomes Daniel , Rocha Bruno M L , Ferreira Jorge , Paiva Mariana Sousa , Santos Rita Reis , Santos Marina Raquel , Cunha Gonçalo , de Araújo Gonçalves Pedro , Fevereiro Susana , Trabulo Marisa , Aguiar Carlos , Sousa-Uva Miguel , Neves José , Mendes Miguel 
Published: October 2022

Abstract

Background
ESC guidelines for non-ST elevation acute coronary syndromes (NSTE-ACS) recommend against P2Y12 pre-treatment receptor inhibitors (P2Y12i) in patients undergoing early invasive management (&lt; 24 h). The rationale is, in part, to prevent bleeding complications and the delay of coronary artery bypass graft surgery (CABG) in patients with suitable anatomy. This study aims to analyze the impact of P2Y12i pre-treatment on delay to CABG surgery in a real-world population with NSTE-ACS.

Methods
Single-centre retrospective cohort of consecutive patients with NSTE-ACS undergoing invasive evaluation in 2019. Those with previous CABG (n = 31) or non-obstructive coronary disease (n = 57) were excluded.

Results
Total cohort included 262 patients (mean age 68 ± 12 years, 69% male, 15% with unstable angina and mean GRACE score 134 ± 35). Median time from first medical contact to angiography was 2 (1–4) days. Overall, 168 (64%) patients underwent percutaneous coronary intervention, 47 (18%) were proposed for CABG and the remainder received conservative management. All patients considered for CABG received pre-treatment with P2Y12i, either clopidogrel or ticagrelor. Median time from angiography to CABG was 12 (7–15) days. Six patients experienced recurrent angina (13%) and 2 (4%) died before surgery due to refractory ventricular fibrillation. Those who underwent CABG under P2Y12i effect were more likely to receive blood and platelets transfusions (64.7% vs. 28.6%, P = 0.017 and 82.4% vs. 21.4%, P &lt; 0.001, respectively), although there were no differences regarding major bleeding.

Conclusion
Pre-treatment with P2Y12i was a potential driver of CABG delay in our cohort. In the real-world, adopting the new recommendations of withholding pre-treatment might decrease this delay.
Poster No. 122 Predicting the rate of progressive dilation by wall shear stress in bicuspidaortic valve patients
Authors: Rodriguez-Palomares Jose , Dux-Santoy Lydia , Teixidó-Turà Gisela , Ruiz-Muñoz Aroa , Garrido-Oliver Juan , Johnson Kevin , Wieven Oliver , Galian Laura , Valente Filipa , Gutierrez Laura , Gonzalez-Alujas Teresa , Sao-Aviles Augusto , Evangelista Arturo , Ferreira-Gonzalez Ignacio , Guala Andrea 
Published: October 2022

Abstract

Background
Despite the high prevalence of ascending aorta (AAo) dilation in bicuspid aortic valve (BAV) patients there is limited evidence of dilation aetiology. Several cross-sectional studies pointed to a role for wall shear stress (WSS), but this hypothesis has not been tested. Recently, a technique for 3D-maps of aortic growth from two contrast-enhanced computed tomography angiograms (CTA) was presented and validated. We aim to test if local WSS predicts local dilation rates in BAV patients.

Materials and methods
Forty BAV patients free from aortic valve disease and previous relevant interventions underwent a baseline 4D flow CMR followed by two CTA. WSS, and its axial and circumferential components, and growth rate (GR) were computed at 64 standardized regions in the ascending aortic (AAo). A two-tailed p-value &lt; 0.05 was considered statistically significant.

Results and conclusions
Patients were relatively young (51 ± 13 yeas) and follow-up duration was 44.8 ± 2.6 months. Growth rate was heterogeneous in the AAo, with fastest progression located in the outer mid AAo region and in the inner region of the proximal-mid AAo. WSS magnitude and WSS axial component were maximum in the right region of the mid AAo while circumferential WSS was highest in the outer region of the mid AAo, the region experiencing fastest growth. Significant associations between GR and circumferential WSS were located in the regions with fastest progressive dilation, while WSS magnitude and its axial component resulted in limited predictive capacity. In conclusion, circumferential WSS is related to fast progressive dilation in BAV patients.

Funding
PI17/00381,SEC/FEC-INV-CLI20/015,LCF/BQ/PR22/11920008,RTC2019-007280-1.