Efficacy and Safety of a Novel Triple Single-Pill For Uncontrolled Hypertension: the OPTION TREAT Trial.

Background: Novel single-pill combinations with blood pressure (BP)-lowering agents are needed to increase treatment options for hypertension.

Objectives: To assess the efficacy and safety of a novel single-pill (candesartan cilexetil, amlodipine, and chlorthalidone) compared with an active control (valsartan, amlodipine, and hydrochlorothiazide) for uncontrolled hypertension.

Methods: OPTION TREAT was a randomized, double-blind, double-dummy, noninferiority trial conducted across 19 sites in Brazil.

Early Withdrawal of Aspirin after PCI in Acute Coronary Syndromes.

Background: Whether potent P2Y12 inhibitor monotherapy without aspirin initiated shortly after successful percutaneous coronary intervention (PCI) is effective and safe for patients with acute coronary syndromes is unclear.

Methods: We conducted a multicenter, open-label, randomized trial in Brazil involving patients with acute coronary syndromes who had undergone successful PCI. Patients were assigned in a 1:1 ratio within the first 4 days of hospitalization to stop treatment with aspirin and receive potent P2Y12 inhibitor monotherapy (ticagrelor or prasugrel) or to receive dual antiplatelet therapy (aspirin and a potent P2Y12 inhibitor) for 12 months.

Effectiveness and Safety of Edoxaban in the Routine Clinical Care of Atrial Fibrillation Patients in Brazil: Prospective 1-Year Follow-Up Study - EdoBRA.

Background: Edoxaban, an orally administered anticoagulant, has been shown to be safe and effective in preventing stroke in atrial fibrillation (AF) patients. Given its widespread use since approval, evaluating edoxaban's real-world performance in the Brazilian clinical context is crucial.

Objective: The study aimed to report the one-year safety and effectiveness of edoxaban in AF patients in Brazil.

In-Hospital influenza vaccination to prevent cardiorespiratory events in the first 45 days after acute coronary syndrome: A prespecified analysis of the VIP-ACS trial.

Background: Influenza vaccination prevents major cardiovascular events in individuals presenting a recent acute coronary syndrome (ACS), however the early effect of an in-hospital double-dose vaccination strategy remains uncertain.

Methods: The VIP-ACS was a randomized, pragmatic, multicenter, open-label trial with a blinded-adjudication endpoint. Patients with ACS ≤ 7 days of hospitalization were randomized to an in-hospital double-dose quadrivalent inactivated influenza vaccine (double-dose) or a standard-dose influenza vaccine at 30 days post-randomization.

Multifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission: The MESSAGE-HF Randomized Clinical Trial.

Importance: Readmissions after an index heart failure (HF) hospitalization are a major contemporary health care problem.

Objective: To evaluate the feasibility and efficacy of an intensive telemonitoring strategy in the vulnerable period after an HF hospitalization.

Design, Setting, And Participants: This randomized clinical trial was conducted in 30 HF clinics in Brazil.

National Registry of Hypertension Control Evaluated by Office and Home Measurements: The LHAR National Registry.

Background: It is known that around 30% of patients have higher blood pressure (BP) values when examined at the office than at home. Worldwide, only 35% of patients with hypertension undergoing treatment have reached their BP targets.

Objective: To provide epidemiological data on BP control in the offices of a sample of Brazilian cardiologists, considering office and home BP measurement.

P2Y12 inhibitor monotherapy versus dual antiplatelet therapy in patients with acute coronary syndromes undergoing coronary stenting: rationale and design of the NEOMINDSET Trial.

Dual antiplatelet therapy (DAPT) is currently the standard of care after percutaneous coronary intervention (PCI). Recent studies suggest that reducing DAPT to 1-3 months followed by an aspirin-free single antiplatelet therapy (SAPT) strategy with a potent P2Y inhibitor is safe and associated with less bleeding. However, to date, no randomised trial has tested the impact of initiating SAPT immediately after PCI, particularly in patients with acute coronary syndromes (ACS).

Lipoprotein(a) levels in a global population with established atherosclerotic cardiovascular disease.

Objective: Lipoprotein(a) (Lp(a)) is an important genetically determined risk factor for atherosclerotic vascular disease (ASCVD). With the development of Lp(a)-lowering therapies, this study sought to characterise patterns of Lp(a) levels in a global ASCVD population and identify racial, ethnic, regional and gender differences.

Methods: A multicentre cross-sectional epidemiological study to estimate the prevalence of elevated Lp(a) in patients with a history of myocardial infarction, ischaemic stroke or peripheral artery disease conducted at 949 sites in 48 countries in North America, Europe, Asia, South America, South Africa and Australia between April 2019 and July 2021.

Design of a multifaceted strategy based on automated text messaging in patients with recent heart failure admission.

Aims: To evaluate a telemonitoring strategy based on automated text messaging and telephone support after heart failure (HF) hospitalization.

Methods And Results: The MESSAGE-HF study is a prospective multicentre, randomized, nationwide trial enrolling patients from 30 clinics in all regions of Brazil. HF patients with reduced left ventricular ejection fraction (<40%) and access to mobile phones are eligible after an acute decompensated HF hospitalization.

Dapagliflozin in patients with cardiometabolic risk factors hospitalised with COVID-19 (DARE-19): a randomised, double-blind, placebo-controlled, phase 3 trial.

Background: COVID-19 can lead to multiorgan failure. Dapagliflozin, a SGLT2 inhibitor, has significant protective benefits for the heart and kidney. We aimed to see whether this agent might provide organ protection in patients with COVID-19 by affecting processes dysregulated during acute illness.

Rivaroxaban in Patients with Atrial Fibrillation and a Bioprosthetic Mitral Valve.

Background: The effects of rivaroxaban in patients with atrial fibrillation and a bioprosthetic mitral valve remain uncertain.

Methods: In this randomized trial, we compared rivaroxaban (20 mg once daily) with dose-adjusted warfarin (target international normalized ratio, 2.0 to 3.

A randomized clinical trial to evaluate the efficacy and safety of rivaroxaban in patients with bioprosthetic mitral valve and atrial fibrillation or flutter: Rationale and design of the RIVER trial.

The efficacy and safety of rivaroxaban in patients with bioprosthetic mitral valves and atrial fibrillation or flutter remain uncertain. DESIGN: RIVER was an academic-led, multicenter, open-label, randomized, non-inferiority trial with blinded outcome adjudication that enrolled 1005 patients from 49 sites in Brazil. Patients with a bioprosthetic mitral valve and atrial fibrillation or flutter were randomly assigned (1:1) to rivaroxaban 20 mg once daily (15 mg in those with creatinine clearance <50 mL/min) or dose-adjusted warfarin (target international normalized ratio 2.

Reference values of office central blood pressure, pulse wave velocity, and augmentation index recorded by means of the Mobil-O-Graph PWA monitor.

Assessment of central blood pressure (BP), pulse wave velocity (PWV), and augmentation index (AIx) measurements may improve cardiovascular risk stratification. This study aimed to establish reference office values for central BP, PWV, and AIx by means of a Mobil-O-Graph PWA monitor and to evaluate the impact of cardiovascular risk factors (CVRFs) on these measurements. We cross-sectionally evaluated clinical characteristics, central BP, PWV, AIx, and peripheral BP measurements among 867 apparently healthy individuals (age = 46.

[Acute kidney injury in hospitalized patients with decompensated heart failure].

Introduction: Acute kidney injury (AKI) occurs frequently in critical patients, but its clinical relevance has not been determined in decompensated heart failure (DHF).

Objectives: To study the occurrence and prognostic value of AKI in patients with DHF and to compare the clinical and laboratory characteristics and in-hospital mortality with those without AKI.

Methods: Prospective study of 85 patients hospitalized in intensive care unit (ICU) with DHF from March 2010 to February 2011.

Influence of respiratory muscle strength in evolution of patients with heart failure after cardiac surgery.

Objective: To investigate the influence of preoperative respiratory muscle strength in postoperative pulmonary complications in patients with heart failure undergoing cardiac surgery.

Methods: From March 2009 to September 2010, 40 patients admitted to the cardiology service of the Fundação de Beneficência Hospital de Cirurgia were divided into two groups according to the values of maximal inspiratory pressure measured by manometer: Group A (n = 21), composed of patients with normal respiratory muscle strength, and Group B (n = 19), patients with reduced strength. After pre-operative evaluation, all patients underwent the surgical procedure and followed until hospital discharge by the same researcher, who recorded on data collection especially its evolution for the presence of pulmonary complications after surgery, which was divided general and specific.

Decompensated heart failure in the emergency department of a cardiology hospital.

Background: National studies on decompensated heart failure (DHF) are key to the understanding of this condition in our midst.

Objective: To determine the characteristics of DHF patients in an emergency department.

Methods: A total of 212 patients diagnosed with decompensated heart failure who had been admitted to an emergency department (EU) of a cardiology hospital were prospectively evaluated.