Prevalence, Characteristics, and Prognostic Relevance of Donor-Transmitted Coronary Artery Disease in Heart Transplant Recipients.

BACKGROUND: The reported prevalence of donor-transmitted coronary artery disease (TCAD) in heart transplantation (HT) is variable, and its prognostic impact remains unclear. OBJECTIVES: The goal of this study was to characterize TCAD in a contemporary multicentric cohort and to study its prognostic relevance. METHODS: This was a retrospective study of consecutive patients >18 years old who underwent HT in 11 Spanish centers from 2008 to 2018. Only patients with a coronary angiography (c-angio) within the first 3 months after HT were studied. Significant TCAD (s-TCAD) was defined as any stenosis ≥50% in epicardial coronary arteries, and nonsignificant TCAD (ns-TCAD) as stenosis <50%. Clinical outcomes were assessed by means of Cox regression and competing risks regression. Patients were followed-up for a median period of 6.3 years after c-angio. RESULTS: From a cohort of 1,918 patients, 937 underwent c-angio. TCAD was found in 172 patients (18.3%): s-TCAD in 65 (6.9%) and ns-TCAD in 107 (11.4%). Multivariable Cox regression analysis did not show a statistically significant association between s-TCAD and all-cause mortality (adjusted HR: 1.44; 95% CI: 0.89-2.35; P = 0.141); however, it was an independent predictor of cardiovascular mortality (adjusted HR: 2.25; 95% CI: 1.20-4.19; P = 0.011) and the combined event cardiovascular death or nonfatal MACE (adjusted HR: 2.42; 95% CI: 1.52-3.85; P < 0.001). No statistically significant impact of ns-TCAD on clinical outcomes was detected. The results were similar when reassessed by means of competing risks regression. CONCLUSIONS: TCAD was not associated with reduced survival in patients alive and well enough to undergo post-HT angiography within the first 3 months; however, s-TCAD patients showed increased risk of cardiovascular death and MACE.

Revisão sistemática das plantas de Interesse ao Sistema Único de Saúde com potencial terapêutico cardiovascular / Revisión sistemática de las plantas de interés para el Sistema de Salud con potencial terapéutico cardiovascular / Systematic review of the plants of interest to the National Health System with cardiovascular therapeutic potential

Introdução: doenças cardiovasculares constituem uma das principais causas de mortalidade, pois muitos são os fatores de risco associados ao seu desenvolvimento. Estudos vêm demonstrando que moléculas extraídas de plantas medicinais podem reduzir o risco de doenças crônicas. Assim, o Ministério da Saúde, publicou em fevereiro de 2009, a Relação Nacional de Plantas Medicinais de Interesse ao SUS. Objetivos: quantificar os estudos clínicos que referem potencial terapêutico sobre doenças cardiovasculares a partir da utilização de Plantas da Medicinais de Interesse ao SUS, publicados entre 2010 e fevereiro de 2013 em três bases de dados científicas (SciELO, Science Direct e Springer). Métodos: os descritores utilizados na busca inicial foram o nome científico das 71 plantas da Relação Nacional de Plantas Medicinais de Interesse ao SUS. Considerou-se todos os artigos científicos gratuitos, disponibilizados sob forma de texto completo nas bases de pesquisa, independente do idioma. A busca inicial resultou na seleção de 21,357 artigos encontrados nas bases de dados. A análise foi realizada inicialmente a partir da leitura do título da publicação. Os artigos selecionados foram avaliados através da leitura do Abstratc. Por fim, foi lido integralmente o texto dos artigos selecionados após a avaliação do Abstract, tendo sido selecionados estudos pré-clínicos e clínicos, in vitro e in vivo, que comprovam potencial terapêutico sobre doenças cardiovasculares. Resultados: esta seleção resultou em 34 artigos de interesse, dos quais, 17 estudos foram realizados com a planta Curcuma longa. Infarto do miocárdio, isquemia cerebral e hipertensão arterial foram as morbidades com a maior quantidade de estudos terapêuticos. Conclusões: os resultados deste estudo fornecem subsídios teóricos para discussões na Saúde Pública sobre tratamentos alternativos para doenças cardiovasculares(AU)

Introducción: las enfermedades cardiovasculares constituyen una de las principales causas de mortalidad, al existir muchos factores de riesgo asociados a su aparición. Hay estudios que demuestran que moléculas extraídas de plantas medicinales pueden reducir el riesgo de enfermedades crónicas. De esta forma, el Ministerio de Salud, publicó en febrero de 2009, la Lista Nacional de Plantas Medicinales de Interés para el SUS. Objetivos: cuantificar los estudios clínicos que refieren potencial terapéutico sobre las enfermedades cardiovasculares a partir de la utilización de Plantas da Medicinais de Interesse ao SUS, publicados entre 2010 y febrero de 2013 en tres bases de datos científicas (SciELO, Science Direct y Springer). Métodos: los descriptores utilizados en la búsqueda inicial fueron el nombre científico de 71 plantas de Plantas da Medicinais de Interesse ao SUS. Se consideraron todos los artículos científicos gratuitos, disponibles en texto completo en las bases de investigación, independiente del idioma. Primero se seleccionaron 21,357 artículos encontrados en las bases de datos. El análisis fue realizado a partir de la lectura del título de publicación. Los artículos seleccionados fueron evaluados a través de la lectura del Abstract. Por último, fueron leídos de forma íntegra el texto de los artículos seleccionados después de la evaluación del Abstract, fueron seleccionados estudios pre-clínicos y clínicos in vitro e in vivo, que comprueban el potencial terapéutico sobre las enfermedades cardiovasculares. Resultados: esta selección resultó de 34 artículos de interés, de los cuales, 17 estudios fueron realizados con la planta Curcuma longa. Infarto de miocardio, isquemia cerebral e hipertensión arterial fueron las comorbilidades con la mayor cantidad de estudios terapéuticos. Conclusiones: los resultados de este estudio ofrecen subsidios teóricos para discusiones en Salud Pública sobre tratamientos alternativos para las enfermedades cardiovasculares(AU)

Introduction: cardiovascular diseases are a major cause of mortality, because there are many risk factors associated with its development. Studies have shown that molecules extracted from medicinal plants can reduce the risk of chronic diseases. Thus, the Ministry of Health, published in February 2009, the National List of Medicinal Plants of Interest to SUS. Objective: to quantify the clinical studies that relate therapeutic potential of cardiovascular disease from the use of the National List of Medicinal Plants of Interest to SUS, published between 2010 and February 2013 in three scientific databases (SciELO, Science Direct and Springer). Methods: the descriptors used in the initial search were the scientific name of the 71 plants from the National List of Medicinal Plants of Interest to SUS. It considered all free papers made available in the form of full text search in databases, regardless of the language. The initial search resulted in the selection of 21 357 articles found in databases. The analysis was initially performed from reading the title of the publication. The articles were evaluated by reading the Abstratc. Finally, it was fully read the text of the articles selected after evaluation of the Abstract and was selected pre-clinical and clinical studies, in vitro and in vivo, that show therapeutic potential for cardiovascular disease. Results: this selection resulted in 34 articles of interest, of which 17 studies were conducted with the Curcuma longa plant. Myocardial infarction, cerebral ischemia and hypertension were morbidities with the greatest amount of therapeutic studies. Conclusions: the results of this study provide theoretical basis for discussions at the Public Health on alternative treatments for cardiovascular disease(AU)