Carbohydrate antigen 125 (CA125) is a congestion and inflammation biomarker and has been proved to be related to a worse prognosis in heart diseases. However, the precise relationship between elevated CA125 in patients with ST-segment elevation myocardial infarction (STEMI) has not yet been sufficiently studied. We set out to determine the association of CA125 with all-cause mortality at 6 months in STEMI. CA125, N-terminal pro brain natriuretic peptide (NTproBNP) and high sensitive C-reactive protein (hs-CRP) were measured in 245 patients admitted consecutively with STEMI undergoing coronary angioplasty. The mean age in our sample was 63.7 years, 64.9% were males, 28.3% had diabetes and 17.7% presented with acute heart failure (Killip ≥ 2). The median serum level of CA125 was 8.1 U/ml. At 6 months, the rate of all-cause mortality was 18% (44 patients). Receiver operating characteristic curve analysis demonstrated that CA125 presented similar performance to predict mortality as NTproBNP and hs-CRP. Patients with CA125 ≥ 11.48 had a higher rate of mortality (Hazard Ratio = 2.07, 95% confidence interval = 1.13-3.77, p = 0.017) than patients with CA125 < 11.48. This study suggests that elevated CA125 levels might be used to identify patients with STEMI with a higher risk of death at 6 months. CA125 seems to be a similar predictor of mortality compared to NTproBNP and hs-CRP. Myocardial infarction with ST-segment elevation (STEMI) is a life-threatening disorder with high morbidity and mortality despite advances in treatment. Patients presenting with STEMI tend to be heterogeneous and immediate risk stratification at the time of presentation is essential for optimal management 1-4. Markers of congestion and inflammation, such as natriuretic peptides (NP) and high sensitive C-reactive protein (hs-CRP), have been shown to be prognostic markers. However, the biomarkers currently available are not perfect, and their correct interpretation requires careful consideration of the specific clinical scenario 5. Carbohydrate antigen 125 (CA125) is a congestion and inflammation biomarker. It has been studied in patients with heart diseases, especially heart failure 6. However, the precise relationship between elevated CA125 in patients with STEMI and cardiovascular events has not yet been sufficiently studied. This study set out to evaluate the relationship between CA125 and mortality in STEMI patients in comparison with N-Terminal pro brain natriuretic peptide (NTproBNP) and hs-CRP. Methods patients and study design. This was a prospective cohort at a single center. Patients consecutively admitted with STEMI undergoing primary angioplasty were included. The diagnosis of STEMI was made based on the third universal definition 7. Two hundred and seventy one patients were considered to be included. Patients were excluded if they had chronic heart failure (n = 3), previous coronary revascularization (n = 11), kidney failure (n = 8), absence of severe coronary disease (n = 4), end-stage liver disease, ongoing infection or malignancy.

Carbohydrate antigen 125 (CA125) has long been used as an ovarian cancer biomarker. However, because it is not specific for ovarian cells, CA125 could also be used to monitor congestion and inflammation in heart disease. Acute heart failure (HF) is used to identify patients with a worse prognosis in ST-segment elevation myocardial infarction (STEMI). We aimed to determine the association of CA125 with acute HF in STEMI and to compare CA125 with N-terminal pro brain natriuretic peptide (NTproBNP) with a cross-sectional study. At admission, patients were examined to define Killip class and then underwent coronary angioplasty. Blood samples, preferably taken in the hemodynamic ward, were centrifuged (1500 g for 15 min at ambient temperature) and stored at −80°C until biomarker assays were performed. Patients were divided into two groups according to the presence or absence of congestion. Patients in Killip class ≥II were in the congestion group and those with Killip

submetidos à esplenectomia com ligadura da veia gástrica esquerda (LVGE), desvascularização da grande curvatura do estômago e esclerose endoscópica pós-operatória, para o tratamento da hipertensão portal esquistossomótica com antecedentes de hemorragia digestiva. Quando da presença de varizes de fundo gástrico (44/125) foi associado ao procedimento cirúrgico, a abertura do estômago e sutura das varizes. Resultados: Varizes de fundo gástrico foram identificadas em 35,2% (44/125) dos pacientes com esquistossomose hepatoesplênica e antecedentes de hemorragia digestiva alta. Durante o seguimento de 26 meses o procedimento cirúrgico erradicou 76,5% das varizes de fundo gástrico. A incidência de trombose da veia porta no período pós-operatório foi maior no grupo de pacientes sem varizes de fundo gástrico (16,3%) quando comparado com os pacientes portadores de varizes de fundo gástrico (8,8%), sem que, no entanto, esta diferença tivesse respaldo estatístico (p = 0,62). Não se identificou correlação entre a presença de varizes do fundo gástrico e o grau de fibrose periportal e o peso do baço. Na análise bioquímica e hematológica, no período pré-operatório dos grupos estudados, o número de leucócitos foi estatisticamente menor no grupo de pacientes que apresentavam varizes de fundo gástrico. Conclusão: A esplenectomia associada a desvascularização da grande curvatura do estômago, ligadura da veia gástrica esquerda, gastrotomia e sutura da varizes de fundo gástrico, erradicou 76,5% das varizes de fundo gástrico, em um seguimento tardio médio de 26 meses.

Aims. The goal of this study was to evaluate the performance of the InspironTM coronary stent (Scitech Medical™, Goiás, Brazil). The InspironTM sirolimus-eluting stent uses an ultrathin L-605 cobalt-chromium alloy with a 75 μm strut thickness platform coated with an abluminal biodegradable polymer. The polymer is eliminated from the body through the tricarboxylic acid cycle in 6–9 months, releasing 80% of the drug within 30 days after its deployment. Methods. It was a prospective, single-center registry. To represent clinical practice, all patients undergoing percutaneous coronary intervention were included in this registry. There were no exclusion criteria. Clinical follow-ups were performed at twelve months. The endpoints were the occurrence of all-cause death, definite stent thrombosis, and new revascularization. Results. Between November 2017 and May 2019, 790 patients were included (1067 lesions). The mean age was 60.42 ± 14.94 years, and 74.7% presented with acute coronary syndrome. Diabetes mellitus was present in 43.9% of patients, and previous myocardial infarction and previous percutaneous coronary intervention were present in 17.9% and 11.3%, respectively. Angiographic success was achieved in 99.1%. The incidence of all-cause death was 11.5% (6.2% in-hospital and 5.3% in the follow-up) and definitive stent thrombosis was 0.2%. New revascularization was performed in only 5.8% (target lesion revascularization: 2.2%; progression of disease in another lesion: 3.6%). Based on the multivariate regression analysis, only chronic renal failure was an independent predictor of adverse events (OR: 3.3; 95% CI: 1.22–8.92). Conclusion. The result of this single-center registry demonstrates the safety and excellent performance of the InspironTM stent in daily clinical practice with a low rate of adverse cardiac events.

RESUMO: Objetivo:Analisar pré-operatoriamente o peso do baço como fator prognóstico do tratamento cirúrgico de pacientes portadores de esquistossomose mansônica. Métodos: Foram analisados 114 pacientes, portadores de esquistossomose mansônica com antecedentes de hemorragia digestiva, submetidos a tratamento cirúrgico. Os pacientes foram divididos em três grupos: Grupo 1 -baço menor que 500 gramas (17); Grupo 2 -baço entre 500 e 1.000 gramas (58); Grupo 3 -baço acima de 1.000 gramas (39). Resultados: No Grupo 1 a recidiva hemorrágica foi de 17,6%, trombose da veia porta de 5,9% e não houve mortalidade. A incidência de hiperesplenismo pré-operatório foi de 29,4% e o calibre da veia porta foi de 1,1cm. No Grupo 2 a recidiva hemorrágica foi de 15,5%, trombose da veia porta de 10,3% e a mortalidade de quatro pacientes (6,9%) (dois pacientes no período pós-operatório e dois no seguimento tardio, hepatocarcinoma e hemorragia digestiva). A incidência de hiperesplenismo foi de 53,4% e o calibre médio da veia porta foi de 1,4cm. No Grupo 3 a recidiva hemorrágica foi de 12,8%, trombose da veia porta de 5,1% e uma mortalidade tardia de dois pacientes (linfoma e infarto agudo do miocárdio). A incidência de hiperesplenismo foi de 76,9% e o calibre da veia porta foi de 1,5cm. Conclusões: O peso do baço apresenta relação com o hiperesplenismo pré-operatório, calibre da veia porta e permanência hospitalar pós-operatória. Não encontramos relação com a incidência de varizes de fundo gástrico, recidiva de sangramento digestivo, trombose da veia porta, grau de fibrose periportal e dados bioquímicos. Descritores: Esquistossomose hepatoesplênica; Esplenectomia; Baço; Fator de risco; Trombose da veia porta. 29 INTRODUÇÃOO tratamento cirúrgico da hipertensão porta esquistossomótica através da esplenectomia com ligadura da veia gástrica esquerda, seguida de esclerose endoscópica pós-operatória, determina uma recidiva hemorrágica de 14,4% e uma mortalidade tardia de 5,4% 1 .Na busca de identificar pré-operatoriamente fatores que possam comprometer os resultados cirúrgicos e talvez determinar condutas diferentes nestes pacientes, fo-