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Introduction: The COVID-19 pandemic has imposed an unprecedented burden on healthcare systems worldwide, changing the profile of interventional cardiology activity., Objectives: To quantify and compare the number of percutaneous coronary interventions (PCIs) performed for acute and chronic coronary syndromes during the first COVID-19 outbreak with the corresponding period in previous years., Methods: Data on PCI from the prospective multicenter Portuguese Registry on Interventional Cardiology (RNCI) were used to analyze changes in PCI for ST-elevation myocardial infarction (STEMI), non-ST-elevation acute coronary syndromes (NSTE-ACS) and chronic coronary syndromes (CCS). The number of PCIs performed during the initial period of the COVID-19 outbreak in Portugal, from March 1 to May 2, 2020, was compared with the mean frequency of PCIs performed during the corresponding period in the previous three years (2017-2019)., Results: The total number of PCIs procedures was significantly decreased during the initial COVID-19 outbreak in Portugal (-36%, p<0.001). The reduction in PCI procedures for STEMI, NSTE-ACS and CCS was, respectively, -25% (p<0.019), -20% (p<0.068) and -59% (p<0.001)., Conclusions: Compared with the corresponding period in the previous three years, the number of PCI procedures performed for STEMI and CCS decreased markedly during the first wave of the COVID-19 pandemic in Portugal., (Copyright © 2022 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Myocardial infarction is frequently the initial form of presentation of coronary artery disease (CAD). Systemic Coronary Risk Estimation (SCORE) risk tables are used in primary prevention and provide an estimate of cardiovascular (CV) risk through known risk factors. The aim of this study was to evaluate the performance of the SCORE, calculated using data previous to the event, to estimate CV risk of a population of patients presenting with ST-elevation myocardial infarction (STEMI) as the first manifestation of CAD., Methods and Results: From a prospective registry including 3056 patients with STEMI subjected to coronary angiography between 2004 and 2014, 1628 patients with STEMI as the first manifestation of CAD were included after the exclusion of patients with known CAD (n=748, 24.5%), patients with high-risk equivalents (n=930, 30.4%), and patients with normal coronaries (n=57, 1.87%). The individual risk profile was calculated using data previous to the event and patients were classified into three established subgroups: low risk (SCORE<5%; n=1162, 71.4%), high risk (SCORE 5-10%; n=409, 25.1%), and very high risk (SCORE≥10%; n=57, 3.5%)., Conclusion: In a population of patients with STEMI as the first manifestation of CAD, the CV risk stratification with the SCORE risk charts, if calculated before the event, would classify as low risk more than two-thirds of the patients (71.4%) and only 3.5% would be classified as very high-risk patients. The high prevalence of low-risk patients indicates the current challenge of CV risk stratification, underlying the need for additional tools in primary prevention to better identify patients at risk.

Introduction and Objectives: The aim of the present paper was to report trends in coronary angioplasty for the treatment of ST-elevation myocardial infarction (STEMI) in Portugal., Methods: Prospective multicenter data from the Portuguese National Registry of Interventional Cardiology (RNCI) and official data from the Directorate-General for Health (DGS) were studied to analyze percutaneous coronary intervention (PCI) procedures for STEMI from 2002 to 2013., Results: In 2013, 3524 primary percutaneous coronary intervention (p-PCI) procedures were performed (25% of all procedures), an increase of 315% in comparison to 2002 (16% of all interventions). Between 2002 and 2013 the rate increased from 106 to 338 p-PCIs per million population per year. Rescue angioplasty decreased from 70.7% in 2002 to 2% in 2013. During this period, the use of drug-eluting stents grew from 9.9% to 69.5%. After 2008, the use of aspiration thrombectomy increased, reaching 46.7% in 2013. Glycoprotein IIb-IIIa inhibitor use decreased from 73.2% in 2002 to 23.6% in the last year of the study. Use of a radial approach increased steadily from 8.3% in 2008 to 54.6% in 2013., Conclusion: During the reporting period there was a three-fold increase in primary angioplasty rates per million population. Rescue angioplasty has been overtaken by p-PCI as the predominant procedure since 2006. New trends in the treatment of STEMI were observed, notably the use of drug-eluting stents and radial access as the predominant approach., (Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)