Percorrer por autor "Gil, Victor"
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- Lipid-lowering therapy and LDL cholesterol control among high- and very high-risk patients in Portugal: An analysis of the SANTORINI studyPublication . Aguiar, Carlos; Aguiar, Patrício; Duarte, João Sequeira; Gil, Victor; Mimoso, Jorge; Monteiro, Pedro; Pinto, Fausto J.; Pinto, Fernando; Raposo, João; von Hafe, Pedro; Ruivo, Jorge A.; Teixeira, Carla; Catapano, Alberico L.; Ray, Kausik K.Introduction and objectives: The SANTORINI study is the first large-scale, European observational study conducted following the release of the 2019 European Society of Cardiology/European Atherosclerosis Society ESC/EAS guidelines on dyslipidemia management. This analysis aims to assess lipid-lowering therapy (LLT) use and low-density lipoprotein cholesterol (LDL-C) goal attainment in patients at high or very high cardiovascular (CV) risk enrolled in Portugal. Methods: In Portugal, 117 patients were enrolled across 10 sites between September 2020 and February 2021. Paired LDL-C values at baseline and one-year follow-up were available for 102 patients. LDL-C levels, LLT utilization patterns, and LDL-C goal attainment (as per the 2019 ESC/EAS guidelines) were assessed at both time points and compared with the broader European cohort, excluding Portuguese participants. Results: Over the one-year follow-up, the use of statin monotherapy decreased from 49.5% to 45.2%, while combination therapy with statin and ezetimibe increased from 35.9% to 40.9%. LLT intensity was escalated in 12.8% of patients, unchanged in 79.5%, and de-escalated in 6.0%. Mean LDL-C levels were similar between baseline and one-year follow-up: corresponding values were 90.2 mg/dL and 90.1 mg/dL in high-risk patients, and 74.1 mg/dL and 75.2 mg/dL in very high-risk patients. LDL-C goal attainment declined from 34.1% to 22.7% in high-risk patients and 27.6% to 22.4% in very high-risk patients. Conclusions: The Portuguese cohort of the SANTORINI study demonstrates both encouraging developments and ongoing challenges in the real-world management of dyslipidemia following the 2019 ESC/EAS guidelines. Reasons for lack of LLT intensification and factors underlying worsening rates for LDL-C goal attainment should be explored. (c) 2025 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
- Predictive value for increased red blood cell distribution width in unprovoked acute venous thromboembolism at the emergency departmentPublication . Febra, Cláudia; Spinu, Verónica; Ferreira, Filipa; Gil, Victor; Maio, Rui; Penque, Deborah; Macedo, AnaAcute venous thromboembolism (VTE) is a common worldwide disease admitted to emergency departments (ED), usually presenting as pulmonary embolism or lower limb deep vein thrombosis (DVT). Due to the lack of typical clinical and biomarker diagnostic features of unprovoked VTE, early identification is challenging and has direct consequences on correct treatment delay. Longitudinal, prospective, observational study. Patients admitted to ED with a suspicion of unprovoked acute VTE between October 2020 and January 2021 were included. Clinical and laboratorial variables were compared between VTE positive and negative diagnoses. Red cell distribution width (RDW) cut point was determinate through a receiver operating characteristic analysis. RDW accuracy, sensitivity, and specificity were calculated. Fifty-eight patients were analyzed. And 82.8% of suspected patients with VTE were diagnosed with an acute thrombotic event confirmed by imaging examination. In patients with VTE, RDW at admission in ED was higher than with other diagnosis, respectively, 14.3% (13.2-15.1) and 13.5% (13.0-13.8). Platelet count was the only additional characteristic that revealed difference between the 2 groups (264x109/L for VTE and 209x109/L for non-VTE). Logistic regression models showed good discriminatory values for RDW & GE;14%, with an area under the curve (AUC) = 0.685 (95% confidence interval, 0.535-0.834). These findings were more pronounced in isolated DVT, with a sensitivity of 76.9%, specificity 100%, and accuracy 85.7%. Our study demonstrated a significant association between an early high RDW and the diagnosis of acute unprovoked DVT. RDW & GE; 14% has an independent predictor of unprovoked VTE in adult patients.