Henrique Porto | Universidade Estacio de Sa, Brasil (original) (raw)

Papers by Henrique Porto

Research paper thumbnail of Four-year clinical follow-up of the first-in-man randomized comparison of a novel sirolimus eluting stent with abluminal biodegradable polymer and ultra-thin strut cobalt-chromium alloy: the INSPIRON-I trial

Cardiovascular diagnosis and therapy, 2015

The Inspiron™ sirolimus-eluting stent (SES) is a low-dose, ultra-thin-strut cobalt-chromium stent... more The Inspiron™ sirolimus-eluting stent (SES) is a low-dose, ultra-thin-strut cobalt-chromium stent abluminally coated with biodegradable polymers (BP). Previous results from the INSPIRON-I trial, a first-in-man study, have proven the efficacy of the novel stent in reducing neointimal proliferation. The present report aims at evaluating the long-term clinical outcomes of patients enrolled into the INSPIRON-I trial (Clinical Trials Gov. identifier: NCT01093391). A total of 57 patients (60 lesions) were randomly allocated in a 2:1 ratio to treatment with the Inspiron™ SES vs. its equivalent Cronus™ bare metal stent (BMS, both by Scitech Medical™, Aparecida de Goiânia, Goiás, Brazil), in four tertiary centers. The primary endpoint of the present analysis was the occurrence of major adverse cardiac events (MACE) [death, myocardial infarction (MI), target vessel revascularization (TVR) and/or target lesion revascularization (TLR)] at 4 years. Baseline clinical and angiographic characterist...

Research paper thumbnail of Acute myocardial infarction complicated by cardiogenic shock. In-hospital and mid-term results of invasive treatment in the National Institute of Cardiology, Warsaw-Anin

Kardiologia polska, 2003

Mortality in acute myocardial infarction (MI) complicated by cardiogenic shock approaches 90%, re... more Mortality in acute myocardial infarction (MI) complicated by cardiogenic shock approaches 90%, regardless of the type of pharmacological treatment. To assess in-hospital and mid-term results of invasive treatment of patients with acute MI with ST segment elevation (STEMI) complicated by cardiogenic shock. From a prospective registry of all patients admitted to our institution for urgent coronary angiography due to acute coronary syndrome between February 2001 and June 2002, patients with STEMI, symptom duration up to 12 hours and cardiogenic shock diagnosed on admission were identified. The in-hospital and mid-term outcome of 37 patients (mean age 65 years, range 54-77, 68% of males) treated with primary percutaneous coronary intervention (PCI) was analysed. Of the 41 patients with STEMI and cardiogenic shock, total occlusion or critical stenosis of a coronary artery were found in 38 patients. One patient with the occlusion of three main coronary arteries underwent urgent surgical r...

Research paper thumbnail of Desfechos tardios da intervenção coronária percutânea com stent farmacológico em pontes de veia safena: dados do registro InCor

Revista Brasileira de Cardiologia Invasiva, 2011

Late Percutaneous Coronary Intervention Outcomes with Drug-Eluting Stent in Saphenous Vein Grafts... more Late Percutaneous Coronary Intervention Outcomes with Drug-Eluting Stent in Saphenous Vein Grafts-Data from the InCor Registry Background: The safety and efficacy of drug-eluting stents in the treatment of saphenous vein graft (SVG) lesions remains controversial. This study assessed the late follow-up of patients with SVG lesions treated with drug-eluting stents. Methods: Single center registry including patients undergoing SVG interventions using drug-eluting stents (n = 82), without clinical or angiographic exclusion criteria, from 2003 to 2009. The rates of major adverse cardiac events (MACE), death, acute myocardial infarction (AMI), target vessel revascularization (TVR) and stent thrombosis were evaluated. Results: Mean age was 67.8 + 10.2 years, most of them were male (85.4%), 40.2% were diabetic and 52.4% had stable angina. An average of 1.45 + 0.5 stents per patient were implanted and Cypher TM was the stent used in most of the cases (61%). Stent diameter was 3.22 + 0.39 mm and stent length was 20.1 + 7.3 mm. Angiographic success rate was 96.3%. In the 4.1-year follow-up, the rate of MACE was 28%, death 6%, AMI 19.5% and TVR 18.2%. There were two cases of definitive or probable stent thrombosis (2.4%) within the follow-up period. Conclusions: Longterm follow-up showed high MACE rates in patients with SVG lesions treated with drug-eluting stents, probably due to the accelerated atherosclerosis that develops within the grafted vein conduits.

Research paper thumbnail of Desfechos intra-hospitalares e preditores de mortalidade no infarto agudo do miocárdio com choque cardiogênico tratados por angioplastia primária: dados do registro InCor

Revista Brasileira de Cardiologia Invasiva, 2012

Research paper thumbnail of Evolução hospitalar de pacientes submetidos a assistência circulatória com balão intra-aórtico durante intervenção coronária percutânea de alto risco: registro InCor

Revista Brasileira de Cardiologia Invasiva, 2011

In-Hospital Outcomes of Patients Submitted to Circulatory Support with Intra-Aortic Balloon Pump ... more In-Hospital Outcomes of Patients Submitted to Circulatory Support with Intra-Aortic Balloon Pump During High Risk Percutaneous Coronary Intervention: InCor Registry Background: The intra-aortic balloon pump (IABP) has been used for decades as a circulatory support device, being recommended in most guidelines, despite poor evidence of mortality reduction. The purpose of this study was to evaluate the use of IABP as an adjunct therapy in percutaneous coronary intervention (PCI). Methods: Single center registry analyzing in-hospital outcomes of 134 consecutive patients submitted to IABP during high risk PCI or in the presence of cardiogenic shock. Results: Mean age was 64.7 + 12.5 years and 67.9% were males. The population presented high-risk features, with 33.5% of diabetic patients, 73.1% treated in the presence of myocardial infarction, 68.6% with three-vessel disease and left ventricular ejection fraction of 38.6 + 16.1%. TIMI 2/3 flow was obtained in 86.4% of the cases and 1.6 + 0.6 lesion/patient was treated. There were 18 (13.4%) reinfarctions, of which 9 (6.7%) were due to stent thrombosis, 2 (1.4%) patients were referred for CABG and 16 (11.9%) for a new PCI. Hospital mortality was 61.2% and the major adverse cardiac events (MACE) rate was 67.2%. By multivariate analysis, predictors of mortality were: age > 65 years, prior PCI, need of dialysis and three-vessel disease. Predictors of survival were: normal ventricular function, TIMI 2/3 flow at the end of the procedure and IABP utilization > 72 hours. Conclusions: Patients RESUMO Introdução: O balão intra-aórtico (BIA) é utilizado há décadas como dispositivo de assistência circulatória, sendo recomendado na maioria das diretrizes, apesar da fraca evidência em relação à redução da mortalidade. O objetivo deste estudo foi avaliar o uso do BIA como ferramenta adjunta na intervenção coronária percutânea (ICP). Métodos: Registro unicêntrico que analisou a evolução hospitalar de 134 pacientes consecutivos que utilizaram BIA durante ICP de alto risco ou na vigência de choque cardiogênico. Resultados: A média de idade foi de 64,7 + 12,5 anos e 67,9% eram do sexo masculino. A população apresentou características de alto risco, com 33,5% de diabéticos, 73,1% tratados na vigência de infarto do miocárdio, 68,6% com padrão triarterial, e fração de ejeção do ventrículo esquerdo de 38,6 + 16,1%. Fluxo TIMI 2/3 foi obtido em 86,4% dos casos, sendo tratada 1,6 + 0,6 lesão/paciente. Ocorreram 18 (13,4%) reinfartos, dos quais

Research paper thumbnail of Stents convencionais de aço inoxidável vs. cromo-cobalto: impacto clínico da liga metálica no cenário atual - registro InCor

Revista Brasileira de Cardiologia Invasiva, 2011

Research paper thumbnail of Infarto agudo do miocárdio complicado por choque cardiogênico: efeito da circulação colateral nos resultados da intervenção coronária percutânea primária - dados do registro InCor

Revista Brasileira de Cardiologia Invasiva, 2011

Research paper thumbnail of Pseudoaneurisma: rara complicação do acesso radial

Revista Brasileira de Cardiologia Invasiva, 2011

Research paper thumbnail of First-in-man randomised comparison of a novel sirolimus-eluting stent with abluminal biodegradable polymer and thin-strut cobalt-chromium alloy: INSPIRON-I trial

EuroIntervention, 2014

Aims: The INSPIRON-I trial is a first-in-man evaluation of the safety and efficacy of the Inspiro... more Aims: The INSPIRON-I trial is a first-in-man evaluation of the safety and efficacy of the Inspiron drug-eluting stent, a sirolimus-eluting stent with abluminal biodegradable polymer coating and thin cobalt-chromium alloy. Methods and results: This is a randomised, multicentre comparison between Inspiron and a stent with the same metallic structure but without polymer coating or drug elution (Cronus). The primary objective was to evaluate the in-segment late loss (LLL) at six months. Secondary endpoints included percent in-stent obstruction as measured by intravascular ultrasound (IVUS) at six months and major adverse cardiac events (MACE). Fifty-eight patients were enrolled (60 lesions), 39 for Inspiron and 19 for Cronus. Baseline clinical and angiographic characteristics of both groups were similar. At six months, the in-segment LLL was reduced in the Inspiron group compared to the control group (0.19±0.16 mm vs. 0.58±0.4 mm, respectively; p<0.001), as well as the percent neointimal obstruction (7.8±7.1% vs. 26.5±11.4%; p<0.001). At two-year follow-up, incidence of MACE was similar between groups (7.9 vs. 21.1%, respectively; p=0.20), with lower target lesion revascularisation for Inspiron (0 vs. 21.1%, respectively; p=0.01) and no stent thrombosis. Conclusions: Sirolimus eluted from an abluminal biodegradable polymer on a cobalt-chromium alloy proved effective in reducing restenosis at six months.

Research paper thumbnail of Angiogenesis between coronary grafts through the aortic wall

International Journal of Cardiology, 2012

... of Cardiology, Volume 155, Issue 2, Pages 299-302, 8 March 2012, Authors:Luiz Fernando Ybarra... more ... of Cardiology, Volume 155, Issue 2, Pages 299-302, 8 March 2012, Authors:Luiz Fernando Ybarra; Henrique Barbosa Ribeiro; Odilson Marcos Silvestre; Carlos Augusto Homem de Magalhães Campos; Augusto Celso de Araújo Lopes; Rodrigo Barbosa Esper; Fernando Bacal ...

Research paper thumbnail of Long term follow-up of drug eluting versus bare metal stents in the treatment of saphenous vein graft lesions

Catheterization and Cardiovascular Interventions, 2013

Introduction: The safety and effectiveness of drug-eluting stent (DES) compared with bare metal s... more Introduction: The safety and effectiveness of drug-eluting stent (DES) compared with bare metal stents (BMS) for the treatment of saphenous vein graft (SVG) disease is controversial, especially because of the lack of long-term follow-up. The aim of this study was to address the late outcome of DES versus BMS for the treatment of SVG lesions. Methods: A matched, case-control study included 82 patients in each group. Patients groups were matched by gender, age, clinical presentation, and diabetes. The primary study end point was occurrence of major adverse cardiovascular events (MACE). Secondary end points included death, cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). Results: Clinical and angiographic characteristics were similar between the groups. At 6 months, TVR (hazard ratio [HR] 6.12, 95% confidence interval [CI] 1.39 to 26.93, P 5 0.05), and MACE (HR 2.54, 95% CI 1.08 to 5.98, P 5 0.04) were higher in the BMS group. At 4 years the risks of MI (P 5 0.21), TVR (P 5 0.99), and MACE (P 5 0.21) were similar between both groups. However, the rates of death (HR 2.74, 95% CI 1.11 to 6.74, P 5 0.04) and cardiac death (HR 4.26, 95% CI 1.59 to 11.35, P 5 0.01) were significantly higher in the BMS group. Conclusions: These results suggest that the use of DES compared with BMS in the treatment of SVG lesions reduces TVR and MACE at 6 months of follow-up, a benefit that was lost over the next 3-4 years. V

Research paper thumbnail of Agregados Reciclados na Ótica de Empresas do Setor da Construção Civil da Cidade de Barretos/SP

Agregados Reciclados na Ótica de Empresas do Setor da Construção Civil da Cidade de Barretos/SP

Research paper thumbnail of Four-year clinical follow-up of the first-in-man randomized comparison of a novel sirolimus eluting stent with abluminal biodegradable polymer and ultra-thin strut cobalt-chromium alloy: the INSPIRON-I trial

Cardiovascular diagnosis and therapy, 2015

The Inspiron™ sirolimus-eluting stent (SES) is a low-dose, ultra-thin-strut cobalt-chromium stent... more The Inspiron™ sirolimus-eluting stent (SES) is a low-dose, ultra-thin-strut cobalt-chromium stent abluminally coated with biodegradable polymers (BP). Previous results from the INSPIRON-I trial, a first-in-man study, have proven the efficacy of the novel stent in reducing neointimal proliferation. The present report aims at evaluating the long-term clinical outcomes of patients enrolled into the INSPIRON-I trial (Clinical Trials Gov. identifier: NCT01093391). A total of 57 patients (60 lesions) were randomly allocated in a 2:1 ratio to treatment with the Inspiron™ SES vs. its equivalent Cronus™ bare metal stent (BMS, both by Scitech Medical™, Aparecida de Goiânia, Goiás, Brazil), in four tertiary centers. The primary endpoint of the present analysis was the occurrence of major adverse cardiac events (MACE) [death, myocardial infarction (MI), target vessel revascularization (TVR) and/or target lesion revascularization (TLR)] at 4 years. Baseline clinical and angiographic characterist...

Research paper thumbnail of Acute myocardial infarction complicated by cardiogenic shock. In-hospital and mid-term results of invasive treatment in the National Institute of Cardiology, Warsaw-Anin

Kardiologia polska, 2003

Mortality in acute myocardial infarction (MI) complicated by cardiogenic shock approaches 90%, re... more Mortality in acute myocardial infarction (MI) complicated by cardiogenic shock approaches 90%, regardless of the type of pharmacological treatment. To assess in-hospital and mid-term results of invasive treatment of patients with acute MI with ST segment elevation (STEMI) complicated by cardiogenic shock. From a prospective registry of all patients admitted to our institution for urgent coronary angiography due to acute coronary syndrome between February 2001 and June 2002, patients with STEMI, symptom duration up to 12 hours and cardiogenic shock diagnosed on admission were identified. The in-hospital and mid-term outcome of 37 patients (mean age 65 years, range 54-77, 68% of males) treated with primary percutaneous coronary intervention (PCI) was analysed. Of the 41 patients with STEMI and cardiogenic shock, total occlusion or critical stenosis of a coronary artery were found in 38 patients. One patient with the occlusion of three main coronary arteries underwent urgent surgical r...

Research paper thumbnail of Desfechos tardios da intervenção coronária percutânea com stent farmacológico em pontes de veia safena: dados do registro InCor

Revista Brasileira de Cardiologia Invasiva, 2011

Late Percutaneous Coronary Intervention Outcomes with Drug-Eluting Stent in Saphenous Vein Grafts... more Late Percutaneous Coronary Intervention Outcomes with Drug-Eluting Stent in Saphenous Vein Grafts-Data from the InCor Registry Background: The safety and efficacy of drug-eluting stents in the treatment of saphenous vein graft (SVG) lesions remains controversial. This study assessed the late follow-up of patients with SVG lesions treated with drug-eluting stents. Methods: Single center registry including patients undergoing SVG interventions using drug-eluting stents (n = 82), without clinical or angiographic exclusion criteria, from 2003 to 2009. The rates of major adverse cardiac events (MACE), death, acute myocardial infarction (AMI), target vessel revascularization (TVR) and stent thrombosis were evaluated. Results: Mean age was 67.8 + 10.2 years, most of them were male (85.4%), 40.2% were diabetic and 52.4% had stable angina. An average of 1.45 + 0.5 stents per patient were implanted and Cypher TM was the stent used in most of the cases (61%). Stent diameter was 3.22 + 0.39 mm and stent length was 20.1 + 7.3 mm. Angiographic success rate was 96.3%. In the 4.1-year follow-up, the rate of MACE was 28%, death 6%, AMI 19.5% and TVR 18.2%. There were two cases of definitive or probable stent thrombosis (2.4%) within the follow-up period. Conclusions: Longterm follow-up showed high MACE rates in patients with SVG lesions treated with drug-eluting stents, probably due to the accelerated atherosclerosis that develops within the grafted vein conduits.

Research paper thumbnail of Desfechos intra-hospitalares e preditores de mortalidade no infarto agudo do miocárdio com choque cardiogênico tratados por angioplastia primária: dados do registro InCor

Revista Brasileira de Cardiologia Invasiva, 2012

Research paper thumbnail of Evolução hospitalar de pacientes submetidos a assistência circulatória com balão intra-aórtico durante intervenção coronária percutânea de alto risco: registro InCor

Revista Brasileira de Cardiologia Invasiva, 2011

In-Hospital Outcomes of Patients Submitted to Circulatory Support with Intra-Aortic Balloon Pump ... more In-Hospital Outcomes of Patients Submitted to Circulatory Support with Intra-Aortic Balloon Pump During High Risk Percutaneous Coronary Intervention: InCor Registry Background: The intra-aortic balloon pump (IABP) has been used for decades as a circulatory support device, being recommended in most guidelines, despite poor evidence of mortality reduction. The purpose of this study was to evaluate the use of IABP as an adjunct therapy in percutaneous coronary intervention (PCI). Methods: Single center registry analyzing in-hospital outcomes of 134 consecutive patients submitted to IABP during high risk PCI or in the presence of cardiogenic shock. Results: Mean age was 64.7 + 12.5 years and 67.9% were males. The population presented high-risk features, with 33.5% of diabetic patients, 73.1% treated in the presence of myocardial infarction, 68.6% with three-vessel disease and left ventricular ejection fraction of 38.6 + 16.1%. TIMI 2/3 flow was obtained in 86.4% of the cases and 1.6 + 0.6 lesion/patient was treated. There were 18 (13.4%) reinfarctions, of which 9 (6.7%) were due to stent thrombosis, 2 (1.4%) patients were referred for CABG and 16 (11.9%) for a new PCI. Hospital mortality was 61.2% and the major adverse cardiac events (MACE) rate was 67.2%. By multivariate analysis, predictors of mortality were: age > 65 years, prior PCI, need of dialysis and three-vessel disease. Predictors of survival were: normal ventricular function, TIMI 2/3 flow at the end of the procedure and IABP utilization > 72 hours. Conclusions: Patients RESUMO Introdução: O balão intra-aórtico (BIA) é utilizado há décadas como dispositivo de assistência circulatória, sendo recomendado na maioria das diretrizes, apesar da fraca evidência em relação à redução da mortalidade. O objetivo deste estudo foi avaliar o uso do BIA como ferramenta adjunta na intervenção coronária percutânea (ICP). Métodos: Registro unicêntrico que analisou a evolução hospitalar de 134 pacientes consecutivos que utilizaram BIA durante ICP de alto risco ou na vigência de choque cardiogênico. Resultados: A média de idade foi de 64,7 + 12,5 anos e 67,9% eram do sexo masculino. A população apresentou características de alto risco, com 33,5% de diabéticos, 73,1% tratados na vigência de infarto do miocárdio, 68,6% com padrão triarterial, e fração de ejeção do ventrículo esquerdo de 38,6 + 16,1%. Fluxo TIMI 2/3 foi obtido em 86,4% dos casos, sendo tratada 1,6 + 0,6 lesão/paciente. Ocorreram 18 (13,4%) reinfartos, dos quais

Research paper thumbnail of Stents convencionais de aço inoxidável vs. cromo-cobalto: impacto clínico da liga metálica no cenário atual - registro InCor

Revista Brasileira de Cardiologia Invasiva, 2011

Research paper thumbnail of Infarto agudo do miocárdio complicado por choque cardiogênico: efeito da circulação colateral nos resultados da intervenção coronária percutânea primária - dados do registro InCor

Revista Brasileira de Cardiologia Invasiva, 2011

Research paper thumbnail of Pseudoaneurisma: rara complicação do acesso radial

Revista Brasileira de Cardiologia Invasiva, 2011

Research paper thumbnail of First-in-man randomised comparison of a novel sirolimus-eluting stent with abluminal biodegradable polymer and thin-strut cobalt-chromium alloy: INSPIRON-I trial

EuroIntervention, 2014

Aims: The INSPIRON-I trial is a first-in-man evaluation of the safety and efficacy of the Inspiro... more Aims: The INSPIRON-I trial is a first-in-man evaluation of the safety and efficacy of the Inspiron drug-eluting stent, a sirolimus-eluting stent with abluminal biodegradable polymer coating and thin cobalt-chromium alloy. Methods and results: This is a randomised, multicentre comparison between Inspiron and a stent with the same metallic structure but without polymer coating or drug elution (Cronus). The primary objective was to evaluate the in-segment late loss (LLL) at six months. Secondary endpoints included percent in-stent obstruction as measured by intravascular ultrasound (IVUS) at six months and major adverse cardiac events (MACE). Fifty-eight patients were enrolled (60 lesions), 39 for Inspiron and 19 for Cronus. Baseline clinical and angiographic characteristics of both groups were similar. At six months, the in-segment LLL was reduced in the Inspiron group compared to the control group (0.19±0.16 mm vs. 0.58±0.4 mm, respectively; p<0.001), as well as the percent neointimal obstruction (7.8±7.1% vs. 26.5±11.4%; p<0.001). At two-year follow-up, incidence of MACE was similar between groups (7.9 vs. 21.1%, respectively; p=0.20), with lower target lesion revascularisation for Inspiron (0 vs. 21.1%, respectively; p=0.01) and no stent thrombosis. Conclusions: Sirolimus eluted from an abluminal biodegradable polymer on a cobalt-chromium alloy proved effective in reducing restenosis at six months.

Research paper thumbnail of Angiogenesis between coronary grafts through the aortic wall

International Journal of Cardiology, 2012

... of Cardiology, Volume 155, Issue 2, Pages 299-302, 8 March 2012, Authors:Luiz Fernando Ybarra... more ... of Cardiology, Volume 155, Issue 2, Pages 299-302, 8 March 2012, Authors:Luiz Fernando Ybarra; Henrique Barbosa Ribeiro; Odilson Marcos Silvestre; Carlos Augusto Homem de Magalhães Campos; Augusto Celso de Araújo Lopes; Rodrigo Barbosa Esper; Fernando Bacal ...

Research paper thumbnail of Long term follow-up of drug eluting versus bare metal stents in the treatment of saphenous vein graft lesions

Catheterization and Cardiovascular Interventions, 2013

Introduction: The safety and effectiveness of drug-eluting stent (DES) compared with bare metal s... more Introduction: The safety and effectiveness of drug-eluting stent (DES) compared with bare metal stents (BMS) for the treatment of saphenous vein graft (SVG) disease is controversial, especially because of the lack of long-term follow-up. The aim of this study was to address the late outcome of DES versus BMS for the treatment of SVG lesions. Methods: A matched, case-control study included 82 patients in each group. Patients groups were matched by gender, age, clinical presentation, and diabetes. The primary study end point was occurrence of major adverse cardiovascular events (MACE). Secondary end points included death, cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). Results: Clinical and angiographic characteristics were similar between the groups. At 6 months, TVR (hazard ratio [HR] 6.12, 95% confidence interval [CI] 1.39 to 26.93, P 5 0.05), and MACE (HR 2.54, 95% CI 1.08 to 5.98, P 5 0.04) were higher in the BMS group. At 4 years the risks of MI (P 5 0.21), TVR (P 5 0.99), and MACE (P 5 0.21) were similar between both groups. However, the rates of death (HR 2.74, 95% CI 1.11 to 6.74, P 5 0.04) and cardiac death (HR 4.26, 95% CI 1.59 to 11.35, P 5 0.01) were significantly higher in the BMS group. Conclusions: These results suggest that the use of DES compared with BMS in the treatment of SVG lesions reduces TVR and MACE at 6 months of follow-up, a benefit that was lost over the next 3-4 years. V

Research paper thumbnail of Agregados Reciclados na Ótica de Empresas do Setor da Construção Civil da Cidade de Barretos/SP

Agregados Reciclados na Ótica de Empresas do Setor da Construção Civil da Cidade de Barretos/SP