Renato Margato

Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, Vila Real, Portugal

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Publications (12)3.55 Total impact

  • Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 06/2012; 31(7-8):525-6. · 0.59 Impact Factor
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    ABSTRACT: Tricuspid stenosis (TS) is an uncommon complication of transvenous ventricular pacemaker implantation, with few cases reported in the literature. The mechanisms described are obstruction of right ventricular inflow by tricuspid vegetations (endocarditis), multiple pacemaker leads and tricuspid valve (TV) fibrosis secondary to perforation or laceration of the TV leaflets, or adherence between redundant portions of the lead and valvular and subvalvular tissue. We report two cases of severe TS, with different etiologies and management: one caused by leaflet perforation, resolved surgically, and the other secondary to fusion between a loop of the pacemaker lead and the subvalvular apparatus, which was treated medically.
    Revista Portuguesa de Cardiologia. 04/2012; 31(4):305–308.
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    ABSTRACT: Tricuspid stenosis (TS) is an uncommon complication of transvenous ventricular pacemaker implantation, with few cases reported in the literature. The mechanisms described are obstruction of right ventricular inflow by tricuspid vegetations (endocarditis), multiple pacemaker leads and tricuspid valve (TV) fibrosis secondary to perforation or laceration of the TV leaflets, or adherence between redundant portions of the lead and valvular and subvalvular tissue. We report two cases of severe TS, with different etiologies and management: one caused by leaflet perforation, resolved surgically, and the other secondary to fusion between a loop of the pacemaker lead and the subvalvular apparatus, which was treated medically.
    Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 03/2012; 31(4):305-8. · 0.59 Impact Factor
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    ABSTRACT: Zolmitriptan is a drug used in the acute treatment of migraine, which should not be used in high cardiovascular risk individuals because of its potential to induce vasospasm. We report a rare case of myocardial infarction precipitated by taking zolmitriptan.
    Revista Portuguesa de Cardiologia. 02/2012; 31(2):167–169.
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    ABSTRACT: Zolmitriptan is a drug used in the acute treatment of migraine, which should not be used in high cardiovascular risk individuals because of its potential to induce vasospasm. We report a rare case of myocardial infarction precipitated by taking zolmitriptan.
    Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 01/2012; 31(2):167-9. · 0.59 Impact Factor
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    ABSTRACT: Acute myocardial infarction (AMI) involving acute transmural ischemia of two vascular territories at the same time, which is known as double or combined infarction, is a well described phenomenon but rarely reported in most series of patients admitted for AMI. This may be related to the fact that AMI with multiple vessel obstruction often causes extensive myocardial injury and death before the patient arrives at the hospital. It is speculated that double infarction results from the overall prothrombotic and inflammatory conditions associated with AMI.
    Revista Portuguesa de Cardiologia. 12/2011; 30(12):925–927.
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    ABSTRACT: Acute myocardial infarction (AMI) involving acute transmural ischemia of two vascular territories at the same time, which is known as double or combined infarction, is a well described phenomenon but rarely reported in most series of patients admitted for AMI. This may be related to the fact that AMI with multiple vessel obstruction often causes extensive myocardial injury and death before the patient arrives at the hospital. It is speculated that double infarction results from the overall prothrombotic and inflammatory conditions associated with AMI.
    Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 11/2011; 30(12):925-7. · 0.59 Impact Factor
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    ABSTRACT: The release of a new bare metal stent (BMS), the Presillion stent, whose main innovative feature is its reduced strut thickness, has created expectations that it may reduce neointimal proliferation and consequently lower the restenosis rate. To evaluate the efficacy and safety profile of Presillion stent implantation in an unselected population referred for coronary revascularization with BMS. This was a prospective study of the first 20 consecutive patients undergoing implantation of at least one Presillion stent. We performed a descriptive analysis of the study population in terms of demographics, clinical context, angiographic characteristics of coronary lesions before and after angioplasty, and clinical outcome. After discharge, patients were followed up and assessed clinically at 3 and 6 months for the occurrence of MACE (cardiovascular death, myocardial infarction, stroke or revascularization). The statistical analysis consisted of calculation of means and standard deviation for continuous variables and relative proportions for categorical variables. The study population was predominantly male (65%), with a mean age of 68.8 years. The indication for cardiac catheterization was acute coronary syndrome in 90% and heart failure in 10% of cases. Half the patients had multivessel disease, and 34 stents, of which 26 were Presillion stents, were implanted in 29 coronary lesions. According to the ACC/AHA classification, the coronary lesions treated with Presillion stents were classified as type A in 0% of cases, type B1 in 27% and type B2 or C in 73%; 27% of these had moderate to severe calcification. The percentage of stenosis and minimal luminal diameter (MLD) before and after angioplasty were respectively 88.5 +/- 9.7% (MLD = 0.65 +/- 0.40 mm) and 10.6 +/- 4.3% (MLD = 2.58 +/- 0.36 mm). The success rate of Presillion implantation was 100%, with no significant drop in hemoglobin, additional elevation of cardiac biomarkers or deterioration in renal function after the procedure. No MACE occurred before hospital discharge. At 6-month follow-up all patients were alive, none had had stroke, two patients (10%) had had acute myocardial infarction in territories not dependent on previously treated arteries and two patients had undergone a new revascularization, but not of the target vessel. This initial experience with Presillion stents showed a high efficacy rate and an excellent safety profile that was maintained over 6 months of follow-up. Their effectiveness compared to other BMS should be demonstrated in larger-scale comparative studies.
    Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 04/2010; 29(4):559-69. · 0.59 Impact Factor
  • Journal of Hepatology - J HEPATOL. 01/2010; 52.
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    ABSTRACT: Estimation of individual risk and choice of initial therapeutic approach for patients with pulmonary embolism (PE) remains controversial. The three key components for risk stratification in PE are clinical evaluation, cardiac biomarkers and assessment of right ventricular size and function. The aim of this study was to assess the ability of admission troponin I (TnI) levels to predict short-term mortality and complicated clinical course in patients with PE. We performed a retrospective analysis of 100 consecutive patients admitted with a diagnosis of PE between January 2004 and November 2007. Patients in whom the diagnosis was confirmed by spiral computed tomography, ventilation perfusion scan, pulmonary angiography or echocardiography and with serum TnI measurement in the first 24 hours of hospital stay were selected. The study population (n = 62) was divided into two groups according to the presence or absence of elevated TnI levels (TnI > or = 0.10 ng/ml). Clinical characteristics, electrocardiographic and echocardiographic signs of right ventricular dysfunction (RVD), brain natriuretic peptide (BNP) levels, in-hospital mortality and the composite endpoint of complicated PE (defined as the presence of at least one of the following: in-hospital death, cardiogenic shock, need for mechanical ventilation or inotropic support) were compared between groups. Thirty-seven patients (59.7%) had elevated TnI levels (Tpos) and 25 (40.3%) had normal levels (Tneg). The two groups were not significantly different (p = NS) in age (66.2 vs. 71 years), gender (female 70.3 vs. 60.0%), clinical presentation or length of hospital stay (14.7 vs. 18.1 days). Tpos patients had a higher prevalence of electrocardiographic signs of RVD (78.4 vs. 40.0%, p < 0.01). Echocardiographic RVD was also more common in the Tpos group but the difference did not reach statistical significance (56.0% vs. 27.3%, p = NS). Elevated serum TnI was significantly associated with complicated in-hospital clinical course (complicated PE: 29.7% in the Tpos group vs. 4.0% in the Tneg group (adjusted OR = 9.08; 95% CI 1.07-77.4; p = 0.044). In-hospital mortality was 8.1%, with a strong trend for higher mortality in the Tpos group (13.5% vs. 0%, p = 0.055). Elevated TnI levels are associated with higher risk for in-hospital mortality and complicated clinical course. Additional studies are needed to assess whether troponin levels, alone or in conjunction with other tests, can be used to guide therapeutic strategy and improve the prognosis of patients with PE.
    Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 11/2009; 28(11):1213-22. · 0.59 Impact Factor
  • European Journal of Internal Medicine - EUR J INTERN MED. 01/2009; 20.
  • European Journal of Internal Medicine - EUR J INTERN MED. 01/2009; 20.