It is unknown whether angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) have a positive, neutral, or negative effect on clinical outcomes in patients with coronavirus disease 2019 (COVID-19).OBJECTIVE To determine whether discontinuation compared with continuation of ACEIs or ARBs changed the number of days alive and out of the hospital through 30 days. DESIGN, SETTING, AND PARTICIPANTSA randomized clinical trial of 659 patients hospitalized in Brazil with mild to moderate COVID-19 who were taking ACEIs or ARBs prior to hospitalization

Objectives To report clinical, angiographic characteristics, outcomes, and predictors of unsuccessful procedures in patients who underwent chronic total occlusion (CTO) percutaneous coronary interventions (PCI) in Latin America. Background CTO PCI has been increasingly performed worldwide, but there is a lack of information in this region. Methods An international multicenter registry was developed to collect data on CTO PCI performed in centers in Latin America. Patient, angiographic, procedural and outcome data were evaluated. Predictors of unsuccessful procedures were assessed by multivariable analysis. Results We have included data related to 1,040 CTO PCIs performed in seven countries in Latin America (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, and Puerto Rico). The mean age was 64 ± 10 years, and CTO PCI was performed mainly for angina control (81%) or treatment of a large ischemic area (30%). Overall technical success rate was 82.5%, and it was achieved with antegrade wire escalation in 81%, antegrade dissection/re‐entry in 8% and with retrograde techniques in 11% of the successful procedures. Multivariable analysis identified moderate/severe calcification, a blunt proximal cap and a previous attempt as independent predictors of unsuccessful procedures. In‐hospital major adverse cardiovascular events (MACE) occurred in 3.1% of the cases, death in 1% and cardiac tamponade in 0.9% Conclusions CTO PCI in Latin America has been performed mainly for ischemia relief. Procedures were associated with a success rate above 80% and low incidence of MACE. Predictors of unsuccessful procedures were similar to those previously reported in the literature.

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Artigo Original RESUMO Introdução: O sangramento associado à intervenção coronária percutânea (ICP) é uma complicação frequente e muitas vezes negligenciada quanto a sua importância prognóstica. Diversos estudos têm demonstrado o impacto clínico adverso do sangramento, principalmente no aumento da mortalidade a curto e longo prazos. O objetivo deste estudo é avaliar os preditores e o impacto clínico do sangramento em uma grande coorte contemporânea de pacientes submetidos a ICP. Método: Avaliamos 2.892 pacientes consecutivos submetidos a ICP eletiva ou de urgência, entre janeiro de 2008 e junho de 2009, em um centro de referência para a realização do procedimento. Foram comparados os grupos que apresentaram ou não sangramento em relação às variáveis clínicas, angiográficas e relacionadas à intervenção, bem como a evolução clínica intrahospitalar. Regressão logística múltipla foi realizada com a finalidade de determinar o grau de influência e independência dos fatores preditores de sangramento. Resultados: A incidência de sangramento periprocedimento foi de 1,7%. Considerando-se apenas os pacientes com síndrome coronária aguda (SCA), a incidência elevou-se para 3,4%. A análise multivariada identificou, como fatores independentes de sangramento, SCA [odds ratio (OR) 3,96, intervalo de confiança de 95% (

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