CESAR AUGUSTO CAPORRINO PEREIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
17 resultados
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Agora exibindo 1 - 10 de 17
- The Use of Oral Beta-Blockers and Clinical Outcomes in Patients with Non-ST-Segment Elevation Acute Coronary Syndromes: a Long-Term Follow-Up Study(2018) NICOLAU, Jose C.; FURTADO, Remo H. M.; BARACIOLI, Luciano M.; LARA, Livia M.; DALCOQUIO, Talia F.; SCANAVINI JUNIOR, Marco A.; PEREIRA, Cesar A. C.; LIMA, Viviane M.; GONCALVES, Talita M.; COLODETTI, Raiza; FERRARI, Aline G.; LOPES, Renato D.; GIUGLIANO, Robert P.BackgroundThe role of beta-blockers in patients with acute coronary syndromes is mainly derived from studies including patients with ST-segment elevation myocardial infarction. Little is known about the use of beta-blockers and associated long-term clinical outcomes in patients with non-ST-elevation acute coronary syndromes (NSTEACS).MethodsWe analyzed short- and long-term clinical outcomes of 2921 patients with NSTEACS using or not oral beta-blockers in the first 24h of the acute coronary syndromes (ACS) presentation. The association between beta-blocker use and mortality was assessed using a propensity score adjusted analysis (N=1378).ResultsPatients starting oral beta-blockers in the first 24h of hospitalization, compared with patients who did not, had lower rates of in-hospital mortality (OR=0.52, 95% CI 0.33 to 0.74, P=0.002) and higher mean survival times in the long-term follow-up (11.860.4years vs. 9.92 +/- 0.39years, P<0.001).Conclusion The use of beta-blockers in the first 24h of patients presenting with NSTEACS was associated with better in-hospital and long-term mortality outcomes.
bookPart Diabetes mellitus(2022) PEREIRA, Cesar Augusto Caporrino; GOMES, Brenno RizerioconferenceObject Platelet reactivity among patients with acute coronary syndromes and multivessel coronary artery disease(2020) FURTADO, R.; SALSOSO, R.; DALCOQUIO, T. F.; DOMINGUES, A. A.; NAKASHIMA, C. A. K.; PEREIRA, C. A. C.; V, R. R. C. Giraldez; LIMA, F. G.; MELO, R. R.; FERRARI, A. G.; GENESTRETI, P. R. R.; BARACIOLI, L. M.; NICOLAU, J. C.conferenceObject Intravenous glycoprotein IIbIIIa inhibitor bridging for urgent coronary artery bypass graft after acute coronary syndrome(2020) FERREIRA, M. R. C.; BARACIOLI, L. M.; DALCOQUIO, T.; NAKASHIMA, C. A. K.; SOFFIALLI, C. D.; BERTOLIN, A. J.; MUSTAFA, S.; I, D. Sobreiro; BALDO, V. M. G. T. F.; PEREIRA, C. A. C.; SALSOSO, R.; LIMA, F. G.; FRANCI, A.; FURTADO, R. H. M.; NICOLAU, J. C.conferenceObject INFLUENCE OF HEALTH INSURANCE ON LONG-TERM ADHERENCE TO STATINS AND BETA-BLOCKERS AFTER ACUTE CORONARY SYNDROMES(2021) NICOLAU, Jose Carlos; SALSOSO, Rocio; DALCOQUIO, Talia; GENESTRETI, Paulo; FRANCI, Andre; FERRARI, Aline; BERTOLIN, Adriadne; LARA, Livia; JULIASZ, Marcela; PEREIRA, Cesar; LIMA, Felipe; BARACIOLI, Luciano; GIRALDEZ, Roberto; FURTADO, Remo- Influenza vaccination strategy in acute coronary syndromes: the VIP-ACS trial(2022) FONSECA, Henrique Andrade R.; FURTADO, Remo Holanda M.; ZIMERMAN, Andre; LEMOS, Pedro A.; FRANKEN, Marcelo; MONFARDINI, Frederico; PEDROSA, Rodrigo P.; PATRIOTA, Rodrigo de Lemos S.; PASSOS, Luiz Carlos S.; DALL'ORTO, Frederico Toledo C.; HOFFMANN FILHO, Conrado R.; NASCIMENTO, Bruno Ramos; BALDISSERA, Felipe A.; PEREIRA, Cesar Augusto C.; CARAMORI, Paulo Ricardo A.; ANDRADE, Pedro Beraldo de; ESTEVES, Carlos; SALIM, Elke Ferreira; SILVA, Jefferson Henrique da; PEDRO, Izabela Chave; SILVA, Mariana Castaldi R.; PEDRI, Ewerton Hernandes de; CARIOCA, Ana Carla R. D.; PIANO, Luciana Pereira A. de; ALBUQUERQUE, Camila Santos N.; MOIA, Diogo D. F.; MOMESSO, Roberta Grazzielli R. A. P.; MACHADO, Felipe P.; DAMIANI, Lucas P.; SOARES, Ronaldo Vicente P.; SCHETTINO, Guilherme P.; V, Luiz Rizzo; NICOLAU, Jose Carlos; BERWANGER, OtavioAims To evaluate whether a strategy of double-dose influenza vaccination during hospitalization for an acute coronary syndrome (ACS) compared with standard-dose outpatient vaccination (as recommended by current guidelines) would further reduce the risk of major cardiopulmonary events. Methods and results Vaccination against Influenza to Prevent cardiovascular events after Acute Coronary Syndromes (VIP-ACS) was a pragmatic, randomized, multicentre, active-comparator, open-label trial with blinded outcome adjudication comparing two strategies of influenza vaccination following an ACS: double-dose quadrivalent inactivated vaccine before hospital discharge vs. standard-dose quadrivalent inactivated vaccine administered in the outpatient setting 30 days after randomization. The primary outcome was a hierarchical composite of all-cause death, myocardial infarction, stroke, unstable angina, hospitalization for heart failure, urgent coronary revascularization, and hospitalization for respiratory causes, analysed by the win ratio method. Patients were followed for 12 months. During two influenza seasons, 1801 participants were included at 25 centres in Brazil. The primary outcome was not different between groups, with 12.7% wins in-hospital double-dose vaccine group and 12.3% wins in the standard-dose vaccine group {win ratio: 1.02 [95% confidence interval (CI): 0.79-1.32], P = 0.84}. Results were consistent for the key secondary outcome, a hierarchical composite of cardiovascular death, myocardial infarction and stroke [win ratio: 0.94 (95% CI: 0.66-1.33), P = 0.72]. Time-to-first event analysis for the primary outcome showed results similar to those of the main analysis [hazard ratio 0.97 (95% CI: 0.75-1.24), P = 0.79]. Adverse events were infrequent and did not differ between groups. Conclusion Among patients hospitalized with an ACS, double-dose influenza vaccination before discharge did not reduce cardiopulmonary outcomes compared with standard-dose vaccination in the outpatient setting.
- Long-term mortality after acute coronary syndromes among patients with normal, mildly reduced, or reduced ejection fraction(2023) FURTADO, Remo H. M.; JULIASZ, Marcela G.; CHIU, Felipe Y. J.; BASTOS, Livia B. C.; DALCOQUIO, Talia F.; LIMA, Felipe G.; ROSA, Renato; CAPORRINO, Cesar A.; BERTOLIN, Adriadne; GENESTRETI, Paulo R. R.; RIBEIRO, Andre S.; ANDRADE, Maria Carolina; V, Roberto R. C. Giraldez; BARACIOLI, Luciano M.; ZELNIKER, Thomas A.; NICOLAU, Jose C.Aims Left ventricular ejection fraction (LVEF) <= 40% is a well-established risk factor for mortality after acute coronary syndromes (ACS). However, the long-term prognostic impact of mildly reduced ejection fraction (EF) (LVEF 41-49%) after ACS remains less clear. Methods and results This was a retrospective study enrolling patients admitted with ACS included in a single-centre databank. LVEF was assessed by echocardiography during index hospitalization. Patients were divided in the following categories according to LVEF: normal (LVEF >= 50%), mildly reduced (LVEF 41-49%), and reduced (LVEF <= 40%). The endpoint of interest was all-cause death after hospital discharge. A multivariable Cox model was used to adjust for confounders. A total of 3200 patients were included (1952 with normal EF, 375 with mildly reduced EF, and 873 with reduced EF). The estimated cumulative incidence rates of mortality at 10 years for patients with normal, mildly reduced, and reduced EF were 24.8%, 33.5%, and 41.3%, respectively. After adjustments, the presence of reduced EF was associated with higher mortality compared with normal EF [adjusted hazard ratio (HR) 1.64; 95% confidence interval (CI) 1.36-1.96; P < 0.001], as was mildly reduced EF compared with normal EF (adjusted HR 1.33; 95% CI 1.05-1.68; P = 0.019). The presence of reduced EF was not associated with a statistically significantly higher mortality compared with mildly reduced EF (adjusted HR 1.23; 95% CI 0.96-1.57; P = 0.095). Conclusions In patients with ACS, mildly reduced EF measured in the acute phase was associated with higher long-term mortality compared with patients with normal EF. These data emphasize the importance of anti-remodelling therapies for ACS patients who have LVEF in the mildly reduced range.
- COVID-19 Myocarditis Mimicking ST-Segment Elevation Myocardial Infarction(2022) CONCEICAO, Anthony Medina; PEREIRA, Cesar A. C.; RAHAL, Maria Julia; ISHIKAWA, Walther Yoshiharu; ROCHITTE, Carlos E.
- Factors associated with actively working in the very long-term following acute coronary syndrome(2021) NICOLAU, Jose C.; FURTADO, Remo H. M.; DALCOQUIO, Talia F.; LARA, Livia M.; JULIASZ, Marcela G.; FERRARI, Aline G.; NAKASHIMA, Carlos A. K.; FRANCI, Andre; PEREIRA, Cesar A. C.; LIMA, Felipe G.; GIRALDEZ, Roberto R.; SALSOSO, Rocio; BARACIOLI, Luciano M.; GOODMAN, ShaunOBJECTIVES: Returning to work after an episode of acute coronary syndrome (ACS) is challenging for many patients, and has both personal and social impacts. There are limited data regarding the working status in the very long-term after ACS. METHODS: We retrospectively analyzed 1,632 patients who were working prior to hospitalization for ACS in a quaternary hospital and were followed-up for up to 17 years. Adjusted models were developed to analyze the variables independently associated with actively working at the last contact, and a prognostic predictive index for not working at follow-up was developed. RESULTS: The following variables were significantly and independently associated with actively working at the last contact: age> median (hazard-ratio [HR], 0.76, p <0.001); male sex (HR, 1.52, p <0.001); government health insurance (HR, 1.36, p <0.001); history of angina (HR, 0.69, p <0.001) or myocardial infarction (MI) (HR, 0.76, p=0.005); smoking (HR, 0.81, p=0.015); ST-elevation MI (HR, 0.81, p=0.021); anterior-wall MI (HR, 0.75, p=0.001); non-primary percutaneous coronary intervention (PCI) (HR, 0.77, p=0.002); fibrinolysis (HR, 0.61, p<0.001); cardiogenic shock (HR, 0.60, p=0.023); statin (HR, 3.01, p < 0.001), beta-blocker (HR, 1.26, p=0.020), angiotensin-converting enzyme (ACE) inhibitor/angiotensin II receptor blocker (ARB) (HR, 1.37, p=0.001) at hospital discharge; and MI at follow-up (HR, 0.72, p=0.001). The probability of not working at the last contact ranged from 24.2% for patients with no variables, up to 80% for patients with six or more variables. CONCLUSIONS: In patients discharged after ACS, prior and in-hospital clinical variables, as well as the quality of care at discharge, have a great impact on the long-term probability of actively working.
- Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction(2022) GENESTRETI, Paulo R. Rizzo; FURTADO, Remo H. M.; SALSOSO, Rocio; DALCOQUIO, Talia F.; FRANCI, Andre; MENEZES, Fernando R.; CAPORRINO, Cesar; FERRARI, Aline G.; NAKASHIMA, Carlos A. K.; SCANAVINI FILHO, Marco A.; LIMA, Felipe G.; V, Roberto R. C. Giraldez; BARACIOLI, Luciano M.; NICOLAU, Jose C.Background: The management of acute myocardial infarction (AMI) presents several challenges in patients with diabetes, among them the higher rate of recurrent thrombotic events, hyperglycemia and risk of subsequent heart failure (HF). The objective of our study was to evaluate effects of DPP-4 inhibitors (DPP-4i) on platelet reactivity (main objective) and cardiac risk markers. Methods: We performed a single-center double-blind randomized trial. A total of 70 patients with type 2 diabetes (T2DM) with AMI Killip <= 2 on dual-antiplatelet therapy (aspirin plus clopidogrel) were randomized to receive sitagliptin 100 mg or saxagliptin 5 mg daily or matching placebo. Platelet reactivity was assessed at baseline, 4 days (primary endpoint) and 30 days (secondary endpoint) after randomization, using VerifyNow Aspirin (TM) assay, expressed as aspirin reaction units (ARUs); B-type natriuretic peptide (BNP) in pg/mL was assessed at baseline and 30 days after (secondary endpoint). Results: Mean age was 62.6 +/- 8.8 years, 45 (64.3%) male, and 52 (74.3%) of patients presented with ST-segment elevation MI. For primary endpoint, there were no differences in mean platelet reactivity (p = 0.51) between the DPP-4i (8.00 {-65.00; 63.00}) and placebo (-14.00 {-77.00; 52.00}) groups, as well in mean BNP levels (p = 0.14) between DPP-4i (-36.00 {-110.00; 15.00}) and placebo (-13.00 {-50.00; 27.00}). There was no difference between groups in cardiac adverse events. Conclusions: DPP4 inhibitor did not reduce platelet aggregation among patients with type 2 diabetes hospitalized with AMI. Moreover, the use of DPP-4i did not show an increase in BNP levels or in the incidence of cardiac adverse events. These findings suggests that DPP-4i could be an option for management of T2DM patients with acute MI.