CESAR AUGUSTO CAPORRINO PEREIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
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conferenceObject 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- 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.
conferenceObject The Effect of Current Smoking on Platelet Reactivity Measures by Point-of-Care Methods in Patients Treated With and Without Clopidogrel(2022) NICOLAU, Jose C.; SALSOSO, Rocio; DALCOQUIO, Talia; GURBEL, Paul A.; TANTRY, Udaya; GIUGLIANO, Robert; NAKASHIMA, Carlos A.; FRANCI, Andre; RIZZO, Paulo; MENEZES, Fernando; GUARDIEIRO, Bruno; SCANAVINI FILHO, Marco Antonio; FERRARI, Aline G.; PEREIRA, Cesar; ARANTES, Flavia B.; BARBOSA, Carlos; BERTOLIN, Adriadne; FURTADO, Remo- Association between Statin Therapy and Lower Incidence of Hyperglycemia in Patients Hospitalized with Acute Coronary Syndromes(2021) FURTADO, Remo Holanda de Mendonca; GENESTRETI, Paulo Rizzo; DALCOQUIO, Talia F.; BARACIOLI, Luciano Moreira; LIMA, Felipe Galego; FRANCI, Andre; V, Roberto R. C. Giraldez; MENEZES, Fernando R.; FERRARI, Aline Gehlen; LIMA, Viviane Moreira; PEREIRA, Cesar A. C.; NAKASHIMA, Carlos Alberto Kenji; SALSOSO, Rocio; GODOY, Lucas Colombo; NICOLAU, Jose C.Background: Increased risk of new-onset diabetes with statins challenges the long-term safety of this drug class. However, few reports have analyzed this issue during acute coronary syndromes (ACS). Objective: To explore the association between early initiation of statin therapy and blood glucose levels in patients admitted with ACS. Methods: This was a retrospective analysis of patients hospitalized with ACS. Stain-naive patients were included and divided according to their use or not of statins within the first 24 hours of hospitalization. The primary endpoint was incidence of in-hospital hyperglycemia (defined as peak blood glucose > 200 mg/dL). Multivariable linear and logistic regression models were used to adjust for confounders, and a propensity-score matching model was developed to further compare both groups of interest. A p-value of less than 0.05 was considered statistically significant. Results: A total of 2,357 patients were included, 1,704 of them allocated in the statin group and 653 in the non-statin group. After adjustments, statin use in the first 24 hours was associated with a lower incidence of in-hospital hyperglycemia (adjusted OR=0.61, 95% Cl 0.46-0.80; p < 0.001) and lower need for insulin therapy (adjusted OR = 0.56, 95% CI 0.41-0.76; p < 0.001). Mese associations remained similar in the propensity-score matching models, as well as after several sensitivity analyses, such as after excluding patients who developed cardiogenic shock, severe infection or who died during index-hospitalization. Conclusions: Among statin-naive patients admitted with ACS, early statin therapy was independently associated with lower incidence of inhospital hyperglycemia.