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- O escore de risco de sangramento como preditor de mortalidade em pacientes com síndromes coronarianas agudas(2013) NICOLAU, José Carlos; MOREIRA, Humberto Graner; BARACIOLI, Luciano Moreira; SERRANO JR, Carlos Vicente; LIMA, Felipe Galego; FRANKEN, Marcelo; GIRALDEZ, Roberto Rocha; GANEM, Fernando; KALIL FILHO, Roberto; RAMIRES, José Antônio Franchini; MEHRAN, RoxanaBACKGROUND: It is well known that the occurrence of bleeding increases in-hospital mortality in patients with acute coronary syndromes (ACS), and there is a good correlation between bleeding risk scores and bleeding incidence. However, the role of bleeding risk score as mortality predictor is poorly studied. OBJECTIVE: The main purpose of this paper was to analyze the role of bleeding risk score as in-hospital mortality predictor in a cohort of patients with ACS treated in a single cardiology tertiary center. METHODS: Out of 1655 patients with ACS (547 with ST-elevation ACS and 1118 with non-ST-elevation ACS), we calculated the ACUITY/HORIZONS bleeding score prospectively in 249 patients and retrospectively in the remaining 1416. Mortality information and hemorrhagic complications were also obtained. RESULTS: Among the mean age of 64.3 ± 12.6 years, the mean bleeding score was 18 ± 7.7. The correlation between bleeding and mortality was highly significant (p < 0.001, OR = 5.296), as well as the correlation between bleeding score and in-hospital bleeding (p < 0.001, OR = 1.058), and between bleeding score and in-hospital mortality (adjusted OR = 1.121, p < 0.001, area under the ROC curve 0.753, p < 0.001). The adjusted OR and area under the ROC curve for the population with ST-elevation ACS were, respectively, 1.046 (p = 0.046) and 0.686 ± 0.040 (p < 0.001); for non-ST-elevation ACS the figures were, respectively, 1.150 (p < 0.001) and 0.769 ± 0.036 (p < 0.001). CONCLUSIONS: Bleeding risk score is a very useful and highly reliable predictor of in-hospital mortality in a wide range of patients with acute coronary syndromes, especially in those with unstable angina or non-ST-elevation acute myocardial infarction.
- Características clínicas, angiográficas e evolução a longo prazo em pacientes com arterite de Takayasu e síndrome coronária aguda(2013) SOEIRO, Alexandre de Matos; ALMEIDA, Maria Carolina Feres de; TORRES, Tatiana Andreucci; FRANKEN, Marcelo; LIMA, Felipe Gallego; GANEM, Fernando; GIRALDEZ, Roberto R.; BARACIOLI, Luciano; TAVARES JR., Mucio Oliveira; SERRANO JR., Carlos V.; NICOLAU, Jose CarlosIntroduction: Monitoring of disease activity and the best therapeutic approach are a challenge in Takayasu arteritis (TA). When associated with acute coronary syndromes (ACS), the best interventional treatment has not been established. The objective of this study was to describe the baseline characteristics, clinical manifestations, treatment and long-term outcome of patients with TA and ACS. Methods: We retrospectively analyzed eight patients between 2004 and 2010. The following data were obtained: age, gender, clinical and electrocardiographic manifestations, Kit lip class, risk factors for ACS, markers of myocardial necrosis (CK-MB and troponin), creatinine clearance, left ventricular ejection fraction, inflammatory markers (C-reactive protein and erythrocyte sedimentation rate [ESR]), medication during hospital stay, angiographic findings, treatment (medical, percutaneous or surgical) and long-term outcome. Statistical data were expressed as percentages and absolute values. Results: All eight patients were women, median age 49 years. Typical chest pain was present in 37.5%. Elevated ESR was observed in 85.7%. Three patients underwent coronary artery bypass grafting, three underwent percutaneous coronary angioplasty (two with bare-metal stents and one with a drug-eluting stent) and two were treated medically. In-hospital mortality was 25%. There were no deaths during a mean follow-up of 30 months. Conclusions: In our study, patients who were discharged home had good outcomes in long-term follow-up with medical, percutaneous or surgical treatment. ESR appears to be associated with ACS in TA.
- Influence of proven oral therapies in the very old with acute coronary syndromes: A 15 year experience(2015) NICOLAU, Jose C.; FRANCI, Andre; BARBOSA, Carlos Jose D. G.; BARACIOLI, Luciano M.; FRANKEN, Marcelo; FURTADO, Remo H. M.; GIRALDEZ, Roberto R. C. V.; GANEM, Fernando; LIMA, Felipe G.; MENEZES, Fernando R.; ARANTES, Flavia B. B.; RAMIRES, Jose A. F.; KALIL FILHO, Roberto; GIUGLIANO, Robert P.
- Diretrizes Brasileiras de antiagregantes plaquetários e anticoagulantes em cardiologia(2013) LORGA FILHO, A. M.; AZMUS, A. D.; SOEIRO, A. M.; QUADROS, A. S.; AVEZUM JUNIOR, A.; MARQUES, A. C.; FRANCI, A.; MANICA, A. L. L.; VOLSCHAN, A.; V, A. A. De Paola; GRECO, A. I. L.; FERREIRA, A. C. N.; SOUSA, A. C. S.; PESARO, A. E. P.; SIMAO, A. F.; LOPES, A. S. S. A.; TIMERMAN, A.; RAMOS, A. I. O.; ALVES, B. R.; CARAMELLI, B.; MENDES, B. A.; POLANCZYK, C. A.; MONTENEGRO, C. E. L.; BARBOSA, C. J. D. G.; V, C. Serrano Junior; MELO, C. C. L.; PINHO, C.; MOREIRA, D. A. R.; CALDERARO, D.; GUALANDRO, D. M.; ARMAGANIJAN, D.; MACHADO NETO, E. A.; BOCCHI, E. A.; PAIVA, E. F.; STEFANINI, E.; D'AMICO, E.; EVARISTO, E. F.; SILVA, E. E. R.; FERNANDES, F.; BRITO JUNIOR, F. S.; BACAL, F.; GANEM, F.; GOMES, F. L. T.; MATTOS, F. R.; MORAES NETO, F. R.; TARASOUTCHI, F.; DARRIEUX, F. C. C.; FEITOSA, G. S.; FENELON, G.; MORAIS, G. R.; CORREA FILHO, H.; CASTRO, I; GONCALVES JUNIOR, I; ATIE, J.; SOUZA NETO, J. D.; FERREIRA, J. F. M.; NICOLAU, J. C.; FARIA NETO, J. R.; ANNICHINO-BIZZACCHI, J. M.; I, L. Zimerman; PIEGAS, L. S.; PIRES, L. J. T.; BARACIOLI, L. M.; SILVA, L. B.; MATTOS, L. A. P.; LISBOA, L. A. F.; MAGALHAES, L. P. M.; LOPES, M. A. C. Q.; MONTERA, M. W.; FIGUEIREDO, M. J. O.; MALACHIAS, M. V. B.; GAZ, M. V. B.; ANDRADE, M. D.; BACELLAR, M. S. C.; BARBOSA, M. R.; CLAUSELL, N. O.; DUTRA, O. P.; COELHO, O. R.; YU, P. C.; LAVITOLA, P. L.; LEMOS NETO, P. A.; ANDRADE, P. B.; FARSKY, P. S.; FRANCO, R. A.; KALIL, R. A. K.; LOPES, R. D.; ESPORCATTE, R.; HEINISCH, R. H.; KALIL FILHO, R.; V, R. R. C. Giraldez; ALVES, R. C.; LEITE, R. E. G. S.; GAGLIARDI, R. J.; RAMOS, R. F.; MONTENEGRO, S. T.; ACCORSI, T. A. D.; V, T. S. Jardim; SCUDELER, T. L.; MOISES, V. A.; PORTAL, V. L.
bookPart Aspectos atuais do infarto agudo do miocárdio sem supradesnivelamento do segmento ST(2016) GIRALDEZ, Roberto Rocha C. V.; GUIMARãES, Patrícia Oliveira; SILVA, Guilherme Nunes da; LIMA, Felipe Gallego; GANEM, Fernando; RAMOS, RuiconferenceObject Early oral betablocker utilization reduces in-hospital mortality in patients submitted to primary percutaneous coronary intervention: a real-world analysis(2017) FURTADO, R. H. M.; DALCOQUIO, T. F.; NAKASHIMA, C. A. K.; SCANAVINI FILHO, M. A.; PEREIRA, C. A. C.; LARA, L. M.; GANEM, F.; GIRALDEZ, R. R. C. V.; FRANKEN, M.; KALIL FILHO, R.; NICOLAU, J. C.