REMO HOLANDA DE MENDONCA FURTADO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
21 resultados
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- Morphine and Cardiovascular Outcomes Among Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Coronary Angiography(2020) FURTADO, Remo H. M.; NICOLAU, Jose C.; GUO, Jianping; IM, Kyungah; WHITE, Jennifer A.; SABATINE, Marc S.; NEWBY, L. Kristin; GIUGLIANO, Robert P.BACKGROUND Mechanistic studies have shown that morphine blunts the antiplatelet effects of oral adenosine diphosphate receptor blockers. However, the clinical relevance of this interaction is controversial. OBJECTIVES This study sought to explore the association between morphine and ischemic events in 5,438 patients treated with concomitant clopidogrel presenting with non-ST-segment elevation acute coronary syndromes (NSTEACS) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome) trial. Patients not treated with clopidogrel (n = 3,462) were used as negative controls. METHODS Endpoints were the composite of death, myocardial infarction (MI), recurrent ischemia, or thrombotic bailout at 96 h (4-way endpoint) and the composite of death or MI at 30 days. RESULTS In patients treated with clopidogrel, morphine use was associated with higher rates of the 4-way endpoint at 96 h (adjusted odds ratio [OR]: 1.40; 95% confidence interval [CI]: 1.04 to 1.87; p = 0.026). There was a trend for higher rates of death or MI at 30 days (adjusted OR: 1.29; 95% CI: 0.98 to 1.70; p = 0.072), driven by events in the first 48 h (adjusted hazard ratio: 1.54; 95% CI: 1.07 to 2.23; p = 0.021). In patients not treated with clopidogrel, morphine was not associated with either the 4-way endpoint at 96 h (adjusted OR: 1.05; 95% CI: 0.74 to 1.49; p = 0.79; p(interaction) = 0.36) or death or MI at 30 days (adjusted OR: 1.07; 95% CI: 0.77 to 1.48; p = 0.70; p(interaction) = 0.46). CONCLUSIONS When used concomitantly with clopidogrel pre-treatment, morphine was associated with higher rates of ischemic events in patients with NSTEACS. (C) 2020 by the American College of Cardiology Foundation.
conferenceObject EFFECT OF EXERCISE TRAINING ON PLATELET AGGREGATION AND ON P2Y12 INHIBITOR RESISTANCE AFTER MYOCARDIAL INFARCTION: A RANDOMIZED CLINICAL TRIAL(2020) DALCOQUIO, Talia; FURTADO, Remo Holanda de Mendonca; ARANTES, Flavia Bittar Britto Britto; SANTOS, Mayara Alves dos; ALVES, Leandro Silva; RONDON, Maria Urbana Pinto Brandao; FERREIRA-SANTOS, Larissa; ALVES, Maria Janieire de Nazare Nunes; FERRARI, Aline Gehlen; GENESTRETI, Paulo Rizzo; BARACIOLI, Luciano Moreira; FRANCI, Andre; SALSOSO, Rocio; NEGRAO, Carlos Eduardo; NICOLAU, Jose CarlosconferenceObject EFFECT OF TICAGRELOR AND CLOPIDOGREL ON CORONARY MICROCIRCULATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION(2019) SCANAVINI FILHO, Marco Antonio; BERWANGER, Otavio; MATHIAS JUNIOR, Wilson; AGUIAR, Miguel Osman; CHIANG, Hsu Po; BARACIOLI, Luciano Moreira; LIMA, Felipe Gallego; MENEZES, Fernando Reis; DALCOQUIO, Talia; FURTADO, Remo Holanda M.; LUCA, Fabio Augusto De; UEZATO, Delcio; RAMIRES, Jose Antonio Franchini; KALIL FILHO, Roberto; NICOLAU, Jose CarlosconferenceObject ACUTE CORONARY SYNDROMES IN THE VERY OLD: THERAPIES AND OUTCOME IN THE LONG-TERM FOLLOW-UP(2014) NICOLAU, Jose C.; FRANCI, Andre; BARBOSA, Carlos; BARACIOLI, Luciano; FURTADO, Remo; GIANNETTI, Natali; GIRALDEZ, Roberto; LIMA, Felipe; FRANKEN, Marcelo; RAMIRES, Jose; KALIL-FILHO, Roberto; FERRAZ, ThiagoconferenceObject DO PATIENTS WITHOUT SIGNIFICANT CORONARY OBSTRUCTIONS HAVE BETTER OUTCOME IN THE LONG RUN POST-ACUTE MYOCARDIAL INFARCTION?(2014) NICOLAU, Jose C.; FRANKEN, Marcelo; FERRAZ, Thiago; BARACIOLI, Luciano; LIMA, Felipe Gallego; GIRALDEZ, Roberto; FURTADO, Remo; GIANNETTI, Natali; KALIL-FILHO, Roberto; RAMIRES, JoseconferenceObject SAFETY AND EFFICACY OF DPP4 INHIBITORS IN ACUTE MYOCARDIAL INFARCTION: A BIOMARKER DRIVEN DOUBLE-BLINDED RANDOMIZED CONTROLLED TRIAL(2021) GENESTRETI, Paulo Rizzo; FURTADO, Remo; SALSOSO, Rocio; DALCOQUIO, Talia; NAKASHIMA, Carlos; LIMA, Viviane; COLODETTI, Raiza; FERRARI, Aline; FRANCI, Andre; MENEZES, Fernando; BARACIOLI, Luciano; NICOLAU, JoseconferenceObject 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, RemoconferenceObject INCREASED BODYWEIGHT AND INADEQUATE RESPONSE TO ASPIRIN IN INDIVIDUALS WITH CORONARY ARTERY DISEASE(2019) FURTADO, Remo Holanda de Mendonca; ARANTES, Flavia; BARBOSA, Carlos; FRANCI, Andre; MENEZES, Fernando; SALSOSO, Rocio; DALCOQUIO, Talia; NAKASHIMA, Carlos; SCANAVINI FILHO, Marco; FERRARI, Aline; GENESTRETI, Paulo; BARACIOLI, Luciano; NICOLAU, Jose C.conferenceObject THE ROLE OF ORAL BETA BLOCKER IN A REAL-WORLD POPULATION WITH NON-ST SEGMENT ELEVATION ACUTE CORONARY SYNDROMES(2017) NICOLAU, Jose C.; FERRARI, Aline; COELHO, Gabriela M. M.; NAKASHIMA, Carlos A. K.; LIMA, Viviane M.; DALCOQUIO, Talia; FURTADO, Remo; MENEZES, Fernando; RAMIRES, Jose; KALIL-FILHO, Roberto; BARACIOLI, Luciano- Effect of Evolocumab on Complex Coronary Disease Requiring Revascularization(2021) OYAMA, Kazuma; FURTADO, Remo H. M.; FAGUNDES JR., Antonio; ZELNIKER, Thomas A.; TANG, Minao; KUDER, Julia; MURPHY, Sabina A.; HAMER, Andrew; WANG, Huei; KEECH, Anthony C.; GIUGLIANO, Robert P.; SABATINE, Marc S.; BERGMARK, Brian A.OBJECTIVES This study sought to evaluate the ability of the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab to reduce the risk of complex coronary atherosclerosis requiring revascularization. BACKGROUND PCSK9 inhibitors induce plaque regression and reduce the risk of coronary revascularization overall. METHODS FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) was a randomized trial of the PCSK9 inhibitor evolocumab versus placebo in 27,564 patients with stable atherosclerotic cardiovascular disease on statin therapy followed for a median of 2.2 years. Clinical documentation of revascularization events was blindly reviewed to assess coronary anatomy and procedural characteristics. Complex revascularization was the composite of complex percutaneous coronary intervention (PCI) (as per previous analyses, >-1 of: multivessel PCI, >-3 stents, >-3 lesions treated, bifurcation PCI, or total stent length >60 mm) or coronary artery bypass grafting surgery (CABG). RESULTS In this study, 1,724 patients underwent coronary revascularization, including 1,482 who underwent PCI, 296 who underwent CABG, and 54 who underwent both. Complex revascularization was performed in 632 (37%) patients. Evolocumab reduced the risk of any coronary revascularization by 22% (hazard ratio [HR]: 0.78; 95% CI: 0.71 to 0.86; p < 0.001), simple PCI by 22% (HR: 0.78; 95% CI: 0.70 to 0.88; p < 0.001), complex PCI by 33% (HR: 0.67; 95% CI: 0.54 to 0.84; p < 0.001), CABG by 24% (HR: 0.76; 95% CI: 0.60 to 0.96; p 1/4 0.019), and complex revascularization by 29% (HR: 0.71; 95% CI: 0.61 to 0.84; p < 0.001). The magnitude of the risk reduction with evolocumab in complex revascularization tended to increase over time (20%, 36%, and 41% risk reductions in the first, second, and beyond second years). CONCLUSIONS Adding evolocumab to statin therapy significantly reduced the risk of developing complex coronary disease requiring revascularization, including complex PCI and CABG individually. (C) 2021 by the American College of Cardiology Foundation.
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