ANTONIO EDUARDO PEREIRA PESARO
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- Pleiotropic effects of ezetimibe/simvastatin vs. high dose simvastatin(2012) PESARO, Antonio Eduardo P.; SERRANO JR., Carlos V.; FERNANDES, Juliano L.; CAVALCANTI, Alexandre B.; CAMPOS, Alexandre H.; MARTINS, Herlon S.; MARANHAO, Raul C.; LEMOS, James A. de; SOUZA, Heraldo P.; NICOLAU, Jose C.Background: In the setting of stable coronary artery disease (CAD), it is not known if the pleiotropic effects of cholesterol reduction differ between combined ezetimibe/simvastatin and high-dose simvastatin alone. Objective: We sought to compare the anti-inflammatory and antiplatelet effects of ezetimibe 10 mg/simvastatin 20 mg (E10/S20) with simvastatin 80 mg (S80). Methods and results: CAD patients (n = 83, 63 +/- 9 years, 57% men) receiving S20, were randomly allocated to receive E10/S20 or S80, for 6 weeks. Lipids, inflammatory markers (C-reactive protein, interleukin-6, monocyte chemoattractant protein-1, soluble CD40 ligand and oxidized LDL), and platelet aggregation (platelet function analyzer [PFA]-100) changes were determined. Baseline lipids, inflammatory markers and PFA-100 were similar between groups. After treatment, E10/S20 and S80 patients presented, respectively: (1) similar reduction in LDL-C (29 +/- 13% vs. 28 +/- 30%, p = 0.46), apo-B (18 +/- 17% vs. 22 +/- 15%, p = 0.22) and oxidized LDL (15 +/- 33% vs. 18 +/- 47%, p = 0.30); (2) no changes in inflammatory markers; and, (3) a higher increase of the PFA-100 with E10/S20 than with S80 (27 +/- 43% vs. 8 +/- 33%, p = 0.02). Conclusions: These data suggest that among stable CAD patients treated with S20, (1) both E10/S20 and S80 were equally effective in further reducing LDL-C; (2) neither treatment had any further significant anti-inflammatory effects; and (3) E10/S20 was more effective than S80 in inhibiting platelet aggregation. Thus, despite similar lipid lowering and doses 4x less of simvastatin, E10/S20 induced a greater platelet inhibitory effect than S80.
- 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.
conferenceObject The Inflammatory Response to Percutaneous Coronary Intervention is Related to Myocardial Injury in Patients with Chronic Ischemic Heart Disease(2021) FRISSO, Priscilla T.; MATTOS, Fernando R.; PINESI, Henrique Trombini; LEMOS, James A. De; PESARO, Antonio E.; RACHED, Fabiana H.; FRANKEN, Marcelo; CAIXETA, Adriano M.; LEMOS NETO, Pedro A.; CHAGAS, Antonio C.; SERRANO JR., Carlos V.bookPart Mecanismos moleculares na rotura da placa e trombose(2022) CARVALHO, Otávio Augusto Oliveira de; BOROS, Gustavo André Boeing; PESARO, Antonio Eduardo; SERRANO JR., Carlos V.- Inflammation and circulating endothelial progenitor cells in patients with coronary artery disease and residual platelet reactivity(2012) PESARO, Antonio Eduardo P.; SERRANO JR., Carlos V.; KATZ, Marcelo; CAMPOS, Alexandre H.; LOPES, Renato D.; MARTI, Luciana C.; MARTINS, Herlon S.; SUNAHARA, Rodrigo S.; MARANHAO, Raul C.; NICOLAU, Jose C.
- Increasing Doses of Simvastatin Versus Combined Ezetimibe/Simvastatin: Effect on Circulating Endothelial Progenitor Cells(2013) PESARO, Antonio Eduardo P.; SERRANO JR., Carlos V.; KATZ, Marcelo; MARTI, Luciana; FERNANDES, Juliano L.; PARRA, Paulo R. G.; CAMPOS, Alexandre H.Background: Patients with coronary artery disease (CAD) should be treated with statins to attain very low cholesterol levels, in order to reduce cardiovascular adverse events. More than 70% of these patients do not reach the appropriate cholesterol goal despite moderate statin doses. However, it is not known whether therapeutic uptitration with different lipid-lowering strategies has a similar pleiotropic effect on atherosclerotic endothelial dysfunction evaluated by measurement of endothelial progenitor cells (EPCs). Objective: We sought to compare, in patients with stable CAD and with a low-density lipoprotein cholesterol (LDL-C) >70 mg/dL on treatment with simvastatin 20 mg, the effects on EPCs by increasing simvastatin to 80 mg versus adding ezetimibe 10 mg. Methods: Patients (n = 68, 63 +/- 9 years, 39% men) were randomly allocated to receive ezetimibe 10/simvastatin 20 mg or simvastatin 80 mg for 6 weeks. Circulating EPCs were measured by flow cytometry before and after the treatment. Results: Both strategies presented similar effects on metabolic parameters. The LDLs were equally reduced by ezetimibe 10/simvastatin 20 mg and simvastatin 80 mg (28.9% +/- 13% vs 21.1% +/- 33%; P = .46, respectively). The levels of EPCs were unaffected by ezetimibe 10/simvastatin 20 mg (median [25th, 75th]: pre- vs posttreatment, 7.0 [2.3; 13.3] vs 3.1 [0.1; 13.2] EPCs/10(4) mononuclear cells; P = .43) or simvastatin 80 mg (pre- vs posttreatment, 6.1 [2.9; 15.2] vs 4.0 [1.4; 10.7] EPCs/10(4) mononuclear cells; P = .5) ,and there were no differences between the groups on treatment effects (P = .9). Conclusions: Among stable patients with CAD and with an LDL-C >70 mg/dL on simvastatin 20 mg, increasing simvastatin dose to 80 mg or adding ezetimibe 10 mg promoted similar further cholesterol reduction but did not have incremental effects on circulating EPCs. These data suggest that the effects of simvastatin moderate doses on EPCs are not increased by intensive lipid-lowering strategies (clinicaltrials.gov: NCT00474123).