FRANCISCO AKIRA MALTA CARDOZO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
19 resultados
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Agora exibindo 1 - 10 de 19
conferenceObject Incidence and outcome of perioperative myocardial injury after noncardiac surgeries diagnosed by different high sensitivity troponin assays(2018) GUALANDRO, D. M.; PUELACHER, C.; CARAMELLI, B.; LURATIBUSE, G.; CARDOZO, F. A.; CALDERARO, D.; YU, P. C.; SAZGARY, L.; HIDVEGI, R.; STRUNZ, C.; BOLLIGER, D.; OSSWALD, S.; MUELLER, C.- Impact of the period of the day on all-cause mortality and major cardiovascular complications after arterial vascular surgeries(2023) ARTIOLI, Thiago; GUALANDRO, Danielle Menosi; CARDOZO, Francisco Akira Malta; ROJAS, Maria Carmen Escalante; CALDERARO, Daniela; YU, Pai Ching; CASELLA, Ivan Benaduce; LUCCIA, Nelson de; CARAMELLI, BrunoBackgroundConflicting results are reported about daytime variation on mortality and cardiac outcomes after non-cardiac surgeries. In this cohort study, we evaluate whether the period of the day in which surgeries are performed may influence all-cause mortality and cardiovascular outcomes in patients undergoing non-cardiac arterial vascular procedures. Methods1,267 patients who underwent non-cardiac arterial vascular surgeries between 2012 and 2018 were prospectively included in our cohort and categorized into two groups: morning (7 a.m. to 12 a.m., 79%) and afternoon/night (12:01 p.m. to 6:59 a.m. in the next day, 21%) surgeries. Primary endpoint was all-cause mortality within 30 days and one year. Secondary endpoints were the incidence of perioperative myocardial injury/infarction (PMI), and the incidence of major adverse cardiac events (MACE, including acute myocardial infarction, acute heart failure, arrhythmias, cardiovascular death) at hospital discharge. ResultsAfter adjusting for confounders in the multivariable Cox proportional regression, all-cause mortality rates at 30 days and one year were higher among those who underwent surgery in the afternoon/night (aHR 1.6 [95%CI 1.1-2.3], P = 0.015 and aHR 1.7 [95%CI 1.3-2.2], P < 0.001, respectively). Afternoon/night patients had higher incidence of PMI (aHR 1.4 [95%CI 1.1-1.7], P < 0.001). There was no significant difference in the incidence of MACE (aHR 1.3 [95%CI 0.9-1.7], P = 0.074). ConclusionsIn patients undergoing arterial vascular surgery, being operated in the afternoon/night was independently associated with increased all-cause mortality rates and incidence of perioperative myocardial injury/infarction.
conferenceObject Incidence and outcome of perioperative myocardial infarction/injury after non-cardiac surgeries diagnosed by high-sensitivity cardiac troponin I(2019) GUALANDRO, D. M.; PUELACHER, C.; HIDVEGI, R.; CARDOZO, F. A.; MARBOT, S.; YU, P. C.; VOGT, R.; CALDERARO, D.; GUECKEL, J.; STRUNZ, C.; BOLLIGER, D.; RENTSCH, K.; CARAMELLI, B.; MUELLER, C.conferenceObject Impact of the period of the day on mortality and major cardiovascular complications after vascular surgeries(2020) CARDOZO, F. A. M.; ARTIOLI, T.; CARAMELLI, B.; CALDERARO, D.; YU, P. C.; ROJAS, M. C. E.; CASELLA, I. B.; LUCCIA, N. De; GUALANDRO, D. M.- Comparison of high-sensitivity cardiac troponin I and T for the prediction of cardiac complications after non-cardiac surgery(2018) GUALANDRO, Danielle M.; PUELACHER, Christian; LURATIBUSE, Giovanna; LAMPART, Andreas; STRUNZ, Celia; CARDOZO, Francisco A.; YU, Pai C.; JAFFE, Allan S.; BARAC, Sanela; BOCK, Lukas; BADERTSCHER, Patrick; LAVALLAZ, Jeanne du Fay de; MARBOT, Stella; SAZGARY, Lorraine; BOLLIGER, Daniel; RENTSCH, Katharina; TWERENBOLD, Raphael; HAMMERER-LERCHER, Angelika; MELO, Edielle S.; CALDERARO, Daniela; DUARTE, Alberto J. S.; LUCCIA, Nelson de; CARAMELLI, Bruno; MUELLER, ChristianBackground: We aimed to directly compare preoperative high-sensitivity cardiac troponin (hs-cTn) I and T concentration for the prediction of major cardiac complications after non-cardiac surgery. Methods: We measured hs-cTnI and hs-cTnT preoperatively in a blinded fashion in 1022 patients undergoing non-cardiac surgery. The primary endpoint was a composite of major cardiac complications including cardiac death, cardiac arrest, myocardial infarction, clinically relevant arrhythmias, and acute heart failure within 30 days. We hypothesized that the type of surgery may impact on the predictive accuracy of hs-cTnI/T and stratified all analyses according to the type of surgery. Results: Major cardiac complications occurred in 108 (11%) patients, 58/243 (24%) patients undergoing vascular surgery and 50/779 (6%, P < .001) patients undergoing non-vascular surgery. Using regulatory-approved 99th percentile cut-off concentrations, preoperative hs-cTnI elevations were less than one-fifth as common as preoperative hs-cTnT elevations (P < .001). Among patients undergoing vascular surgery, preoperative hs-cTnI concentrations, but not hs-cTnT, was an independent predictor of cardiac complications (adjusted odds ratio (aOR) 1.5, 95% confidence interval (95% CI) 1.0-2.1). The area under the receiver-operating characteristics curve (AUC) was 0.67 (95% CI, 0.59-0.75) for hs-cTnI versus 0.59 (95% CI 0.51-0.67, P=.012) for hs-cTnT. In contrast, among patients undergoing non-vascular surgery both preoperative hs-cTnI and hs-cTnT were independent predictors of the primary endpoint (aOR 1.6, 95% CI 1.3-2.0, and aOR 3.0, 95% CI 2.0-4.6, respectively) and showed higher predictive accuracy (AUC 0.77, 95% CI, 0.71-0.83, and 0.79, 95% CI 0.73-0.85, P = ns). Conclusions: Preoperative hs-cTnI and hs-cTnT concentrations predict major cardiac complications after non-vascular surgery, while, in patients undergoing vascular surgery, hs-cTnI may have better accuracy.
conferenceObject Predictors of acute heart failure after vascular surgery(2015) GUALANDRO, D. M.; MARCONDES-BRAGA, F. G.; YU, P. C.; CARDOZO, F. A. M.; LLOBET, G. B.; CALDERARO, D.; MELO, E. S.; CASELLA, I. B.; LUCCIA, N.; CARAMELLI, B.- Psoas muscle area and one-year mortality in a cohort of patients undergoing vascular surgery(2022) TAVARES, Caio Assis Moura; GUALANDRO, Danielle Menosi; CARDOZO, Francisco Akira Malta; ORANGES FILHO, Marcelo; ANDO, Sabrina de Mello; CALDERARO, Daniela; CARAMELLI, Bruno
conferenceObject Dabigatran versus Warfarin on Cognitive Outcomes in Nonvalvular Atrial Fibrillation: Results of the GIRAF Trial(2021) CARAMELLI, Bruno; YU, Pai C.; CARDOZO, Francisco A.; MAGALHAES, Iuri R.; FEITOSA, Raul R.; SPERA, Raphael; AMADO, Daniel; ROJAS, Maria Carmen Escalante; GUALANDRO, Danielle M.; CALDERARO, Daniela; TAVARES, Caio de Assis Moura A.; BORG-ES-JUNIOR, Flavio A.; PASTANA, Adriana F.; MATHEUS, Mariana G. Gomes; BRUCKI, Sonia M.; RODRIGUES, Ana C.; NITRINI, Ricardo M.; CARAMELLI, Paulo- High risk coronavirus disease 2019: The primary results of the CoronaHeart multi-center cohort study(2021) GUIMARAES, Patricia O.; SOUZA, Francis R. de; LOPES, Renato D.; BITTAR, Cristina; CARDOZO, Francisco A.; CARAMELLI, Bruno; CALDERARO, Daniela; ALBUQUERQUE, Cicero P.; DRAGER, Luciano F.; FERES, Fausto; BARACIOLI, Luciano; FILHO, Gilson Feitosa; BARBOSA, Roberto R.; RIBEIRO, Henrique B.; RIBEIRO, Expedito; ALVES, Renato J.; SOEIRO, Alexandre; FAILLACE, Bruno; FIGUEIREDO, Estevao; DAMIANI, Lucas P.; VAL, Renata M. do; HUEMER, Natassja; NICOLAI, Lisie G.; HAJJAR, Ludhmila A.; ABIZAID, Alexandre; FILHO, Roberto KalilBackground: Patients with Coronavirus Disease 2019 (COVID-19) may present high risk features during hospitalization, including cardiovascular manifestations. However, less is known about the factors that may further increase the risk of death in these patients. Methods: We included patients with COVID-19 and high risk features according to clinical and/or labo-ratory criteria at 21 sites in Brazil from June 10th to October 23rd of 2020. All variables were collected until hospital discharge or in-hospital death. Results: A total of 2546 participants were included (mean age 65 years; 60.3% male). Overall, 70.8% were admitted to intensive care units and 54.2% had elevated troponin levels. In-hospital mortality was 41.7%. An interaction among sex, age and mortality was found (p = 0.007). Younger women presented higher rates of death than men (30.0% vs 22.9%), while older men presented higher rates of death than women (57.6% vs 49.2%). The strongest factors associated with in-hospital mortality were need for mechanical ventilation (odds ratio [OR] 8.2, 95% confidence interval [CI] 5.4-12.7), elevated C-reactive protein (OR 2.3, 95% CI 1.7-2.9), cancer (OR 1.8, 95 %CI 1.2-2.9), and elevated troponin levels (OR 1.8, 95% CI 1.4-2.3). A risk score was developed for risk assessment of in-hospital mortality. Conclusions: This cohort showed that patients with COVID-19 and high risk features have an elevated rate of in-hospital mortality with differences according to age and sex. These results highlight unique aspects of this population and might help identifying patients who may benefit from more careful initial surveil-lance and potential subsequent interventional therapies. (c) 2021 Published by Elsevier B.V.
- Cardiology referral during the COVID-19 pandemic(2021) SANTORIO, Nathalia Conci; CARDOZO, Francisco Akira Malta; MIADA, Rodrigo Freddi; PITTA, Fabio Grunspun; TAVARES, Caio de Assis Moura; HABRUM, Fabio Cetinic; PINESI, Henrique Trombini; MAGALHAES, Iuri Reseda; MENEZES, Maria Clara Saad; CARAMELLI, Bruno; CALDERARO, DanielaOBJECTIVES: This study presents the cardiology referral model adopted at the University of Sao Paulo-Hospital das Cli acute accent nicas complex during the initial period of the coronavirus disease (COVID-19) pandemic, main reasons for requesting a cardiologic evaluation, and clinical profile of and prognostic predictors in patients with COVID-19. METHODS: In this observational study, data of all cardiology referral requests between March 30, 2020 and July 6, 2020 were collected prospectively. A descriptive analysis of the reasons for cardiologic evaluation requests and the most common cardiologic diagnoses was performed. A multivariable model was used to identify independent predictors of in-hospital mortality among patients with COVID-19. RESULTS: Cardiologic evaluation was requested for 206 patients admitted to the ICHC-COVID. A diagnosis of COVID-19 was confirmed for 180 patients. Cardiologic complications occurred in 77.7% of the patients. Among these, decompensated heart failure was the most common complication (38.8%), followed by myocardial injury (35%), and arrhythmias, especially high ventricular response atrial fibrillation (17.7%). Advanced age, greater need of ventilatory support on admission, and pre-existing heart failure were independently associated with in -hospital mortality. CONCLUSIONS: A hybrid model combining in-person referral with remote discussion and teaching is a viable alternative to overcome COVID-19 limitations. Cardiologic evaluation remains important during the pan-demic, as patients with COVID-19 frequently develop cardiovascular complications or decompensation of the underlying heart disease.