FRANCISCO AKIRA MALTA CARDOZO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
bookPart O exame cardíaco(2021) CARDOZO, Francisco Akira Malta; CARAMELLI, BrunoconferenceObject 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.
- Worsening of heart failure by coronavirus disease 2019 is associated with high mortality(2021) BOCCHI, Edimar Alcides; LIMA, Ivna Girard Cunha Vieira; BISELLI, Bruno; SALEMI, Vera Maria Cury; FERREIRA, Silvia Moreira Ayub; CHIZZOLA, Paulo Roberto; MUNHOZ, Robinson Tadeu; PESSOA, Ranna Santos; CARDOSO, Francisco Akira Malta; BELLO, Mariana Vieira de Oliveira; HAJJAR, Ludhmila Abrahao; GOMES, Brenno RizerioAims Patients with advanced heart failure (HF) with reduced left ventricular ejection fraction (HFrEF) and concurrent coronavirus disease 2019 (COVID-19) might have a higher risk of severe events. Methods and results We retrospectively studied 16 patients with advanced HFrEF who developed COVID-19 between 1 March and 29 May 2020. Follow-up lasted until 30 September. Ten patients previously hospitalized with decompensated HFrEF were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during hospitalization. Six patients undergoing ambulatory care at initiation of COVID-19 symptoms were hospitalized because of advanced HFrEF. All patients who experienced worsening of HFrEF due to COVID-19 required higher doses or introduction of additional inotropic drugs or intra-aortic balloon pump in the intensive care unit. The mean intravenous dobutamine dose before SARS-CoV-2 infection in previously hospitalized patients (n = 10) and the median (inter-quartile range) peak intravenous dobutamine dose during SARS-CoV-2 infection in all patients (n = 16) were 2 (0-7) mu g/kg/min and 20 (14-20) (P < 0.001), respectively. During follow-up, 56% underwent heart transplantation (n = 2) or died (n = 7). Four patients died during hospitalization from mixed shock consequent to severe acute respiratory syndrome with inflammatory storm syndrome associated with septic and cardiogenic shock during COVID-19. After COVID-19 recovery, two patients died from mixed septic and cardiogenic shock and one from sustained ventricular tachycardia and cardiogenic shock. Five patients were discharged from hospital to ambulatory care. Four were awaiting heart transplantation. Conclusion Worsening of advanced HF by COVID-19 is associated with high mortality. This report highlights the importance of preventing COVID-19 in patients with advanced HF.
- 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.
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.; BORGES-JUNIOR, Flavio A.; PASTANA, Adriana F.; MATHEUS, Mariana G. Gomes; BRUCKI, Sonia M.; RODRIGUES, Ana C.; NITRINI, Ricardo M.; CARAMELLI, Paulo- Incidence and outcomes of perioperative myocardial infarction/injury diagnosed by high-sensitivity cardiac troponin I(2021) GUALANDRO, Danielle M.; PUELACHER, Christian; BUSE, Giovanna Lurati; GLARNER, Noemi; CARDOZO, Francisco A.; VOGT, Ronja; HIDVEGI, Reka; STRUNZ, Celia; BOLLIGER, Daniel; GUECKEL, Johanna; YU, Pai C.; LIFFERT, Marcel; ARSLANI, Ketina; PREPOUDIS, Alexandra; CALDERARO, Daniela; HAMMERER-LERCHER, Angelika; LAMPART, Andreas; STEINER, Luzius A.; SCHAEREN, Stefan; KINDLER, Christoph; GUERKE, Lorenz; OSSWALD, Stefan; DEVEREAUX, P. J.; CARAMELLI, Bruno; MUELLER, Christian; MARBOT, Stella; STREBEL, Ivo; GENINI, Alessandro; RENTSCH, Katharina; BOEDDINGHAUS, Jasper; NESTELBERGER, Thomas; WILD, Karin; ZIMMERMANN, Tobias; DUARTE, Alberto J. S.; BUSER, Andreas; LUCCIA, Nelson de; KOECHLIN, Luca; WUSSLER, Desiree; WALTER, Joan; WIDMER, Velina; FREESE, Michael; LOPEZ-AYALA, Pedro; TWERENBOLD, Raphael; BADERTSCHER, Patrick; SEEBERGER, Esther; WOLFF, Thomas; MUJAGIC, Edin; MEHRKENS, Arne; DINORT, Julia; FAHRNI, Gregor; JEGER, Raban; KAISER, Christoph; MATHEUS, Mariana; PASTANA, Adriana F.Background Perioperative myocardial infarction/injury (PMI) diagnosed by high-sensitivity troponin (hs-cTn) T is frequent and a prognostically important complication of non-cardiac surgery. We aimed to evaluate the incidence and outcome of PMI diagnosed using hs-cTnI, and compare it to PMI diagnosed using hs-cTnT. Methods We prospectively included 2455 patients at high cardiovascular risk undergoing 3111 non-cardiac surgeries, for whom hs-cTnI and hs-cTnT concentrations were measured before surgery and on postoperative days 1 and 2. PMI was defined as a composite of perioperative myocardial infarction (PMIInfarct) and perioperative myocardial injury (PMIInjury), according to the Fourth Universal Definition of Myocardial Infarction. All-cause mortality was the primary endpoint. Results Using hs-cTnI, the incidence of overall PMI was 9% (95% confidence interval [CI] 8-10%), including PMIInfarct 2.6% (95% CI 2.0-3.2) and PMIInjury 6.1% (95% CI 5.3-6.9%), which was lower versus using hs-cTnT: overall PMI 15% (95% CI 14-16%), PMIInfarct 3.7% (95% CI 3.0-4.4) and PMIInjury 11.3% (95% CI 10.2-12.4%). All-cause mortality occurred in 52 (2%) patients within 30 days and 217 (9%) within 1 year. Using hs-cTnI, both PMIInfarct and PMIInjury were independent predictors of 30-day all-cause mortality (adjusted hazard ratio [aHR] 2.5 [95% CI 1.1-6.0], and aHR 2.8 [95% CI 1.4-5.5], respectively) and, 1-year all-cause mortality (aHR 2.0 [95% CI 1.2-3.3], and aHR 1.8 [95% CI 1.2-2.7], respectively). Overall, the prognostic impact of PMI diagnosed by hs-cTnI was comparable to the prognostic impact of PMI using hs-cTnT. Conclusions Using hs-cTnI, PMI is less common versus using hs-cTnT. Using hs-cTnI, both PMIInfarct and PMIInjury remain independent predictors of 30-day and 1-year mortality. [GRAPHICS] .