JOSE JAYME GALVAO DE LIMA

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico

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    Blood pressure level imposes different cardiovascular risk on renal transplant candidates in the presence of previous stroke or myocardial infarction
    (2013) GOWDAK, L. H. W.; PAULA, F. J. De; CESAR, L. A. M.; BORTOLOTTO, L. A.; LIMA, J. J. G. De
  • conferenceObject
    Increased Blood Pressure Variability and Baroreflex Impairment in Patients With End-stage Renal Disease Undergoing Hemodialysis
    (2013) SCAPINI, Katia B.; HONG, Valeria C.; FERREIRA, Janaina B.; SOUZA, Silvia B.; FERREIRA, Naomi V.; MORAES, Oscar A.; CONSOLIM-COLOMBO, Fernanda M.; LIMA, Jose J. de; MOSTARDA, Cristiano; IRIGOYEN, Maria C.
  • article 0 Citação(ões) na Scopus
    Evolução clínica após intervenção coronária percutânea em indivíduos com transplante renal prévio
    (2013) TRENTIN, Fábio; MELO, Eduardo França Pessoa de; SANTO, Carlos Vinicius Abreu do Espírito; PAULA, Flavio Jota de; NAHAS, William Carlos; SPADARO, André Gasparin; LIMA, Jose Jayme de; GOWDAK, Luiz Henrique; CAMPOS, Carlos Augusto Homem de Magalhães; LEMOS NETO, Pedro Alves
    BACKGROUND: Coronary artery disease is a major cause of death in patients with chronic kidney disease. Moreover, due to the high prevalence of risk factors for atherosclerosis, many of these patients require percutaneous coronary intervention (PCI) even after renal transplantation. The aim of this study is to report the late follow-up of patients with renal transplantation treated with PCI and stenting. METHODS: Patients > 18 years of age, with prior kidney transplantation, and treated with PCI were included. Clinical follow-up was evaluated by medical record analysis and telephone contact. The study endpoint was the incidence of major adverse cardiac events (MACE) during follow-up. RESULTS: Twenty-nine patients were included. Mean age was 54.8 ± 8 years and the majority male (72.4%). The prevalence of hypertension was 89.7%, dyslipidemia 69% and diabetes 51.7%. Most of them had multivessel disease (2-vessel: 44.8%; 3-vessel: 41.4%). Lesion complexity was high, being 84.3% type B2 or C lesions and 27.5% bifurcation lesions. Procedural success rate was 100%. Bare metal stents were used in 96.6% of cases. The follow-up time was 1,378 ± 977 days. The mortality rate was 25.1%, target vessel revascularization rate was 15.9% and none of the patients presented non-fatal infarction. The incidence of MACE during follow-up was 34.5%. CONCLUSIONS: Late follow-up after PCI in renal transplantation patients demonstrated a high probability of clinical events. However, the study population was a sample of high clinical and angiographic complexity.
  • article 4 Citação(ões) na Scopus
    Renal Artery Stenosis Predicts Coronary Artery Disease in Patients with Hypertension
    (2013) MACEDO, Thiago A.; PEDROSA, Rodrigo P.; COSTA-HONG, Valeria; KAJITA, Luiz J.; MORAIS, Gustavo R.; LIMA, Jose J. G. De; DRAGER, Luciano F.; BORTOLOTTO, Luiz A.
    In hypertensive patients with indication of renal arteriography to investigate renal artery stenosis (RAS) there are no recommendations regarding when to investigate coronary artery disease (CAD). Moreover, the predictors of CAD in patients with RAS are not clear. We aimed to evaluate the frequency and the determinants of CAD in hypertensive patients referred to renal angiography. Eighty-two consecutive patients with high clinical risk suggesting the presence of RAS systematically underwent renal angiography and coronary angiography during the same procedure. Significant arterial stenosis was defined by an obstruction >= 70% to both renal and coronary territories. Significant CAD was present in 32/82 (39%) and significant RAS in 32/82 (39%) patients. Both CAD and RAS were present in 25.6% from the 82 patients. Patients with severe CAD were older (63 +/- 12 vs. 56 +/- 13 years; p = 0.03) and had more angina (41 vs. 16%; p = 0.013) compared to patients without severe CAD. Significant RAS was associated with an increased frequency of severe CAD compared to patients without significant RAS (66% vs. 22%, respectively; p<0.001). Myocardial scintigraphy showed ischemia in 21.8% of the patients with CAD. Binary logistic regression analysis showed that RAS >= 70% was independently associated with CAD >= 70% (OR: 11.48; 95% CI 3.2-40.2; p<0.001), even in patients without angina (OR: 13.48; 95% CI 2.6-12.1; p<0.001). Even considering a small number of patients with significant RAS, we conclude that in hypertensive patients referred to renal angiography, RAS >= 70% may be a strong predictor of severe CAD, independently of angina, and dual investigation should be considered.