CARLOS AUGUSTO HOMEM DE MAGALHAES CAMPOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- The Clinical Course of Takotsubo Syndrome Diagnosed According to the InterTAK Criteria(2020) FUNDÃO, Nelson Henrique Fantin; RIBEIRO, Henrique Barbosa; CAMPOS, Carlos de Magalhães; SELEME, Vinicius Bocchino; SOEIRO, Alexandre de Matos; VIEIRA, Marcelo Luiz Campos; MATHIAS JR, Wilson; HAJJAR, Ludhmilla Abraão; RIBEIRO, Expedito E.; KALIL FILHO, RobertoAbstract Background There has been an increase in the number of cases of Takotsubo syndrome (TTS) and of scientific publications on the theme over the last years. However, little is known about the status of this disease in Brazilian hospitals. Objective To assess mortality and major adverse cardiovascular events (MACE) during hospitalization and follow-up of TTS patients seen in a tertiary hospital in Brazil. Methods This was a retrospective, observational study on 48 patients. Clinical data, signs and symptoms, complementary tests, MACE and all-cause mortality were assessed on admission and during follow-up. Kaplan-Meier curves were used for analysis of all-cause mortality and risk for MACE at median follow-up. The 95% confidence interval was also calculated for a significance level of 5%. Results Mean age of patients was 71 years (SD±13 years), and most patients were women (n=41; 85.4%). During hospitalization, four patients (8.3%) died and five (10.4%) developed MACE. At median follow-up of 354.5 days (IQR of 81.5-896.5 days), the risk of all-cause mortality and MACE was 11.1% (95% CI= 1.8-20.3%) and 12.7% (95% CI= 3.3-22.3%), respectively. Conclusion TTS was associated with high morbidity and mortality rates in a tertiary hospital in Brazil, which were comparable to those observed in acute coronary syndrome. Therefore, the severity of TTS should not be underestimated, and new therapeutic strategies are required. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0
- Remoção Precoce do Introdutor Arterial Após Intervenção Coronária Percutânea por Via Femoral: Estudo de Segurança e Eficácia(2014) ZAGO, Gabriel; TRENTIN, Fabio; PRADO JR., Guy F. A.; SPADARO, Andre Gasparini; SILVA, Expedito Eustáquio Ribeiro da; CAMPOS, Carlos Magalhães; PERIN, Marco Antonio; FALCÃO, Breno de Alencar Araripe; ESTEVES-FILHO, Antonio; KAJITA, Luiz Junya; GAMA, Marcus Nogueira da; MARCHIORI, Gilberto; HORTA, Pedro Eduardo; TAKIMURA, Celso Kiyochi; MARIANI JR., Jose; GALON, Micheli Zanotti; SOARES, Paulo Rogerio; ZALC, Silvio; KALIL-FILHO, Roberto; LEMOS NETO, Pedro AlvesIntroduction: We evaluated the safety and efficacy of protamine administration, guided by activated clotting time, for the immediate femoral arterial sheath removal in patients undergoing percutaneous coronary intervention with unfractionated heparin in order to propose an algorithm for clinical practice. Methods: Prospective study with consecutive patients with stable angina or low-to-moderate risk acute coronary syndrome. We compared patients with an early removal of the arterial sheath to those whose sheath removal was based on a standard protocol. Results: The early removal group (n = 149) had lower access manipulation time than the conventional group (58.3 ± 21.4 minutes vs. 355.0 ± 62.9 minutes; p < 0.01), mainly due to a reduced time to sheath removal (42.3 ± 21.1 minutes vs. 338.6 ± 61.5 minutes; p < 0.01), with no impact on the duration of femoral compression (16.0 ± 3.6 minutes vs. 16.4 ± 5.1 minutes; p = 0.49). There was no stent thrombosis during hospitalization and no significant differences in the incidence of major vascular or bleeding events. The incidence of other bleeding events leading to a prolonged in-hospital length of stay was lower in the early removal group (1.3% vs. 5.1%; p = 0.05). Conclusions: The selective use of an approach for immediate femoral sheath removal, based on activated clotting time guidance and protamine administration, is a safe and effective option in patients undergoing percutaneous coronary intervention by femoral access.
- Evolução hospitalar de pacientes com choque cardiogênico por infarto agudo do miocárdio com supradesnivelamento do segmento ST(2013) FEITOSA FILHO, Francisco Hedilberto; CONEJO, Fabio; SANTOS, Luciano Nunes dos; CAMPOS, Carlos Augusto; LEMOS NETO, Pedro AlvesBACKGROUND: Cardiogenic shock is a clinical condition of inadequate tissue perfusion due to cardiac dysfunction. The most common etiology is ST-segment elevation myocardial infarction (STEMI) leading to left ventricular failure, but it may also be caused by mechanical complications such as acute mitral regurgitation, ventricular septal rupture or rupture of the left ventricular free wall. Despite therapeutic advances, mortality rates remain high. METHODS: Retrospective, observational, single-center study, including consecutive patients admitted with a diagnosis of STEMI and cardiogenic shock treated by percutaneous coronary intervention (PCI) at a tertiary hospital specialized in cardiology. The primary objective was to evaluate in-hospital clinical outcomes. RESULTS: A total of 78 patients were included, most of them were male (67.9%), mean age was 67.5 ± 13,4 years and 41.0% were diabetic. Primary PCI was performed in 46.2% of the patients, rescue PCI in 25.6% and elective PCI in 28.2% of the cases. The most frequently involved arteries were the left anterior descending artery and the right coronary artery, with 44.9% each. Intra-aortic balloon pump was used in 32.1% of cases and glycoprotein IIb/IIIa inhibitors in 30.8% of the cases. The incidence of acute renal failure was 61.5%. The need for reintervention was observed in 9.0% and the rate of acute/subacute thrombosis was 3.8%. Death due to cardiogenic shock was observed in 46.2%. Conclusions: Cardiogenic shock remains a frequent and serious condition with almost 50% of in-hospital mortality despite the therapeutic advances.
- Desfechos intra-hospitalares e preditores de mortalidade no infarto agudo do miocárdio com choque cardiogênico tratados por angioplastia primária: dados do registro InCor(2012) BIENERT, Igor Ribeiro de Castro; RIBEIRO, Henrique Barbosa; VALIM, Leandro Richa; CAMPOS, Carlos Augusto Homem de Magalhães; LOPES JR., Augusto Celso; ESPER, Rodrigo Barbosa; KAJITA, Luiz Junya; ESTEVES FILHO, Antonio; GAMA, Marcus Nogueira da; HORTA, Pedro Eduardo; MARCHIORI, Gilberto Guilherme Ajjar; SPADARO, Andre Gasparini; ZALC, Silvio; SOARES, Paulo Rogério; PERIN, Marco Antonio; LEMOS NETO, Pedro Alves; SILVA, Expedito Eustáquio Ribeiro daBACKGROUND: Cardiogenic shock is the leading cause of death in patients with ST-segment elevation myocardial infarction (STEMI). The present study evaluated patients with STEMI and cardiogenic shock undergoing primary percutaneous coronary intervention in order to establish their profile and predictors of in-hospital mortality. METHODS: Single center registry, including 100 patients evaluated from 2001 to 2009 for clinical, angiographic and procedure-related characteristics and in-hospital outcomes. Independent predictors of in-hospital mortality were determined by multivariate analysis. RESULTS: We observed a high prevalence of risk factors, angiographic success rate was 92%, despite the lesion complexity (83.1% were type B2/C). The left anterior descending artery was the most affected artery (45%) and 73% of the patients had multivessel disease. Mortality rate was 45%, and its independent predictors were multivessel disease [odds ratio (OR) 2.62, 95% confidence interval (95% CI) 1.16-5.90) and TIMI flow < 3 at the end of the procedure (OR 2.11, 95% CI 1.48-3.02). CONCLUSIONS: Patients with STEMI complicated by cardiogenic shock presented high-risk clinical and angiographic characteristics and despite the high angiographic success rate of the procedure, mortality rates were high. The presence of multivessel disease and TIMI flow < 3 at the end of the procedure were independent predictors of mortality.
- Impacto da insuficiência renal aguda na evolução hospitalar após tratamento percutâneo do infarto agudo do miocárdio(2013) SANTOS, Luciano Nunes dos; CONEJO, Fabio; FEITOSA FILHO, Francisco Hedilberto; CAMPOS, Carlos Augusto Homem de Magalhães; MARIANI JUNIOR, J.; TAKIMURA, Celso Kiyochi; ESTEVES FILHO, Antônio; SILVA, Expedito Eustáquio Ribeiro da; KALIL FILHO, Roberto; LEMOS NETO, Pedro AlvesBACKGROUND: Acute renal failure (ARF) is a possible complication after percutaneous coronary intervention (PCI). The objective of this study was to evaluate the occurrence and prognostic impact of ARF after PCI in patients with ST segment elevation myocardial infarction (STEMI). METHODS: Single-center registry evaluating in-hospital outcomes of 501 patients admitted with STEMI undergoing primary, rescue or late PCI. The incidence and predictors of ARF after PCI were evaluated. RESULTS: Mean age was 60.7 ± 12.6 years and 67% were male. The population had high cardiovascular risk characteristics, with 30% of diabetics and 7.4% with preexisting chronic kidney disease (CKD). The left anterior descending artery was the culprit vessel in 49.4% of the cases and 15% of patients had Killip class III or IV. ARF was observed in 24.7% of patients, who were significantly older, had more diabetes, history of CKD or heart failure, had higher enzyme elevation and lower ejection fraction when compared to those without ARF. In-hospital mortality was higher in patients who developed ARF (29% vs. 4.8%; P < 0.01). Independent predictors of ARF were age > 76 years, previous CKD, Killip class III or IV, need of vascular surgery or blood transfusion. CONCLUSIONS: Acute renal failure after PCI in STEMI was a frequent complication and was associated with increased in-hospital mortality.
- Influência da localização das lesões nos desfechos clínicos tardios após intervenção coronária percutânea em enxertos de veia safena(2013) BEZERRA, Cristiano Guedes; VAHLE, Vitor de Andrade; MELO, Eduardo França Pessoa de; RIBEIRO, Henrique Barbosa; FALCÃO, Breno de Alencar Araripe; CAMPOS, Carlos Augusto Homem de Magalhães; PERIN, Marco Antônio; SILVA, Expedito Eustáquio Ribeiro da; KALIL FILHO, Roberto; LEMOS NETO, Pedro AlvesBACKGROUND: Little is known about the late clinical outcomes of patients undergoing saphenous vein graft percutaneous coronary intervention (SVG-PCI), and there are controversies regarding the role of lesion location (aorto-ostial or graft body). METHODS: Single-center registry including patients undergoing SVG-PCI between 2006 and 2011. Aorto-ostial lesion was defined as a lesion within the first 8 mm of the graft; graft body lesion was defined as a lesion located in the remaining portions of the graft. Interventions approaching only the distal anastomosis or the native coronary bed were excluded. We evaluated the rates of major adverse cardiac events (MACE), death, myocardial infarction (MI), and target vessel revascularization (TVR) between the groups. RESULTS: One hundred and ninety-five patients were evaluated, 69 in the Aorto-Ostial Group and 126 in the Graft Body Group. Mean age was 69.6 ± 10.2 years, 41% were diabetic, 65.1% had acute coronary syndromes and most of them were treated with bare metal stents (82.5%). There was no statistical difference between groups for most of the characteristics evaluated. In the late follow-up, the TVR rate (50.8% vs. 22%; P = 0.03) was greater in the Aorto-Ostial Group. The MACE rate (67.7% vs. 63.3%; P = 0.33), death (31.7% vs. 35.6%; P = 0.95) and MI (55% vs. 42%; P = 0.64) were similar between the two groups. CONCLUSIONS: This population included a high-risk subgroup, with high late mortality rates, regardless of the location of the lesion in the graft. In patients treated predominantly by bare-metal stents, aorto-ostial lesions had a higher reintervention rate when compared to graft body lesions.
- 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 AlvesBACKGROUND: 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.