RICARDO D'OLIVEIRA VIEIRA

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    EVOLUTION OF VENTRICULAR FUNCTION IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE SUBMITTED TO ON-PUMP OR OFF-PUMP CORONARY ARTERY BYPASS GRAFT IN MASS III TRIAL
    (2012) STASZKO, Kamila F.; HUEB, Whady; LIMA, Eduardo; BISELLI, Bruno; GARCIA, Rosa Maria Rahmi; VIEIRA, Ricardo D. O.; GARZILLO, Cibele Larrosa; PEREIRA, Alexandre Costa; HUEB, Alexandre Ciappina; REZENDE, Paulo Cury; CASELLA-FILHO, Antonio; RAMIRES, Jose; KALIL-FILHO, Roberto
    Background Ventricular function is a major determinant of prognosis in patients with coronary artery disease (CAD). Few data are available to assess the evolution of ventricular function among patients submitted to off-pump coronary artery bypass graft surgery (OPCAB). Purpose To compare the evolution of ventricular function in a long-term follow-up among patients with stable CAD submitted to OPCAB or On-Pump coronary artery bypass graft (ONCAB) Methods Patients with stable CAD and preserved systolic left ventricular function were randomized to OPCAB or ONCAB and followed for 5 years. Patients who undergone a new evaluation of ventricular function in this follow-up were studied. Left ventricular ejection fraction (LVEF) was assessed by echocardiogram. Results Of 308 patients randomized to OPCAB (n=155) or ONCAB (n=153), 91 had a new assessment of ventricular function by echocardiogram in a 5-year follow-up: 49 in ONCAB group and 42 in OPCAB group. In ONCAB group the initial and final mean of LVEF was respectively 59.85% and 56.16% (p=0.10). In OPCAB group the initial and final mean of LVEF was respectively 59.18 % and 56.07 (p=0.17). Conclusion There was no difference in the evolution of LVEF among patients with stable CAD randomized to ONCAB or OPCAB in a 5-year follow-up. ACC Moderated Poster Contributions McCormick Place South, Hall A Monday, March 26, 2012, 9:30 a.m.-10:30 a.m. Session Title: Fresh CABG: Good for SIHD? Abstract Category: 3. Chronic CAD/Stable Ischemic Heart Disease: Therapy Presentation Number: 1208-409
  • conferenceObject
    IMPACT OF METABOLIC SYNDROME ON THE OUTCOME OF PATIENTS WITH STABLE CORONARY ARTERY DISEASE SUBMITTED TO DIFFERENT TYPES OF TREATMENT: 10-YEAR FOLLOW-UP OF THE MASS II STUDY
    (2012) LIMA, Eduardo Gomes; HUEB, Whady; GARCIA, Rosa Maria Rahmi; VIEIRA, Ricardo D. O.; GARZILLO, Cibele Larrosa; PEREIRA, Alexandre Costa; HUEB, Alexandre Ciappina; REZENDE, Paulo Cury; CASELLA-FILHO, Antonio; RAMIRES, Jose; KALIL-FILHO, Roberto
    Background Metabolic syndrome (MetS) is understood as a condition that promotes atherosclerosis and confers an additional risk of adverse cardiovascular events in patients with coronary artery disease. The prognosis of this syndrome in this subset of patients in a long term follow up is inconclusive. Objective Evaluate the impact of metabolic syndrome on cardiac death in patients with symptomatic chronic multivessel coronary artery disease. Methods Patients randomized in MASS II study submitted to coronary artery bypass graft (CABG), angioplasty (PCI) or medical treatment (MT) were evaluated for the presence of MetS and followed prospectively for 10 years. We evaluated the incidence of overall and cardiac death in this period. Results Criteria for MetS were fulfilled in 283 patients of 583 (54%) randomized to three therapeutic strategies. The presence of MetS, was associated with an increased cardiac related death in studied population. During a 10-year follow-up, the probability cardiac mortality free survival was significantly different among patients in the 2 groups (MetS = 81,6% × non-MetS = 91,3% P=0.004). Stratifying patients with MetS by therapeutic approach we identify a statistical difference in cardiac death free survival comparing interventional approaches (CABG and PCI) to MT: 82,4% for CABG; 86,2% for PCI and 75,9% for MT (P=0,003). Besides, there is a group with best prognosis: patients without MetS submitted to CABG presenting 98,7% of patients free of cardiac death in a 10-year follow-up. Conclusion MetS confers high rates of cardiac death in patients with stable coronary artery disease irrespective of therapeutic strategy used. In patients with MetS, interventional approaches (PCI or CABG) seem to confer more protection against cardiac death in a 10-year follow-up. ACC Moderated Poster Contributions McCormick Place South, Hall A Monday, March 26, 2012, 11:00 a.m.-Noon Session Title: DES and Drugs: Decisions in Diabetics Abstract Category: 3. Chronic CAD/Stable Ischemic Heart Disease: Therapy Presentation Number: 1209-477
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    Impact of metabolic syndrome on the outcome of patients with stable coronary artery disease submitted to different types of treatment: 10-year follow-up of the MASS II study
    (2012) LIMA, E. G.; HUEB, W.; RAHMI, R.; VIEIRA, R. D. O.; GARZILLO, C. L.; PEREIRA, A. C.; HUEB, A. C.; REZENDE, P. C.; RAMIRES, J. A. F.; KALIL FILHO, R.
    Purpose: Metabolic syndrome (MetS) is understood as a condition that promotes atherosclerosis and confers an additional risk of adverse cardiovascular eventsin patients with coronary artery disease. The prognosis of this syndrome in this subset of patients in a long term follow up is inconclusive. Evaluate the impact of metabolic syndrome on cardiac death in patients with symptomatic chronic multivessel coronary artery disease. Methods: Patients randomized in MASS II study submitted to coronary artery bypass graft (CABG),angioplasty (PCI) or medical treatment (MT) were evaluated for the presence of MetS and followed prospectively for 10 years. We evaluated the incidence of overall and cardiac death in this period. Results: Criteria for MetS were fulfilled in 283 patients of 583 (54%) randomized to three therapeutic strategies. The presence of MetS was associated with an increased cardiac related death in studied population. During a 10-year follow- up, the probability cardiac mortality free survival was significantly different among patients in the 2 groups (MetS = 81,6% x non-MetS = 91,3% P=0.004). Stratifying patients with MetS by therapeutic approach we identify a statistical difference in cardiac death free survival comparing interventional approaches (CABG and PCI) to MT: 82,4% for CABG; 86,2% for PCI and 75,9% for MT(P=0,003). Besides, there is a group with best prognosis: patients without MetS submitted to CABG presenting 98,7% of patients free of cardiac death in a 10-year follow-up. Conclusion: MetS confers high rates of cardiac death in patients with stable coronary artery disease irrespective of therapeutic strategy used. In patients with MetS, interventional approaches (PCI or CABG) seem to confer more protection against cardiac death in a 10-year follow-up.