DESIDERIO FAVARATO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
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conferenceObject Beneficial effects of red wine intake upon gut microbiota and parallel effects upon plasma metabolomics(2019) HAAS, E.; FAVARATO, D.; LAURINDO, F. R. M.; SAAD, M. J. A.; SANTOS, A.; SERRANO JR., C. V.; CESAR, L. A. M.; ISOSAKI, M.; LIBBY, P.; LUZ, P. L. Da- Case 1/2019-A 51-year-old Man with Arterial Hypertension, Aortic Dissection and Aortic Valve Regurgitation, in Addition to Heart Failure with Unchanged Clinical Course After Surgical Intervention(2019) FAVARATO, Desiderio; AIELLO, Vera Demarchi
- VARIABILITY IN GLYCATED HEMOGLOBIN VALUES AND CARDIOVASCULAR EVENTS IN PATIENTS WITH TYPE 2 DIABETES AND MULTIVESSEL CORONARY ARTERY DISEASE(2019) REZENDE, Paulo; HUEB, Whady; HLATKY, Mark; GARCIA, Rosa; GARZILLO, Cibele; SCUDELER, Thiago; BOROS, Gustavo Andre Boeing; RIBAS, Fernando Faglioni; DALLAZEN, Anderson Roberto; FAVARATO, Desiderio; RAMIRES, Jose; KALIL-FILHO, Roberto
- Ten-Year Follow-Up of Off-Pump and On-Pump Multivessel Coronary Artery Bypass Grafting: MASS III(2019) HUEB, Whady; REZENDE, Paulo Cury; GERSH, Bernard J.; SOARES, Paulo Rogerio; FAVARATO, Desiderio; LIMA, Eduardo Gomes; GARZILLO, Cibele Larrosa; JATENE, Fabio B.; RAMIRES, Jose Antonio Franchini; KALIL FILHO, RobertoIt was a randomized trial, and 308 patients undergoing revascularization were randomly assigned: 155 to off-pump coronary artery bypass (OPCAB) and 153 to on-pump coronary artery bypass (ONCAB). End points were freedom from death, myocardial infarction, revascularization, and cerebrovascular accidents. The rates for 10-year, event-free survival for ONCAB versus OPCAB were 69.6% and 64%, (hazard ratio [HR]: 0.88; 95% confidence interval [CI] 0.86-1.02; P = .41), respectively. Adjusted Cox proportional hazard ratio was similar (HR: 0.92; 95% CI 0.61-1.38, P = .68). A difference occurred between the duration of OPCAB and ONCAB, respectively (4.9 +/- 1.5 vs 6.6 +/- 1.1 h, P < .001). Statistical differences occurred between OPCAB and ONCAB in the length of intensive care unit (ICU) stay (20 +/- 2.5 vs 48 +/- 10 hours, P < .001), time to extubation (5.5 +/- 4.2 vs 10.2 +/- 3.5 hours, P < .001), hospital stay (6.7 +/- 1.4 vs 9.2 +/- 1.3 days, P < .001), higher incidence of atrial fibrillation (AF; 33 vs 5 patients, P < .001), and blood requirements (46 vs 64 patients, P < .001). Grafts per patient was higher in ONCAB (3.15 vs 2.55 grafts, P < .001). No difference existed between the groups in primary composite end points at 10-year follow-up. Although OPCAB surgery was related to a lower number of grafts and higher incidence of AF, it had no effects related to long-term outcomes.
- Association Between Stress Testing-Induced Myocardial Ischemia and Clinical Events in Patients With Multivessel Coronary Artery Disease(2019) GARZILLO, Cibele Larrosa; HUEB, Whady; GERSH, Bernard; REZENDE, Paulo Cury; LIMA, Eduardo Gomes; FAVARATO, Desiderio; RAMIRES, Jose Antonio Franchini; KALIL FILHO, RobertoIMPORTANCE The long-term prognostic implications of myocardial ischemia documented during stress testing in patients with multivessel coronary artery disease (CAD) are unclear. OBJECTIVE To assess whether documented stress testing-induced myocardial ischemia is associated with major adverse cardiovascular events or ventricular function changes in patients with stable multivessel CAD. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study was conducted using data from a single-center randomized clinical trial (Medicine, Angioplasty, or Surgery Study [MASS] II) to examine the association of myocardial ischemia documented during stress testing at baseline with cardiovascular events and ventricular function changes during follow-up. Participants were previously randomized (May 1, 1995, to May 31, 2000) to medical therapy, percutaneous coronary intervention with bare metal stents, or coronary artery bypass grafting. Event-free survival was estimated by the Kaplan-Meier method, and multivariable Cox regression models were calculated to assess the association between ischemia and the primary composite end point. The vital status was determined on February 28, 2011. Data were analyzed from February 1, 2016, to April 1, 2017. MAIN OUTCOMES AND MEASURES Cardiovascular events (overall mortality, myocardial infarction, and revascularization for refractory angina) were tracked from the time of randomization to the end of the 10-year follow-up (mean [SD] duration, 11.4 [4.3] years). Myocardial ischemia was assessed at baseline and at 1-year intervals by exercise stress testing, and ventricular function (left ventricular ejection fraction) was assessed by echocardiography at baseline and after 10 years. Patients with documented ischemia were compared with those without ischemia regarding the outcomes and changes in ventricular function. RESULTS Of 611 participants, 535 underwent exercise stress testing at baseline: 270 with documented ischemia and 265 without. Of these 535 patients, 373 (69.7%) were men, and the mean (SD) age for the entire cohort was 59.7 (9.2) years. No association was found between the presence of ischemia at baseline and survival free of combined cardiovascular events (hazard ratio, 1.00; 95% CI, 0.80-1.27; P = .95) after multivariable adjustment that included CAD initial randomized treatments. In addition, among 320 patients who underwent echocardiographic evaluation, the slight decline in left ventricular ejection fraction after 10 years was similar in both groups (median [SD] difference, -4.9% [18.7%] vs -6.6% [20.0%], respectively, for groups with and without ischemia; P = .97). CONCLUSIONS AND RELEVANCE In this study, regardless of the therapeutic strategy applied, the presence of documented myocardial ischemia did not appear to be associated with an increased occurrence of major adverse cardiovascular events or changes in ventricular function in patients with multivessel CAD during a long-term follow-up.