ANTONIO CASELLA FILHO
Projetos de Pesquisa
Unidades Organizacionais
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
conferenceObject LIPID TRANSFER TO HDL IN PATIENTS WITH CORONARY ARTERY DISEASE(2014) SPRANDEL, Mar lia O.; HUEB, Whady; CASELLA-FILHO, Antonio; SCUDELER, Thiago; REZENDE, Paulo; LIMA, Eduardo; SEGRE, Alexandre; CARVALHO, Ana; MARANHAO, Raul; KALIL-FILHO, RobertoconferenceObject 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, RobertoBackground 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: 1208-409conferenceObject Lipid Transfer to HDL in Patients With Coronary Artery Disease(2013) SPRANDEL, Marilia C.; HUEB, Whady; CASELLA-FILHO, Antonio; SEGRE, Carlos A.; CARVALHO, Ana Luiza O.; REZENDE, Paulo C.; CESAR, Luiz A.; RAMIRES, Jose A.; KALIL FILHO, Roberto; MARANHAO, Raul C.conferenceObject LIPID TRANSFER TO HIGH DENSITY LIPOPROTEINS IN TYPE 2 DIABETIC PATIENTS WITH AND WITHOUT CORONARY ARTERY DISEASE(2012) SPRANDEL, Marilia C. O.; HUEB, Whady; CASELLA-FILHO, Antonio; SEGRE, Alexandre; REZENDE, Paulo Cury; CARVALHO, Ana L. O.; FAVARATO, Desiderio; MARANHAO, Raul C.; RAMIRES, Jose; KALIL-FILHO, RobertoBackground In type 2 diabetes mellitus (DM2), HDL-cholesterol is diminished and it is important to understand the functional and metabolic changes existing in HDL in DM2 patients that may predispose to coronary artery disease (CAD). Lipid transfers between HDL and the other lipoproteins, mediated by cholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP), are crucial steps in HDL formation and role in reverse cholesterol transfer. Objective Investigate whether development of CAD in DM2 patients are associated with alterations in lipid transfers to HDL and in content of free cholesterol in the plasma. Methods 78 patients with DM2 and CAD (DM2-CAD) and 78 with DM2 without CAD, as diagnosed by cineangiography, were studied. They were of both genders, aged 40-80 yrs. Plasma was incubated for 1h at 37oC with a donor nanoemulsion labeled with 3H -cholesteryl-esters and14C -phospholipids or with 14C-free-cholesterol and 3H -triglycerides. Radioactive lipids transferred from the donor nanoemulsion to HDL were measured in the supernatant after chemical precipitation of non-HDL fractions and the nanoemulsion. Results are % of the total radioactivity of each lipid in HDL. Results In DM2-CAD, LDL-cholesterol and triglycerides were higher than in DM2; HDL-cholesterol was lower. Compared to DM2, DM2-CAD showed diminished transfer to HDL of free-cholesterol (DM2-CAD=4.23±0.24; DM2= 5.66±0.14, p<0.0001) and of triglycerides (1.65±0.13 vs 3.08±0.11, p<0.0001), whereas cholesteryl-ester transfer was increased (3.67±0.16 vs 2.25±0.13, p<0.0001); phospholipid transfer was equal (15.37±0.60 vs15.18±0.20, p=0.76). CETP concentration was equal, while plasma free-cholesterol was higher in DM2-CAD (DM2-CAD=36.9±0.9; DM2=33.1±0.7, p=0.003).HDL particle diameter was equal in both groups. Conclusion The reduction of free-cholesterol transfer to HDL may hinder cholesterol esterification and reverse cholesterol transport. Alterations in triglyceride and cholesteryl-ester transfer may affect lipoprotein stability. Those disturbances in HDL metabolism may facilitate CAD development in DM2. ACC Oral Contributions McCormick Place South, S100c Sunday, March 25, 2012, 9:04 a.m.-9:17 a.m. Session Title: Prevention: Focus on Lipids Abstract Category: 9. Prevention: Clinical Presentation Number: 911-8conferenceObject 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, RobertoBackground 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: 1209-477conferenceObject Lipid Transfer to Hdl in Type 2 Diabetic Patients With and Without Coronary Artery Disease(2013) SPRANDEL, Marilia C.; HUEB, Whady; CASELLA-FILHO, Antonio; SEGRE, Carlos A.; CARVALHO, Ana Luiza O.; REZENDE, Paulo C.; CESAR, Luiz A.; RAMIRES, Jose A.; KALIL FILHO, Roberto; MARANHAO, Raul C.conferenceObject THE TRIGLYCERIDE/HDL RATIO REMAINS AS AN INDEPENDENT PLASMA LIPID MARKER OF MAJOR CARDIOVASCULAR EVENTS IN DIABETIC PATIENTS 10-YEAR FOLLOW-UP FROM THE MEDICINE ANGIOPLASTY OR SURGERY STUDY II (MASS II) TRIAL(2012) CASELLA-FILHO, Antonio; HUEB, Whady; JONKE, Vivian; SANTOS, Raul; FAVARATO, Desiderio; LIMA, Eduardo; SEGRE, Alexandre; REZENDE, Paulo Cury; GARZILLO, Cibele Larrosa; CHACRA, Ana P. M.; RAMIRES, Jose; KALIL-FILHO, RobertoBackground: The second Medical, Angioplasty, or Surgery Study (MASS II) compared the long-term effects of medical treatment (MT), angioplasty (PCI), or surgical strategies (CABG) among patients with stable angina symptoms of multivessel coronary artery disease (CAD) and preserved ventricular function who were appropriate candidates for all 3 therapies. Plasma lipids are important risk factors for cardiovascular events in CAD patients, especially in diabetics. We showed previously that the TG/HDL ratio was the only parameter independently associated with major cardiovascular events (MACE; overall death, myocardial infarction, and unstable angina that required myocardial revascularization) in patients after the 10-year follow up of stable CAD patients in the MASS II. In this analysis we evaluated the association of plasma lipids with MACE in diabetic patients after a 10-year follow-up of the MASS II. Methods: The data of 200 patients of the MASS II, 100 diabetics and 100 non diabetics, were analyzed for risk factors and plasma lipids levels. The levels of fasting plasma lipids were determined at baseline and 6 months after randomization. It was instituted in all study patient groups the same lipid therapy. Concentrations of total cholesterol, HDL, non-HDL and LDL-cholesterol as well as LDL/HDL, and TG/HDL ratios were divided according to distribution quartiles. The association of plasma lipids at baseline and at 6 months with MACE was determined by Cox regression models. Results: The patients were followed up for an average of 11.4 years. In the subgroup of diabetic patients, after adjustment for confounders, older age (> 65 years old), randomized treatment for CAD (CABG vs. MT) and the TG/HDL ratio determined at 6 months were independently associated with MACE. There was no association between MACE and other plasma lipids. Conclusions: The TG/HDL remains as a lipid parameter independently associated with MACE in diabetic patients after the 10-year follow up of stable CAD patients in the MASS II.conferenceObject HIGH SENSITIVITY CARDIAC TROPONIN I AS A DIAGNOSTIC TOOL FOR THE PRESENCE OF CORONARY ARTERY DISEASE IN STABLE DIABETIC PATIENTS(2014) SEGRE, Alexandre; HUEB, Whady; SPRANDEL, Marilia O.; CASELLA-FILHO, Antonio; FAVARATO, Desiderio; STRUNZ, Celia; VENTURA, Laura; CARVALHO, Ana; MARANHAO, Raul C.; RAMIRES, Jose; KALIL-FILHO, Roberto