CARLOS ALEXANDRE WAINROBER SEGRE
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
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conferenceObject Cardiovascular secondary prevention setting and lipid controlu, update data from PINNACLE BRAZIL REGISTRY(2019) SARAIVA, J. F. K.; MATTOS, A. Cordeiro; SARAIVA, G. B. F.; PINTO, I. M.; ROMBALDI, A. R.; KATO, N. H.; SILVA, L. F. Gomes Da; MINELLI, C.; CARVALHO, I. T. N.; DANTAS, J. M. M.; SOUZA FILHO, J. M. De; FIGUINHA, F. C. R.; SEGRE, C. A. W.; FONSECA, H. A. R.; AVEZUM, A.conferenceObject Prognosis in 10 years of follow-up of three therapeutic strategies for chronic multivessel coronary artery disease in women (study MASS)(2013) MANSUR, A. P.; HUEB, W. A.; TAKADA, J. Y.; AVAKIAN, S. D.; REZENDE, P. C.; SEGRE, A.; SOARES, P. R.; GARZILLO, C.; RAMIRES, J. A. F.; KALIL FILHO, R.conferenceObject Five year follow-up of on-pump versus off pump coronary artery bypass surgery in elderly patients - the MASS III trial(2012) MELO, R. M. Vieira De; REZENDE, P. C.; GARZILLO, C. L.; LIMA, E. G.; SEGRE, C. A. W.; COSTA, L. M. A.; OIKAWA, F. T.; HUEB, W.; RAMIRES, J. A. F.; KALIL FILHO, R.Purpose: Advanced age is associated with increased mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG), which may be a consequence of cardiopulmonary bypass. Thus, off-pump surgery may have an increased benefit in elderly patients. We aim to evaluate cardiac events and long-term clinical outcomes in elderly patients with stable coronary artery disease and preserved left ventricular ejection fraction undergoing off-pump and on-pump CABG. Methods: The MASS III was a single-center randomized trial that evaluate 308 patients with stable coronary artery disease and preserved ventricular function assigned for off-pump (n=155) or on-pump (n=153) CABG. Of this, 176 (58,3%) patients had 60 years or older at the time of randomization (of-pump=90 and on-pump=86). Primary composite end points were death, myocardial infarction, further revascularization (surgery or angioplasty), or stroke. Results: The two randomized groups were well-matched for baseline demographic, clinical, and angiographic characteristics. The mean age was 67,2 ( ± 5,0) years. After 5-year follow-up, there were no significant differences between on- pump and off-pump groups in the composite end points: 27,9% vs 21,1% (hazard ratio 1.17, 95% CI 0.87 to 1.59; P=0.29) Figure 1. Six patients (7.0%) died in the on-pump group compared with 10 (11.1%) in the of-pump group (hazard ratio 0.78, 95% CI 0.47 to 1.29; p=0.33). On-pump patients had a higher incidence of postoperative stroke or myocardial infarction: 13 (15.1%) vs 5 (5,6%); p=0,036. Conclusions: Patients undergoing off-pump surgery had a lower incidence of in hospital stroke or myocardial infarction. This finding did not add benefit in clinical outcomes at 5-years follow-up.conferenceObject Expression of ischemic preconditioning in patients with chronic coronary artery disease with and without diabetes mellitus(2013) REZENDE, P. C.; GARCIA, R. M. R.; UCHIDA, A. H.; SEGURO, L. F. B. C.; LIMA, E. G.; GARZILLO, C. L.; SEGRE, C. A. W.; HUEB, W.; RAMIRES, J. A. F.; KALIL FILHO, R.conferenceObject Impact of chronic kidney dysfunction among patients with stable coronary artery disease: ten-year follow-up of mass II trial(2017) LIMA, E. G.; HUEB, W.; GARZILLO, C. L.; FAVARATO, D.; SEGRE, C. A. W.; AZEVEDO, D. F. C.; HUEB, A. C.; REZENDE, P. C.; SILVA, E. E. R.; GARCIA, R. M. R.; SCUDELER, T. L.; RAMIRES, J. A. F.; KALIL FILHO, R.conferenceObject Anti-inflammatory properties of HDL after short-term exercise training in patients with metabolic syndrome(2012) CASELLA-FILHO, A.; TROMBETTA, I. C.; CASELLA, L. B.; DOURADO, P. M. M.; SEGRE, A.; FAVARATO, D.; ROEVER-BORGES, L.; NEGRAO, C. E.; MARANHAO, R. C.; CHAGAS, A. C. P.Background: Recent study showed that short-term exercise, associated with diet and weight loss, improves the anti-inflammatory properties of HDL in metabolic syndrome (MS). However, diet and weight loss, per se, can alter the functionality of HDL and, in real life, many patients do not follow the medical counseling of diet and exercise simultaneously. We showed previously that the antioxidative characteristics and the capacity to accept lipids of HDL are early improved by short-term exercise training (Tr) with no diet associated. We sought to verify whether the anti-inflammatory properties of HDL are affected by Tr, without any diet associated, in patients with MS. Methods: Forty sedentary persons (30 with MetS,10 controls) were evaluated. Twenty of those with MS were subjected to a 3 times/week training load (45 min/day) for 3 months on a bicycle. Plasma high-sensitivity C-reactive protein (hs-CRP) was analyzed and HDL sub-fractions were obtained by plasma ultracentrifugation. Endothelial cells were cultured, stimulated with TNF-α and lipopolysacharide, and coincubated with HDL subfractions obtained before and after Tr. Sequentially, those cultures of endothelial cells were coincubated with THP-1 cells labeled with a fluorescent marker. The labeled THP-1 cells that adhered on endothelial cells were counted under fluoroscopic microscope. Results: Baseline plasma levels of HDL-C were lower in the MS group compared to controls and Tr did not change neither HDL-C nor weight in MS group. Hs-CRP plasma levels from patients with MetS were higher than controls (3.0±1.5 vs 1.5±1.5 mg/L respectively, p<0.05) and did not change after Tr(3.0±1.5 vs 2.8±1.8 mg/L, before and after Tr respectively, p>0.05). The number of adhered labeled THP-1 cells coincubated with endothelial cells did not change significantly when mixed with HDL2a or HDL3b from patients with MS after Tr, compared with HDL2a or HDL3b obtained before Tr. Conclusion: Our results showed that Tr did not change an inflammatory serum marker (hs-CRP) and the adherence of THP-1 cells on endothelium cells, suggesting that the anti-inflammatory properties of HDL are not early improved by short-term exercise, when there is no diet associated.conferenceObject Impact of SYNTAX score on release of cardiac biomarkers in post-revascularization procedures among patients with stable multivessel disease: MASS-V insights(2017) AZEVEDO, D. F. C.; HUEB, W.; LIMA, E. G.; REZENDE, P. C.; GARZILLO, C. L.; STRUNZ, C. M. C.; NOMURA, C. H.; SEGRE, C. A. W.; FAVARATO, D.; SCUDELER, T. L.; HUEB, A. C.; SILVA, E. E. R.; GARCIA, R. M. R.; RAMIRES, J. A. F.; KALIL FILHO, R.