ROSA MARIA RAHMI GARCIA

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  • article 1 Citação(ões) na Scopus
    Effect of chronic kidney disease in ischemic cardiomyopathy Long-term follow-up-REVISION-DM2 trial
    (2019) HUEB, Thiago Ovanessian; LIMA, Eduardo Gomes; ROCHA, Mauricio S.; SIQUEIRA, Sergio F.; NISHIOKA, Silvana Angelina Dorio; PEIXOTO, Giselle L.; SACCAB, Marcos M.; GARCIA, Rosa Maria Rahmi; RAMIRES, Jose Antonio F.; KALIL FILHO, Roberto; MARTINELLI FILHO, Martino
    A strong association exists between chronic kidney disease (CKD) and coronary artery disease (CAD). The role of CKD in the long-term prognosis of CAD patients with versus those without CKD is unknown. This study investigated whether CKD affects ventricular function. From January 2009 to January 2010, 918 consecutive patients were selected from an outpatient database. Patients had undergone percutaneous, surgical, or clinical treatment and were followed until May 2015. In patients with preserved renal function (n = 405), 73 events (18%) occurred, but 108 events (21.1%) occurred among those with CKD (n = 513) (P < .001). Regarding left ventricular ejection fraction (LVEF) <50%, we found 84 events (21.5%) in CKD patients and 12 (11.8%) in those with preserved renal function (P < .001). The presence of LVEF <50% brought about a modification effect. Death occurred in 22 (5.4%) patients with preserved renal function and in 73 (14.2%) with CKD (P < .001). In subjects with LVEF <50%, 66 deaths (16.9%) occurred in CKD patients and 7 (6.9%) in those with preserved renal function (P = .001). No differences were found in CKD strata regarding events or overall death among those with preserved LVEF. In a multivariate model, creatinine clearance remained an independent predictor of death (P < .001). We found no deleterious effects of CKD in patients with CAD when ventricular function was preserved. However, there was a worse prognosis in patients with CKD and ventricular dysfunction. Resgistry number is ISRCTN17786790 at .
  • conferenceObject
    Role of T1 Mapping and Extracellular Volume in Evaluating the Interstitial Matrix in Diabetic Patients With Stable Coronary Artery Disease
    (2019) BOROS, Gustavo A.; HUEB, Whady; REZENDE, Paulo C.; GARCIA, Rosa M.; ROCHITTE, Carlos E.; NOMURA, Cesar H.; DALLAZEN, Anderson Roberto; MORAIS, Thamara C.; RIBEIRO, Matheus; SERRANO, Carlos V.; RAMIRES, Jose A.; KALIL, Roberto
  • conferenceObject
    T1 mapping and myocardial extracellular volume assessed by cardiac magnetic resonance in diabetic patients with stable coronary artery disease
    (2019) BOROS, G. A. B.; HUEB, W.; REZENDE, P. C.; RIBAS, F. F.; DALLAZEN, A. R.; RIBEIRO, M. O. L.; GARCIA, R. M. R.; GARZILLO, C. L.; LIMA, E. G.; MORAIS, T.; NOMURA, C. H.; ROCHITTE, C. E.; SERRANO JUNIOR, C. V.; RAMIRES, J. A. F.; KALIL FILHO, R.
  • article 0 Citação(ões) na Scopus
    Effect of ischemic preconditioning on cardiovascular outcomes in patients with symptomatic coronary artery disease: a cohort study
    (2019) RAHMI, Rosa M.; HUEB, Whady; REZENDE, Paulo C.; GARZILLO, Cibele L.; UCHIDA, Augusto H.; SCUDELER, Thiago L.; RAMIRES, Jose A. F.; FILHO, Roberto K.
    Background Despite the powerful myocardial protection of ischemic preconditioning (IP) observed in experimental studies, it remains a challenge to observe such protection in humans. Thus, the aim of this study was to evaluate the possible effects of IP on clinical outcomes in patients with coronary artery disease (CAD). Patients and methods In this cohort study, patients with multivessel CAD, preserved systolic ventricular function, and stable angina were prospectively selected. They underwent two sequential exercise stress tests (EST) to evaluate IP presence. IP was considered present if patients had an improvement in the time to the onset of 1.0-mm STsegment deviation in the second EST. The primary end point was the composite rate of cardiac death, nonfatal myocardial infarction, or revascularization during 1-year follow-up. Patients with (IP+) and without (IP-) the cardioprotective mechanism were compared regarding clinical end points. Results A total of 229 patients completed EST and had IP evaluated: 165 (72%) were IP+ and 64 (28%) were IP - patients. Of these, 218 patients had complete follow-up. At 1-year, event-free survival regarding the primary end point was 95.5 versus 83.6% (P = 0.0024) and event-free survival regarding cardiac death or myocardial infarction was 99.4 versus 91.7% (P=0.0020), respectively, in IP + and IP - groups. The unadjusted hazard ratio (IP + /IP-) for the primary end point was 4.63 (1.52-14.08). After multivariate analysis, IP was still significantly associated with better clinical outcomes (P = 0.0025). Conclusion This data suggest that IP may contribute to better clinical outcomes in patients with ischemic heart disease.