FABIANA GOULART MARCONDES BRAGA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Anatomopathological Consequences of the Change in the Clinical-Demographic Profile of Chagasic Patients Who Are Candidates for Heart Transplantation in Recent Years(2022) ARAGAO, C. A.; CAMPOS, I. W.; DUARTE, N.; FURQUIM, S.; GALBIATI, L. C.; PEREZ, M.; PIERI, R.; GRINBERG, M. S. Avila; SEGURO, L. F.; MARCONDES-BRAGA, F. G.; MANGINI, S.; STRABELLI, T. M.; GAIOTTO, F. A.; BACAL, F.- Survival of Heart Transplant Patients with Chagas' Disease Under Different Antiproliferative Immunosuppressive Regimens(2023) FURQUIM, Silas Ramos; GALBIATI, Luana Campoli; AVILA, Monica S.; MARCONDES-BRAGA, Fabiana G.; FUKUSHIMA, Julia; MANGINI, Sandrigo; SEGURO, Luis Fernando Bernal da Costa; CAMPOS, Iascara Wozniak de; STRABELLI, Tania Mara Varejao; BARONE, Fernanda; PAULO, Audrey Rose da Silveira Amancio de; OHE, Luciana Akutsu; GALANTE, Mariana Cappelletti; GAIOTTO, Fabio Antonio; BACAL, FernandoBackground: Chagas' disease (CD) is an important cause of heart transplantation (HT). The main obstacle is Chagas' disease reactivation (CDR), usually associated to high doses of immunosuppressants. Previous studies have suggested an association of mycophenolate mofetil with increased CDR. However, mortality predictors are unknown.Objectives: To identify mortality risk factors in heart transplant patients with CD and the impact of antiproliferative regimen on survival.Methods: Retrospective study with CD patients who underwent HT between January 2004 and September 2020, under immunosuppression protocol that prioritized azathioprine and change to mycophenolate mofetil in case of rejection. We performed univariate regression to identify mortality predictors; and compared survival, rejection and evidence of CDR between who received azathioprine, mycophenolate mofetil and those who changed from azathioprine to mycophenolate mofetil after discharge (""Change"" group). A p-value < 0.05 was considered statistically significant. Results: Eighty-five patients were included, 54.1% men, median age 49 (39-57) years, and 91.8% were given priority in waiting list. Nineteen (22.4%) used azathioprine, 37 (43.5%) mycophenolate mofetil and 29 (34.1%) switched therapy; survival was not different between groups, 2.9 (1.6-5.0) x 2.9 (1.8-4.8) x 4.2 (2.0-5.0) years, respectively; p=0.4. There was no difference in rejection (42%, 73% and 59% respectively; p=0.08) or in CDR (T. cruzi positive by endomyocardial biopsy 5% x 11% x 7%; p=0.7; benznidazole use 58% x 65% x 69%; p=0.8; positive PCR for T. cruzi 20% x 68% x 42% respectively; p=0.1) rates.Conclusions: This retrospective study did not show difference in survival in heart transplant patients with CD receiving different antiproliferative regimens. Mycophenolate mofetil was not associated with statistically higher rates of CDR or graft rejection in this cohort. New randomized clinical trials are necessary to address this issue.
conferenceObject Comparative Survival Analysis Between Azathioprine and Mykophenolate in Chagasic Patients Undergoing Heart Transplantation(2022) FURQUIM, S.; ARAGAO, C. A.; GALBIATI, L. C.; CAMPOS, I. W.; SEGURO, L. F.; MARCONDES-BRAGA, F. G.; GAIOTTO, F. A.; MANGINI, S.; STRABELLI, T. M.; GRINBERG, M. S. Avila; BACAL, F.- 3rd Brazilian Directive on Cardiac Transplantation(2018) BACAL, Lemando; MARCONDES-BRAGA, Fabiana C.; ROHDE, Luis Eduardo Paim; XAVIER JUNIOR, Jose Leudo; BRITO, Flavio de Souza; MOURA, Lidia Ana Zytynski; COLAFRANCESCHI, Alexandre Siciliano; LAVAGNOLI, Carlos Fernando Ramos; GELAPE, Claudio Leo; ALMEIDA, Dirceu Rodrigues; GAIOTTO, Fabio Antonio; ATIK, Fernando Antibas; FIGUEIRA, Fernando Augusto M. S.; SOUZA, Germano Emilio Conceicao; RODRIGUES, Helcio; CAMPOS, Iascara Wozniak; SOUZA NETO, Joao David de; ROSSI NETO, Joao Manoel; GASPARETTO, Juliano; GOLDRAICH, Livia Adams; BENVENUTI, Luiz Alberto; SEGURO, Luis Fernando B. C.; ULHOA JUNIOR, Marcelo Boteiho; V, Maria da Consolacao Moreira; AVILA, Monica Samuel; CARNEIRO, Rodrigo; MANGINI, Sandrigo; FERREIRA, Silvia Moreira Ayub; STRABELLI, Tania Mara
conferenceObject Survival analysis of basiliximab as induction therapy in heart transplantation(2014) BISELLI, BBruno; FRANCO, G. P.; MARCONDES-BRAGA, F. G.; MANGINI, S.; AVILA, M. S.; LIMA, C. G.; SEGURO, L. F. B.; STRABELLI, T. M. V.; GAIOTTO, F. A.; BACAL, F.conferenceObject Characteristics and Outcomes of Heart Transplant Recipients with Coronavirus-19 Disease(2021) MARCONDES-BRAGA, F. G.; MURAD, C. M.; BELFORT, D. D.; DANTAS, R. C.; LIRA, M. S.; ARAGAO, C.; SICILIANO, R. F.; MANGINI, S.; SEGURO, L.; CAMPOS, I. W. de; AVILA, M. S.; BELLO, M. V.; BARONE, F.; STRABELLI, T. M.; GAIOTTO, F. A.; BACAL, F.- Biomarkers for prediction of mortality in left-sided infective endocarditis(2020) SICILIANO, Rinaldo F.; GUALANDRO, Danielle M.; BITTENCOURT, Marcio Sommer; PAIXAO, Milena; MARCONDES-BRAGA, Fabiana; SOEIRO, Alexandre de Matos; STRUNZ, Celia; PACANARO, Ana Paula; PUELACHER, Christian; TARASOUTCHI, Flavio; SOMMA, Salvatore Di; CARAMELLI, Bruno; OLIVEIRA JUNIOR, Mucio Tavares de; MANSUR, Alfredo Jose; MUELLER, Christian; BARRETTO, Antonio Carlos Pereira; STRABELLI, Tania Mara VarejaoBackground: Evidence regarding biomarkers for risk prediction in patients with infective endocarditis (IE) is limited. We aimed to investigate the value of a panel of biomarkers for the prediction of in-hospital mortality in patients with IE. Methods: Between 2016 and 2018, consecutive IE patients admitted to the emergency department were prospectively included. Blood concentrations of nine biomarkers were measured at admission (D0) and on the seventh day (D7) of antibiotic therapy: C-reactive protein (CRP), sensitive troponin I (s-cTnI), procalcitonin, B-type natriuretic peptide (BNP), neutrophil gelatinase-associated lipocalin (NGAL), interleukin 6 (IL6), tumor necrosis fator a (TNF-a), proadrenomedullin, alpha-1-acid glycoprotein, and galectin 3. The primary endpoint was in-hospital mortality. Results: Among 97 patients, 56% underwent cardiac surgery, and in-hospital mortality was 27%. At admission, six biomarkers were independent predictors of in-hospital mortality: s-cTnI (OR 3.4; 95%CI 1.8-6.4; P < 0.001), BNP (OR 2.7; 95%CI 1.4-5.1; P = 0.002), IL-6 (OR 2.06; 95%CI 1.3-3.7; P = 0.019), procalcitonin (OR 1.9; 95%CI 1.1-3.2; P = 0.018), TNF-alpha (OR 1.8; 95%CI 1.1-2.9; P = 0.019), and CRP (OR 1.8; 95%CI 1.0-3.3; P = 0.037). At admission, S-cTnI provided the highest accuracy for predicting mortality (area under the ROC curve: s-cTnI 0.812, BNP 0.727, IL-6 0.734, procalcitonin 0.684, TNF-alpha 0.675, CRP 0.670). After 7 days of antibiotic therapy, BNP and inflammatory biomarkers improved their performance (s-cTnI 0.814, BNP 0.823, IL-6 0.695, procalcitonin 0.802, TNF-alpha 0.554, CRP 0.759). Conclusion: S-cTnI concentration measured at admission had the highest accuracy for mortality prediction in patients with IE. (C) 2020 The Authors.
conferenceObject Chagas' Disease Reactivation after Heart Transplant: Update on New Immunosuppression Era(2018) CAMPOS, I. W.; SEGURO, L. F.; ANDRADE, C. R.; MARCONDES-BRAGA, F. G.; SOARES, L. P.; AVILA, M. S.; MANGINI, S.; GALANTE, M. C.; GAIOTTO, F. A.; STRABELLI, T.; BACAL, F.conferenceObject Infection profile in cardiac transplant recipients after using basiliximab(2014) FRANCO, G. P.; MARCONDES-BRAGA, F. G.; BISELLI, BBruno; MANGINI, S.; STRABELLI, T. M. V.; AVILA, M. S.; SEGURO, L. F. B.; LIMA, C. G.; BACAL, F.article 3rd Brazilian Directive on Cardiac Transplantation (vol 111, pg 230, 2018)(2019) BACAL, Fernando; MARCONDES-BRAGA, Fabiana G.; ROHDE, Luis Eduardo Paim; JUNIOR, Jose Leudo Xavier; BRITO, Flavio de Souza; MOURA, Lidia Ana Zytynski; COLAFRANCESCHI, Alexandre Siciliano; LAVAGNOLI, Carlos Fernando Ramos; GELAPE, Claudio Leo; ALMEIDA, Dirceu Rodrigues; GAIOTTO, Fabio Antonio; ATIK, Fernando Antibas; FIGUEIRA, Fernando Augusto M. S.; SOUZA, Germano Emilio Conceicao; RODRIGUES, Helcio; CAMPOS, Iacara Wozniak; NETO, Joao David de Souza; NETO, Joao Manoel Rossi; GASPARETTO, Juliano; GOLDRAICH, Livia Adams; BENVENUTI, Luiz Alberto; SEGURO, Luis Fernando B. C.; JUNIOR, Marcelo Botelho Ulhoa; MOREIRA, Maria da Consolacao V.; AVILA, Monica Samuel; CARNEIRO, Rodrigo; MANGINI, Sandrigo; FERREIRA, Silvia Moreira Ayub; STRABELLI, Tania Mara