RAFAEL CAIRE DE OLIVEIRA DOS SANTOS
Projetos de Pesquisa
Unidades Organizacionais
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- One-year Mortality after an Acute Coronary Event and its Clinical Predictors: The ERICO Study(2015) SANTOS, Itamar Souza; GOULART, Alessandra Carvalho; BRANDAO, Rodrigo Martins; SANTOS, Rafael Caire de Oliveira; BITTENCOURT, Marcio Sommer; SITNIK, Debora; PEREIRA, Alexandre Costa; PASTORE, Carlos Alberto; SAMESIMA, Nelson; LOTUFO, Paulo Andrade; BENSENOR, Isabela MartinsBackground: Information about post-acute coronary syndrome (ACS) survival have been mostly short-term findings or based on specialized, cardiology referral centers. Objectives: To describe one-year case-fatality rates in the Strategy of Registry of Acute Coronary Syndrome (ERICO) cohort, and to study baseline characteristics as predictors. Methods: We analyzed data from 964 ERICO participants enrolled from February 2009 to December 2012. We assessed vital status by telephone contact and official death certificate searches. The cause of death was determined according to the official death certificates. We used log-rank tests to compare the probabilities of survival across subgroups. We built crude and adjusted (for age, sex and ACS subtype) Cox regression models to study if the ACS subtype or baseline characteristics were independent predictors of all-cause or cardiovascular mortality. Results: We identified 110 deaths in the cohort (case-fatality rate, 12.0%). Age [Hazard ratio (HR) = 2.04 per 10 year increase; 95% confidence interval (95% CI) = 1.75-2.38], non-ST elevation myocardial infarction (HR = 3.82; 95% CI = 2.21-6.60) or ST elevation myocardial infarction (HR = 2.59; 95% CI = 1.38-4.89) diagnoses, and diabetes (HR = 1.78; 95% CI = 1.20-2.63) were significant risk factors for all-cause mortality in the adjusted models. We found similar results for cardiovascular mortality. A previous coronary artery disease diagnosis was also an independent predictor of all-cause mortality (HR = 1.61; 95% CI = 1.04-2.50), but not for cardiovascular mortality. Conclusions: We found an overall one-year mortality rate of 12.0% in a sample of post-ACS patients in a community, non-specialized hospital in Sao Paulo, Brazil. Age, ACS subtype, and diabetes were independent predictors of poor one-year survival for overall and cardiovascular-related causes.
- Frequency and Reasons for Non-Administration and Suspension of Drugs During an Acute Coronary Syndrome Event. The ERICO Study(2020) SANTOS, Rafael C. O.; BENSENOR, Isabela M.; GOULART, Alessandra C.; LOTUFO, Paulo A.; SANTOS, Itamar S.Background: Few studies have discussed the reasons for pharmacological undertreatment of Acute Coronary Syndrome (ACS). Objectives: To determine the frequency and reasons for the non-administration and suspension of medications during in-hospital treatments of ACS in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Methods: The present study analyzed the medical charts of the 563 participants in the ERICO study to evaluate the frequency and reasons for the non-administration and/or suspension of medications. Logistic regression models were built to analyze if sex, age >= 65 years of age, educational level, or ACS subtype were associated with (a) the nonadministration of >= 1 medications; and (b) the non-administration or suspension of >= 1 medications. The significance level was set at 5%. Results: This study's sample included 58.1% males, with a median of 62 years of age. In 183 (32.5%) participants, >= 1 medications were not administered, while in 288 (51.2%), medications were not administered or were suspended. The most common reasons were the risk of bleeding (aspirin, clopidogrel, and heparin), heart failure (beta blockers), and hypotension (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers). Individuals aged >= 65 (odds ratio [OR]:1.51; 95% confidence interval [95% CI]:1.05-2.19) and those with unstable angina (OR:1.72; 95% CI:1.07-2.75) showed a higher probability for the non-administration of >= 1 medication. Considering only patients with myocardial infarction, being >= 65 years of age was associated with both the non-administration and the non- administration or suspension of >= 1 medication. Conclusions: Non-administration or suspension of >= 1 medication proved to be common in this ERICO study. Individuals of >= 65 years of age or with unstable angina showed a higher probability of the non-administration of >= 1 medication and may be undertreated in this scenario.
- Time-To-Treatment of Acute Coronary Syndrome and Unit of First Contact in the ERICO Study(2016) SANTOS, Rafael Caire de Oliveira dos; GOULART, Alessandra Carvalho; KISUKURI, Alan Loureiro Xavier; BRANDAO, Rodrigo Martins; SITNIK, Debora; STANIAK, Henrique Lane; BITTENCOURT, Marcio Sommer; LOTUFO, Paulo Andrade; BENSENOR, Isabela Martins; SANTOS, Itamar de SouzaBackground: To the best of our knowledge, there are no studies evaluating the influence of the unit of the first contact on the frequency and time of pharmacological treatment during an acute coronary syndrome (ACS) event. Objectives: The main objective was to investigate if the unit of first contact influenced the frequency and time of aspirin treatment in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Methods: We analyzed the pharmacological treatment time in 830 ERICO participants - 700 individuals for whom the hospital was the unit of first contact and 130 who initially sought primary care units. We built logistic regression models to study whether the unit of first contact was associated with a treatment time of less than three hours. Results: Individuals who went to primary care units received the first aspirin dose in those units in 75.6% of the cases. The remaining 24.4% received aspirin at the hospital. Despite this finding, individuals from primary care still had aspirin administered within three hours more frequently than those who went to the hospital (76.8% vs 52.6%; p<0.001 and 100% vs. 70.7%; p=0.001 for non ST-elevation ACS and ST-elevation myocardial infarction, respectively). In adjusted models, individuals coming from primary care were more likely to receive aspirin more quickly (odds ratio: 3.66; 95% confidence interval: 2.06-6.51). Conclusions: In our setting, individuals from primary care were more likely to receive aspirin earlier. Enhancing the ability of primary care units to provide early treatment and safe transportation may be beneficial in similar settings.