EDUARDO GOMES LIMA
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
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- The ORBITA trial: A point of view(2018) OLIVEIRA, Vitor Dornela de; GIUGNI, Fernando Rabioglio; MARTINS, Eduardo Bello; AZEVEDO, Diogo Freitas Cardoso de; LIMA, Eduardo Gomes; SERRANO JUNIOR, Carlos VicenteTreatment of stable coronary artery disease (CAD) relies on improved prognosis and relief of symptoms. National and international guidelines on CAD support the indication for revascularization in patients with limiting symptoms and refractory to drug treatment. Previous studies attested the efficacy of angioplasty to improve angina as well as the functional capacity of patients with symptomatic stable CAD. The ORBITA trial, recently published in an international journal, showed no benefit in terms of exercise tolerance compared to a placebo procedure in a population of single-vessel patients undergoing contemporary percutaneous coronary intervention. In this point of view article, the authors discuss the ORBITA trial regarding methodological issues, limitations and clinical applicability.
- Occurrence of recently diagnosed atrial fibrillation in the immediate postoperative period of myocardial revascularization surgery. Although common, a devalued complication(2020) PEREIRA, Marcel de Paula; LIMA, Eduardo Gomes; GARZILLO, Cibele Larrosa; BARBOSA, Camila Talita Machado; SAMPAIO, Leon Pablo Cartaxo; DARRIEUX, Francisco Carlos da Costa; SERRANO JR., Carlos VicenteAtrial fibrillation (AF) is the most common arrhythmia in the postoperative period of cardiac surgery, with a prevalence between 15-40% after coronary artery bypass surgery (CABG). Several strategies have been tested for the prevention and management of AF postoperatively. Previous studies and analysis of records have shown higher rates of hospitalization and clinical outcomes associated with this entity, including increased mortality in the short- and long-term. This perspective reviews the topic, and offers recommendations for the management of this arrhythmia in the postoperative period of CABG, with a special focus on anticoagulation strategies.
- Coronavirus disease-2019 and heart: assessment of troponin and cardiovascular comorbidities as prognostic markers in patients hospitalized with coronavirus disease-2019 in a tertiary center in Brazil(2023) PINESI, Henrique Trombini; GIUGNI, Fernando Rabioglio; MATUCK, Bruna Romanelli Scarpa; PITTA, Fabio Grusnpun; GARZILLO, Cibele Larrosa; LIMA, Eduardo Gomes; KALIL FILHO, Roberto; SERRANO JUNIOR, Carlos VicenteOBJECTIVE: Our study aimed to evaluate the correlation of cardiac troponin T levels with comorbidities and in-hospital outcomes in patients with coronavirus disease-2019 in Brazil.METHODS: Data from a cohort of 3,596 patients who were admitted with suspected coronavirus disease-2019 in a Brazilian tertiary center, between March and August 2020, were reviewed. A total of 2,441 (68%) patients had cardiac troponin T determined in the first 72 h of admission and were stratified into two groups: elevated cardiac troponin T (cardiac troponin T >0.014 ng/mL) and normal cardiac troponin T. Associations between troponin, comorbidities, biomarkers, and outcomes were assessed. Regression models were built to assess the association of several variables with in-hospital mortality.RESULTS: A total of 2,441 patients were embraced, of which 924 (38%) had normal cardiac troponin T and 1,517 (62%) had elevated cardiac troponin T. Patients with elevated cardiac troponin T were older and had more comorbidities, such as cardiovascular disease, hypertension, diabetes, arrhythmia, renal dysfunction, liver disease, stroke, cancer, and dementia. Patients with abnormal cardiac troponin T also had more altered laboratory parameters on admission (i.e., leukocytes, C-reactive protein, D-dimer, and B-type natriuretic peptide), as well as more need for intensive care unit, vasoactive drugs, mechanical ventilation, dialysis, and blood transfusion. All-cause mortality was markedly higher among patients with increased cardiac troponin T (42 vs. 16%, P<0.001). Multiple regression analysis demonstrated that in-hospital mortality was not independently associated with troponin elevation.CONCLUSION: This study showed that cardiac troponin T elevation at admission was common and associated with several comorbidities, biomarkers, and clinical outcomes in patients hospitalized with coronavirus disease-2019, but it was not an independent marker of in-hospital mortality.
- Viral infections and atherothrombosis: Another caution in the wake of COVID-19?(2020) PEREIRA, Marcel de Paula; LIMA, Eduardo Gomes; SERRANO JUNIOR, Carlos Vicente
- Dual platelet antiaggregation therapy after myocardial revascularization surgery(2019) FEITOSA, Mateus Paiva Marques; SOFFIATTI, Carla David; LINHARES FILHO, Jaime Paula Pessoa; BATISTA, Daniel Valente; LOBO FILHO, Heraldo Guedis; LIMA, Eduardo Gomes; SERRANO JUNIOR, Carlos VicenteCoronary artery bypass graft (CABG) is a consolidated treatment in patients with coronary artery disease (CAD) for both symptom control and improvement of prognosis. The patency of venous grafts is still the most vulnerable point of the surgical treatment since it presents a high prevalence of occlusion both in the immediate postoperative period and in the long-term follow-up. Aspirin plays a well-established role in this setting, and for a long time, clopidogrel use has been restricted to patients allergic to aspirin. Recently, subgroup analyses of studies with different anti-platelet therapies have shown reduced mortality and cardiovascular events in patients on dual anti-platelet antiplatelet therapy (DAPT) undergoing CABG, although such studies have not been designed to evaluate this patient profile. However, there is still an insufficient number of randomized studies using DAPT in this context, resulting in a disagreement between the European and American cardiology societies guidelines regarding their indication and generating doubts in clinical practice.
- Critical analysis of the classic indications for myocardial revascularization(2019) AZEVEDO, Diogo Freitas Cardoso de; LIMA, Eduardo Gomes; RIBEIRO, Matheus de Oliveira Laterza; LINHARES FILHO, Ijaime Paula Pessoa; SERRANO JUNIOR, Carlos VicenteTreatment of stable coronary artery disease (CAD) relies on improved prognosis and relief of symptoms. National and international guidelines on CAD support the indication of revascularization in patients with limiting symptoms and refractory to optimal medical treatment, as well as in clinical situations where there is a prognostic benefit of interventional treatment. Most of the studies that support the guidelines for indication of revascularization date back to the 1980s and 1990s of the last century. Recent studies have revisited the theme and brought a new breath. The present review provides a critical analysis of classic indications for revascularization, reviewing evidence from the studies of the 1970s to the recent controversial ORBITA study.
- CULPRIT-SHOCK study(2018) SOUZA JUNIOR, Jorge Mangabeira de; KULCHETSCKI, Rodrigo Melo; LINHARES FILHO, Jaime Paula Pessoa; LIMA, Eduardo Gomes; SERRANO JUNIOR, Carlos VicenteThe treatment of patients with ST-segment elevation myocardial infarction concomitant with the presence of multivessel disease has been studied in several recent studies with the purpose of defining the need, as well as the best moment to approach residual lesions. However, such studies included only stable patients. The best therapeutic approach to cardiogenic shock secondary to acute coronary syndrome, however, remains controversial, but there are recommendations from specialists for revascularization that include nonevent related injuries. Recently published, the CULPRIT-SHOCK study showed benefit of the initial approach only of the injury blamed for the acute event, in view of the multivessel percutaneous intervention, in the context of cardiogenic shock. In this perspective, the authors discuss the work in question, regarding methodological questions, limitations and clinical applicability.
- Ischemic left ventricle systolic dysfunction: An evidence-based approach in diagnostic tools and therapeutics(2017) LIMA, Eduardo Gomes; CARVALHO, Felipe Pereira Camara de; LINHARES FILHO, Jaime Paula Pessoa; PITTA, Fabio Grunspun; SERRANO JR., Carlos VicenteCoronary artery disease (CAD) associated with left ventricular systolic dysfunction is a condition related to poor prognosis. There is a lack of robust evidence in many aspects related to this condition, from definition to treatment. Ischemic cardiomyopathy is a spectrum ranging from stunned myocardium associated with myocardial fibrosis to hibernating myocardium and repetitive episodes of ischemia. In clinical practice, relevance lies in identifying the myocardium that has the ability to recover its contractile reserve after revascularization. Methods to evaluate cellular integrity tend to have higher sensitivity, while the ones assessing contractile reserve have greater specificity, since a larger mass of viable myocytes is required in order to generate contractility change. Since there are many methods and different ways to detect viability, sensitivity and specificity vary widely. Dobutamine-cardiac magnetic resonance with late gadolinium enhancement has the best accuracy is this setting, giving important predictors of prognostic and revascularization benefit such as scar burden, contractile reserve and end-systolic volume index. The latter has shown differential benefit with revascularization in some recent trials. Finally, authors discuss interventional procedures in this population, focusing on coronary artery bypass grafting and evolution of evidence from CASS to post-STICH era.
- Pharmacological therapy and cardiovascular risk reduction for type 2 diabetes(2020) MARTINS, Eduardo Bello; LIMA, Eduardo Gomes; PITTA, Fabio Grunspun; CARVALHO, Leticia Neves Solon; QUEIROZ, Thiago Dias de; SERRANO JUNIOR, Carlos VicenteThe pharmacological therapy for type 2 diabetes mellitus has presented important advances in recent years, which has impacted the treatment of patients with established cardiovascular disease or with high cardiovascular risk. In this scenario, two drug classes have emerged and demonstrated clear clinical benents:SGLT-2 inhibitors and GLP-1 agonists. The present review discusses the pharmacology, adverse effects, and clinical trials that have demonstrated the benefits of these medications in reducing cardiovascular risk.