Hospital das Clínicas da Faculdade de Medicina - HC

URI Permanente desta comunidade

Inaugurado em 19 de abril de 1944, o Hospital das Clínicas da Faculdade de Medicina da USP (HC-FMUSP) é uma Autarquia de regime especial e associada à Universidade de São Paulo para fins de ensino, pesquisa, ações e serviços de saúde prestados à comunidade.

Trata-se do mais antigo sistema universitário de saúde brasileiro e ocupa posição referencial no campo do ensino, pesquisa e assistência.
O Hospital das Clínicas da FMUSP atua na área assistencial por meio de ações de promoção da saúde, prevenção das doenças, atenção médico-hospitalar no nível terciário de complexidade e reabilitação de pacientes com sequelas devidas a tratamentos de doenças.

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article 0 Citação(ões) na Scopus
Renal denervation by radiofrequency in patients with hypertension: systematic review and meta-analysis
(2024) SILVINATO, Antonio; FLORIANO, Idevaldo; BERNARDO, Wanderley Marques
The Guidelines Project, which is an initiative of the Brazilian Medical Association, aims to combine information from the medical field to standardize how to conduct and assist in the reasoning and decision-making of doctors. The information provided by this project must be critically evaluated by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical condition of each patient. Brazilian Medical Association.
article 0 Citação(ões) na Scopus
Dyslipidemia: A Narrative Review on Pharmacotherapy
(2024) OLIVEIRA, Lucas Lentini Herling de; ASSIS, Arthur Cicupira Rodrigues de; GIRALDEZ, Viviane Zorzanelli Rocha; SCUDELER, Thiago Luis; SOARES, Paulo Rogerio
Dyslipidemia plays a fundamental role in the development and progression of atherosclerosis. Current guidelines for treating dyslipidemia focus on low-density lipoprotein-cholesterol (LDL-C). Despite advances in the pharmacotherapy of atherosclerosis, the most successful agents used to treat this disease-statins-remain insufficient in the primary or secondary prevention of acute myocardial infarction. Advancing therapy for hypercholesterolemia with emerging new drugs, either as monotherapy or in combination, is expected to improve cardiovascular outcomes. An emerging field in dyslipidemia pharmacotherapy is research on genetic therapies and genetic modulation. Understanding the genetic mechanisms underlying lipid alterations may lead to the development of personalized treatments that directly target the genetic causes of dyslipidemia. RNA messenger (mRNA)-based therapies are also being explored, offering the ability to modulate gene expression to normalize lipid levels. Furthermore, nanotechnology raises new possibilities in drug delivery for treating dyslipidemia. Controlled-release systems, nanoparticles, and liposomes can enhance the effectiveness and safety of medications by providing more precise and sustained release. This narrative review summarizes current and emerging therapies for the management of patients with dyslipidemia.
Right ventricular dysfunction after pericardiectomy for tuberculous constrictive pericarditis: A case report
(2024) DUARTE, Natania Ferreira; FERREIRA, Stella de Aguiar Trigueirinho; FILHO, Daniel Abdalla Added; VIDAL, Carlos Henrique Lopes; LIMA, Roger Sales; MARTINS, Ana Vitoria Vitoreti; CASTRO, Rafael Oliveira; ASSIS, Arthur Cicupira Rodrigues de; SOARES, Paulo Rogerio; SCUDELER, Thiago Luis
This case report provides a peculiar case of tuberculous constrictive pericarditis (TCP) who presented with right ventricular dysfunction after pericardiectomy. Right ventricular dysfunction is one of the main postoperative complications after pericardiectomy. Rapid and accurate identification of right ventricular dysfunction confirmed by transthoracic echocardiography (TTE), associated with the rapid initiation of diuretics and inotropic therapy is necessary for the patient's complete recovery.AbstractTCP is a condition characterized by chronic inflammation and fibrosis of the pericardium. Pericardiectomy is the standard treatment for patients with constrictive pericarditis and persistent symptoms. One possible surgical complication is right ventricle (RV) failure. We report a case of a 44-year-old man who developed RV failure after pericardiectomy for TCP. A 41-year-old man with no medical history was referred to our hospital due to progressive dyspnea associated with edema of the lower limbs and significant weight loss (30 kg) over the past 5 months. TTE revealed significant pericardial thickening and mild pericardial effusion with normal RV function. Chest X-ray showed moderate bilateral pleural effusion. The patient underwent pericardiectomy and bilateral pleural drainage. Histopathological examination showed tuberculosis granulomas with caseous necrosis, and antituberculosis medication was initiated. Postoperative TTEs showed normal RV function and mild pericardial thickening. The patient was discharged home after successful postoperative recovery. Three weeks later, the patient was admitted to the emergency department with dyspnea and hypoxemia. TTE revealed RV systolic dysfunction. Chest CT showed a recurrence of moderate pleural effusion, this time loculated, with restrictive atelectasis of the adjacent lung parenchyma. Diuretics and inotropic therapy were initiated, and the patient underwent lung decortication after confirmation of tuberculous empyema. The patient experienced significant clinical improvement. TTE before discharge showed a decreased RV chamber size with improved RV systolic function. The patient was discharged in a stable condition 30 days after admission with a low dose of oral furosemide. Four months after discharge, he remained asymptomatic with good functional status. Pericardiectomy for TCP may carry the risk of developing RV dysfunction. Furthermore, TCP itself may be associated with other complications, such as empyema. We emphasize the importance of conducting a thorough clinical evaluation for patients with TCP, particularly those undergoing pericardiectomy, to mitigate potential adverse outcomes.
article 0 Citação(ões) na Scopus
Could there be a slower physiological healing process in vegan individuals?
(2024) DIAS, Lais Ferreira; ACOSTA-NAVARRO, Julio Cesar; SILVA, Tuane Cassemiro da
The article ""Comparing Tattoo Removal Responses in Vegan and Omnivore Patients"" by Fusano et al. investigates the clinical outcomes of Q-switched laser tattoo removal in vegans and omnivores. The study reveals that vegans required more laser sessions, exhibited poorer clinical responses, and experienced extended healing periods compared to omnivores. When well-planned vegetarian diets offer numerous health benefits. Unfortunately, the study does not assess the diets of the groups, nor does it address factors like hydration levels and prior skincare regimens, limiting the interpretation of results.
article 0 Citação(ões) na Scopus
Smoking cessation decreases arterial blood pressure in hypertensive smokers: A subgroup analysis of the randomized controlled trial GENTSMOKING
(2024) V, Patricia Gaya; FONSECA, Guilherme Wesley P.; TANJI, Lucas Tsuyoshi; ABE, Tania O.; ALVES, Maria Janieire N. N.; SANTOS, Paulo Caleb Junior de Lima; COLOMBO, Fernanda M. Consolim; SCHOLZ, Jaqueline R.
INTRODUCTION High blood pressure in hypertensive smokers is affected by nicotine consumption. This study aimed to evaluate the effect of smoking cessation treatments on blood pressure in hypertensive smokers. METHODS A total of 113 hypertensive smokers on antihypertensives during smoking cessation treatment in the randomized controlled trial GENTSMOKING were considered for analysis. At Baseline (T0) and Week 12 (T12), systolic and diastolic blood pressure (SBP and DBP), and heart rate (HR) were measured using a semiautomated digital oscillometric device. Mean arterial pressure (MAP) and delta differences for SBP, DBP, HR, and MAP were calculated. Smoking cessation was confirmed by measuring carbon monoxide (CO) in exhaled air. RESULTS After 12 weeks of treatment, 72 participants ceased smoking (cessation group) and 41 did not (no cessation group). At T0, there was no statistically meaningful difference between groups with respect to age, body mass index, CO, and daily cigarette consumption. At T12, daily cigarette consumption and CO had decreased in both groups (p<0.001). The cessation group showed decreased SBP (131 +/- 2 vs 125 +/- 2 mmHg, p=0.00 4), DBP (79 +/- 1 vs 77 +/- 1 mmHg, p=0.031), MAP (96 +/- 1 vs 93 +/- 1 mmHg, p=0.005), and HR (79 +/- 1 vs 74 +/- 1 beats/min, p=0.001), and increased body weight (77.4 +/- 2.1 vs 79.2 +/- 2.2 kg, p<0.001). No significant differences were seen for these variables in the no cessation group. Decrease in blood pressure was significantly higher among hypertensive participants with SBP >= 130 mmHg: SBP (145 +/- 2 vs 132 +/- 2 mmHg, p<0.001), DBP (85 +/- 2 vs 80 +/- 1 mmHg, p=0.002), MAP (105 +/- 1 vs 97 +/- 1 mmHg, p<0.001), and HR (81 +/- 2 vs 74 +/- 2 beats/min, p=0.002). A positive correlation was found between HR and CO (r=0.34; p=0.001). CONCLUSIONS Smoking cessation treatment reduced blood pressure in hypertensive smokers, allowing them to reach therapeutic targets for hypertension management. Smoking cessation has a positive impact on hypertension treatment; therefore, it should be encouraged in clinical practice.
article 40 Citação(ões) na Scopus
GWAS and meta-analysis identifies 49 genetic variants underlying critical COVID-19
(2023) PAIRO-CASTINEIRA, Erola; RAWLIK, Konrad; BRETHERICK, Andrew D.; QI, Ting; WU, Yang; NASSIRI, Isar; MCCONKEY, Glenn A.; ZECHNER, Marie; KLARIC, Lucija; GRIFFITHS, Fiona; OOSTHUYZEN, Wilna; KOUSATHANAS, Athanasios; RICHMOND, Anne; MILLAR, Jonathan; RUSSELL, Clark D.; MALINAUSKAS, Tomas; THWAITES, Ryan; MORRICE, Kirstie; KEATING, Sean; MASLOVE, David; NICHOL, Alistair; SEMPLE, Malcolm G.; KNIGHT, Julian; SHANKAR-HARI, Manu; SUMMERS, Charlotte; HINDS, Charles; HORBY, Peter; LING, Lowell; MCAULEY, Danny; MONTGOMERY, Hugh; OPENSHAW, Peter J. M.; BEGG, Colin; WALSH, Timothy; TENESA, Albert; FLORES, Carlos; RIANCHO, Jose A.; ROJAS-MARTINEZ, Augusto; LAPUNZINA, Pablo; YANG, Jian; PONTING, Chris P.; WILSON, James F.; VITART, Veronique; ABEDALTHAGAFI, Malak; LUCHESSI, Andre D.; PARRA, Esteban J.; CRUZ, Raquel; CARRACEDO, Angel; FAWKES, Angie; MURPHY, Lee; ROWAN, Kathy; PEREIRA, Alexandre C.; LAW, Andy; FAIRFAX, Benjamin; HENDRY, Sara Clohisey; BAILLIE, J. Kenneth
Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown(1) to be highly efficient for discovery of genetic associations(2). Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group(3). Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling (JAK1), monocyte-macrophage activation and endothelial permeability (PDE4A), immunometabolism (SLC2A5 and AK5), and host factors required for viral entry and replication (TMPRSS2 and RAB2A). An analysis of 24,202 critical cases of COVID-19 identifies potentially druggable targets in inflammatory signalling (JAK1), monocyte-macrophage activation and endothelial permeability (PDE4A), immunometabolism (SLC2A5 and AK5), and host factors required for viral entry and replication (TMPRSS2 and RAB2A).
article 2 Citação(ões) na Scopus
GWAS and meta-analysis identifies 49 genetic variants underlying critical COVID-19 (vol 617, pg 764, 2023)
(2023) PAIRO-CASTINEIRA, Erola; RAWLIK, Konrad; BRETHERICK, Andrew D.; QI, Ting; WU, Yang; NASSIRI, Isar; MCCONKEY, Glenn A.; ZECHNER, Marie; KLARIC, Lucija; GRIFFITHS, Fiona; OOSTHUYZEN, Wilna; KOUSATHANAS, Athanasios; RICHMOND, Anne; MILLAR, Jonathan; RUSSELL, Clark D.; MALINAUSKAS, Tomas; THWAITES, Ryan; MORRICE, Kirstie; KEATING, Sean; MASLOVE, David; NICHOL, Alistair; SEMPLE, Malcolm G.; KNIGHT, Julian; SHANKAR-HARI, Manu; SUMMERS, Charlotte; HINDS, Charles; HORBY, Peter; LING, Lowell; MCAULEY, Danny; MONTGOMERY, Hugh; OPENSHAW, Peter J. M.; BEGG, Colin; WALSH, Timothy; TENESA, Albert; FLORES, Carlos; RIANCHO, Jose A.; ROJAS-MARTINEZ, Augusto; LAPUNZINA, Pablo; YANG, Jian; PONTING, Chris P.; WILSON, James F.; VITART, Veronique; ABEDALTHAGAFI, Malak; LUCHESSI, Andre D.; PARRA, Esteban J.; CRUZ, Raquel; CARRACEDO, Angel; FAWKES, Angie; MURPHY, Lee; ROWAN, Kathy; PEREIRA, Alexandre C.; LAW, Andy; FAIRFAX, Benjamin; HENDRY, Sara Clohisey; BAILLIE, J. Kenneth
article 4 Citação(ões) na Scopus
Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
(2023) ZHOU, Bin; SHEFFER, Kate E.; BENNETT, James E.; GREGG, Edward W.; DANAEI, Goodarz; SINGLETON, Rosie K.; SHAW, Jonathan E.; MISHRA, Anu; LHOSTE, Victor P. F.; CARRILLO-LARCO, Rodrigo M.; KENGNE, Andre P.; PHELPS, Nowell H.; HEAP, Rachel A.; RAYNER, Archie W.; STEVENS, Gretchen A.; PACIOREK, Chris J.; RILEY, Leanne M.; COWAN, Melanie J.; SAVIN, Stefan; HOORN, Stephen Vander; LU, Yuan; PAVKOV, Meda E.; IMPERATORE, Giuseppina; AGUILAR-SALINAS, Carlos A.; AHMAD, Noor Ani; ANJANA, Ranjit Mohan; DAVLETOV, Kairat; FARZADFAR, Farshad; GONZALEZ-VILLALPANDO, Clicerio; KHANG, Young-Ho; KIM, Hyeon Chang; LAATIKAINEN, Tiina; LAXMAIAH, Avula; MBANYA, Jean Claude N.; NARAYAN, K. M. Venkat; RAMACHANDRAN, Ambady; WADE, Alisha N.; ZDROJEWSKI, Tomasz; ABBASI-KANGEVARI, Mohsen; RAHIM, Hanan F. Abdul; ABU-RMEILEH, Niveen M.; ADAMBEKOV, Shalkar; ADAMS, Robert J.; AEKPLAKORN, Wichai; AGDEPPA, Imelda A.; AGHAZADEH-ATTARI, Javad; AGYEMANG, Charles; AHMADI, Ali; AHMADI, Naser; AHMADI, Nastaran; AHMED, Soheir H.; AJLOUNI, Kamel; AL-HINAI, Halima; AL-LAHOU, Badreya; AL-LAWATI, Jawad A.; ASFOOR, Deena Al; QAOUD, Nawal M. Al; ALAROUJ, Monira; ALBUHAIRAN, Fadia; ALDHUKAIR, Shahla; ALDWAIRJI, Maryam A.; ALI, Mohamed M.; ALINEZHAD, Farbod; ALKANDARI, Abdullah; ALOMIRAH, Husam F.; ALY, Eman; AMARAPURKAR, Deepak N.; ANDERSEN, Lars Bo; ANDERSSEN, Sigmund A.; ANDRADE, Dolores S.; ANSARI-MOGHADDAM, Alireza; AOUNALLAH-SKHIRI, Hajer; ARIS, Tahir; ARLAPPA, Nimmathota; ARYAL, Krishna K.; ASSAH, Felix K.; ASSEMBEKOV, Batyrbek; AUVINEN, Juha; AVDICOVA, Maria; AZAD, Kishwar; AZIMI-NEZHAD, Mohsen; AZIZI, Fereidoun; BACOPOULOU, Flora; BALAKRISHNA, Nagalla; BAMOSHMOOSH, Mohamed; BANACH, Maciej; BANDOSZ, Piotr; BANEGAS, Jose R.; BARBAGALLO, Carlo M.; BARCELO, Alberto; BARETIC, Maja; BARRERA, Lena; BASIT, Abdul; BATIEHA, Anwar M.; BATISTA, Aline P.; BAUR, Louise A.; BELAVENDRA, Antonisamy; ROMDHANE, Habiba Ben; BENET, Mikhail; BERKINBAYEV, Salim; BERNABE-ORTIZ, Antonio; CARRASOLA, Ximena Berrios; BETTIOL, Heloisa; BEYBEY, Augustin F.; BHARGAVA, Santosh K.; LELE, Elysee Claude Bika; BIKBOV, Mukharram M.; BISTA, Bihungum; BJERREGAARD, Peter; BJERTNESS, Espen; BJERTNESS, Marius B.; BJORKELUND, Cecilia; V, Katia Bloch; BLOKSTRA, Anneke; BO, Simona; BOBAK, Martin; BOGGIA, Jose G.; BONACCIO, Marialaura; BONILLA-VARGAS, Alice; BORGHS, Herman; BOVET, Pascal; BRAJKOVICH, Imperia; BRENNER, Hermann; BREWSTER, Lizzy M.; BRIAN, Garry R.; BRICENO, Yajaira; BRITO, Miguel; BUGGE, Anna; BUNTINX, Frank; LEON, Antonio Cabrera de; CAIXETA, Roberta B.; CAN, Gunay; CANDIDO, Ana Paula C.; V, Mario Capanzana; CAPKOVA, Nadezda; CAPUANO, Eduardo; CAPUANO, Rocco; CAPUANO, Vincenzo; CARDOSO, Viviane C.; CARLSSON, Axel C.; CASANUEVA, Felipe F.; CENSI, Laura; CERVANTES-LOAIZA, Marvin; CHAMNAN, Parinya; CHAMUKUTTAN, Snehalatha; CHAN, Queenie; CHARCHAR, Fadi J.; CHATURVEDI, Nish; CHEN, Huashuai; CHERAGHIAN, Bahman; CHIRLAQUE, Maria-Dolores; CHUDEK, Jerzy; CIFKOVA, Renata; CIRILLO, Massimo; CLAESSENS, Frank; COHEN, Emmanuel; CONCIN, Hans; COOPER, Cyrus; COSTANZO, Simona; COWELL, Chris; CRUJEIRAS, Ana B.; CRUZ, Juan J.; V, Felipe Cureau; CUSCHIERI, Sarah; D'ARRIGO, Graziella; D'ORSI, Eleonora; DALLONGEVILLE, Jean; DAMASCENO, Albertino; DASTGIRI, Saeed; CURTIS, Amalia De; GAETANO, Giovanni de; HENAUW, Stefaan De; DEEPA, Mohan; DEGENNARO JR., Vincent; DEMAREST, Stefaan; DENNISON, Elaine; DESCHAMPS, Valerie; DHIMAL, Meghnath; DIKA, Zivka; DJALALINIA, Shirin; DONFRANCESCO, Chiara; DONG, Guanghui; DOROBANTU, Maria; DORR, Marcus; DRAGANO, Nico; DRYGAS, Wojciech; DU, Yong; DUANTE, Charmaine A.; DUBOZ, Priscilla; DUSHPANOVA, Anar; DZIANKOWSKA-ZABORSZCZYK, Elzbieta; EBRAHIMI, Narges; EDDIE, Ricky; EFTEKHAR, Ebrahim; EFTHYMIOU, Vasiliki; EGBAGBE, Eruke E.; EGHTESAD, Sareh; EL-KHATEEB, Mohammad; ATI, Jalila El; ELDEMIRE-SHEARER, Denise; ELOSUA, Roberto; ENANG, Ofem; ERASMUS, Rajiv T.; ERBEL, Raimund; EREM, Cihangir; ERGOR, Gul; ERIKSEN, Louise; ERIKSSON, Johan G.; ESMAEILI, Ali; EVANS, Roger G.; FAKHRADIYEV, Ildar; FALL, Caroline H.; FARAMARZI, Elnaz; FARJAM, Mojtaba; FARZI, Yosef; FATTAHI, Mohammad Reza; FAWWAD, Asher; FELIX-REDONDO, Francisco J.; FERGUSON, Trevor S.; FERNANDEZ-BERGES, Daniel; FERRARI, Marika; FERRECCIO, Catterina; FERREIRA, Haroldo S.; FERRER, Eldridge; FESKENS, Edith J. M.; FLOOD, David; FORSNER, Maria; FOSSE, Sandrine; FOTTRELL, Edward F.; FOUAD, Heba M.; FRANCIS, Damian K.; FRONTERA, Guillermo; FURUSAWA, Takuro; GACIONG, Zbigniew; GARNETT, Sarah P.; GASULL, Magda; GAZZINELLI, Andrea; GEHRING, Ulrike; GHADERI, Ebrahim; GHAMARI, Seyyed-Hadi; GHANBARI, Ali; GHASEMI, Erfan; GHEORGHE-FRONEA, Oana-Florentina; GHIMIRE, Anup; GIALLUISI, Alessandro; GIAMPAOLI, Simona; GIANFAGNA, Francesco; GILL, Tiffany K.; GIRONELLA, Glen; GIWERCMAN, Aleksander; GOLTZMAN, David; GOMULA, Aleksandra; GONCALVES, Helen; GONCALVES, Mauer; GONZALEZ-CHICA, David A.; GONZALEZ-GROSS, Marcela; GONZALEZ-RIVAS, Juan P.; GONZALEZ-VILLALPANDO, Maria-Elena; GONZALEZ, Angel R.; GOTTRAND, Frederic; GRAFNETTER, Dusan; GRODZICKI, Tomasz; GRONTVED, Anders; GUERRERO, Ramiro; GUJRAL, Unjali P.; GUPTA, Rajeev; GUTIERREZ, Laura; GWEE, Xinyi; HAGHSHENAS, Rosa; HAKIMI, Hamid; HAMBLETON, Ian R.; HAMZEH, Behrooz; HANEKOM, Willem A.; HANGE, Dominique; HANTUNEN, Sari; HAO, Jie; KUMAR, Rachakulla Hari; HAROONI, Javad; HASHEMI-SHAHRI, Seyed Mohammad; HATA, Jun; HEIDEMANN, Christin; HENRIQUE, Rafael dos Santos; HERRALA, Sauli; HERZIG, Karl-Heinz; HESHMAT, Ramin; HO, Sai Yin; HOLDSWORTH, Michelle; HOMAYOUNFAR, Reza; HOPMAN, Wilma M.; HORIMOTO, Andrea R. V. R.; HORMIGA, Claudia; HORTA, Bernardo L.; HOUTI, Leila; HOWITT, Christina; HTAY, Thein Thein; HTET, Aung Soe; HTIKE, Maung Maung Than; HUERTA, Jose Maria; HUHTANIEMI, Ilpo Tapani; HUISMAN, Martijn; HUSSEINI, Abdullatif; HUYBRECHTS, Inge; IACOVIELLO, Licia; IAKUPOVA, Ellina M.; IANNONE, Anna G.; WONG, Norazizah Ibrahim; IJOMA, Chinwuba; IRAZOLA, Vilma E.; ISHIDA, Takafumi; ISIGUZO, Godsent C.; ISLAM, Sheikh Mohammed Shariful; ISLEK, Duygu; ITTERMANN, Till; IWASAKI, Masanori; JAASKELAINEN, Tuija; JACOBS, Jeremy M.; JADDOU, Hashem Y.; JADOUL, Michel; JALLOW, Bakary; JAMES, Kenneth; JAMIL, Kazi M.; JANUS, Edward; JARVELIN, Marjo-Riitta; JASIENSKA, Grazyna; JELAKOVIC, Ana; JELAKOVIC, Bojan; JENNINGS, Garry; JHA, Anjani Kumar; JIMENEZ, Ramon O.; JOCKEL, Karl-Heinz; JOKELAINEN, Jari J.; JONAS, Jost B.; JOSHI, Pradeep; JOSIPOVIC, Josipa; JOUKAR, Farahnaz; JOZWIAK, Jacek; KAFATOS, Anthony; KAJANTIE, Eero O.; KALMATAYEVA, Zhanna; KARKI, Khem B.; KATIBEH, Marzieh; KAUHANEN, Jussi; KAZAKBAEVA, Gyulli M.; KAZE, Francois F.; KE, Calvin; KEINANEN-KIUKAANNIEMI, Sirkka; KELISHADI, Roya; KERAMATI, Maryam; KERSTING, Mathilde; KHADER, Yousef Saleh; KHALEDIFAR, Arsalan; KHALILI, Davood; KHEIRI, Bahareh; KHERADMAND, Motahareh; KHOSRAVI, Alireza; KIECHL-KOHLENDORFER, Ursula; KIECHL, Sophia J.; KIECHL, Stefan; KINGSTON, Andrew; KLAKK, Heidi; KLANOVA, Jana; KNOFLACH, Michael; KOLSTEREN, Patrick; KONIG, Jurgen; KORPELAINEN, Raija; KORROVITS, Paul; KOS, Jelena; KOSKINEN, Seppo; KOWLESSUR, Sudhir; KOZIEL, Slawomir; KRIEMLER, Susi; KRISTENSEN, Peter Lund; KROMHOUT, Daan; KUBINOVA, Ruzena; KUJALA, Urho M.; KULIMBET, Mukhtar; KURJATA, Pawel; KYOBUTUNGI, Catherine; Quang Ngoc La; LABADARIOS, Demetre; LACHAT, Carl; LAID, Youcef; LALL, Lachmie; LANKILA, Tiina; LANSKA, Vera; LAPPAS, Georg; LARIJANI, Bagher; LATT, Tint Swe; LAURENZI, Martino; LEHMANN, Nils; LEHTIMAKI, Terho; LEMOGOUM, Daniel; LEUNG, Gabriel M.; LI, Yanping; LIMA-COSTA, M. Fernanda; LIN, Hsien-Ho; LIND, Lars; LISSNER, Lauren; LIU, Xiaotian; LOPEZ-GARCIA, Esther; LOPEZ, Tania; LOZANO, Jose Eugenio; LUKSIENE, Dalia; LUNDQVIST, Annamari; LUNET, Nuno; LUSTIGOVA, Michala; MACHADO-COELHO, George L. L.; MACHADO-RODRIGUES, Aristides M.; MACIA, Enguerran; MACIEIRA, Luisa M.; MADAR, Ahmed A.; MAESTRE, Gladys E.; MAGGI, Stefania; MAGLIANO, Dianna J.; MAGRIPLIS, Emmanuella; MAHASAMPATH, Gowri; MAIRE, Bernard; MAKDISSE, Marcia; MALEKPOUR, Mohammad-Reza; MALEKZADEH, Fatemeh; MALEKZADEH, Reza; RAO, Kodavanti Mallikharjuna; MALYUTINA, Sofia; V, Lynell Maniego; MANIOS, Yannis; MANNIX, Masimango Imani; MANSOUR-GHANAEI, Fariborz; MANZATO, Enzo; MARGOZZINI, Paula; MARINO, Joany; MARQUES, Larissa Pruner; MARTORELL, Reynaldo; MASCARENHAS, Luis P.; MASINAEI, Masoud; MATHIESEN, Ellisiv B.; MATSHA, Tandi E.; POSSO, Anselmo J. Mc Donald; MCFARLANE, Shelly R.; MCGARVEY, Stephen T.; BENCHEKOR, Sounnia Mediene; MEHLIG, Kirsten; MEHRPARVAR, Amir Houshang; MELGAREJO, Jesus D.; MENDEZ, Fabian; MENEZES, Ana Maria B.; MEREKE, Alibek; MESHRAM, Indrapal I.; METO, Diane T.; MINDERICO, Claudia S.; MINI, G. K.; MIQUEL, Juan Francisco; MIRANDA, J. Jaime; MIRJALILI, Mohammad Reza; MODESTI, Pietro A.; MOGHADDAM, Sahar Saeedi; MOHAMED, Mostafa K.; MOHAMMAD, Kazem; MOHAMMADI, Mohammad Reza; MOHAMMADI, Zahra; MOHAMMADIFARD, Noushin; MOHAMMADPOURHODKI, Reza; MOHAN, Viswanathan; YUSOFF, Muhammad Fadhli Mohd; MOHEBBI, Iraj; MOLLER, Niels C.; MOLNAR, Denes; MOMENAN, Amirabbas; MONDO, Charles K.; MENDOZA, Roger A. Montenegro; MONTERRUBIO-FLORES, Eric; MOOSAZADEH, Mahmood; MORADPOUR, Farhad; MOREJON, Alain; MORENO, Luis A.; MORGAN, Karen; MORIN, Suzanne N.; MOSLEM, Alireza; MOSQUERA, Mildrey; MOSSAKOWSKA, Malgorzata; MOSTAFA, Aya; MOSTAFAVI, Seyed-Ali; MOTLAGH, Mohammad Esmaeel; MOTTA, Jorge; MSYAMBOZA, Kelias P.; Thet Thet Mu; MUIESAN, Maria L.; MURSU, Jaakko; MUSA, Kamarul Imran; MUSTAFA, Norlaila; MUYER, Muel Telo M. C.; NABIPOUR, Iraj; NAGEL, Gabriele; NAIDU, Balkish M.; NAJAFI, Farid; NAMESNA, Jana; NANGIA, Vinay B.; NASERI, Take; NEELAPAICHIT, Nareemarn; NEJATIZADEH, Azim; NENKO, Ilona; NERVI, Flavio; Tze Pin Ng; NGUYEN, Chung T.; Quang Ngoc Nguyen; NI, Michael Y.; NIE, Peng; NIETO-MARTINEZ, Ramfis E.; NINOMIYA, Toshiharu; NOALE, Marianna; NOBOA, Oscar A.; NOTO, Davide; NSOUR, Mohannad Al; NUHOGLU, Irfan; O'NEILL, Terence W.; ODILI, Augustine N.; OH, Kyungwon; OHTSUKA, Ryutaro; OMAR, Mohd Azahadi; ONAT, Altan; ONG, Sok King; ONODUGO, Obinna; ORDUNEZ, Pedro; ORNELAS, Rui; ORTIZ, Pedro J.; OSMOND, Clive; OSTOVAR, Afshin; OTERO, Johanna A.; OTTENDAHL, Charlotte B.; OTU, Akaninyene; OWUSU-DABO, Ellis; PALMIERI, Luigi; PAN, Wen-Harn; PANDA-JONAS, Songhomitra; PANZA, Francesco; PAOLI, Mariela; PARK, Suyeon; PARSAEIAN, Mahboubeh; PATEL, Nikhil D.; PECHLANER, Raimund; PECIN, Ivan; PEDRO, Joao M.; PEIXOTO, Sergio Viana; PELTONEN, Markku; PEREIRA, Alexandre C.; PRAZERES, Thaliane Mayara Pessoa dos; PEYKARI, Niloofar; PHALL, Modou Cheyassin; Son Thai Pham; Hiep Hoang Phan; PICHARDO, Rafael N.; PIKHART, Hynek; PILAV, Aida; PILER, Pavel; PITAKAKA, Freda; PIWONSKA, Aleksandra; PIZARRO, Andreia N.; PLANS-RUBIO, Pedro; PLATA, Silvia; PORTA, Miquel; POUDYAL, Anil; POURFARZI, Farhad; POURSHAMS, Akram; POUSTCHI, Hossein; PRADEEPA, Rajendra; PROVIDENCIA, Rui; PUDER, Jardena J.; PUHAKKA, Solie; PUNAB, Margus; QORBANI, Mostafa; QUINTANA, Hedley K.; Tran Quoc Bao; RAHIMIKAZEROONI, Salar; RAITAKARI, Olli; RAMIREZ-ZEA, Manuel; RAMKE, Jacqueline; RAMOS, Rafel; RAMPAL, Lekhraj; RAMPAL, Sanjay; REINA, Daniel A. Rangel; RASHIDI, Mohammad-Mahdi; REDON, Josep; RENNER, Jane D. P.; REUTER, Cezane P.; REVILLA, Luis; REZAEI, Negar; REZAIANZADEH, Abbas; RIGO, Fernando; ROA, Reina G.; ROBINSON, Louise; RODRIGUEZ-ARTALEJO, Fernando; RODRIGUEZ-PEREZ, Maria Del Cristo; RODRIGUEZ-VILLAMIZAR, Laura A.; RODRIGUEZ, Andrea Y.; ROGGENBUCK, Ulla; ROHLOFF, Peter; ROMEO, Elisabetta L.; ROSENGREN, Annika; RUBINSTEIN, Adolfo; RUST, Petra; RUTKOWSKI, Marcin; SABBAGHI, Hamideh; SACHDEV, Harshpal S.; SADJADI, Alireza; SAFARPOUR, Ali Reza; SAFI, Sare; SAFIRI, Saeid; SAGHI, Mohammad Hossien; SAIDI, Olfa; SAKI, Nader; SALAJ, Sanja; SALANAVE, Benoit; SALONEN, Jukka T.; SALVETTI, Massimo; SANCHEZ-ABANTO, Jose; SANTOS, Diana A.; SANTOS, Lelita C.; SANTOS, Maria Paula; SANTOS, Tamara R.; SARAMIES, Jouko L.; SARDINHA, Luis B.; SARRAFZADEGAN, Nizal; SAUM, Kai-Uwe; SBARAINI, Mariana; SCAZUFCA, Marcia; SCHAAN, Beatriz D.; SCHEIDT-NAVE, Christa; SCHIPF, Sabine; SCHMIDT, Carsten O.; Ben Schottker; SCHRAMM, Sara; SEBERT, Sylvain; SEDAGHATTALAB, Moslem; SEIN, Aye Aye; SEPANLOU, Sadaf G.; SEWPAUL, Ronel; SHAMAH-LEVY, Teresa; SHAMSHIRGARAN, Seyed Morteza; SHARAFKHAH, Maryam; SHARMA, Sanjib K.; SHARMAN, Almaz; SHAYANRAD, Amaneh; SHAYESTEH, Ali Akbar; SHIMIZU-FURUSAWA, Hana; SHIRI, Rahman; SHRESTHA, Namuna; SI-RAMLEE, Khairil; SILVA, Diego Augusto Santos; SIMON, Mary; SIMONS, Judith; SIMONS, Leon A.; SJOSTROM, Michael; SLOWIKOWSKA-HILCZER, Jolanta; SLUSARCZYK, Przemyslaw; SMEETH, Liam; SOBNGWI, Eugene; SODERBERG, Stefan; SOEMANTRI, Agustinus; SOFAT, Reecha; SOLFRIZZI, Vincenzo; SOMI, Mohammad Hossein; SOUMARE, Aicha; SOUSA-POZA, Alfonso; SPARRENBERGER, Karen; STAESSEN, Jan A.; STAVRESKI, Bill; STEENE-JOHANNESSEN, Jostein; STEHLE, Peter; STEIN, Aryeh D.; STESSMAN, Jochanan; STOKWISZEWSKI, Jakub; STRONKS, Karien; SUAREZ-ORTEGON, Milton F.; SUEBSAMRAN, Phalakorn; SUNDSTROM, Johan; SURIYAWONGPAISAL, Paibul; SYLVA, Rene Charles; SZKLO, Moyses; TAMOSIUNAS, Abdonas; TARAWNEH, Mohammed Rasoul; TARQUI-MAMANI, Carolina B.; TAYLOR, Anne; TAYLOR, Julie; TELLO, Tania; THANKAPPAN, K. R.; THEOBALD, Holger; THEODORIDIS, Xenophon; THOMAS, Nihal; THRIFT, Amanda G.; TIMMERMANS, Erik J.; TJANDRARINI, Dwi Hapsari; TOLONEN, Hanna K.; TOLSTRUP, Janne S.; TOMASZEWSKI, Maciej; TOPBAS, Murat; TORRES-COLLADO, Laura; TRAISSAC, Pierre; TRIANTAFYLLOU, Areti; TUITELE, John; TULIAKOVA, Azaliia M.; TULLOCH-REID, Marshall K.; TUOMAINEN, Tomi-Pekka; TZALA, Evangelia; TZOURIO, Christophe; UEDA, Peter; UGEL, Eunice; UKOLI, Flora A. M.; ULMER, Hanno; UUSITALO, Hannu M. T.; VALDIVIA, Gonzalo; BORN, Bert-Jan Van den; HEYDEN, Johan Van der; Hoang Van Minh; ROSSEM, Lenie van; SCHOOR, Natasja M. Van; VALKENGOED, Irene G. M. van; ZUTPHEN, Elisabeth M. van; VANDERSCHUEREN, Dirk; VANUZZO, Diego; VASAN, Senthil K.; VEGA, Tomas; VELASQUEZ-MELENDEZ, Gustavo; VERSTRAETEN, Roosmarijn; VIET, Lucie; VILLALPANDO, Salvador; VIOQUE, Jesus; VIRTANEN, Jyrki K.; VISWANATHAN, Bharathi; VOUTILAINEN, Ari; BEBAKAR, Wan Mohamad Wan; MOHAMUD, Wan Nazaimoon Wan; WANG, Chongjian; WANG, Ningli; WANG, Qian; WANG, Ya Xing; WANG, Ying-Wei; WANNAMETHEE, S. Goya; WEBSTER-KERR, Karen; WEDDERKOPP, Niels; WEI, Wenbin; WESTBURY, Leo D.; WHINCUP, Peter H.; WIDHALM, Kurt; WIDYAHENING, Indah S.; WIECEK, Andrzej; WILKS, Rainford J.; WILLEIT, Johann; WILLEIT, Peter; WILSGAARD, Tom; WOJTYNIAK, Bogdan; WONG, Andrew; WONG, Emily B.; WOODWARD, Mark; WU, Frederick C.; XU, Haiquan; XU, Liang; YAACOB, Nor Azwany; YAN, Li; YAN, Weili; YOOSEFI, Moein; YOSHIHARA, Akihiro; YOUNGER-COLEMAN, Novie O.; YU, Yu-Ling; YU, Yunjiang; YUSOFF, Ahmad Faudzi; ZAINUDDIN, Ahmad A.; ZAMANI, Farhad; ZAMBON, Sabina; ZAMPELAS, Antonis; ZAW, Ko Ko; VRKIC, Tajana Zeljkovic; ZENG, Yi; ZHANG, Zhen-Yu; ZHOLDIN, Bekbolat; ZIMMET, Paul; ZITT, Emanuel; ZOGHLAMI, Nada; CISNEROS, Julio Zuniga; EZZATI, Majid
Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance. Analysis of HbA1c and FPG levels across 117 population-based studies demonstrates regional variation in prevalence of previously undiagnosed screen-detected diabetes using one or both measures and suggests that use of elevated FPG alone could underestimate diabetes prevalence in low- and middle-income countries.
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Data-driven models for the prediction of coronary atherosclerotic plaque progression/regression
(2024) BULANT, Carlos A.; BORONI, Gustavo A.; BASS, Ronald; RABER, Lorenz; LEMOS, Pedro A.; GARCIA-GARCIA, Hector M.; BLANCO, Pablo J.
Coronary artery disease is defined by the existence of atherosclerotic plaque on the arterial wall, which can cause blood flow impairment, or plaque rupture, and ultimately lead to myocardial ischemia. Intravascular ultrasound (IVUS) imaging can provide a detailed characterization of lumen and vessel features, and so plaque burden, in coronary vessels. Prediction of the regions in a vascular segment where plaque burden can either increase (progression) or decrease (regression) following a certain therapy, has remained an elusive major milestone in cardiology. Studies like IBIS-4 showed an association between plaque burden regression and high-intensity rosuvastatin therapy over 13 months. Nevertheless, it has not been possible to predict if a patient would respond in a favorable/adverse fashion to such a treatment. This work aims to (i) Develop a framework that processes lumen and vessel cross-sectional contours and extracts geometric descriptors from baseline and follow-up IVUS pullbacks; and to (ii) Develop, train, and validate a machine learning model based on baseline/follow-up IVUS datasets that predicts future percent of atheroma volume changes in coronary vascular segments using only baseline information, i.e. geometric features and clinical data. This is a post hoc analysis, revisiting the IBIS-4 study. We employed 140 arteries, from 81 patients, for which expert delineation of lumen and vessel contours were available at baseline and 13-month follow-up. Contour data from baseline and follow-up pullbacks were co-registered and then processed to extract several frame-wise features, e.g. areas, plaque burden, eccentricity, etc. Each pullback was divided into regions of interest (ROIs), following different criteria. Frame-wise features were condensed into region-wise markers using tools from statistics, signal processing, and information theory. Finally, a stratified 5-fold cross-validation strategy (20 repetitions) was used to train/validate an XGBoost regression models. A feature selection method before the model training was also applied. When the models were trained/validated on ROI defined by the difference between follow-up and baseline plaque burden, the average accuracy and Mathews correlation coefficient were 0.70 and 0.41 respectively. Using a ROI partition criterion based only on the baseline's plaque burden resulted in averages of 0.60 accuracy and 0.23 Mathews correlation coefficient. An XGBoost model was capable of predicting plaque progression/regression changes in coronary vascular segments of patients treated with rosuvastatin therapy in 13 months. The proposed method, first of its kind, successfully managed to address the problem of stratification of patients at risk of coronary plaque progression, using IVUS images and standard patient clinical data.
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Early versus delayed coronary angiography in patients with out-of-hospital cardiac arrest and no ST-segment elevation: a systematic review and meta-analysis of randomized controlled trials
(2024) HAMIDI, Fardin; ANWARI, Elaaha; SPAULDING, Christian; HAUW-BERLEMONT, Caroline; VILFAILLOT, Aurelie; VIANA-TEJEDOR, Ana; KERN, Karl B.; HSU, Chiu-Hsieh; BERGMARK, Brian A.; QAMAR, Arman; BHATT, Deepak L.; FURTADO, Remo H. M.; MYHRE, Peder L.; HENGSTENBERG, Christian; LANG, Irene M.; FREY, Norbert; FREUND, Anne; DESCH, Steffen; THIELE, Holger; PREUSCH, Michael R.; ZELNIKER, Thomas A.
Background Recent randomized controlled trials did not show benefit of early/immediate coronary angiography (CAG) over a delayed/selective strategy in patients with out-of-hospital cardiac arrest (OHCA) and no ST-segment elevation. However, whether selected subgroups, specifically those with a high pretest probability of coronary artery disease may benefit from early CAG remains unclear. Methods We included all randomized controlled trials that compared a strategy of early/immediate versus delayed/ selective CAG in OHCA patients and no ST elevation and had a follow-up of at least 30 days. The primary outcome of interest was all-cause death. Odds ratios (OR) were calculated and pooled across trials. Interaction testing was used to assess for heterogeneity of treatment effects. Results In total, 1512 patients (67 years, 26% female, 23% prior myocardial infarction) were included from 5 randomized controlled trials. Early/immediate versus delayed/selective CAG was not associated with a statistically significant difference in odds of death (OR 1.12, 95%-CI 0.91-1.38), with similar findings for the composite outcome of all-cause death or neurological deficit (OR 1.10, 95%-CI 0.89- 1.36). There was no effect modification for death by age, presence of a shockable initial cardiac rhythm, history of coronary artery disease, presence of an ischemic event as the presumed cause of arrest, or time to return of spontaneous circulation (all P-interaction > 0.10). However, early/immediate CAG tended to be associated with higher odds of death in women (OR 1.52, 95%- CI 1.00- 2.31, P = 0.050) than in men (OR 1.04, 95%-CI 0.82-1.33, P = 0.74; P-interaction 0.097). Conclusion In OHCA patients without ST-segment elevation, a strategy of early/immediate versus delayed/selective CAG did not reduce all-cause mortality across major subgroups. However, women tended to have higher odds of death with early CAG. [GRAPHICS]