JULIO YOSHIO TAKADA

(Fonte: Lattes)
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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • conferenceObject
    Multiple thrombogenic and atherogenic markers were involved in premature coronary artery disease
    (2012) MANSUR, A. P.; TAKADA, J. Y.; STRUNZ, C. M. C.; AVAKIAN, S. D.; CESAR, L. A. M.; RAMIRES, J. A. F.
    Atherogenic and thrombogenic factors are implicated in the pathogenesis of coronary artery disease (CAD). Polymorphisms in the lymphotoxin-alfa (LTA) gene, a pro-inflammatory cytokine, have been also associated with susceptibility to myocardial infarction, but results in different studies are conflicting. We examined the association of atherothrombotic markers and the LTA promoter A252G polymorphism with risk of premature CAD. Methods: A case-control study was conducted in 336 patients with documented premature CAD and 189 unrelated health controls both with less than 50 years old. Clinical characteristics and laboratorial data which included thrombogenic factors (fibrinogen, protein C, protein S and antithrombin III); and atherogenic factors (fasting glucose, lipid profile; lipoprotein (a), apolipoproteins AI and B fractions) were evaluated. Genetic variability of LTA was determined by polymerase chain reaction. Results: Male, history of premature CAD, smoking status, diabetes, hypertension and dyslipidemia were significantly more prevalent in the CAD group. Compared with controls, CAD cases had significantly lower mean concentrations of apolipoprotein AI (1.34±0.21 vs 1.23±0.22 mg/dL;<0.01), HDL-cholesterol (46.4±11.9 vs 41.1±11.2 mg/dL; p<0.01) and antithrombin III(100±12.7 vs 94.2±17.8%; p=0.02), and higher plasma concentration of fasting glucose (103.3±26.9 vs 112.1±45.3 mg/dL; p<0.01) and Lipoprotein (a) levels(32.8±32.6 vs 50.1±49.2 mg/dL; p<0.01). The LTA A252G polymorphism frequency for AA, AG and GG was respectively 55.0%, 37,6%, and 7.4% for control group and 42.7%, 46.0% and 11.3% for patients group (p=0.02). A multivariable logistic regression analysis showed that hypertension (OR 2.19 95% CI 1.290-3.716), smoker (OR 2.18; 95% CI 1.455-3.277), dyslipidemia (OR 1.94; 95% CI1.233-3.072), family history (OR 7.13; 95% CI 4.383-11.606) and LTA polymorphism (OR 1.88; 95% CI 1.193-2.972) were independent risk factors for susceptibility to CAD. LTA mutant was risk marker for CAD only in male without the traditional risk factors. Conclusions: Worse traditional risk factors profile and atherothrombogenic markers were associated with susceptibility to premature CAD. LTA mutant allelic was independently associated with premature CAD in male in the absence of traditional risk factors. Premature CAD was associated with worse clinical and laboratory multimarkers.
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    Randomized study of 30 days of resveratrol and caloric restriction on serum levels of sirtuin-1 in healthy subjects
    (2015) MANSUR, A. P.; ROGGERIO, A.; GOES, M. F. S.; TAKADA, J. Y.; AVAKIAN, S. D.; STRUNZ, C. M. C.
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    Effects of resveratrol and caloric restriction on serum levels of norepinephrine in healthy subjects
    (2015) MANSUR, A. P.; ROGGERIO, A.; GOES, M. F. S.; TAKADA, J. Y.; AVAKIAN, S. D.; STRUNZ, C. M. C.
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    Left ventricular ejection fraction, systolic blood pressure and smoking history are good predictors of respiratory muscle weakness in systolic heart failure
    (2018) NAKAGAWA, N. K. Naomi Kondo; DIZ, M. A.; KAWAUCHI, T. S.; ANDRADE, G. N.; UMEDA, Iik; MURAKAMI, F. M.; OLIVEIRA-MAUL, J. P.; NASCIMENTO, J. A.; NUNES, N.; TAKADA, J. Y.; MANSUR, A. P.; CAHALIN, L. P.
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    Education and lifestyle measures for awareness of syncope prodroms to prevent syncope recurrence in schoolchildren
    (2021) MAIR, V.; SANTOS, F. R. A.; PEREIRA, H. G.; PASTORE, C. A.; SAMESIMA, N.; DINIZ, L. J.; TAKADA, J. Y.; MANSUR, A. P.; NAKAGAWA, N. K.
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    Prognosis in 10 years of follow-up of three therapeutic strategies for chronic multivessel coronary artery disease in women (study MASS)
    (2013) MANSUR, A. P.; HUEB, W. A.; TAKADA, J. Y.; AVAKIAN, S. D.; REZENDE, P. C.; SEGRE, A.; SOARES, P. R.; GARZILLO, C.; RAMIRES, J. A. F.; KALIL FILHO, R.
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    Prognosis importance of absence of angina in non-ST elevation myocardial infarction
    (2012) TAKADA, J. Y.; RAMOS, R. B.; AVAKIAN, S. D.; RAMIRES, J. A. F.; MANSUR, A. P.
    Purpose: Cardiac troponins increased myocardial infarction diagnosis in patients without specific electrocardiographic changes. Absence of angina has become common and prognostic significance remains unclear. Methods: We followed 204 consecutive patients after myocardial infarction non-ST elevation(NSTEMI) at emergency department. Outcomes were in-hospital death and follow-up death or cardiac readmission. Results: No-angina (NAG) group (n = 27, 13.2%) had more women (p = 0.001), higher blood glucose (p =0.011) and B-type natriuretic factor (p < 0.001). In-hospital (14.8% vs 4.5%,p = 0.035) and 20-months follow-up mortality (43.5% vs 12.9%, p<0.001) were higher in NAG. Combination of death and cardiac read- mission was similar (70.4%vs 53.1%, p = 0.093). Age (HR = 1.038, 95% CI 1.006 to 1.071), absence of angina at admission (HR 2.554, 95% CI 1.037 to 6.289), male gender (HR 2.706, 95% CI 1.099 to 6.667) and dyspnea (HR 3.113, 95% CI 1.417 to 6.842) were independent predictors of long-term mortality. Conclusion: The absence of chest pain in NSTEMI implies in higher in-hospitaland long-term mortality.
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    Risk factors for cardiovascular disease, metabolic syndrome and sleepiness in truck drivers
    (2013) MANSUR, A. P.; TAKADA, J. Y.; AVAKIAN, S. D.; LINS, S. M. B.; ROCHA, M. A. B. S.; SANTOS, A. J.; ANDRADE, A. M. C. A.; VASCONCELOS JR., J. R.; MONTEIRO, L. B. M.; LEYTON, V.
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    Ten-year follow-up survival of the medicine, angioplasty, or surgery study (MASS II): randomized controlled clinical trial of 3 therapeutic strategies for multivessel coronary artery disease in women
    (2012) MANSUR, A. P.; HUEB, W. A.; TAKADA, J. Y.; AVAKIAN, S. D.; SOARES, P. R.; GARZILO, C. L.; RAMIRES, J. A. F.; KALIL FILHO, R.
    Purpose: Coronary artery disease (CAD) is the leading cause of death in women. The proposed treatments, percutaneous coronary intervention (PCI), medical treatment (MT) or coronary artery bypass graft (CABG), are similar to those madefor men. However, in women with multivessel stable CAD and normal left ventricular (LV) function, the best treatment is unknown. Methods: Prospective study with 10 years of follow-up randomized 188 womenwith chronic stable CAD to MT (N = 63; 33%), PCI (N = 69; 37%) or CABG (N = 56; 30%). CAD was defined by the presence of angina pectoris CCS class II and III, positive stress test, LV ejection fraction > 40% and ≥ 2 coronary lesions >70%. The primary end points were the incidence of total mortality, Q-wave MI, or refractory angina that required revascularization. All data were analyzed according to the intention-to-treat principle. Results: Patients treated with PCI and MT had more primary events than CABG and, respectively, of 34%, 44% and 22% (p=0.003) (Figure). The 10-year survival rates were 72% with CABG, 72% with PCI, and 56% with MT (p=0.156). Relative to the composite end point, Cox regression analysis showed a higher incidence of primary events in MT than in CABG [HR=2.38 (95%CI: 1.40 to 4.05); p=0.001], lower incidence in PCI than in MT [HR=0.60 (95%CI: 0.38 to 0.95); p=0.031] but no differences between CABG and PCI [HR=1.42 (95%CI: 0.83 to 2.45); p=0.203]. To death, a protective effect of PCI compared to MT [HR=0.44 (95%CI: 0.21 to 0.90); p=0.025] was observed but not between PCI and CABG or MT and CABG. Conclusion: Women with multivessel CAD and normal LV function, CABG and PCI were associated with fewer primary events and PCI with lower mortality.