ANTONIO DE PADUA MANSUR
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
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bookPart Panorama da Mortalidade por Doenças Cardiovasculares no Brasil e no Mundo(2016) MANSUR, Antonio de PaduaconferenceObject 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.conferenceObject Biochemical markers of muscle damage in women and men treated with statins(2017) NOGUEIRA, A.; ROGGERIO, A.; STRUNZ, C. M. C.; MANSUR, A. P.- Smoking load reduction is insufficient to downregulate miR-301b, a lung cancer promoter(2020) ARCAS, Camila dos Santos; LIN-WANG, Hui Tzu; UMEDA, Iracema Ioco Kikuchi; SOUSA, Marcio Goncalves de; UTIYAMA, Daniela Mitiyo Odagiri; MANSUR, Antonio de Padua; MACCHIONE, Mariangela; HIRATA, Mario Hiroyuki; NAKAGAWA, Naomi KondoSeveral circulating miRNAs identified in the plasma of smokers have been implicated as promoters of nasopharyngeal and lung carcinoma. To investigate the plasma profile of miRNAs in subjects who reduces the number of smoked cigarettes and who quit after six months. We accompanied 28 individuals enrolled in a Smoking Cessation Program over 6 months. At Baseline, clinical characteristics, co-morbidities, and smoking history were similar among subjects. After 6 months, two groups were defined: who successfully quitted smoking (named ""quitters"", n=18, mean age 57 years, 11 male) and who reduced the number of cigarettes smoked (20-90%) but failed to quit smoking (named ""smokers"", n=10, mean age 52 years, 3 male). No significant clinical changes were observed between groups at baseline and after a 6-month period, however, quitters showed significant downregulations in seven miRNAs at baseline: miR-17 (-2.90 -fold, p=0.029), miR-20a (-3.80-fold, p=0.021); miR-20b (-4.71-fold, p=0.027); miR-30a (-3.95-fold, p=0.024); miR-93 (-3.63-fold, p=0.022); miR-125a(-1.70 -fold, p= 0.038); and miR-195 (-5.37-fold, p=0.002), and after a 6-month period in 6 miRNAs: miR-17 (-5.30-fold, p=0.012), miR-20a (-2.04-fold, p=0.017), miR-20b (-5.44-fold, p=0.017), miR-93 (-4.00-fold, p=0.041), miR-101 (-4.82-fold, p=0.047) and miR-125b (-3.65-fold, p=0.025). Using time comparisons, only quitters had significant downregulation in miR-301b (-2.29-fold, p=0.038) after 6-month. Reductions in the number of smoked cigarettes was insufficient to change the plasma profile of miRNA after 6 months. Only quitting smoking (100% reduction) significantly downregulated miR-301b related to hypoxic conditions, promotion of cell proliferation, decreases in apoptosis, cancer development, and progression as increases in radiotherapy and chemotherapy resistance.
- Demographic and Cardiovascular Risk Factors Associated with Drug Use in Truck Drivers in the State of Sao Paulo, Brazil: A Cross-Sectional Study(2021) PEREIRA, Mariana Moura; MANSUR, Antonio de Padua; TAKADA, Julio Yoshio; LEYTON, VilmaThe aim of the study is to analyze the association between risk factors for the health of truck drivers and previous use of illicit drugs. A cross-sectional study examined the data from 2071 truck drivers between 2010 and 2016. Demographic variables, risk factors for cardiovascular disease (CVD) and the use of illicit drugs were analyzed. The stepwise logistic regression model was used for the adjusted analysis. The dependent variable was the previous use of illicit drugs, and independent variables were those with p < 0.1 at a bivariate analysis. The average age of the truck drivers was 42.27 +/- 11.07 years, and the previous use of illicit drugs was reported or detected in 388 (18.7%) drivers. Compared to non-users, drug users were younger (37.25 +/- 9.45 vs. 43.43 +/- 11.1 years; p < 0.001) and single (43.3% vs. 28.4%; p < 0.001). The independent variables for illicit drugs were age (OR = 0.93 (95% CI: 0.91-0.95; p < 0.001)), smoking (OR = 2.18 (95% CI: 1.39-3.44; p = 0.001)), alcohol consumption (OR = 1.626 (95% CI: 1.06-2.49; p = 0.026)) and driving hours per day (OR = 1.08 (95% CI: 1.01-1.15; p = 0.012)). Users of illicit drugs had multiple risk factors for CVD and traffic accidents.
- Lipid transfers to HDL are predictors of precocious clinical coronary heart disease(2012) MARANHAO, Raul C.; FREITAS, Fatima R.; STRUNZ, Celia M.; SANTOS, Raul D.; MANSUR, Alfredo J.; MANSUR, Antonio P.Background: High-density-lipoprotein (HDL) has several antiatherogenic properties and, although the concentration of HDL-cholesterol negatively correlates with incidence of coronary artery disease (CAD), this is not sufficient to evaluate the overall HDL protective role. The aim was to investigate whether precocious CAD patients show abnormalities in lipid transfers to HDL, a fundamental step in HDL metabolism and function. Methods: Thirty normocholesterolemic CAD patients aged <50 y and 30 controls paired for sex, age and B.M.I. were studied. Fasting blood samples were collected for the in vitro lipid transfer assay and plasma lipid determination. A donor nanoemulsion labeled with radioactive free-cholesterol. cholesteryl esters, phospholipids and triglycerides was incubated with whole plasma and after chemical precipitation of non-HDL fractions, supernatant was counted for radioactivity in HDL. Results: LDL and HDL-cholesterol and triglycerides were equal in both groups. Transfers of free-cholesterol (3.8 +/- 1.2%vs 7.0 +/- 33%,p<0.0001) and triglycerides (3.7 +/- 1.7%vs 4.9 +/- 1.9%, p = 0.0125) were diminished in CAD patients whereas cholesteryl ester transfer increased (6.5 +/- 1.9%vs 4.8 +/- 1.8%, p = 0.0008); phospholipid transfer was equal (17.8 +/- 3.5% vs19.5 +/- 3.9%). Conclusion: Alterations in the transfer of lipids to HDL may constitute a new marker for precocious CAD and relation of this metabolic alteration with HDL antiatherogenic function should be investigated in future studies. (C) 2011 Published by Elsevier B.V.
- BNP and Admission Glucose as In-Hospital Mortality Predictors in Non-ST Elevation Myocardial Infarction(2012) TAKADA, Julio Yoshio; RAMOS, Rogerio Bicudo; AVAKIAN, Solange Desiree; SANTOS, Soane Mota dos; RAMIRES, Jose Antonio Franchini; MANSUR, Antonio de PaduaObjectives. Admission hyperglycemia and B-type natriuretic peptide (BNP) are associated with mortality in acute coronary syndromes, but no study compares their prediction in-hospital death. Methods. Patients with non-ST-elevation myocardial infarction (NSTEMI), in-hospital mortality and two-year mortality or readmission were compared for area under the curve (AUC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) of glycemia and BNP. Results. Respectively, AUC, SEN, SPE, PPV, NPV, and ACC for prediction of in-hospital mortality were 0.815, 71.4%, 84.3%, 26.3%, 97.4%, and 83.3% for glycemia = 200 mg/dL and 0.748, 71.4%, 68.5%, 15.2%, 96.8% and 68.7% for BNP = 300 pg/mL. AUC of glycemia was similar to BNP (P = 0.411). In multivariate analysis we found glycemia >= 200mg/dL related to in-hospital death (P = 0.004). No difference was found in two-year mortality or readmission in BNP or hyperglycemic subgroups. Conclusion. Hyperglycemia was an independent risk factor for in-hospital mortality in NSTEMI and had a good ROC curve level. Hyperglycemia and BNP, although poor in-hospital predictors of unfavorable events, were independent risk factors for death or length of stay >10 days. No relation was found between hyperglycemia or BNP and long-term events.
conferenceObject 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.- Accuracy of multidetector computed tomography for detection of coronary artery stenosis in acute coronary syndrome compared with stable coronary disease: A CORE64 multicenter trial substudy(2014) SARA, Leonardo; ROCHITTE, Carlos E.; LEMOS, Pedro A.; NIINUMA, Hiroyuki; DEWEY, Marc; SHAPIRO, Edward P.; GOTTLIEB, Ilan; MANSUR, Antonio P.; NICOLAU, Jose C.; LARDO, Albert C.; AZEVEDO, Clerio F.; KALIL-FILHO, Roberto; VAVERE, Andrea L.; COHN, Silvia; COX, Christopher; BRINKER, Jeffrey; MILLER, Julie M.; LIMA, Joao A. C.Background: Multi-detector computed tomography angiography (MDCTA) is a promising method for risk assessment of patients with acute chest pain. However, its diagnostic performance in higher-risk patients has not been investigated in a large international multicenter trial. Therefore, in the present study we sought to estimate the diagnostic accuracy of MDCTA to detect significant coronary stenosis in patients with acute coronary syndrome (ACS). Methods: Patients included in the CORE64 study were categorized as suspected-ACS or non-ACS based on clinical data. A 64-row coronary MDCTA was performed before invasive coronary angiography (ICA) and both exams were evaluated by blinded, independent core laboratories. Results: From 371 patients included, 94 were categorized as suspected ACS and 277 as non-ACS. Patient-based analysis showed an area under the receiver-operating-characteristic curve (AUC) for detecting >= 50% coronary stenosis of 0.95 (95% CI: 0.88-0.98) in ACS and 0.92 (95% CI: 0.88-0.95) in non-ACS group (P = 0.29). The sensitivity, specificity, positive and negative predictive values of MDCTA were 0.90(0.80-0.96), 0.88(0.70-0.98), 0.95(0.87-0.99) and 0.77(0.58-0.90) in suspected ACS patients and 0.87(0.81-0.92), 0.86(0.79-0.92), 0.91(0.85-0.95) and 0.82(0.74-0.89) in non-ACS patients (P NS for all comparisons). The mean calcium scores (CS) were 282 +/- 449 in suspected ACS and 435 +/- 668 in non-ACS group. The accuracy of CS to detect significant coronary stenosis was only moderate and the absence or minimal coronary artery calcification could not exclude the presence of significant coronary stenosis, particularly in ACS patients. Conclusions: The diagnostic accuracy of MDCTA to detect significant coronary stenosis is high and comparable for both ACS and non-ACS patients.
- Sirtuin 1 and Vascular Function in Healthy Women and Men: A Randomized Clinical Trial Comparing the Effects of Energy Restriction and Resveratrol(2023) GONCALINHO, Gustavo Henrique Ferreira; KUWABARA, Karen Lika; FARIA, Nathalia Ferreira de Oliveira; GOES, Marisa Fernandes da Silva; ROGGERIO, Alessandra; AVAKIAN, Solange Desiree; STRUNZ, Celia Maria Cassaro; MANSUR, Antonio de PaduaBackground: Sirtuin 1 (SIRT1) has been associated with longevity and protection against cardiometabolic diseases, but little is known about how it influences human vascular function. Therefore, this study evaluated the effects of SIRT1 activation by resveratrol and energy restriction on vascular reactivity in adults. Methods: A randomized trial allocated 48 healthy adults (24 women and 24 men), aged 55 to 65 years, to resveratrol supplementation or energy restriction for 30 days. Blood lipids, glucose, insulin, C-reactive protein, noradrenaline, SIRT1 (circulating and gene expression), and flow-mediated vasodilation (FMD) and nitrate-mediated vasodilation (NMD) were measured. Results: Both interventions increased circulating SIRT1 (p < 0.001). Pre- and post-tests changes of plasma noradrenaline were significant for both groups (resveratrol: p = 0.037; energy restriction: p = 0.008). Baseline circulating SIRT1 was inversely correlated with noradrenaline (r = -0.508; p < 0.01), and post-treatment circulating SIRT1 was correlated with NMD (r = 0.433; p < 0.01). Circulating SIRT1 was a predictor of FMD in men (p = 0.045), but not in women. SIRT1 was an independent predictor of NMD (p = 0.026) only in the energy restriction group. Conclusions: Energy restriction and resveratrol increased circulating SIRT1 and reduced sympathetic activity similarly in healthy adults. SIRT1 was independently associated with NMD only in the energy restriction group.