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
44 resultados
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- 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.
- 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.
- 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.
- Cardiac Troponin I in Patients Undergoing Percutaneous and Surgical Myocardial Revascularization: Comparison of Analytical Methods(2023) VENDRAMINI, Sabrina Pacheco do Amaral; STRUNZ, Celia Maria Cassaro; HUEB, Whady Armindo; MANSUR, Antonio de PaduaThe myocardial infarction (MI) types 4a and 5 guidelines recommend cardiac troponin (cTn) diagnostic decision limits of 5 and 10 times the 99th percentile, respectively. Different cTn kits elicit different responses, so the MI diagnosis is still challenging. The study aimed to establish the cutoff values and the accuracy of three different cTnI kits in the diagnosis of post-procedural MI. We analyzed 115 patients with multivessel stable chronic coronary artery disease; 26 underwent percutaneous coronary intervention, and 89 underwent coronary artery bypass graft. Delayed-enhancement magnetic resonance imaging was performed before and after each intervention for definitive MI diagnoses. Two contemporary and one high-sensitivity cTnI immunoassays were used. ROC curves determined the accuracy of each assay. Low accuracy was observed after applying the current guidelines recommendations. The three cTnI assays accuracies improved when adjusted by the new ROC cutoffs, reaching 82% for MI type 5 for all assays, and 78%, 88%, and 87% for MI type 4 for Siemens, Beckman, and Abbott, respectively. The ultrasensitive and contemporary tests' accuracy for MI types 4a and 5 diagnoses are equivalent when adjusted for these new cutoffs. The hs-cTnI assays had lower accuracy than contemporary tests for MI types 4a and 5 diagnoses.
- Cardiovascular and Cancer Death Rates in the Brazilian Population Aged 35 to 74 Years, 1996-2017(2021) MANSUR, Antonio de Padua; FAVARATO, DesiderioBackground: Cardiovascular diseases (CVD) and cancer are the main causes of death worldwide. These diseases share many risk factors. Control of traditional risk factors for CVD was associated with lower incidence of cancers. Objective: To analyze CVD and cancer mortality rate trends in Brazilian population aged 35-74 years from 1996 to 2017. Methods: Crude and age-adjusted death rate trends were analyzed for all causes of death, CVD, and cancer. Data were obtained from mortality database of the Ministry of Health. Joinpoint Regression Program performed analysis of trends and adjustments in death rates. The degree of changes was determined by the average annual percent change (AAPC). Level of statistical significance was set at p < 0.05. Results: Mortality from all causes of death (AAPC=-1.6%; p<0.001), CVD (AAPC=-2.3; p<0.001), ischemic heart disease (IHD) (AAPC=-1.6; p<0.001) and stroke (AAPC=-3.7; p<0.001) declined. Same trends were observed for CVD (p<0.001) in men and women. Death rates from all causes of cancer (AAPC=-0.1; p=0.201), in men (AAPC=-0.1; p=0.193) and in women (AAPC=-0.1; p=0,871) remained unchanged. In 2002, mortality from cancer exceeded the sum of deaths from IHD and stroke. If trends continue, cancer mortality will also exceed mortality from CVD by 2024. In women, death rates from breast, lung and colon cancer increased, and from cervical and gastric cancers decreased. In men, mortality from lung, stomach and esophagus cancer decreased, and from prostate cancer remained unchanged. Conclusion: CVD are currently the leading cause of death in Brazil, but death rates from cancer will exceed those from CVD in a few years.
- In-hospital death in acute coronary syndrome was related to admission glucose in men but not in women(2012) TAKADA, Julio Yoshio; RAMOS, Rogerio Bicudo; ROZA, Larissa Cardoso; AVAKIAN, Solange Desiree; RAMIRES, Jose Antonio Franchini; MANSUR, Antonio de PaduaBackground: Admission hyperglycaemia is associated with mortality in patients with acute coronary syndrome (ACS), but controversy exists whether hyperglycaemia uniformly affects both genders. We evaluated coronary risk factors, gender, hyperglycaemia and their effect on hospital mortality. Methods: 959 ACS patients (363 women and 596 men) were grouped based on glycaemia >= or < 200 mg/dL and gender: men with glucose < 200 mg/dL (menG-); women with glucose < 200 mg/dL (womenG-); men with glucose >= 200 mg/dL (menG+); and women with glucose >= 200 mg/dL (womenG+). A logistic regression analysis compared the relation between gender and glycaemia groups and death, adjusted for coronary risk factors and laboratory data. Results group: menG- had lower mortality than menG+ (OR = 0.172, IC95% 0.062-0.478), and womenG+ (OR = 0.275, IC95% 0.090-0.841); womenG- mortality was lower than menG+ (OR = 0.230, IC95% 0.074-0.717). No difference was found between menG+ vs womenG+ (p = 0.461), or womenG- vs womenG+ (p = 0.110). Age (OR = 1.067, IC95% 1.031-1.104), EF (OR = 0.942, IC95% 0.915-0.968), and serum creatinine (OR = 1.329, IC95% 1.128-1.566) were other independent factors related to in-hospital death. Conclusions: Death was greater in hyperglycemic men compared to lower blood glucose men and women groups, but there was no differences between women groups in respect to glycaemia after adjustment for coronary risk factors.
article 60 Citação(ões) na Scopus V Diretriz da Sociedade Brasileira de Cardiologia sobre Tratamento do Infarto Agudo do Miocárdio com Supradesnível do Segmento ST(2015) PIEGAS, L. S.; TIMERMAN, A.; FEITOSA, G. S.; NICOLAU, J. C.; MATTOS, L. A. P.; ANDRADE, M. D.; AVEZUM, A.; FELDMAN, A.; CARVALHO, A. C. C. De; SOUSA, A. C. S.; MANSUR, A. P.; BOZZA, A. E. Z.; FALCAO, B. A. A.; MARKMAN FILHO, B.; POLANCZYK, C. A.; GUN, C.; V, C. Serrano Junior; OLIVEIRA, C. C.; MOREIRA, D.; PRECOMA, D. B.; MAGNONI, D.; ALBUQUERQUE, D. C.; ROMANO, E. R.; STEFANINI, E.; SANTOS, E. S.; GOD, E. M. G.; RIBEIRO, E. E.; BRITO JUNIOR, F. S.; FEITOSA-FILHO, G. S.; ARRUDA, G. D. S.; OLIVEIRA, G. B. F.; OLIVEIRA, G. B. F.; LIMA, G. G.; DOHMANN, H. F. R.; LIGUORI, I. M.; COSTA, J. R.; SARAIVA, J. F. K.; MAIA, L. N.; MOREIRA, L. F. P.; ARRAIS, M.; CANESIN, M. F.; COUTINHO, M. S. S. A.; MORETTI, M. A.; GHORAYEB, N.; VIEIRA, N. W.; DUTRA, O. P.; COELHO, O. R.; LEAES, P. E.; ROSSI, P. R. F.; ANDRADE, P. B.; LEMOS, P. A.; PAVANELLO, R.; COSTA, Vivacqua R. C.; BASSAN, R.; ESPORCATTE, R.; MIRANDA, R.; V, R. R. C. Giraldez; RAMOS, R. F.; MARTINS, S. K.; ESTEVES, V. B. C.; MATHIAS JUNIOR, W.- Changes in cardiac heparan sulfate proteoglycan expression and streptozotocin-induced diastolic dysfunction in rats(2011) STRUNZ, Celia M. C.; MATSUDA, Monique; SALEMI, Vera M. C.; NOGUEIRA, Adriana; MANSUR, Antonio P.; CESTARI, Ismar N.; MARQUEZINI, Monica V.Background: Changes in the proteoglycans glypican and syndecan-4 have been reported in several pathological conditions, but little is known about their expression in the heart during diabetes. The aim of this study was to investigate in vivo heart function changes and alterations in mRNA expression and protein levels of glypican-1 and syndecan-4 in cardiac and skeletal muscles during streptozotocin (STZ)-induced diabetes. Methods: Diabetes was induced in male Wistar rats by STZ administration. The rats were assigned to one of the following groups: control (sham injection), after 24 hours, 10 days, or 30 days of STZ administration. Echocardiography was performed in the control and STZ 10-day groups. Western and Northern blots were used to quantify protein and mRNA levels in all groups. Immunohistochemistry was performed in the control and 30-day groups to correlate the observed mRNA changes to the protein expression. Results: In vivo cardiac functional analysis performed using echocardiography in the 10-day group showed diastolic dysfunction with alterations in the peak velocity of early (E) diastolic filling and isovolumic relaxation time (IVRT) indices. These functional alterations observed in the STZ 10-day group correlated with the concomitant increase in syndecan-4 and glypican-1 protein expression. Cardiac glypican-1 mRNA and skeletal syndecan-4 mRNA and protein levels increased in the STZ 30-day group. On the other hand, the amount of glypican in skeletal muscle was lower than that in the control group. The same results were obtained from immunohistochemistry analysis. Conclusion: Our data suggest that membrane proteoglycans participate in the sequence of events triggered by diabetes and inflicted on cardiac and skeletal muscles.
- Anomalous Coronary Artery Origin in a Young Patient with Marfan Syndrome(2017) DUARTE, S. B. C. P.; BERALDO, D. O.; CESAR, L. A. M.; MANSUR, A. P.; TAKADA, J. Y.Marfan syndrome is an autosomal dominant genetic disorder that a affects connective tissue and is caused by mutations in the fibrillin 1 gene present at chromosome 15. Aortic aneurysm is its main complication, and along the dilation of the aorta root and its descending portion (60-100%), with secondary aortic insufficiency, it increases risk of acute aortic dissection and death. Coronary artery anomalies a affect between 0.3% and 1.6% of the general population and are the second leading cause of sudden death in young adults, especially if the anomalous coronary passes through aorta and pulmonary artery. The anomalous origin of the left main coronary artery in the right Valsalva sinus has a prevalence of 0.02%-0.05% and is commonly related to other congenital cardiac anomalies, such as transposition of great vessels, coronary fistulas, bicuspid aortic valve, and tetralogy of Fallot. Its association with Marfan syndrome is not known, and there is no previous report in the literature. We describe here a case of a female with Marfan syndrome diagnosed with symptomatic anomalous origin of the left coronary artery in the right Valsalva sinus.