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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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.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.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.
conferenceObject 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.conferenceObject 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.conferenceObject Lack of knowledge on acute stroke in children, adolescents and adults from public schools(2021) SALLES, I. C.; GOUVEA, G. B.; CALDERARO, M.; MONTEIRO, V. S.; CORREA, R. F.; SILVA, S. N. M. F.; SHINOHARA, H. N. I.; UMEDA, I. I. K.; AIKAWA, P.; CARVALHO, H. B.; MANSUR, A. P.; CARMONA, M. J. C.; SEMERARO, F.; BOTTIGER, B. W.; NAKAGAWA, N. K.conferenceObject Effect of caloric restriction and statins on the process of cholesterol transfer to HDL in women with premature CAD(2020) LEAL, D. P.; TAVONI, T. M.; KAWABARA, K. L.; FARIA, N. F. O.; NASCIMENTO, J. R. O.; CESAR, L. A. M.; STRUNZ, C. M. C.; MANSUR, A. D. P.- 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.
- 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.