MUCIO TAVARES DE OLIVEIRA JUNIOR

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  • article 4 Citação(ões) na Scopus
    Effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life among patients with acute heart failure
    (2021) BELKIN, Maria; WUSSLER, Desiree; GUALANDRO, Danielle Menosi; SHRESTHA, Samyut; STREBEL, Ivo; GOUDEV, Assen; MAEDER, Micha T.; WALTER, Joan; FLORES, Dayana; KOZHUHAROV, Nikola; LOPEZ-AYALA, Pedro; DANIER, Isabelle; OLIVEIRA JUNIOR, Mucio Tavares de; KOBZA, Richard; RICKLI, Hans; BREIDTHARDT, Tobias; ERNE, Paul; MUENZEL, Thomas; MUELLER, Christian
    Aims We aimed to assess the long-term effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life (HRQL) among patients with acute heart failure (AHF). Methods and results Health-related quality of life was prospectively assessed by the generic 3-levelled EQ-5D and the disease-specific Kansas City Cardiomyopathy Questionnaire (KCCQ) among adult AHF patients enrolled in an international, multicentre, randomised, open-label blinded-end-point trial of a strategy that emphasized early intensive and sustained vasodilation using maximally tolerated doses of established oral and transdermal vasodilators according to systolic blood pressure. Changes in EQ-5D and KCCQ from admission to 180 day follow-up were individually compared between the intensive vasodilatation and the usual care group. Among 666 patients eligible for 180 day follow-up, 284 (43%, median age 79 years, 35% women) and 198 (30%, median age 77 years, 35% women) had completed the EQ-5D and KCCQ at baseline and follow-up, respectively. There was a significant improvement in HRQL as quantified by both, EQ-5D and KCCQ, from hospitalization to 180 day follow-up, with no significant differences in the change of HRQL between both treatment strategies. For instance, 39 (26%) versus 33 (25%) patients had an improvement by at least one level in at least two categories in the EQ-5D. Median increase in KCCQ overall summary score (KCCQ-OSS) was 17.6 (IQR 2.0-42.6) in the intervention group versus 18.5 (IQR 3.9-39.3) in the usual care group (P < 0.001 vs. baseline, P = 0.945 between groups). Conclusions Among patients with AHF, long-term HRQL quantified by EQ-5D and KCCQ improved substantially, with overall no significant differences between a strategy of comprehensive vasodilation versus usual care.
  • article 1 Citação(ões) na Scopus
    Comprehensive vasodilatation in women with acute heart failure: Novel insights from the GALACTIC randomized controlled trial
    (2023) WUSSLER, Desiree; BELKIN, Maria; MAEDER, Micha T.; WALTER, Joan; SHRESTHA, Samyut; KUPSKA, Karolina; STIERLI, Michelle; FLORES, Dayana; KOZHUHAROV, Nikola; GUALANDRO, Danielle Menosi; OLIVEIRA JUNIOR, Mucio Tavares de; SABTI, Zaid; NOVEANU, Markus; SOCRATES, Thenral; BAYES-GENIS, Antoni; SIONIS, Alessandro; SIMON, Patrick; MICHOU, Eleni; GUJER, Samuel; GORI, Tommaso; WENZEL, Philip; PFISTER, Otmar; ARENJA, Nisha; KOBZA, Richard; RICKLI, Hans; BREIDTHARDT, Tobias; MUENZEL, Thomas; MUELLER, Christian; GALACTIC Investigators
    Aims Sex-specific differences in acute heart failure (AHF) are both relevant and underappreciated. Therefore, it is crucial to evaluate the risk/benefit ratio and the implementation of novel AHF therapies in women and men separately.Methods and results We performed a pre-defined sex-specific analysis in AHF patients randomized to a strategy of early intensive and sustained vasodilatation versus usual care in an international, multicentre, open-label, blinded endpoint trial. Inclusion criteria were AHF with increased plasma concentrations of natriuretic peptides, systolic blood pressure >= 100 mmHg, and plan for treatment in a general ward. Among 781 eligible patients, 288 (37%) were women. Women were older (median 83 vs. 76 years), had a lower body weight (median 64.5 vs. 77.6 kg) and lower estimated glomerular filtration rate (median 48 vs. 54 ml/min/1.73 m(2)). The primary endpoint, a composite of all-cause mortality or rehospitalization for AHF at 180 days, showed a significant interaction of treatment strategy and sex (p for interaction = 0.03; hazard ratio adjusted for female sex 1.62, 95% confidence interval 1.05-2.50; p = 0.03). The combined endpoint occurred in 53 women (38%) in the intervention group and in 35 (24%) in the usual care group. The implementation of rapid up-titration of renin-angiotensin-aldosterone system (RAAS) inhibitors was less successful in women versus men in the overall cohort and in patients with heart failure with reduced ejection fraction (median discharge % target dose in patients randomized to intervention: 50% in women vs. 75% in men).Conclusion Rapid up-titration of RAAS inhibitors was less successfully implemented in women possibly explaining their higher rate of all-cause mortality and rehospitalization for AHF.
  • article
    Telecardiology guideline in Patient Care with Acute Coronary Syndrome and Other Respiratory Diseases
    (2015) OLIVEIRA JUNIOR, Mucio Tavares de; CANESIN, Manoel Fernandes; MARCOLINO, Milena Soriano; RIBEIRO, Antonio Luiz Pinho; CARVALHO, Antonio Carlos de Camargo; REDDY, Shankar; SANTOS, Adson Roberto Franca dos; FERNANDES, Alfredo Manoel da Silva; AMARAL, Amaury Zatorre; REZENDE, Ana Carolina de; NECHAR JUNIOR, Antonio; NASCIMENTO, Bruno Ramos do; PASTORE, Carlos Alberto; WEN, Chao Lung; GUALANDRO, Danielle Menosi; NAPOLI, Domingos Guilherme; FRANCA, Francisco Faustino A. C.; FEITOSA-FILHO, Gilson Soares; SAAD, Jamil Abdalla; PILLI, Jeanne; PAULA, Leonardo Jorge Cordeiro de; LODI-JUNQUEIRA, Lucas; CESAR, Luis Antonio Machado; BODANESE, Luiz Carlos; GUTIERREZ, Marco Antonio; ALKMIM, Maria Beatriz Moreira; NUNES, Mauricio Batista; MEDEIROS, Orlando Otavio de; MORENO, Ramon Alfredo; GUNDIM, Rosangela Simoes; MONTENEGRO, Sergio Tavares; NAZIMA, Willyan Issamu
  • article 0 Citação(ões) na Scopus
    Position Statement on Cardiovascular Safety of Vaccines Against COVID-19-2022
    (2022) MOREIRA, Humberto Graner; OLIVEIRA JUNIOR, Mucio Tavares de; VALDIGEM, Bruno Pereira; MARTINS, Cristiane Nunes; POLANCZYK, Carisi Anne
  • article 13 Citação(ões) na Scopus
    Biomarkers for prediction of mortality in left-sided infective endocarditis
    (2020) SICILIANO, Rinaldo F.; GUALANDRO, Danielle M.; BITTENCOURT, Marcio Sommer; PAIXAO, Milena; MARCONDES-BRAGA, Fabiana; SOEIRO, Alexandre de Matos; STRUNZ, Celia; PACANARO, Ana Paula; PUELACHER, Christian; TARASOUTCHI, Flavio; SOMMA, Salvatore Di; CARAMELLI, Bruno; OLIVEIRA JUNIOR, Mucio Tavares de; MANSUR, Alfredo Jose; MUELLER, Christian; BARRETTO, Antonio Carlos Pereira; STRABELLI, Tania Mara Varejao
    Background: Evidence regarding biomarkers for risk prediction in patients with infective endocarditis (IE) is limited. We aimed to investigate the value of a panel of biomarkers for the prediction of in-hospital mortality in patients with IE. Methods: Between 2016 and 2018, consecutive IE patients admitted to the emergency department were prospectively included. Blood concentrations of nine biomarkers were measured at admission (D0) and on the seventh day (D7) of antibiotic therapy: C-reactive protein (CRP), sensitive troponin I (s-cTnI), procalcitonin, B-type natriuretic peptide (BNP), neutrophil gelatinase-associated lipocalin (NGAL), interleukin 6 (IL6), tumor necrosis fator a (TNF-a), proadrenomedullin, alpha-1-acid glycoprotein, and galectin 3. The primary endpoint was in-hospital mortality. Results: Among 97 patients, 56% underwent cardiac surgery, and in-hospital mortality was 27%. At admission, six biomarkers were independent predictors of in-hospital mortality: s-cTnI (OR 3.4; 95%CI 1.8-6.4; P < 0.001), BNP (OR 2.7; 95%CI 1.4-5.1; P = 0.002), IL-6 (OR 2.06; 95%CI 1.3-3.7; P = 0.019), procalcitonin (OR 1.9; 95%CI 1.1-3.2; P = 0.018), TNF-alpha (OR 1.8; 95%CI 1.1-2.9; P = 0.019), and CRP (OR 1.8; 95%CI 1.0-3.3; P = 0.037). At admission, S-cTnI provided the highest accuracy for predicting mortality (area under the ROC curve: s-cTnI 0.812, BNP 0.727, IL-6 0.734, procalcitonin 0.684, TNF-alpha 0.675, CRP 0.670). After 7 days of antibiotic therapy, BNP and inflammatory biomarkers improved their performance (s-cTnI 0.814, BNP 0.823, IL-6 0.695, procalcitonin 0.802, TNF-alpha 0.554, CRP 0.759). Conclusion: S-cTnI concentration measured at admission had the highest accuracy for mortality prediction in patients with IE. (C) 2020 The Authors.
  • article 9 Citação(ões) na Scopus
    Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?
    (2018) SOEIRO, Alexandre de Matos; ARAUJO, Victor Arrais; VELLA, Julia Pitombo; BOSSA, Aline Siqueira; BISELLI, Bruno; LEAL, Tatiana de Carvalho Andreucci Torres; SOEIRO, Maria Carolina Feres de Almeida; SERRANO JR., Carlos V.; MUELLER, Christian; OLIVEIRA JUNIOR, Mucio Tavares de
    Background: Some small studies have related higher levels of thyrotropin (TSH) to potentially worse prognosis in acute coronary syndromes. However, this relationship remains uncertain. Objective: To analyze the outcomes of patients with acute coronary syndromes in relation to the value of TSH at admission. Methods: Observational and retrospective study with 505 patients (446 in group I [TSH <= 4 mIU/L] and 59 in group II [TSH > 4 mIU/L]) with acute coronary syndromes between May 2010 and May 2014. We obtained data about comorbidities and the medications used at the hospital. The primary endpoint was in-hospital all-cause death. The secondary endpoint included combined events (death, non-fatal unstable angina or myocardial infarction, cardiogenic shock, bleeding and stroke). Comparisons between groups were made by one-way ANOVA and chi-square test. Multivariate analysis was determined by logistic regression. Analyses were considered significant when p < 0.05. Results: Significant differences between groups I and II were observed regarding the use of enoxaparin (75.2% vs. 57.63%, p = 0.02) and statins (84.08% vs. 71.19%, p < 0.0001), previous stroke (5.83% vs. 15.25%, p = 0.007), combined events (14.80% vs. 27.12%, OR = 3.05, p = 0.004), cardiogenic shock (4.77% vs. 6.05%, OR = 4.77, p = 0.02) and bleeding (12.09% vs. 15.25%, OR = 3.36, p = 0.012). Conclusions: In patients with acute coronary syndromes and TSH > 4 mIU/L at admission, worse prognosis was observed, with higher incidences of in-hospital combined events, cardiogenic shock and bleeding.
  • article 24 Citação(ões) na Scopus
    Emerging Topics Update of the Brazilian Heart Failure Guideline-2021
    (2021) MARCONDES-BRAGA, Fabiana G.; MOURA, Lidia Ana Zytynski; ISSA, Victor Sarli; VIEIRA, Jefferson Luis; ROHDE, Luis Eduardo; SIMOES, Marcus Vinicius; FERNANDES-SILVA, Miguel Morita; RASSI, Salvador; ALVES, Silvia Marinho Martins; ALBUQUERQUE, Denilson Campos de; ALMEIDA, Dirceu Rodrigues de; BOCCHI, Edimar Alcides; RAMIRES, Felix Jose Alvarez; BACAL, Fernando; ROSSI NETO, Joao Manoel; DANZMANN, Luiz Claudio; MONTERA, Marcelo Westerlund; OLIVEIRA JUNIOR, Mucio Tavares de; CLAUSELL, Nadine; SILVESTRE, Odilson Marcos; BESTETTI, Reinaldo Bulgarelli; BERNADEZ-PEREIRA, Sabrina; JR, Aguinaldo F. Freitas; BIOLO, Andreia; BARRETTO, Antonio Carlos Pereira; JORGE, Antonio Jose Lagoeiro; BISELLI, Bruno; MONTENEGRO, Carlos Eduardo Lucena; SANTOS JUNIOR, Edval Gomes Dos; FIGUEIREDO, Estevao Lanna; FERNANDES, Fabio; SILVEIRA, Fabio Serra; ATIK, Fernando Antibas; BRITO, Flavio de Souza; SOUZA, Germano Emilio Conceicao; RIBEIRO, Gustavo Calado de Aguiar; VILLACORTA, Humberto; SOUZA NETO, Joao David de; GOLDRAICH, Livia Adams; BECK-DA-SILVA, Luis; CANESIN, Manoel Fernandes; BITTENCOURT, Marcelo Imbroinise; BONATTO, Marcely Gimenes; MOREIRA, Maria da Consolacao Vieira; AVILA, Monica Samuel; COELHO FILHO, Otavio Rizzi; SCHWARTZMANN, Pedro Vellosa; MOURILHE-ROCHA, Ricardo; MANGINI, Sandrigo; FERREIRA, Silvia Moreira Ayub; FIGUEIREDO NETO, Jose Albuquerque de; MESQUITA, Evandro Tinoco
  • article 0 Citação(ões) na Scopus
    Paciente com Mixoma Atrial e Sinais de Obstrução de Via de Saída de Ventrículo Esquerdo
    (2017) FREIRE, Antonio Fernando Diniz; SOARES, Alexandre Anderson de Sousa; LEAL, Tatiana de Carvalho Andreucci Torres; OLIVEIRA JUNIOR, Mucio Tavares de; SOEIRO, Alexandre de Matos
  • bookPart
    Caso clínico baseado em diretriz: Paciente com insuficiência cardíaca e arritmias
    (2017) MATEOS, José Carlos Pachón; OLIVEIRA JUNIOR, Mucio Tavares de
  • article 87 Citação(ões) na Scopus
    Effect of a Strategy of Comprehensive Vasodilation vs Usual Care on Mortality and Heart Failure Rehospitalization Among Patients With Acute Heart Failure The GALACTIC Randomized Clinical Trial
    (2019) KOZHUHAROV, Nikola; GOUDEV, Assen; FLORES, Dayana; MAEDER, Micha T.; WALTER, Joan; SHRESTHA, Samyut; GUALANDRO, Danielle Menosi; OLIVEIRA JUNIOR, Mucio Tavares de; SABTI, Zaid; MUELLER, Beat; NOVEANU, Markus; SOCRATES, Thenral; ZILLER, Ronny; BAYES-GENIS, Antoni; SIONIS, Alessandro; SIMON, Patrick; MICHOU, Eleni; GUJER, Samuel; GORI, Tommaso; WENZEL, Philip; PFISTER, Otmar; CONEN, David; KAPOS, Ioannis; KOBZA, Richard; RICKLI, Hans; BREIDTHARDT, Tobias; MUENZEL, Thomas; ERNE, Paul; MUELLER, Christian; DIMOV, Bojidar; HARTWIGER, Sabine; HERR, Natascha; ISENRICH, Rahel; MOSIMANN, Tamina; TWERENBOLD, Raphael; BOEDDINGHAUS, Jasper; NESTELBERGER, Thomas; PUELACHER, Christian; FREESE, Michael; VOGELE, Janine; MEISSNER, Kathrin; MARTIN, Jasmin; STREBEL, Ivo; WUSSLER, Desiree; SCHUMACHER, Carmela; OSSWALD, Stefan; VOGT, Fabian; HILTI, Jonas; SCHWARZ, Jonas; FITZE, Brigitte; HARTWIGER, Sabine; ARENJA, Nisha; GLATZ, Bettina; RENTSCH, Katharina; BOSSA, Aline; JALLAD, Sergio; SOEIRO, Alexandre; JANSEN, Thomas; GEBEL, Gabriele; BOSSARD, Matthias; CHRIST, Michael
    IMPORTANCE Short-term infusions of single vasodilators, usually given in a fixed dose, have not improved outcomes in patients with acute heart failure (AHF). OBJECTIVE To evaluate the effect of a strategy that emphasized early intensive and sustained vasodilation using individualized up-titrated doses of established vasodilators in patients with AHF. DESIGN, SETTING, AND PARTICIPANTS Randomized, open-label blinded-end-point trial enrolling 788 patients hospitalized for AHF with dyspnea, increased plasma concentrations of natriuretic peptides, systolic blood pressure of at least 100mmHg, and plan for treatment in a general ward in 10 tertiary and secondary hospitals in Switzerland, Bulgaria, Germany, Brazil, and Spain. Enrollment began in December 2007 and follow-up was completed in February 2019. INTERVENTIONS Patients were randomized 1:1 to a strategy of early intensive and sustained vasodilation throughout the hospitalization (n = 386) or usual care (n = 402). Early intensive and sustained vasodilation was a comprehensive pragmatic approach of maximal and sustained vasodilation combining individualized doses of sublingual and transdermal nitrates, low-dose oral hydralazine for 48 hours, and rapid up-titration of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or sacubitril-valsartan. MAIN OUTCOMES AND MEASURES The primary end pointwas a composite of all-cause mortality or rehospitalization for AHF at 180 days. RESULTS Among 788 patients randomized, 781 (99.1%; median age, 78 years; 36.9% women) completed the trial and were eligible for primary end point analysis. Follow-up at 180 days was completed for 779 patients (99.7%). The primary end point, a composite of all-cause mortality or rehospitalization for AHF at 180 days, occurred in 117 patients (30.6%) in the intervention group (including 55 deaths [14.4%]) and in 111 patients (27.8%) in the usual care group (including 61 deaths [15.3%]) (absolute difference for the primary end point, 2.8% [95% CI, -3.7% to 9.3%]; adjusted hazard ratio, 1.07 [95% CI, 0.83-1.39]; P =.59). The most common clinically significant adverse events with early intensive and sustained vasodilation vs usual care were hypokalemia (23% vs 25%), worsening renal function (21% vs 20%), headache (26% vs 10%), dizziness (15% vs 10%), and hypotension (8% vs 2%). CONCLUSIONS AND RELEVANCE Among patients with AHF, a strategy of early intensive and sustained vasodilation, compared with usual care, did not significantly improve a composite outcome of all-cause mortality and AHF rehospitalization at 180 days.