ALEXANDRE DE MATOS SOEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Coxiella Burnetii Endocarditis: Can Positron Emission Tomography be an Alternative to Diagnosis?(2022) MIZUTA, Marjorie Hayashida; ROMERO, Cristhian Espinoza; VINTIMILLA, Santiago Castro; LEAL, Tatiana de Carvalho Andreucci Torres; SOARES, Paulo Rogerio; SOEIRO, Alexandre de Matos
- Quality improvement program in Latin America decreases mortality after cardiac surgery: a before-after intervention study(2022) MEJIA, Omar Asdrubal Vilca; BORGOMONI, Gabrielle Barbosa; DALLAN, Luis Roberto Palma; MIOTO, Bruno Mahler; ACCORSI, Tarso Augusto Duenhas; LIMA, Eduardo Gomes; SOEIRO, Alexandre de Matos; LIMA, Felipe Gallego; BRANDAO, Carlos Manuel de Almeida; POMERANTZEFF, Pablo Maria Alberto; DALLAN, Luis Alberto Oliveira; LISBOA, Luiz Augusto FerreiraBackground: The current challenge of cardiac surgery (CS) is to improve outcomes in adverse scenarios. The aim of this study was to assess the impact of a quality improvement program (QIP) on hospital mortality in the largest CS center in Latin America.Methods: Patients were divided into two groups: before (Jan 2013-Dec 2015, n = 3534) and after establishment of the QIP (Jan 2017-Dec 2019, n = 3544). The QIP consisted of the implementation of 10 central initiatives during 2016. The procedures evaluated were isolated coronary artery bypass grafting surgery (CABG), mitral valve surgery, aortic valve surgery, combined mitral and aortic valve surgery, and CABG associated with heart valve surgery. Propensity Score Matching (PSM) was used to adjust for inequality in patients' preoperative characteristics before and after the implementation of QIP. A multivariate logistic regression model was built to predict hospital mortality and validated using discrimination and calibration metrics.Results: The PMS paired two groups using 5 variables, obtaining 858 patients operated before (non-QIP) and 858 patients operated after the implementation of the QIP. When comparing the QIP versus Non-QIP group, there was a shorter length of stay in all phases of hospitalization. In addition, the patients evolved with less anemia (P = 0.001), use of intra-aortic balloon pump (P = 0.003), atrial fibrillation (P = 0.001), acute kidney injury (P < 0.001), cardiogenic shock (P = 0.011), sepsis (P = 0.046), and hospital mortality (P = 0.001). In the multiple model, among the predictors of hospital mortality, the lack of QIP increased the chances of mortality by 2.09 times.Conclusion: The implementation of a first CS QIP in Latin America was associated with a reduction in length of hospital stay, complications and mortality after the cardiac surgeries analyzed.
bookPart Diagnóstico diferencial da dor torácica(2022) SOUZA, Paulo Vinicius Ramos; MADRINI JUNIOR, Vagner; SOEIRO, Alexandre de Matos- Sonothrombolysis Promotes Improvement in Left Ventricular Wall Motion and Perfusion Scores after Acute Myocardial Infarction(2022) TAVARES, Bruno G.; AGUIAR, Miguel Osman; TSUTSUI, Jeane; OLIVEIRA, Mucio; SOEIRO, Alexandre de Matos; NICOLAU, Jose; RIBEIRO, Henrique; POCHIANG, Hsu; SBANO, Joao; ROCHITTE, Carlos Eduardo; LOPES, Bernardo; RAMIREZ, Jose; KALIL FILHO, Roberto; MATHIAS, WilsonBackground: It has recently been demonstrated that the application of high-energy ultrasound and microbubbles, in a technique known as sonothrombolysis, dissolves intravascular thrombi and increases the angiographic recanalization rate in patients with ST-segment-elevation myocardial infarction (STEMI). Objective: To evaluate the effects of sonothrombolysis on left ventricular wall motion and myocardial perfusion in patients with STEMI, using real-time myocardial perfusion echocardiography (RTMPE). Methods: One hundred patients with STEMI were randomized into the following 2 groups: therapy (50 patients treated with sonothrombolysis and primary coronary angioplasty) and control (50 patients treated with primary coronary angioplasty). The patients underwent RTMPE for analysis of left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and number of segments with myocardial perfusion defects 72 hours after STEMI and at 6 months of follow-up. P < 0.05 was considered statistically significant. Results: Patients treated with sonothrombolysis had higher LVEF than the control group at 72 hours (50% +/- 10% versus 44% +/- 10%; p = 0.006), and this difference was maintained at 6 months of follow-up (53% +/- 10% versus 48% +/- 12%; p = 0.008). The WMSI was similar in the therapy and control groups at 72 hours (1.62 +/- 0.39 versus 1.75 +/- 0.40; p = 0.09), but it was lower in the therapy group at 6 months (1.46 +/- 0.36 versus 1.64 +/- 0.44; p = 0.02). The number of segments with perfusion defects on RTMPE was similar in therapy and control group at 72 hours (5.92 +/- 3.47 versus 6.94 +/- 3.39; p = 0.15), but it was lower in the therapy group at 6 months (4.64 +/- 3.31 versus 6.57 +/- 4.29; p = 0.01). Conclusion: Sonothrombolysis in patients with STEMI resulted in improved wall motion and ventricular perfusion scores over time.
- How Can the Presence of Cardiovascular Diseases Impact Morbidity and Mortality in Patients with COVID-19?(2022) SOEIRO, Alexandre de Matos
- Are There Alternative Ways to Estimate Atherosclerotic Inflammatory Activity in Patients with Acute Coronary Syndrome?(2022) SOEIRO, Alexandre de Matos
bookPart Introdução(2022) SOEIRO, Alexandre de Matos; LEAL, Tatiana de Carvalho Andreucci Torres; BISELLI, Bruno; JúNIOR, Carlos Vicente Serrano; KALIL FILHO, Roberto; JúNIOR, Múcio Tavares de OliveiraconferenceObject Preliminary Analysis of the Symptoms and Quality of Life After Discharge in Noncritically Ill Patients with COVID-19: The ACTIV-4a and ATTACC Randomized Controlled Trial(2022) HUBEL, K. A.; GREENSTEIN, Y. Y.; VENUGOPAL, V.; LAI, Y.; BERGER, J. S.; CHANG, S. Y.; COLOVOS, C.; SHAH, F.; ISLAM, M.; JIMENEZ, J.; KHAN, M.; KORNBLITH, L. Z.; LAWLER, P. R.; GADDH, M.; MOISES, J.; GUERRERO, R. Morillo; NKEMDIRIM, W.; REYNOLDS, H. R.; AMIGO, J. Seijas; SOEIRO, A.; WAHID, L.; ZAHRA, A.; GOLIGHER, E. C.; ZARYCHANSKI, R.; CUSHMAN, M.; GONG, M. N.- Diagnostic Performance of Coronary Tomography Angiography and Serial Measurements of Sensitive Cardiac Troponin in Patients With Chest Pain and Intermediate Risk for Cardiovascular Events(2022) SOEIRO, Alexandre de Matos; BISELLI, Bruno; LEAL, Tatiana C. A. T.; BOSSA, Aline Siqueira; CESAR, Maria Cristina; JALLAD, Sergio; GOLDSTEIN, Priscila Gherardi; GUIMARAES, Patricia Oliveira; JR, Carlos Vicente Serrano; NOMURA, Cesar Higa; NAKAMURA, Debora; ROCHITTE, Carlos Eduardo; SOARES, Paulo Rogerio; JR, Mucio Tavares de OliveiraBackground: Coronary tomography angiography (CTA) has been mainly used for chest pain evaluation in low-risk patients, and few data exist regarding patients at intermediate risk. Objective: To evaluate the performance of serial measures of sensitive troponin and CTA in intermediate-risk patients. Methods: A total of 100 patients with chest pain, TIMI risk scores of 3 or 4, and negative troponin were prospectively included. All patients underwent CTA and those with coronary stenosis >= 50% were referred to invasive coronary angiography. Patients with coronary lesions <50% were discharged and contacted 30 days later by a telephone call to assess clinical outcomes. Outcomes were hospitalization, death, and myocardial infarction at 30 days. The comparison between methods was performed by Kappa agreement test. The performance of troponin measures and CTA for detecting significant coronary lesions and clinical outcomes was calculated. Results were considered statistically significant when p < 0.05. Results: Coronary stenosis >= 50% on CTA was found in 38% of patients and significant coronary lesions on coronary angiography were found in 31 patients. Two clinical events were observed. Kappa agreement analysis showed low agreement between troponin measures and CTA in the detection of significant coronary lesions (kappa = 0.022, p = 0.78). The performance of CTA for detecting significant coronary lesions on coronary angiography or for predicting clinical events at 30 days was better than sensitive troponin measures (accuracy of 91% versus 60%). Conclusion: CTA performed better than sensitive troponin measures in the detection of significant coronary disease in patients with chest pain and intermediate risk for cardiovascular events.
conferenceObject Early Biomarkers to Predict a Worse Outcome After Acute Myocardial Infarction: Circulating Infectious Extracellular Vesicles From Archaea and M. Pneumoniae Are Present and Correlated to Cytokines IL-6 and IL-10(2022) MORENO, Camila R.; SOEIRO, Alexandre M.; SATO, Maria N.; PEREIRA, Jaqueline J.; IKEGAMI, Renata N.; KAWAKAMI, Joyce T.; REIS, Marcia M.; OLIVEIRA, Luanda M.; HIGUCHI, Maria Lourdes