FRANCISCO CARLOS DA COSTA DARRIEUX
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
conferenceObject Cost-effectiveness of dabigatran etexilate versus warfarin for stroke prevention in patients with non-valvular atrial fibrillation under the public and private healthcare system in Brazil(2012) NASCIBEN, V. D.; GIANGRANDE, L.; PIEGAS, L.; FIGUEIREDO, M.; DARRIEUX, F.; MARTINS, S.Objectives: To compare costs and effectiveness of dabigatran etexilate (DAB) versus warfarin (WAR) in patients with Non-Valvular Atrial Fibrillation (NVAF) from a private and public health care system perspective in Brazil. Methods: A Markov model was built to compare DAB versus WAR to derive the incremental cost effectiveness ratio (ICER) of DAB (150 mg BID or 110 mg BID), based on the international literature and a modified Delphi panel with Brazilian experts (local clinical practice pattern on the management of NVAF patients) assuming in the model a hypothetical population considering similar profile of the RELY trial. The model estimated the number of ischaemic and haemorrhagic strokes, systemic embolisms, intracranial hemorrhages, transient ischaemic attacks, extracranial hemorrhages, minor bleeds and acute myocardial infarctions associated with the respective treatments. To each clinical event costs, disabilities and/or reduction in quality of life, and risk of death were assigned. Only direct medical costs were considered and a discount rate of 5% was assumed, according to Brazilian HTA guidelines. A probabilistic sensitivity analysis was designed to assess uncertainty. Results: Under both, the private and public perspective, DAB was associated with additional 0.30 life years gained (LY) (9.42 life year for DAB versus 9.11 life years for WAR), additional 0.35 QALYs (7.25 QALYs for DAB versus 6.91 QALYs for WAR) and demonstrated a lower incidence of intracranial events versus WAR, resulting in lower event costs (R$ 4,030.31 for DAB versus R$ 4,828.38 for WAR in the public health care system and R$ 9,767.99 for DAB versus R$ 11,539.30 for WAR in the private healthcare system) and follow-up costs (R$ 8,549.87 for DAB versus R$ 9,530.77 for WAR in the public healthcare system and R$ 16,275.83 for DAB versus R$ 19,444.25 for WAR in the private healthcare system). The ICER for DAB versus WAR was R$ 39,740/LY and R$ 34,867/QALY from the public and R$ 25,252.48/LY and R$ 22,160.20/QALY from the private perspective. Sensitivity analyses confirmed the cost-effectiveness of DAB. Conclusion: Findings suggest that DAB can be cost-effective for stroke prevention when used instead of WAR in NVAF patients in Brazil, given that the ICERS were below the threshold of other technologies reimbursed.- Redução da Densidade de Extrassístoles e dos Sintomas Relacionados após Administração de Magnésio por Via Oral(2012) FALCO, Cristina Nadja Muniz Lima De; GRUPI, Cesar; SOSA, Eduardo; SCANAVACCA, Mauricio; HACHUL, Denise; LARA, Sissy; SACILOTTO, Luciana; PISANI, Cristiano F.; RAMIRES, Jose A. F.; DARRIEUX, FranciscoBackground: Premature ventricular and supraventricular complexes (PVC and PsVC) are frequent and often symptomatic. The magnesium (Mg) ion plays a role in the physiology of cell membranes and cardiac rhythm. Objective: We evaluated whether the administration of Mg Pidolate (MgP) in patients with PVC and PsVC is superior to placebo (P) in improving symptoms and arrhythmia frequency. Methods: Randomized double-blind study with 60 consecutive symptomatic patients with more than 240 PVC or PsVC/h on 24-hour Holter monitoring who were selected to receive placebo or MgP. To evaluate symptom improvement, a categorical and a specific questionnaire for symptoms related to PVC and PsVC was made. Improvement in premature complex density (PCD) per hour was considered significant if percentage reduction was >= 70% after treatment. The dose of MgP was 3.0 g/day for 30 days, equivalent to 260mg of Mg element. None of the patients had structural heart disease or renal failure. Results: Of the 60 patients, 33 were female (55%). Ages ranged from 16 to 70 years old. In the MgP group, 76.6% of patients had a PCD reduction >70%, 10% of them >50% and only 13.4% <50%. In the P group, 40% showed slight improvement, <30%, in the premature complexes frequency (p < 0.001). Symptom improvement was achieved in 93.3% of patients in the MgP group, compared with only 16.7% in the P group (p < 0.001). Conclusion: Oral Mg supplementation decreases PCD, resulting in symptom improvement. (Arq Bras Cardiol 2012;98(6):480-487)
- Radiofrequency Ablation of Childhood Arrhythmia. Observational Registry in 125 Children(2012) MELO, Sissy Lara de; SCANAVACCA, Mauricio Ibrahim; PISANI, Cristiano; DARRIEUX, Francisco; HACHUL, Denise; HARDY, Carina; CAMARGO, Paulo Roberto; ATIK, Edmar; SOSA, Eduardo ArgentinoBackground: Radiofrequency ablation (RFA) in children is an increasingly common practice. Objective: To evaluate, in our institution, the results of RFA in children younger than 15 years. Methods: A total of 125 children submitted to RFA between May 1991 and May 2010 were analyzed. Results: Sixty-seven (53.6%) children were males, aged between 44 days and 15 years (mean 8.6 +/- 3.3 years) with median weight of 31 kg. Heart disease was present in 21 (16.8%) patients. The RFA of accessory pathways (AP) was the most common procedure (62 children - 49.6%). The RFA of nodal reentrant tachycardia (NRT) was the second most common arrhythmia in 27 (21.6%), followed by atrial tachycardia (AT) in 16 (12.8%) and ventricular tachycardias (VT) in 8 (6.4%) children. The success criteria were achieved in 86.9%, 96.1%, 80% and 62.5% of patients undergoing RFA of AP, NRT, AT and VT, respectively. Transient AVB occurred during RFA in 4 (3.2%) and LBBB in 7 (5.6%) children. Twenty-five children underwent a new RFA due to initial failure or recurrence. During the mean follow up of 5.5 +/- 3.4 years, 107 (88.4%) remained without recurrence. There was no statistical difference regarding the results and the age at which the patient underwent the procedure. No child had persistent AVB or required a permanent pacemaker. Conclusion: Catheter ablation is a safe and effective alternative therapy in children with recurrent tachycardias refractory to medical treatment. (Arq Bras Cardiol 2012;98(6):514-518)
conferenceObject COST-EFFECTIVENESS OF DABIGATRAN ETEXILATE VERSUS WARFARIN FOR STROKE PREVENTION IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION UNDER THE PRIVATE AND PUBLIC HEALTH CARE SYSTEM IN BRAZIL(2012) NASCIBEN, V; FIGUEIREDO, M. J. D. O.; DARRIEUX, F. C. D. C.; PIEGAS, L. S. P.; MARTINS, S. C. O.