FABIANA GOULART MARCONDES BRAGA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
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- Value-based health care in heart failure: Quality of life and cost analysis(2023) GHISLENI, Eduarda Chiesa; ASTOLFI, Vit oria Rech; ZIMMERMANN, Larissa; LIRA, Camila Nogueira Leandro; NASCIMENTO, Eduarda Faria do; ETGES, Ana Paula Beck da Silva; MARCONDES-BRAGA, Fabiana G.; BACAL, Fernando; DANZMANN, Luiz Claudio; POLANCZYK, Carisi Anne; BIOLO, AndreiaObjectives: To measure Quality of Life (QoL) and costs of Heart Failure (HF) outpatients in Brazil as an introduction to the Value-Based Health Care (VBHC) concept.Materials and methods: Cross-sectional study, patients with HF, with ejection fraction <50%, were recruited from three hospitals in Brazil. Two QoL (36-Item Short Form Survey [SF-36] and Minnesota Living with Heart Failure Questionnaire [MLHFQ]) and two anxiety/depression questionnaires were applied. SF-36 scores were stratified by domains. Treatment costs were calculated using the Time-Driven Activity-Based Costing (TDABC) method. Results were stratified by NYHA functional class and sex.Results: From October 2018 to January 2021, 198 patients were recruited, and the median MLHFQ (49.5 [IQR 21.0, 69.0]) and SF-36 scores demonstrated poor QoL, worse at higher NYHA classes. A third of patients had moderate/severe depression and anxiety symptoms, and women had higher anxiety scores. Mean costs of outpatient follow-up were US$ 215 +/- 238 for NYHA I patients, US$ 296 +/- 399 for NYHA II and US$ 667 +/- 1012 for NYHA III/IV. Lab/exam costs represented 30% of the costs in NYHA I, and 74% in NYHA III/IV (US $ 63.26 vs. US$ 491.05).Conclusion: Patients with HF in Brazil have poor QoL and high treatment costs; both worsen as the NYHA classifi-cation increases. It seems that HF has a greater impact on the mental health of women. Costs increase mostly related to lab/exams. Accurate and crossed information about QoL and costs is essential to drive care and reim-bursement strategies based on value.
- Survival of Heart Transplant Patients with Chagas' Disease Under Different Antiproliferative Immunosuppressive Regimens(2023) FURQUIM, Silas Ramos; GALBIATI, Luana Campoli; AVILA, Monica S.; MARCONDES-BRAGA, Fabiana G.; FUKUSHIMA, Julia; MANGINI, Sandrigo; SEGURO, Luis Fernando Bernal da Costa; CAMPOS, Iascara Wozniak de; STRABELLI, Tania Mara Varejao; BARONE, Fernanda; PAULO, Audrey Rose da Silveira Amancio de; OHE, Luciana Akutsu; GALANTE, Mariana Cappelletti; GAIOTTO, Fabio Antonio; BACAL, FernandoBackground: Chagas' disease (CD) is an important cause of heart transplantation (HT). The main obstacle is Chagas' disease reactivation (CDR), usually associated to high doses of immunosuppressants. Previous studies have suggested an association of mycophenolate mofetil with increased CDR. However, mortality predictors are unknown.Objectives: To identify mortality risk factors in heart transplant patients with CD and the impact of antiproliferative regimen on survival.Methods: Retrospective study with CD patients who underwent HT between January 2004 and September 2020, under immunosuppression protocol that prioritized azathioprine and change to mycophenolate mofetil in case of rejection. We performed univariate regression to identify mortality predictors; and compared survival, rejection and evidence of CDR between who received azathioprine, mycophenolate mofetil and those who changed from azathioprine to mycophenolate mofetil after discharge (""Change"" group). A p-value < 0.05 was considered statistically significant. Results: Eighty-five patients were included, 54.1% men, median age 49 (39-57) years, and 91.8% were given priority in waiting list. Nineteen (22.4%) used azathioprine, 37 (43.5%) mycophenolate mofetil and 29 (34.1%) switched therapy; survival was not different between groups, 2.9 (1.6-5.0) x 2.9 (1.8-4.8) x 4.2 (2.0-5.0) years, respectively; p=0.4. There was no difference in rejection (42%, 73% and 59% respectively; p=0.08) or in CDR (T. cruzi positive by endomyocardial biopsy 5% x 11% x 7%; p=0.7; benznidazole use 58% x 65% x 69%; p=0.8; positive PCR for T. cruzi 20% x 68% x 42% respectively; p=0.1) rates.Conclusions: This retrospective study did not show difference in survival in heart transplant patients with CD receiving different antiproliferative regimens. Mycophenolate mofetil was not associated with statistically higher rates of CDR or graft rejection in this cohort. New randomized clinical trials are necessary to address this issue.
conferenceObject Breath acetone changes in advanced heart failure patients on inotropes(2023) COSTA-DAN, D. M.; BACAL, F.; LIRA, C. N. L.; FURLAN, D. A. G.; SILVA, B. G.; RINCO, R. S.; SOIERO, A. M.; LEAL, T. C. A. T.; AVILA, M. S.; BISELLI, B.; BOCCHI, E. A.; SOARES, P. R.; OLIVEIRA JUNIOR, M. T.; GUTZ, I. G. R.; MARCONDES-BRAGA, F. G.- Cumulative Disorder of Myocardial Lipofuscin after Long-Term Heart Transplantation: A Study Based on Endomyocardial Biopsies(2023) BENVENUTI, Luiz Alberto; MARCONDES-BRAGA, Fabiana G.; BACAL, Fernando
conferenceObject Necropsy findings in heart transplant recipients with and without primary graft dysfunction: a retrospective study(2023) BELFORT, D. S. P.; MANGINI, S.; AVILA, M. S.; MARCONDES-BRAGA, F. G.; CAMPOS, I. W.; SEGURO, L. F. B. C.; BACAL, F.; GUTIERREZ, P. S.- Percutaneous Strategies in Structural Heart Diseases: Focus on Chronic Heart Failure(2023) FILIPPINI, Filippe Barcellos; RIBEIRO, Henrique Barbosa; BOCCHI, Edimar; BACAL, Fernando; MARCONDES-BRAGA, Fabiana G.; AVILA, Monica S.; STURMER, Janine Daiana; MARCHI, Mauricio Felippi de Sa; KANHOUCHE, Gabriel; FERNANDO, Antonio; CASSAR, Renata; JR, Fabio Sandoli de Brito; ABIZAID, Alexandre A.Innovations in devices during the last decade contributed to enhanced diagnosis and treatment of patients with cardiac insufficiency. These tools progressively adapted to minimally invasive strategies with rapid, widespread use. The present article focuses on actual and future directions of device-related diagnosis and treatment of chronic heart failure.
conferenceObject The Role of High-Sensitive Troponin in Identifying Patients with Cardiac Allograft Rejection(2023) SCUSSEL, A. A.; MARCONDES-BRAGA, F. G.; ESPINOZA, C.; MARCHI, D. De; AVILA, M.; DUQUE, A. P.; PAULO, A. R. de; MANGINI, S.; CAMPOS, I. W. de; SEGURO, L. F.; GAIOTTO, F. A.; BACAL, F.bookPart Insuficiência cardíaca(2023) MARCONDES-BRAGA, Fabiana Goulart; SEGURO, Luis Fernando Bernal da Costa; BACAL, Fernando- Position Statement on Ischemic Heart Disease-Women-Centered Health Care-2023(2023) OLIVEIRA, Glaucia Maria Moraes de; ALMEIDA, Maria Cristina Costa de; RASSI, Daniela do Carmo; BRAGANCA, Erika Olivier Vilela; MOURA, Lidia Zytynski; ARRAIS, Magaly; CAMPOS, Milena dos Santos Barros; LEMKE, Viviana Guzzo; AVILA, Walkiria Samuel; LUCENA, Alexandre Jorge Gomes de; ALMEIDA, Andre Luiz Cerqueira de; BRANDAEO, Andrea Araujo; FERREIRA, Andrea Dumsch de Aragon; BIOLO, Andreia; MACEDO, Ariane Vieira Scarlatelli; FALCAEO, Breno de Alencar Araripe; POLANCZYK, Carisi Anne; LANTIERI, Carla Janice Baister; MARQUES-SANTOS, Celi; FREIRE, Claudia Maria Vilas; PELLEGRINI, Denise; ALEXANDRE, Elizabeth Regina Giunco; BRAGA, Fabiana Goulart Marcondes; OLIVEIRA, Fabiana Michelle Feitosa de; CINTRA, Fatima Dumas; COSTA, Isabela Bispo Santos da Silva; SILVA, Jose Sergio Nascimento; CARREIRA, Lara Terra F.; MAGALHAEES, Lucelia Batista Neves Cunha; MATOS, Luciana Diniz Nagem Janot de; ASSAD, Marcelo Heitor Vieira; BARBOSA, Marcia M.; SILVA, Marconi Gomes da; RIVERA, Maria Alayde Mendonca; IZAR, Maria Cristina de Oliveira; COSTA, Maria Elizabeth Navegantes Caetano; PAIVA, Maria Sanali Moura de Oliveira; CASTRO, Marildes Luiza de; UELLENDAHL, Marly; OLIVEIRA JUNIOR, Mucio Tavares de; SOUZA, Olga Ferreira de; COSTA, Ricardo Alves da; COUTINHO, Ricardo Quental; SILVA, Sheyla Cristina Tonheiro Ferro da; MARTINS, Silvia Marinho; BRANDAEO, Simone Cristina Soares; BUGLIA, Susimeire; BOSA, Tatiana Maia Jorge de UlhoaBar; NASCIMENTO, Thais Aguiar do; VIEIRA, Thais; CAMPAGNUCCI, Valquiria Pelisser; CHAGAS, Antonio Carlos Palandri