SOLANGE DESIREE AVAKIAN MANSUR

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico

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Agora exibindo 1 - 10 de 27
  • 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.
  • article 5 Citação(ões) na Scopus
    BNP and Admission Glucose as In-Hospital Mortality Predictors in Non-ST Elevation Myocardial Infarction
    (2012) TAKADA, Julio Yoshio; RAMOS, Rogerio Bicudo; AVAKIAN, Solange Desiree; SANTOS, Soane Mota dos; RAMIRES, Jose Antonio Franchini; MANSUR, Antonio de Padua
    Objectives. Admission hyperglycemia and B-type natriuretic peptide (BNP) are associated with mortality in acute coronary syndromes, but no study compares their prediction in-hospital death. Methods. Patients with non-ST-elevation myocardial infarction (NSTEMI), in-hospital mortality and two-year mortality or readmission were compared for area under the curve (AUC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) of glycemia and BNP. Results. Respectively, AUC, SEN, SPE, PPV, NPV, and ACC for prediction of in-hospital mortality were 0.815, 71.4%, 84.3%, 26.3%, 97.4%, and 83.3% for glycemia = 200 mg/dL and 0.748, 71.4%, 68.5%, 15.2%, 96.8% and 68.7% for BNP = 300 pg/mL. AUC of glycemia was similar to BNP (P = 0.411). In multivariate analysis we found glycemia >= 200mg/dL related to in-hospital death (P = 0.004). No difference was found in two-year mortality or readmission in BNP or hyperglycemic subgroups. Conclusion. Hyperglycemia was an independent risk factor for in-hospital mortality in NSTEMI and had a good ROC curve level. Hyperglycemia and BNP, although poor in-hospital predictors of unfavorable events, were independent risk factors for death or length of stay >10 days. No relation was found between hyperglycemia or BNP and long-term events.
  • 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.
  • article 3 Citação(ões) na Scopus
    Sirtuin 1 and Vascular Function in Healthy Women and Men: A Randomized Clinical Trial Comparing the Effects of Energy Restriction and Resveratrol
    (2023) GONCALINHO, Gustavo Henrique Ferreira; KUWABARA, Karen Lika; FARIA, Nathalia Ferreira de Oliveira; GOES, Marisa Fernandes da Silva; ROGGERIO, Alessandra; AVAKIAN, Solange Desiree; STRUNZ, Celia Maria Cassaro; MANSUR, Antonio de Padua
    Background: Sirtuin 1 (SIRT1) has been associated with longevity and protection against cardiometabolic diseases, but little is known about how it influences human vascular function. Therefore, this study evaluated the effects of SIRT1 activation by resveratrol and energy restriction on vascular reactivity in adults. Methods: A randomized trial allocated 48 healthy adults (24 women and 24 men), aged 55 to 65 years, to resveratrol supplementation or energy restriction for 30 days. Blood lipids, glucose, insulin, C-reactive protein, noradrenaline, SIRT1 (circulating and gene expression), and flow-mediated vasodilation (FMD) and nitrate-mediated vasodilation (NMD) were measured. Results: Both interventions increased circulating SIRT1 (p < 0.001). Pre- and post-tests changes of plasma noradrenaline were significant for both groups (resveratrol: p = 0.037; energy restriction: p = 0.008). Baseline circulating SIRT1 was inversely correlated with noradrenaline (r = -0.508; p < 0.01), and post-treatment circulating SIRT1 was correlated with NMD (r = 0.433; p < 0.01). Circulating SIRT1 was a predictor of FMD in men (p = 0.045), but not in women. SIRT1 was an independent predictor of NMD (p = 0.026) only in the energy restriction group. Conclusions: Energy restriction and resveratrol increased circulating SIRT1 and reduced sympathetic activity similarly in healthy adults. SIRT1 was independently associated with NMD only in the energy restriction group.
  • 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
    Prognosis in 10 years of follow-up of three therapeutic strategies for chronic multivessel coronary artery disease in women (study MASS)
    (2013) MANSUR, A. P.; HUEB, W. A.; TAKADA, J. Y.; AVAKIAN, S. D.; REZENDE, P. C.; SEGRE, A.; SOARES, P. R.; GARZILLO, C.; RAMIRES, J. A. F.; KALIL FILHO, R.
  • article 71 Citação(ões) na Scopus
    Serum concentrations and gene expression of sirtuin 1 in healthy and slightly overweight subjects after caloric restriction or resveratrol supplementation: A randomized trial
    (2017) MANSUR, Antonio P.; ROGGERIO, Alessandra; GOES, Marisa F. S.; AVAKIAN, Solange D.; LEAL, Dalila P.; MARANHAO, Raul C.; STRUNZ, Celia M. C.
    Background: Sirtuin 1 (Sirt1) plays an important role in vascular biology, and influences aspects of age-dependent atherosclerosis. In animals, the sirtuin system is strongly influenced by resveratrol and caloric restriction, but its expression in humans is controversial. This study investigated the effects of resveratrol and caloric restriction on Sirt1 serum concentrations and vascular biomarkers in a healthy human population. Methods and results: Forty-eight healthy participants (24 women) aged 55-65 years were randomized to either 30 days of resveratrol administration (500 mg/day) or caloric restriction (1000 cal/day). Blood was collected at baseline and day 30. Laboratory data analyzed were triglycerides, total cholesterol, HDL, VLDL, LDL, apolipoprotein A1, apolipoprotein B, lipoprotein (a), non-esterified fatty acids (NEFA), glucose, insulin, oxidative stress, C-reactive protein, and Sirt1. Expression of the Sirt1 gene was analyzed using real-time PCR. Caloric restriction diminished the abdominal circumference and improved the lipid profile, but not resveratrol intervention. Resveratrol and caloric restriction increased serum concentrations of Sirt1, from 1.06 +/- 0.71 to 5.75 +/- 2.98 ng/mL; p < 0.0001, and from 1.65 +/- 1.81 to 5.80 +/- 2.23 ng/mL; p < 0.0001, respectively. Sirt1 increased in women and men in both interventions. On the other hand expression of Sirt1 mRNA was not different after caloric restriction and resveratrol treatment. Conclusions: Caloric restriction and resveratrol significantly increased plasma concentrations of Sirt1. The longterm impact of these interventions on atherosclerosis should be assessed.
  • article 13 Citação(ões) na Scopus
    In-hospital death in acute coronary syndrome was related to admission glucose in men but not in women
    (2012) TAKADA, Julio Yoshio; RAMOS, Rogerio Bicudo; ROZA, Larissa Cardoso; AVAKIAN, Solange Desiree; RAMIRES, Jose Antonio Franchini; MANSUR, Antonio de Padua
    Background: Admission hyperglycaemia is associated with mortality in patients with acute coronary syndrome (ACS), but controversy exists whether hyperglycaemia uniformly affects both genders. We evaluated coronary risk factors, gender, hyperglycaemia and their effect on hospital mortality. Methods: 959 ACS patients (363 women and 596 men) were grouped based on glycaemia >= or < 200 mg/dL and gender: men with glucose < 200 mg/dL (menG-); women with glucose < 200 mg/dL (womenG-); men with glucose >= 200 mg/dL (menG+); and women with glucose >= 200 mg/dL (womenG+). A logistic regression analysis compared the relation between gender and glycaemia groups and death, adjusted for coronary risk factors and laboratory data. Results group: menG- had lower mortality than menG+ (OR = 0.172, IC95% 0.062-0.478), and womenG+ (OR = 0.275, IC95% 0.090-0.841); womenG- mortality was lower than menG+ (OR = 0.230, IC95% 0.074-0.717). No difference was found between menG+ vs womenG+ (p = 0.461), or womenG- vs womenG+ (p = 0.110). Age (OR = 1.067, IC95% 1.031-1.104), EF (OR = 0.942, IC95% 0.915-0.968), and serum creatinine (OR = 1.329, IC95% 1.128-1.566) were other independent factors related to in-hospital death. Conclusions: Death was greater in hyperglycemic men compared to lower blood glucose men and women groups, but there was no differences between women groups in respect to glycaemia after adjustment for coronary risk factors.
  • conferenceObject
    Prognosis importance of absence of angina in non-ST elevation myocardial infarction
    (2012) TAKADA, J. Y.; RAMOS, R. B.; AVAKIAN, S. D.; RAMIRES, J. A. F.; MANSUR, A. P.
    Purpose: Cardiac troponins increased myocardial infarction diagnosis in patients without specific electrocardiographic changes. Absence of angina has become common and prognostic significance remains unclear. Methods: We followed 204 consecutive patients after myocardial infarction non-ST elevation(NSTEMI) at emergency department. Outcomes were in-hospital death and follow-up death or cardiac readmission. Results: No-angina (NAG) group (n = 27, 13.2%) had more women (p = 0.001), higher blood glucose (p =0.011) and B-type natriuretic factor (p < 0.001). In-hospital (14.8% vs 4.5%,p = 0.035) and 20-months follow-up mortality (43.5% vs 12.9%, p<0.001) were higher in NAG. Combination of death and cardiac read- mission was similar (70.4%vs 53.1%, p = 0.093). Age (HR = 1.038, 95% CI 1.006 to 1.071), absence of angina at admission (HR 2.554, 95% CI 1.037 to 6.289), male gender (HR 2.706, 95% CI 1.099 to 6.667) and dyspnea (HR 3.113, 95% CI 1.417 to 6.842) were independent predictors of long-term mortality. Conclusion: The absence of chest pain in NSTEMI implies in higher in-hospitaland long-term mortality.
  • conferenceObject