CARLOS JOSE DORNAS GONCALVES BARBOSA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
8 resultados
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conferenceObject Is there a Correlation Between Bleeding Risk Score and Platelet Aggregability?(2014) ARANTES, Flavia B.; FURTADO, Remo H.; BARBOSA, Carlos J.; FRANCI, Andre; MENEZES, Fernando R.; FALCAO, Talia D.; NAKASHIMA, Carlos A.; BARACIOLI, Luciano M.; RAMIRES, Jose A.; NICOLAU, Jose C.conferenceObject INCREASED BODYWEIGHT AND INADEQUATE RESPONSE TO ASPIRIN IN INDIVIDUALS WITH CORONARY ARTERY DISEASE(2019) FURTADO, Remo Holanda de Mendonca; ARANTES, Flavia; BARBOSA, Carlos; FRANCI, Andre; MENEZES, Fernando; SALSOSO, Rocio; DALCOQUIO, Talia; NAKASHIMA, Carlos; SCANAVINI FILHO, Marco; FERRARI, Aline; GENESTRETI, Paulo; BARACIOLI, Luciano; NICOLAU, Jose C.- Influence of Direct Thrombin Inhibitor and Low Molecular Weight Heparin on Platelet Function in Patients with Coronary Artery Disease: A Prospective Interventional Trial(2020) ARANTES, Flavia B. B.; MENEZES, Fernando R.; FRANCI, Andre; BARBOSA, Carlos J. D. G.; DALCOQUIO, Talia F.; NAKASHIMA, Carlos A. K.; BARACIOLI, Luciano M.; FURTADO, Remo H. M.; NOMELINI, Quintiliano S. S.; RAMIRES, Jose A. F.; KALIL FILHO, Roberto; NICOLAU, Jose C.Introduction The interaction between anticoagulants and platelet function is complex. Previous publications showed mixed results regarding the role of heparins in platelet aggregation. On the other hand, the direct thrombin inhibitor (DTI) dabigatran might enhance the risk of myocardial infarction in patients with atrial fibrillation, which could be related to increased platelet aggregability. Methods This was a prospective, interventional study of patients with chronic coronary artery disease (CAD) taking low-dose aspirin. The objective of the current study was to compare the effects of dabigatran versus enoxaparin on platelet aggregability. Subjects initially were on orally administered dabigatran for 5 days followed by subcutaneously administered enoxaparin after a 30-day washout period. Platelet function was assessed at baseline and after each intervention by multiple electrode aggregometry (MEA-ASPI) (primary endpoint), serum thromboxane B2 (TXB2), VerifyNow Aspirin (TM), and coagulation tests (secondary endpoints). Results Compared to baseline MEA-ASPI values, dabigatran increased platelet aggregation while enoxaparin decreased platelet aggregation (+ 5 U +/- 24.1 vs - 6 U +/- 22.2, respectively, p = 0.012). The TXB2 assay showed the same pattern (+ 2 pg/ml for dabigatran vs - 13 pg/ml for enoxaparin, p = 0.011). None of the additional tests showed significant differences between the groups. Individually, compared to baseline TXB2 results, enoxaparin significantly decreased platelet activation [33 (16.5-95) pg/mL vs 20 (10-52) pg/mL, respectively, p = 0.026], but no significant differences were observed with dabigatran. Conclusions DTI and anti-Xa drugs exert opposite effects on platelet function. A significant decrease in platelet activation through COX1 (also known as prostaglandin G/H synthase 1) was observed with enoxaparin, but no significant differences in platelet function were observed with dabigatran.
conferenceObject DRUG INTERACTION BETWEEN CLOPIDOGREL AND RANITIDINE OR OMEPRAZOLE IN PATIENTS WITH CORONARY HEART DISEASE: A DOUBLE-BLIND, DOUBLE-DUMMY, RANDOMIZED COMPARATIVE STUDY(2014) FURTADO, Remo Holanda de Mendonca; FREIRE, Beatriz Tonon; STRUNZ, Celia; BARBOSA, Carlos J. D. G.; FRANCI, Andre; ARANTES, Flavia B. B.; FILHO, Cyrillo C.; MENEZES, Fernando R.; D'AMICO, Elbio A.; NICOLAU, Jose- Influence of proven oral therapies in the very old with acute coronary syndromes: A 15 year experience(2015) NICOLAU, Jose C.; FRANCI, Andre; BARBOSA, Carlos Jose D. G.; BARACIOLI, Luciano M.; FRANKEN, Marcelo; FURTADO, Remo H. M.; GIRALDEZ, Roberto R. C. V.; GANEM, Fernando; LIMA, Felipe G.; MENEZES, Fernando R.; ARANTES, Flavia B. B.; RAMIRES, Jose A. F.; KALIL FILHO, Roberto; GIUGLIANO, Robert P.
conferenceObject INFLUENCE OF GLYCEMIC CONTROL ON CLOPIDOGREL RESPONSE IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE: A SUB-ANALYSIS FROM A RANDOMIZED, DOUBLE-BLIND STUDY(2015) FURTADO, Remo Holanda de Mendonca; BARBOSA, Carlos; STRUNZ, Celia; FRANCI, Andre; MENEZES, Fernando; ARANTES, Flavia; AMICO, Elbio D.; ROCHA, Tania Rubia Flores; GENESTRETI, Paulo; NICOLAU, Jose- Increased bodyweight and inadequate response to aspirin in individuals with coronary artery disease(2019) FURTADO, Remo H. M.; GIUGLIANO, Robert P.; DALCOQUIO, Talia F.; ARANTES, Flavia B. B.; BARBOSA, Carlos J. D. G.; GENESTRETI, Paulo R. R.; FRANCI, Andre; MENEZES, Fernando R.; NAKASHIMA, Carlos A. K.; SCANAVINI FILHO, Marco A.; FERRARI, Aline G.; SALSOSO, Rocio; BARACIOLI, Luciano M.; NICOLAU, Jose C.Recent reports have suggested that aspirin effect might be influenced by bodyweight, with decreased efficacy in heavier individuals. We investigated the influence of bodyweight on aspirin pharmacodynamics in two independent datasets of patients taking non-enteric coated aspirin 100mg QD for coronary artery disease (CAD). In the first dataset, 368 patients had their platelet aggregation assessed using VerifyNow Aspirin and measured in Aspirin Reaction Units (ARU). In the second dataset, 70 patients had serum thromboxane B2 (TXB2) dosage assessed by an ELISA assay and measured in pg/mL. Platelet aggregation was independently associated with bodyweight, with 8.41 (95% CI 1.86-14.97; adjusted p-value=0.012) increase in ARU for every 10kg. Furthermore, the rate of non-response to aspirin (defined as ARU550) was significantly associated with increased bodyweight (adjusted p-value=0.007), with OR=1.23 (95% CI 1.06-1.42) for every 10kg. Similar results were found considering body mass index (in kg/m(2)), with 15.5 (95% CI 5.0 to 25.9; adjusted p-value=0.004) increase in ARU for every 10kg and non-response OR=1.43 (95% CI 1.13 to 1.81, adjusted p-value=0.003) for every 5kg/m(2). Moreover, serum TXB2 was higher in patients weighting more than 70kg (222.6 +/- 62.9 versus 194.9 +/- 61.9pg/mL; adjusted p-value=0.018). In two different datasets of patients with CAD on non-enteric coated aspirin 100mg QD, increased bodyweight was independently associated with impaired response to aspirin.
conferenceObject EFFECTS OF LOW MOLECULAR WEIGHT HEPARIN VERSUS DABIGATRAN ON PLATELET AGGREGATION IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE(2017) ARANTES, Flavia Bittar Britto; MENEZES, Fernando; FRANCI, Andre; BARBOSA, Carlos; DALCOQUIO, Talia F.; NAKASHIMA, Carlos K.; FERRARI, Aline; SCANAVINI FILHO, Marco; FURTADO, Remo; BARACIOLI, Luciano; RAMIRES, Jose; KALIL-FILHO, Roberto; NICOLAU, Jose