CARLOS JOSE DORNAS GONCALVES BARBOSA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
14 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.- Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease(2020) SALSOSO, Rocio; DALCOQUIO, Talia F.; FURTADO, Remo H. M.; FRANCI, Andre; BARBOSA, Carlos J. D. G.; GENESTRETI, Paulo R. R.; STRUNZ, Celia M. C.; LIMA, Viviane; BARACIOLI, Luciano M.; GIUGLIANO, Robert P.; GOODMAN, Shaun G.; GURBEL, Paul A.; MARANHAO, Raul C.; NICOLAU, Jose C.Introduction Lipoprotein (a) [Lp(a)] is a risk factor for coronary artery disease (CAD). To the best of our knowledge, this is the first study addressing the relationship between Lp(a) and platelet reactivity in primary and secondary prevention. Methods Lp(a) was evaluated in 396 individuals with (82.3%) and without (17.7%) obstructive CAD. The population was divided into two groups according to Lp(a) concentrations with a cutoff value of 50 mg/dL. The primary objective was to evaluate the association between Lp(a) and adenosine diphosphate (ADP)-induced platelet reactivity using the VerifyNow (TM) P2Y(12)assay. Platelet reactivity was also induced by arachidonic acid and collagen-epinephrine (C-EPI) and assessed by Multiplate (TM), platelet function analyzer (TM) 100 (PFA-100), and light transmission aggregometry (LTA) assays. Secondary objectives included the assessment of the primary endpoint in individuals with or without CAD. Results Overall, 294 (74.2%) individuals had Lp(a) < 50 mg/dL [median (IQR) 13.2 (5.8-27.9) mg/dL] and 102 (25.8%) had Lp(a) >= 50 mg/dL [82.5 (67.6-114.5) mg/dL],P < 0.001. Univariate analysis in the entire population revealed no differences in ADP-induced platelet reactivity between individuals with Lp(a) >= 50 mg/dL (249.4 +/- 43.8 PRU) versus Lp(a) < 50 mg/dL (243.1 +/- 52.2 PRU),P = 0.277. Similar findings were present in individuals with (P = 0.228) and without (P = 0.669) CAD, and regardless of the agonist used or method of analysis (allP > 0.05). Finally, multivariable analysis did not show a significant association between ADP-induced platelet reactivity and Lp(a) >= 50 mg/dL [adjusted OR = 1.00 [(95% CI 0.99-1.01),P = 0.590]. Conclusion In individuals with or without CAD, Lp(a) >= 50 mg/dL was not associated with higher platelet reactivity.
conferenceObject ACUTE CORONARY SYNDROMES IN THE VERY OLD: THERAPIES AND OUTCOME IN THE LONG-TERM FOLLOW-UP(2014) NICOLAU, Jose C.; FRANCI, Andre; BARBOSA, Carlos; BARACIOLI, Luciano; FURTADO, Remo; GIANNETTI, Natali; GIRALDEZ, Roberto; LIMA, Felipe; FRANKEN, Marcelo; RAMIRES, Jose; KALIL-FILHO, Roberto; FERRAZ, Thiago- Platelet function, coagulation and fibrinolysis in patients with previous coronary and cerebrovascular ischemic events(2019) BARBOSA, Carlos Jose Dornas Goncalves; BARREIROS, Renata de Souza; FRANCI, Andre; ARANTES, Flavia Bittar Brito; FURTADO, Remo Holanda de Mendonca; STRUNZ, Celia Maria Cassaro; ROCHA, Tania Rubia Flores da; BARACIOLI, Luciano Moreira; RAMIRES, Jose Antonio Franchini; KALIL-FILHO, Roberto; NICOLAU, Jose CarlosOBJECTIVES: Ischemic stroke (IS) or transient ischemic attack (TIA) history is present in 4-17% of patients with coronary artery disease (CAD). This subgroup of patients is at high risk for both ischemic and bleeding events. The aim of this study was to determine the role of platelet aggregability, coagulation and endogenous fibrinolysis in patients with CAD and previous IS or TIA. METHODS: A prospective case-control study that included 140 stable CAD patients divided into two groups: the CASE group (those with a previous IS/TIA, n=70) and the CONTROL group (those without a previous IS/TIA, n=70). Platelet aggregability (VerifyNow Aspirin (R) and VerifyNow P2Y12 (R)), coagulation (fibrinogen and thromboelastography by Reorox (R)) and endogenous fibrinolysis (D dimer and plasminogen activator inhibitor-1) were evaluated. RESULTS: Patients in the CASE group presented significantly higher systolic blood pressure levels (135.84 +/- 16.09 vs 123.68 +/- 16.11, p <0.01), significantly more previous CABG (25.71% vs 10%, p=0.015) and significantly higher calcium channel blocker usage (42.86% vs 24.29%, p=0.02) than those in the control group. In the adjusted models, low triglyceride values, low hemoglobin values and higher systolic blood pressure were significantly associated with previous IS/TIA (CASE group). Most importantly, platelet aggregability, coagulation and fibrinolysis tests were not independently associated with previous cerebrovascular ischemic events (CASE group). CONCLUSION: Platelet aggregability, coagulation and endogenous fibrinolysis showed similar results among CAD patients with and without previous IS/TIA. Therefore, it remains necessary to identify other targets to explain the higher bleeding risk presented by these patients.
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 HDL Dysfunction in Patients With Coronary Artery Disease and Previous Ischemic Cerebrovascular Event(2016) BARBOSA, Carlos J.; MARANHAO, Raul C.; BARREIROS, Renata S.; FRANCI, Andre; FURTADO, Remo H.; ARANTES, Flavia B.; FREITAS, Fatima R. Sousa e; RAMIRES, Jos A.; KALIL-FILHO, Roberto; NICOLAU, Jose C.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