ROBERTO ROCHA CORREA VEIGA GIRALDEZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
9 resultados
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- Do Diabetic Patients with Acute Coronary Syndromes Have a Higher Threshold for Ischemic Pain?(2014) NICOLAU, Jose Carlos; BARBOSA, Carlos Jose Dornas Goncalves; FRANCI, Andre; BARACIOLI, Luciano Moreira; FRANKEN, Marcelo; LIMA, Felipe Gallego; GIRALDEZ, Roberto Rocha; KALIL FILHO, Roberto; RAMIRES, Jose Antonio Franchini; GIUGLIANO, Robert P.Background: Data from over 4 decades have reported a higher incidence of silent infarction among patients with diabetes mellitus (DM), but recent publications have shown conflicting results regarding the correlation between DM and presence of pain in patients with acute coronary syndromes (ACS). Objective: Our primary objective was to analyze the association between DM and precordial pain at hospital arrival. Secondary analyses evaluated the association between hyperglycemia and precordial pain at presentation, and the subgroup of patients presenting within 6 hours of symptom onset. Methods: We analyzed a prospectively designed registry of 3,544 patients with ACS admitted to a Coronary Care Unit of a tertiary hospital. We developed multivariable models to adjust for potential confounders. Results: Patients with precordial pain were less likely to have DM (30.3%) than those without pain (34.0%; unadjusted p = 0.029), but this difference was not significant after multivariable adjustment, for the global population (p = 0.84), and for subset of patients that presented within 6 hours from symptom onset (p = 0.51). In contrast, precordial pain was more likely among patients with hyperglycemia (41.2% vs 37.0% without hyperglycemia, p = 0.035) in the overall population and also among those who presented within 6 hours (41.6% vs. 32.3%, p = 0.001). Adjusted models showed an independent association between hyperglycemia and pain at presentation, especially among patients who presented within 6 hours (OR = 1.41, p = 0.008). Conclusion: In this non-selected ACS population, there was no correlation between DM and hospital presentation without precordial pain. Moreover, hyperglycemia correlated significantly with pain at presentation, especially in the population that arrived within 6 hours from symptom onset.
- O escore de risco de sangramento como preditor de mortalidade em pacientes com síndromes coronarianas agudas(2013) NICOLAU, José Carlos; MOREIRA, Humberto Graner; BARACIOLI, Luciano Moreira; SERRANO JR, Carlos Vicente; LIMA, Felipe Galego; FRANKEN, Marcelo; GIRALDEZ, Roberto Rocha; GANEM, Fernando; KALIL FILHO, Roberto; RAMIRES, José Antônio Franchini; MEHRAN, RoxanaBACKGROUND: It is well known that the occurrence of bleeding increases in-hospital mortality in patients with acute coronary syndromes (ACS), and there is a good correlation between bleeding risk scores and bleeding incidence. However, the role of bleeding risk score as mortality predictor is poorly studied. OBJECTIVE: The main purpose of this paper was to analyze the role of bleeding risk score as in-hospital mortality predictor in a cohort of patients with ACS treated in a single cardiology tertiary center. METHODS: Out of 1655 patients with ACS (547 with ST-elevation ACS and 1118 with non-ST-elevation ACS), we calculated the ACUITY/HORIZONS bleeding score prospectively in 249 patients and retrospectively in the remaining 1416. Mortality information and hemorrhagic complications were also obtained. RESULTS: Among the mean age of 64.3 ± 12.6 years, the mean bleeding score was 18 ± 7.7. The correlation between bleeding and mortality was highly significant (p < 0.001, OR = 5.296), as well as the correlation between bleeding score and in-hospital bleeding (p < 0.001, OR = 1.058), and between bleeding score and in-hospital mortality (adjusted OR = 1.121, p < 0.001, area under the ROC curve 0.753, p < 0.001). The adjusted OR and area under the ROC curve for the population with ST-elevation ACS were, respectively, 1.046 (p = 0.046) and 0.686 ± 0.040 (p < 0.001); for non-ST-elevation ACS the figures were, respectively, 1.150 (p < 0.001) and 0.769 ± 0.036 (p < 0.001). CONCLUSIONS: Bleeding risk score is a very useful and highly reliable predictor of in-hospital mortality in a wide range of patients with acute coronary syndromes, especially in those with unstable angina or non-ST-elevation acute myocardial infarction.
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, ThiagoconferenceObject DO PATIENTS WITHOUT SIGNIFICANT CORONARY OBSTRUCTIONS HAVE BETTER OUTCOME IN THE LONG RUN POST-ACUTE MYOCARDIAL INFARCTION?(2014) NICOLAU, Jose C.; FRANKEN, Marcelo; FERRAZ, Thiago; BARACIOLI, Luciano; LIMA, Felipe Gallego; GIRALDEZ, Roberto; FURTADO, Remo; GIANNETTI, Natali; KALIL-FILHO, Roberto; RAMIRES, Jose- Características clínicas, angiográficas e evolução a longo prazo em pacientes com arterite de Takayasu e síndrome coronária aguda(2013) SOEIRO, Alexandre de Matos; ALMEIDA, Maria Carolina Feres de; TORRES, Tatiana Andreucci; FRANKEN, Marcelo; LIMA, Felipe Gallego; GANEM, Fernando; GIRALDEZ, Roberto R.; BARACIOLI, Luciano; TAVARES JR., Mucio Oliveira; SERRANO JR., Carlos V.; NICOLAU, Jose CarlosIntroduction: Monitoring of disease activity and the best therapeutic approach are a challenge in Takayasu arteritis (TA). When associated with acute coronary syndromes (ACS), the best interventional treatment has not been established. The objective of this study was to describe the baseline characteristics, clinical manifestations, treatment and long-term outcome of patients with TA and ACS. Methods: We retrospectively analyzed eight patients between 2004 and 2010. The following data were obtained: age, gender, clinical and electrocardiographic manifestations, Kit lip class, risk factors for ACS, markers of myocardial necrosis (CK-MB and troponin), creatinine clearance, left ventricular ejection fraction, inflammatory markers (C-reactive protein and erythrocyte sedimentation rate [ESR]), medication during hospital stay, angiographic findings, treatment (medical, percutaneous or surgical) and long-term outcome. Statistical data were expressed as percentages and absolute values. Results: All eight patients were women, median age 49 years. Typical chest pain was present in 37.5%. Elevated ESR was observed in 85.7%. Three patients underwent coronary artery bypass grafting, three underwent percutaneous coronary angioplasty (two with bare-metal stents and one with a drug-eluting stent) and two were treated medically. In-hospital mortality was 25%. There were no deaths during a mean follow-up of 30 months. Conclusions: In our study, patients who were discharged home had good outcomes in long-term follow-up with medical, percutaneous or surgical treatment. ESR appears to be associated with ACS in TA.
- 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.
- Brazilian Society of Cardiology Guidelines on Unstable Angina and Acute Myocardial Infarction without ST-Segment Elevation-2021(2021) NICOLAU, Jose Carlos; FEITOSA FILHO, Gilson Soares; PETRIZ, Joao Luiz; FURTADO, Remo Holanda de Mendonca; PRECOMA, Dalton Bertolim; LEMKE, Walmor; LOPES, Renato Delascio; TIMERMAN, Ari; MARIN-NETO, Jose A.; NETO, Luiz Bezerra; GOMES, Bruno Ferraz de Oliveira; SANTOS, Eduardo Cavalcanti Lapa; PIEGAS, Leopoldo Soares; SOEIRO, Alexandre de Matos; NEGRI, Alexandre Jorge de Andrade; FRANCI, Andre; MARKMAN FILHO, Brivaldo; BACCARO, Bruno Mendonca; MONTENEGRO, Carlos Eduardo Lucena; ROCHITTE, Carlos Eduardo; BARBOSA, Carlos Jose Dornas Goncalves; VIRGENS, Claudio Marcelo Bittencourt das; STEFANINI, Edson; MANENTI, Euler Roberto Fernandes; LIMA, Felipe Gallego; MONTEIRO JUNIOR, Francisco das Chagas; CORREA FILHO, Harry; PENA, Henrique Patrus Mundim; PINTO, Ibraim Masciarelli Francisco; FALCAO, Joao Luiz de Alencar Araripe; SENA, Joberto Pinheiro; PEIXOTO, Jose Maria; SOUZA, Juliana Ascencao de; SILVA, Leonardo Sara da; MAIA, Lilia Nigro; OHE, Louis Nakayama; BARACIOLI, Luciano Moreira; DALLAN, Luis Alberto de Oliveira; DALLAN, Luis Augusto Palma; MATTOS, Luiz Alberto Piva e; BODANESE, Luiz Carlos; RITT, Luiz Eduardo Fonteles; CANESIN, Manoel Fernandes; RIVAS, Marcelo Bueno da Silva; FRANKEN, Marcelo; MAGALHAES, Marcos Jose Gomes; OLIVEIRA JUNIOR, Mucio Tavares de; FILGUEIRAS FILHO, Nivaldo Menezes; DUTRA, Oscar Pereira; COELHO, Otavio Rizzi; LEAES, Paulo Ernesto; ROSSI, Paulo Roberto Ferreira; SOARES, Paulo Rogerio; LEMOS NETO, Pedro Alves; FARSKY, Pedro Silvio; CAVALCANTI, Rafael Rebelo C.; ALVES, Renato Jorge; KALIL, Renato Abdala Karam; ESPORCATTE, Roberto; MARINO, Roberto Luiz; GIRALDEZ, Roberto Rocha Correa Veiga; MENEGHELO, Romeu Sergio; LIMA, Ronaldo de Souza Leao; RAMOS, Rui Fernando; FALCAO, Sandra Nivea dos Reis Saraiva; DALCOQUIO, Talia Falcao; LEMKE, Viviana de Mello Guzzo; CHALELA, William Azem; MATHIAS JUNIOR, Wilson
- In Patients With Acute Myocardial Infarction, the Impact of Hyperglycemia as a Risk Factor for Mortality Is Not Homogeneous Across Age-Groups(2012) NICOLAU, Jose Carlos; SERRANO JR., Carlos Vicente; GIRALDEZ, Roberto Rocha; BARACIOLI, Luciano Moreira; MOREIRA, Humberto Graner; LIMA, Felipe; FRANKEN, Marcelo; KALIL, Roberto; RAMIRES, Jose Antonio Franchini; GIUGLIANO, Robert P.OBJECTIVE To assess the impact of hyperglycemia in different age-groups of patients with acute myocardial infarction (AM I). RESEARCH DESIGN AND METHODS A total of 2,027 patients with AMI were categorized into one of five age-groups: <50 years (n = 301), >= 50 and <60 (n = 477),>= 60 and <70 (n = 545), >= 70 and <80 (n = 495), and years (n = 209). Hyperglycemia was defined as initial glucose >= 115 mg/dL. RESULTS The adjusted odds ratios for hyperglycemia predicting hospital mortality in groups 1-5 were, respectively, 7.57 (P = 0.004), 3.21 (P 0.046), 3.50 (P = 0.003), 3.20 (P < 0.001.), and 2.16 (P = 0.021). The adjusted P values for correlation between glucose level (as a continuous variable) and mortality were 0.007, <0.001, 0.043, <0.001, and 0.064. The areas under the ROC curves (AUCs) were 0.785, 0.709, 0.657, 0.648, and 0.613. The AUC in group 1 was significantly higher than those in groups 3-5. CONCLUSIONS The impact of hyperglycemia as a risk factor for hospital mortality in AMI is more pronounced in younger patients.
bookPart Medicações utilizadas em síndromes coronárias agudas(2016) GUIMARãES, Patrícia Oliveira; GIRALDEZ, Roberto Rocha Correa Veiga; FRANKEN, Marcelo