MARIA CAROLINA FERES DE ALMEIDA SOEIRO
Índice h a partir de 2011
7
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
10 resultados
Resultados de Busca
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conferenceObject Superiority of prothrombin complex concentrate versus frozen fresh plasma in cardiologic patients with coumarin intoxication(2016) SOEIRO, A.; CESAR, M. C.; BISELLI, B.; BOSSA, A. S.; ARAUJO, V. A.; HAJJAR, L. A.; LEAL, T. C. A. T.; SOEIRO, M. C. F. A.; VELLA, J. P.; SERRANO JR., C. V.; OLIVEIRA JR., M. T.conferenceObject Suspected Acute Coronary Syndrome With Normal Coronary Arteries: The Value of Cardiac Magnetic Resonance in Changes of Treatment(2015) SOEIRO, Alexandre M.; NAKAMURA, Debora Y.; LEAL, Tatiana C.; BOSSA, Aline S.; SOEIRO, Maria C.; SERRANO JR., Carlos V.; OLIVEIRA JR., Mocio T.- Is There Safety in the Use of Clopidogrel Loading Dose in Patients Over 75 Years of Age with Acute Coronary Syndrome?(2019) SOEIRO, Alexandre de Matos; CASALE, Guilherme; LOPES, Maria Antonieta Albanez Albuquerque de Medeiros; GODOY, Lucas Colombo; BOSSA, Aline Siqueira; BISELLI, Bruno; LEAL, Tatiana de Carvalho Andreucci Torres; SOEIRO, Maria Carolina Feres de Almeida; SERRANO JR., Carlos V; OLIVEIRA JR., Múcio TavaresAbstract Background: There is limited evidence in the literature regarding the administration of clopidogrel to acute coronary syndrome (ACS) in patients over 75 years of age. Most studies excluded this age group, making the subject controversial due to the increased risk of bleeding in this population. Objective: This is a retrospective, unicentric, and observational study aimed at assessing whether the administration of clopidogrel loading dose increases bleeding rates in patients over 75 years of age. Methods: Patients were divided into two groups: group I: 75 mg of clopidogrel; group II: 300-to 600-mg loading dose of clopidogrel. A total of 174 patients (129 in group I and 45 in group II) were included between May 2010 and May 2015. Statistical analysis: The primary outcome was bleeding (major and/or minor). The secondary outcome was combined events (cardiogenic shock, reinfarction, death, stroke and bleeding). The comparison between groups was performed through Q-square and T-test. The multivariate analysis was performed by logistic regression, being considered significant p < 0.05. Results: Comparisons between groups I and II showed differences in the prevalence of diabetes (46.5% vs. 24.4%, p = 0.01), arterial hypertension (90.7% vs. 75, p = 0.01), dyslipidemia (62% vs. 42.2%, p = 0.021), ST segment elevation (11.6% vs. 26.6%, p = 0.016) and coronary intervention percutaneous (16.5% vs. 62.2%, p < 0.0001), respectively. In the multivariate analysis, significant differences were observed between groups I and II in relation to the occurrence of bleeding (8.5% vs. 20%, OR = 0.173, 95% CI: 0.049 - 0.614, p = 0.007). Conclusion: A loading dose of 300 mg or more of clopidogrel.
- Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?(2018) SOEIRO, Alexandre de Matos; ARAUJO, Victor Arrais; VELLA, Julia Pitombo; BOSSA, Aline Siqueira; BISELLI, Bruno; LEAL, Tatiana de Carvalho Andreucci Torres; SOEIRO, Maria Carolina Feres de Almeida; SERRANO JR., Carlos V.; MUELLER, Christian; OLIVEIRA JUNIOR, Mucio Tavares deBackground: Some small studies have related higher levels of thyrotropin (TSH) to potentially worse prognosis in acute coronary syndromes. However, this relationship remains uncertain. Objective: To analyze the outcomes of patients with acute coronary syndromes in relation to the value of TSH at admission. Methods: Observational and retrospective study with 505 patients (446 in group I [TSH <= 4 mIU/L] and 59 in group II [TSH > 4 mIU/L]) with acute coronary syndromes between May 2010 and May 2014. We obtained data about comorbidities and the medications used at the hospital. The primary endpoint was in-hospital all-cause death. The secondary endpoint included combined events (death, non-fatal unstable angina or myocardial infarction, cardiogenic shock, bleeding and stroke). Comparisons between groups were made by one-way ANOVA and chi-square test. Multivariate analysis was determined by logistic regression. Analyses were considered significant when p < 0.05. Results: Significant differences between groups I and II were observed regarding the use of enoxaparin (75.2% vs. 57.63%, p = 0.02) and statins (84.08% vs. 71.19%, p < 0.0001), previous stroke (5.83% vs. 15.25%, p = 0.007), combined events (14.80% vs. 27.12%, OR = 3.05, p = 0.004), cardiogenic shock (4.77% vs. 6.05%, OR = 4.77, p = 0.02) and bleeding (12.09% vs. 15.25%, OR = 3.36, p = 0.012). Conclusions: In patients with acute coronary syndromes and TSH > 4 mIU/L at admission, worse prognosis was observed, with higher incidences of in-hospital combined events, cardiogenic shock and bleeding.
- Mortality reduction with use of oral beta-blockers in patients with acute coronary syndrome(2016) SOEIRO, Alexandre de Matos; SILVA, Pedro Gabriel Melo de Barros e; ROQUE, Eduardo Alberto de Castro; BOSSA, Aline Siqueira; ZULLINO, Cindel Nogueira; SIMOES, Sheila Aparecida; OKADA, Mariana Yumi; LEAL, Tatiana de Carvalho Andreucci Torres; SOEIRO, Maria Carolina Feres de Almeida; SERRANO JR., Carlos V.; OLIVEIRA JR., Mucio TavaresOBJECTIVES: Recent studies have revealed a relationship between beta-blocker use and worse prognosis in acute coronary syndrome, mainly due to a higher incidence of cardiogenic shock. However, the relevance of this relationship in the reperfusion era is unknown. The aim of this study was to analyze the outcomes of patients with acute coronary syndrome that started oral beta-blockers within the first 24 hours of hospital admission (group I) compared to patients who did not use oral beta-blockers in this timeframe (group II). METHODS: This was an observational, retrospective and multicentric study with 2,553 patients (2,212 in group I and 341 in group II). Data regarding demographic characteristics, coronary treatment and medication use in the hospital were obtained. The primary endpoint was in-hospital all-cause mortality. The groups were compared by ANOVA and the chi-square test. Multivariate analysis was conducted by logistic regression and results were considered significant when p < 0.05. RESULTS: Significant differences were observed between the groups in the use of angiotensin-converting enzyme inhibitors, enoxaparin, and statins; creatinine levels; ejection fraction; tabagism; age; and previous coronary artery bypass graft. Significant differences were also observed between the groups in mortality (2.67% vs 9.09%, OR= 0.35, p= 0.02) and major adverse cardiovascular events (11% vs 29.5%, OR= 4.55, p= 0.02). CONCLUSIONS: Patients with acute coronary syndrome who underwent early intervention with oral betablockers during the first 24 hours of hospital admission had a lower in-hospital death rate and experienced fewer major adverse cardiovascular events with no increase in cardiogenic shock or sustained ventricular arrhythmias compared to patients who did not receive oral beta-blockers within this timeframe.
- CardioER (R) - Using smartphone medical applications as an aid to clinical decision-making - are we ready for this?(2018) SOEIRO, Alexandre de Matos; LEAL, Tatiana de Carvalho Andreucci Torres; BOSSA, Aline Siqueira; SOEIRO, Maria Carolina Feres de Almeida; SERRANO JR., Carlos Vicente; OLIVEIRA JR., Mucio Tavares
- Complete Treatment Versus Residual Lesion - Long-Term Evolution After Acute Coronary Syndrome(2016) SOEIRO, Alexandre de Matos; SCANAVINI FILHO, Marco Antonio; BOSSA, Aline Siqueira; ZULLINO, Cindel Nogueira; SOEIRO, Maria Carolina F. Almeida; LEAL, Tatiana Carvalho Andreucci T.; SERRANO JR., Carlos Vicente; HAJJAR, Ludhmila Abrahao; KALIL FILHO, Roberto; OLIVEIRA JR., Mucio TavaresIntroduction: A recently published study raised doubts about the need for percutaneous treatment of nonculprit lesions in patients with acute coronary syndromes (ACS). Methods: Retrospective, unicentric, observational study. Objective: To analyze the long-term outcomes in patients undergoing treatment of the culprit artery, comparing those who remained with significant residual lesions in nonculprit arteries (group I) versus those without residual lesions in other coronary artery beds (group II). The study included 580 patients (284 in group I and 296 in group II) between May 2010 and May 2013. We obtained demographic and clinical data, as well as information regarding the coronary treatment administered to the patients. In the statistical analysis, the primary outcome included combined events (reinfarction/ angina, death, heart failure, and need for reintervention). The comparison between groups was performed using the chisquare test and ANOVA. The long-term analysis was conducted with the Kaplan-Meier method, with a mean follow-up of 9.86 months. Results: The mean ages were 63 years in group I and 62 years in group II. On long-term follow-up, there was no significant difference in combined events in groups I and II (31.9% versus 35.6%, respectively, p=0.76). Conclusion: The strategy of treating the culprit artery alone seems safe. In this study, no long-term differences in combined endpoints were observed between patients who remained with significant lesions compared with those without other obstructions.
conferenceObject Acute coronary syndrome with normal coronary arteries: the value of cardiac magnetic resonance in changes of diagnosis and treatment(2017) SOEIRO, A.; NAKAMURA, D.; BISELLI, B.; LEAL, T. C. A. T.; CESAR, M. C.; BOSSA, A. S.; SOEIRO, M. C. F. A.; SERRANO JR., C. V.; OLIVEIRA JR., M. T.- Prognostic Differences between Men and Women with Acute Coronary Syndrome. Data from a Brazilian Registry(2018) SOEIRO, Alexandre de Matos; SILVA, Pedro Gabriel Melo de Barros e; ROQUE, Eduardo Alberto de Castro; BOSSA, Aline Siqueira; BISELLI, Bruno; LEAL, Tatiana de Carvalho Andreucci Torres; SOEIRO, Maria Carolina Feres de Almeida; PITTA, Fabio Grunspun; V, Carlos Serrano Jr; JR, Mucio Tavares OliveiraBackground: Gender-related differences have been reported in patients with acute coronary syndrome. The description of this comparative finding in a Brazilian registry has not yet been documented. Objective: To compare male vs. female patients regarding the baseline characteristics, coronary findings, treatment and in-hospital and long-term prognosis. Methods: This is a retrospective, multicenter and observational study that included 3,745 patients (2,437 males and 1,308 females) between May 2010 and May 2015. The primary in-hospital outcome was all-cause mortality. The secondary outcome consisted of combined events (cardiogenic shock, reinfarction, death, stroke and bleeding). The comparison between groups was performed using the chi-square and the t test, considering p < 0.05 as significant. In the long term, mortality and combined events were assessed using the Kaplan-Meier method, with a mean follow-up of 8.79 months. Results: The mean age was 60.3 years for males and 64.6 for females (p < 0.0001). The most prevalent risk factor was systemic arterial hypertension in 72.9% of the women and 67.8% of the men (p = 0.001). Percutaneous coronary intervention was carried out in 44.9% of the males and 35.4% of the females (p < 0.0001), and coronary artery bypass grafting (CABG) was performed in 17% of the males and 11.8% of females (p < 0.0001), with a higher prevalence of three-vessel coronary artery disease in males (27.3% vs. 16.2%, p < 0.0001). Approximately 79.9% of the female patients received a diagnosis of acute coronary syndrome without ST-segment elevation, while in the male patients, this diagnosis was attained in 71.5% (p < 0.0001). No significant differences were observed between the groups in the short and long term, regarding both mortality and the combined events. Conclusion: Several gender-related differences were observed in patients with acute coronary syndrome regarding the demographic characteristics, coronary artery disease pattern and implemented treatment. However, the prognostic evolution was similar between the groups.
- Sensitive Troponin I Assay in Patients with Chest Pain - Association with Significant Coronary Lesions with or Without Renal Failure(2018) SOEIRO, Alexandre de Matos; GUALANDRO, Danielle Menosi; BOSSA, Aline Siqueira; ZULLINO, Cindel Nogueira; BISELLI, Bruno; SOEIRO, Maria Carolina Feres de Almeida; LEAL, Tatiana de Carvalho Andreucci Torres; SERRANO JR., Carlos Vicente; OLIVEIRA JUNIOR, Mucio Tavares deIntroduction: Despite having higher sensitivity as compared to conventional troponins, sensitive troponins have lower specificity, mainly in patients with renal failure. Objective: Study aimed at assessing the sensitive troponin I levels in patients with chest pain, and relating them to the existence of significant coronary lesions. Methods: Retrospective, single-center, observational. This study included 991 patients divided into two groups: with (N = 681) and without (N = 310) significant coronary lesion. For posterior analysis, the patients were divided into two other groups: with (N = 184) and without (N = 807) chronic renal failure. The commercial ADVIA Centaur (R) TnI-Ultra assay (Siemens Healthcare Diagnostics) was used. The ROC curve analysis was performed to identify the sensitivity and specificity of the best cutoff point of troponin as a discriminator of the probability of significant coronary lesion. The associations were considered significant when p < 0.05. Results: The median age was 63 years, and 52% of the patients were of the male sex. The area under the ROC curve between the troponin levels and significant coronary lesions was 0.685 (95% CI: 0.65 -0.72). In patients with or without renal failure, the areas under the ROC curve were 0.703 (95% CI: 0.66 - 0.74) and 0.608 (95% CI: 0.52 - 0.70), respectively. The best cutoff points to discriminate the presence of significant coronary lesion were: in the general population, 0.605 ng/dL (sensitivity, 63.4%; specificity, 67%); in patients without renal failure, 0.605 ng/dL (sensitivity, 62.7%; specificity, 71%); and in patients with chronic renal failure, 0.515 ng/dL (sensitivity, 80.6%; specificity, 42%). Conclusion: In patients with chest pain, sensitive troponin I showed a good correlation with significant coronary lesions when its level was greater than 0.605 ng/dL. In patients with chronic renal failure, a significant decrease in specificity was observed in the correlation of troponin levels and severe coronary lesions.