CIBELE LARROSA GARZILLO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
conferenceObject Two-year Follow-up Of Patients With Chronic Ischemic Heart Disease In A Specialized Center In Brazil(2021) PINESI, Henrique Trombini; MOREIRA, Eduardo M.; BOLTA, Paula M.; MARTINS, Eduardo B.; PITTA, Fabio G.; REZENDE, Paulo C.; LIMA, Eduardo G.; HUEB, Whady; GARZILLO, Cibele L.; SERRANO, Carlos V.- Effect of diabetic kidney disease on therapeutic strategies for coronary artery disease: ten year follow-up(2021) BATISTA, Daniel Valente; HUEB, Whady; LIMA, Eduardo Gomes; REZENDE, Paulo Cury; GARZILLO, Cibele Larrosa; GARCIA, Rosa Maria Rahmi; LINHARES FILHO, Jaime Paula Pessoa; MARTINS, Eduardo Bello; SERRANO JUNIOR, Carlos Vicente; RAMIRES, Jose Antonio Franchini; KALIL FILHO, RobertoBackground: The best treatment for coronary artery disease (CAD) in patients with type 2 diabetes (DM2) and chronic kidney disease is unknown. Methods: This retrospective study included MASS registry patients with DM2 and multivessel CAD, stratified by kidney function. Primary endpoint was combined of mortality, myocardial infarction, or additional revascularization. Results: Median follow-up was 9.5 years. Primary endpoint occurrences among strata 1 and 2 were 53.4% and 40.7%, respectively (P=.020). Mortality rates were 37.4% and 24.6% in strata 1 and 2, respectively (P<.001). We observed a lower rate of major adverse cardiovascular events (MACE) (P=.027 for stratum 1 and P<.001 for stratum 2) and additional revascularization (P=.001 for stratum 1 and P<.001 for stratum 2) for those in the surgical group. In a multivariate analysis, eGFR was an independent predictor of MACE (P=.034) and mortality (P=.020). Conclusions: Among subjects with DM2 and CAD the presence of lower eGFR rate was associated with higher rates of MACE and mortality, irrespective of treatment choice. CABG was associated with lower rates of MACE in both renal function strata. eGFR was an independent predictor of MACE and mortality in a 10-year follow-up.
- Intensive care management of patients with COVID-19: a practical approach(2021) HAJJAR, Ludhmila Abrahao; COSTA, Isabela Bispo Santos da Silva; RIZK, Stephanie Itala; BISELLI, Bruno; GOMES, Brenno Rizerio; BITTAR, Cristina Salvadori; OLIVEIRA, Gisele Queiroz de; ALMEIDA, Juliano Pinheiro de; BELLO, Mariana Vieira de Oliveira; GARZILLO, Cibele; LEME, Alcino Costa; ELENA, Moizo; VAL, Fernando; LOPES, Marcela de Almeida; LACERDA, Marcus Vinicius Guimaraes; RAMIRES, Jose Antonio Franchini; KALIL FILHO, Roberto; TEBOUL, Jean-Louis; LANDONI, GiovanniSARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19), is responsible for the largest pandemic facing humanity since the Spanish flu pandemic in the early twentieth century. Since there is no specific antiviral treatment, optimized support is the most relevant factor in the patient's prognosis. In the hospital setting, the identification of high-risk patients for clinical deterioration is essential to ensure access to intensive treatment of severe conditions in a timely manner. The initial management of hypoxemia includes conventional oxygen therapy, high-flow nasal canula oxygen, and non-invasive ventilation. For patients requiring invasive mechanical ventilation, lung-protective ventilation with low tidal volumes and plateau pressure is recommended. Cardiovascular complications are frequent and include myocardial injury, thrombotic events, myocarditis, and cardiogenic shock. Acute renal failure is a common complication and is a marker of poor prognosis, with significant impact in costs and resources allocation. Regarding promising therapies for COVID-19, the most promising drugs until now are remdesivir and corticosteroids although further studies may be needed to confirm their effectiveness. Other therapies such as, tocilizumab, anakinra, other anti-cytokine drugs, and heparin are being tested in clinical trials. Thousands of physicians are living a scenario that none of us have ever seen: demand for hospital exceed capacity in most countries. Until now, the certainty we have is that we should try to decrease the number of infected patients and that an optimized critical care support is the best strategy to improve patient's survival.
conferenceObject THE EVOLUTION OF RENAL FUNCTION IS NOT IMPACTED BY THE THERAPEUTIC MODALITY OF CORONARY ARTERY DISEASE IN DIABETIC PATIENTS. MASS REGISTRY 10-YEAR FOLLOW-UP(2021) BATISTA, Daniel Valente; LIMA, Eduardo; HUEB, Whady; LINHARES FILHO, Jaime; MARTINS, Eduardo; REZENDE, Paulo; RAMIRES, Jose; GARZILLO, Cibele; KALIL-FILHO, Roberto; SERRANO, CarlosconferenceObject Diabetes and Chronic Kidney Disease: Prevalence, Associated Factors and Influence on Optimal Medical Therapy in Patients with Coronary Artery Disease(2021) MOREIRA, Eduardo M.; PINESI, Henrique Trombini; BOLTA, Paula; MARTINS, Eduardo; RACHED, Fabiana H.; PITTA, Fabio G.; FAVARATO, Desiderio; LIMA, Eduardo G.; GARZILLO, Cibele L.; SEGRE, Carlos A.; SERRANO, Carlos V.conferenceObject The Challenge of Treating a Previously Surgical Revascularized Patient With Acute ST-Elevation Myocardial Infarction (STEMI) and Coronary- Subclavian Steal Syndrome(2021) PINESI, Henrique Trombini; MARINS, Pedro H.; BALZAN, Hadrien F.; HABRUM, Fabio Cetinic; MATUCK, Bruna R.; MEDEIROS, Marina A. de; PITTA, Fabio G.; LIMA, Eduardo G.; GARZILLO, Cibele L.; SERRANO, Carlos V.- Surgical and percutaneous revascularization outcomes based on SYNTAX I, II, and residual scores: a long-term follow-up study(2021) MARTINS, Eduardo Bello; HUEB, Whady; BROWN, David L.; SCUDELER, Thiago Luis; LIMA, Eduardo Gomes; REZENDE, Paulo Cury; SOARES, Paulo Rogerio; GARZILLO, Cibele Larrosa; LINHARES FILHO, Jaime Paula Pessoa; BATISTA, Daniel Valente; RAMIRES, Jose Antonio Franchini; KALIL FILHO, RobertoBackground The objective of this study was to evaluate the association of SYNTAX scores I, II, and residual with cardiovascular outcomes of patients undergoing coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) and compare both procedures in a long-term follow-up. Methods This is a retrospective single-center study from the MASS registry at the Heart Institute of the University of Sao Paulo, Brazil in which 969 patients with stable coronary artery disease undergoing CABG (559) or PCI (410) were included. We assessed the SYNTAX scores I, II and residual in both interventions. Clinical endpoints were the first occurrence of a composite of overall death, myocardial infarction, stroke, or repeat revascularization (MACCE) and the total occurrence of each component of MACCE. Results In the CABG sample, SSI had a median of 23 (IQR 17-29.5), median SSII of 25.4 (IQR 19.2-32.8), and median rSS of 2 (IQR 0-6.5); in PCI SSI had a median of 14 (IQR 10-19.1), median SSII of 28.7 (IQR 23-34.2), and median rSS of 4.7 (IQR 0-9). Total of 174 events were documented and CABG patients had a lower rate of MACCE (15.6% vs. 21.2%; adjusted HR 1.98; 95% CI 1.13-3.47; P = 0.016) and repeat revascularization (3.8% vs. 11.5%; adjusted HR 4.35; CI 95% 1.74-10.85; P = 0.002) compared with PCI. No SYNTAX score tertile found a difference in death rate between procedures. In a multivariate analysis, the rSS was an independent predictor for MACCE (HR 1.04; 95% CI 1.01-1.06; P = 0.001). Regarding death, the only independent predictors were ejection fraction and renal function. Conclusion Surgical revascularization resulted in a more complete revascularization and lower rates of major cardiac or cerebrovascular events in a long-term follow-up. Also, grading the incompleteness of revascularization through the residual SYNTAX score identified a higher event rate, suggesting that complete revascularization is associated with a better prognosis.