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Rassi DDC, Freitas AF, Rassi S. The Importance of Characterizing Chest Pain in the Management of Unstable Angina. Arq Bras Cardiol 2024; 121:e20240168. [PMID: 38716965 PMCID: PMC11081193 DOI: 10.36660/abc.20240168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Affiliation(s)
- Daniela do Carmo Rassi
- Faculdade de Medicina da Universidade Federal de GoiásGoiâniaGOBrasilFaculdade de Medicina da Universidade Federal de Goiás, Goiânia, GO – Brasil
| | - Aguinaldo Figueiredo Freitas
- Faculdade de Medicina da Universidade Federal de GoiásGoiâniaGOBrasilFaculdade de Medicina da Universidade Federal de Goiás, Goiânia, GO – Brasil
| | - Salvador Rassi
- Faculdade de Medicina da Universidade Federal de GoiásGoiâniaGOBrasilFaculdade de Medicina da Universidade Federal de Goiás, Goiânia, GO – Brasil
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Lopes MMGD, Sousa IM, Queiroz SA, Bezerra MRO, Gonzalez MC, Fayh APT. Bioelectrical impedance vector analysis is different according to the comorbidity burden in post-acute myocardial infarction. Nutr Clin Pract 2024; 39:450-458. [PMID: 37740504 DOI: 10.1002/ncp.11074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/01/2023] [Accepted: 08/20/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND The prevalence of a high comorbidity burden in patients who suffered an acute myocardial infarction (AMI) is increasing with the aging population, and the nutrition status also may be a predictor of clinical outcomes for these patients. This study aimed to investigate the relationship between the comorbidity burden and the characteristics of the bioelectrical impedance vector analysis (BIVA) in patients post-AMI. METHODS This prospective observational cohort study was conducted with adult patients who were hospitalized with AMI. Pre-existing comorbidities were assessed by the Charlson comorbidity index (CCI) adjusted by age, and anthropometric and BIVA characteristics were evaluated after the hemodynamic stabilization. All patients were followed-up until hospital discharge, and their length of stay was observed. RESULTS A total of 184 patients (75% were males; mean age, 60.2 ± 12.3 years) were included. The most common comorbidities were dyslipidemia (73.9%), hypertension (62%), and type 2 diabetes (34.2%). A higher CCI (≥3) was associated with sex (P = 0.008) and age (P < 0.001). Regarding BIVA, statistically significant differences were detected between sex (P < 0.001), age (P < 0.001), and CCI (P = 0.003), with longer vectors in female, older adults, and those with CCI ≥ 3. CONCLUSION Finding a relationship between BIVA and CCI suggests the first identified coherent differences, potentially correlated with diseases, representing a first contribution to support this type of assessment. Therefore, with BIVA, healthcare professionals may monitor abnormalities and adopt preventive nutrition care measures on patients post-AMI to improve their clinical status.
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Affiliation(s)
- Marcia M G D Lopes
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Applied Sciences to Women's Health, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Iasmin M Sousa
- Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sandra Azevedo Queiroz
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Mara R O Bezerra
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Maria Cristina Gonzalez
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ana Paula Trussardi Fayh
- Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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de Faria RR, de Siqueira SF, Haddad FA, Del Monte Silva G, Spaggiari CV, Martinelli M. The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases - The Gaps in Current Guidelines. Arq Bras Cardiol 2024; 120:e20230408. [PMID: 38198361 PMCID: PMC10735241 DOI: 10.36660/abc.20230408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/29/2023] [Accepted: 10/25/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs), also known as chronic diseases that are long-lasting, are considered the major cause of death and disability worldwide, and the six pillars of lifestyle medicine (nutrition, exercise, toxic control, stress management, restorative sleep, and social connection) play an important role in a holistic management of their prevention and treatment. In addition, medical guidelines are the most accepted documents with recommendations to manage NCDs. OBJECTIVE The present study aims to analyze the lack of lifestyle pillars concerning the major Brazilian medical guidelines for NCDs and identify evidence in the literature that could justify their inclusion in the documents. METHOD Brazilian guidelines were selected according to the most relevant causes of death in Brazil, given by the Mortality Information System, published by the Brazilian Ministry of Health in 2019. Journals were screened in the PUBMED library according to the disease and non-mentioned pillars of lifestyle. RESULTS Relevant causes of deaths in Brazil are acute myocardial infarction (AMI), diabetes mellitus (DM), and chronic obstructive pulmonary diseases (COPD). Six guidelines related to these NCDs were identified, and all address aspects of lifestyle, but only one, regarding cardiovascular prevention, highlights all six pillars. Despite this, a literature search involving over 50 articles showed that there is evidence that all the pillars can help control each of these NCDs. CONCLUSION Rarely are the six pillars of lifestyle contemplated in Brazilian guidelines for AMI, DM, and COPD. The literature review identified evidence of all lifestyle pillars to offer a holistic approach for the management and prevention of NCDs.
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Affiliation(s)
- Rafaella Rogatto de Faria
- Cultivare Prevenção e Promoção da SaúdePesquisa e DesenvolvimentoSão PauloSPBrasilCultivare Prevenção e Promoção da Saúde – Pesquisa e Desenvolvimento, São Paulo, SP – Brasil
- Hospital das Clínicas da FMUSPMedicina do EsporteSão PauloSPBrasilMedicina do Esporte – Hospital das Clínicas da FMUSP, São Paulo, SP – Brasil
| | - Sergio Freitas de Siqueira
- Cultivare Prevenção e Promoção da SaúdePesquisa e DesenvolvimentoSão PauloSPBrasilCultivare Prevenção e Promoção da Saúde – Pesquisa e Desenvolvimento, São Paulo, SP – Brasil
- Hospital das Clínicas da FMUSPInstituto do CoraçãoSão PauloSPBrasilInstituto do Coração (InCor), Hospital das Clínicas da FMUSP, São Paulo, SP – Brasil
| | - Francisco Aguerre Haddad
- Cultivare Prevenção e Promoção da SaúdePesquisa e DesenvolvimentoSão PauloSPBrasilCultivare Prevenção e Promoção da Saúde – Pesquisa e Desenvolvimento, São Paulo, SP – Brasil
- Pontifícia Universidade Católica de São PauloSão PauloSPBrasilPontifícia Universidade Católica de São Paulo, São Paulo, SP – Brasil
| | - Gustavo Del Monte Silva
- Cultivare Prevenção e Promoção da SaúdePesquisa e DesenvolvimentoSão PauloSPBrasilCultivare Prevenção e Promoção da Saúde – Pesquisa e Desenvolvimento, São Paulo, SP – Brasil
- Pontifícia Universidade Católica de São PauloSão PauloSPBrasilPontifícia Universidade Católica de São Paulo, São Paulo, SP – Brasil
| | - Caio Vitale Spaggiari
- Hospital das Clínicas da FMUSPInstituto do CoraçãoSão PauloSPBrasilInstituto do Coração (InCor), Hospital das Clínicas da FMUSP, São Paulo, SP – Brasil
| | - Martino Martinelli
- Cultivare Prevenção e Promoção da SaúdePesquisa e DesenvolvimentoSão PauloSPBrasilCultivare Prevenção e Promoção da Saúde – Pesquisa e Desenvolvimento, São Paulo, SP – Brasil
- Hospital das Clínicas da FMUSPInstituto do CoraçãoSão PauloSPBrasilInstituto do Coração (InCor), Hospital das Clínicas da FMUSP, São Paulo, SP – Brasil
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Martins-Santos CB, Duarte LTA, Ferreira-Junior CR, Feitosa AGT, Oliveira EVG, Campos ICMB, Melo EVD, Andrade SM, Sousa ACS, Oliveira JLM. Exaggerated Systolic Blood Pressure Increase with Exercise and Myocardial Ischemia on Exercise Stress Echocardiography. Arq Bras Cardiol 2023; 120:e20230047. [PMID: 38126513 PMCID: PMC10773463 DOI: 10.36660/abc.20230047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Central Illustration : Exaggerated Systolic Blood Pressure Increase with Exercise and Myocardial Ischemia on Exercise Stress Echocardiography ESBPRE: exaggerated systolic blood pressure response to exercise; HR: heart rate; SBP: systolic blood pressure. BACKGROUND The association between exaggerated systolic blood pressure response to exercise (ESBPRE) and myocardial ischemia is controversial and little studied in patients with established or suspected chronic coronary syndrome. OBJECTIVE To verify the relationship between myocardial ischemia and ESBPRE in patients undergoing exercise stress echocardiography (ESE). METHODS This is a cross-sectional study with 14,367 patients undergoing ESE, from January 2000 to January 2022, divided into the following 2 groups: G1, composed of patients whose peak systolic pressure increased ≥ 90 mmHg (value corresponding to the 95th percentile of the study population), and G2, patients who did not demonstrate an exaggerated hypertensive response. The groups were compared using Student's t and chi-square tests. P values < 0.05 were considered significant. Logistic regression was also performed to identify independent risk factors for myocardial ischemia, ESBPRE, complaints of typical chest pain prior to the exam, and angina during the test. RESULTS Of the 14,367 patients, 1,500 (10.4%) developed ESBPRE, and 7,471 (52.0%) were female. The percentages of previous complaints of typical chest pain, angina during the test, and myocardial ischemia in patients with ESBPRE were 5.8%, 2.4% and 18.1%, compared to 7.4%, 3.9%, and 24.2%, in patients without ESBPRE, respectively (p = 0.021,p = 0.004, p < 0.001). In multivariate analysis, ESBPRE was independently associated with a lower probability of myocardial ischemia (odds ratio: 0.73; 95% confidence interval: 0.58 to 0.93; p = 0.009). CONCLUSION Exaggerated increase in systolic blood pressure during ESE may be a marker for excluding myocardial ischemia.
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Affiliation(s)
| | | | | | | | | | - Iana Carine Machado Bispo Campos
- Rede D'Or São Luiz - Clínica e Hospital São Lucas , Aracaju , SE - Brasil
- Rede Primavera - Setor de Métodos Gráficos do Hospital Primavera , Aracaju , SE - Brasil
- Fundação de Beneficência Hospital de Cirurgia - Setor de Métodos Gráficos , Aracaju , SE - Brasil
| | | | - Stephanie Macedo Andrade
- Rede D'Or São Luiz - Clínica e Hospital São Lucas , Aracaju , SE - Brasil
- Rede Primavera - Setor de Métodos Gráficos do Hospital Primavera , Aracaju , SE - Brasil
| | - Antônio Carlos Sobral Sousa
- Universidade Federal de Sergipe , São Cristóvão , SE - Brasil
- Rede D'Or São Luiz - Clínica e Hospital São Lucas , Aracaju , SE - Brasil
| | - Joselina Luzia Menezes Oliveira
- Universidade Federal de Sergipe , São Cristóvão , SE - Brasil
- Rede D'Or São Luiz - Clínica e Hospital São Lucas , Aracaju , SE - Brasil
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Guardieiro B, Santos-Paul MA, Furtado RHDM, Dalçóquio T, Salsoso R, Neves ILI, Neves RS, Cavalheiro Filho C, Baracioli LM, Nicolau JC. Comparison between two different local hemostatic methods for dental extractions in patients on dual antiplatelet therapy: a within-person, single-blind, randomized study. J Evid Based Dent Pract 2023; 23:101863. [PMID: 37689449 DOI: 10.1016/j.jebdp.2023.101863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/09/2023] [Accepted: 04/03/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Dual antiplatelet therapy (DAPT) provides additional risk reduction of ischemic events compared to aspirin monotherapy, at cost of higher bleeding risk. There are few data comparing new techniques for reducing bleeding after dental extractions in these patients. PURPOSE This study investigated the effectiveness of the HemCon Dental Dressing (HDD) compared to oxidized cellulose gauze. MATERIALS AND METHODS This randomized study included 60 patients on DAPT who required at least two dental extractions (120 procedures). Each surgical site was randomized to HDD or oxidized regenerated cellulose gauze as the local hemostatic method. Intra-oral bleeding time was measured immediately after the dental extraction and represents our main endpoint for comparison of both hemostatic agents. Prolonged bleeding, platelet reactivity measured by Multiplate Analyser (ADPtest and ASPItest) and tissue healing comparison after 7 days were also investigated. RESULTS Intra-oral bleeding time was lower in HDD compared with control (2 [2-5] vs. 5 [2-8] minutes, P=0.001). Prolonged postoperative bleeding was observed in 7 cases (11.6%), all of them successfully managed with local sterile gauze pressure. More HDD treated sites presented better healing when compared with control sites [21 (36.8%) vs. 5 (8.8%), P=0.03]. There was poor correlation between platelet reactivity and intra-oral bleeding time. CONCLUSIONS In patients on DAPT, HDD resulted in a lower intra-oral bleeding time compared to oxidized cellulose gauze after dental extractions. Moreover, HDD also seems to improve healing conditions.
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Affiliation(s)
- Bruno Guardieiro
- Instituto do Coracao (InCor), Unidade de Odontologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - Marcela Alves Santos-Paul
- Instituto do Coracao (InCor), Unidade de Odontologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - Remo Holanda de Mendonça Furtado
- Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil; Academic Research Organization, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Talia Dalçóquio
- Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - Rocío Salsoso
- Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - Itamara Lúcia Itagiba Neves
- Instituto do Coracao (InCor), Unidade de Odontologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - Ricardo Simões Neves
- Instituto do Coracao (InCor), Unidade de Odontologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - Cyrillo Cavalheiro Filho
- Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - Luciano Moreira Baracioli
- Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - José Carlos Nicolau
- Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil.
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Oliveira GMMD, Almeida MCCD, Rassi DDC, Bragança ÉOV, Moura LZ, Arrais M, Campos MDSB, Lemke VG, Avila WS, Lucena AJGD, Almeida ALCD, Brandão AA, Ferreira ADDA, Biolo A, Macedo AVS, Falcão BDAA, Polanczyk CA, Lantieri CJB, Marques-Santos C, Freire CMV, Pellegrini D, Alexandre ERG, Braga FGM, Oliveira FMFD, Cintra FD, Costa IBSDS, Silva JSN, Carreira LTF, Magalhães LBNC, Matos LDNJD, Assad MHV, Barbosa MM, Silva MGD, Rivera MAM, Izar MCDO, Costa MENC, Paiva MSMDO, Castro MLD, Uellendahl M, Oliveira Junior MTD, Souza OFD, Costa RAD, Coutinho RQ, Silva SCTFD, Martins SM, Brandão SCS, Buglia S, Barbosa TMJDU, Nascimento TAD, Vieira T, Campagnucci VP, Chagas ACP. Position Statement on Ischemic Heart Disease - Women-Centered Health Care - 2023. Arq Bras Cardiol 2023; 120:e20230303. [PMID: 37556656 PMCID: PMC10382148 DOI: 10.36660/abc.20230303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - Walkiria Samuel Avila
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | | | | | - Andreia Biolo
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
| | | | | | | | | | - Celi Marques-Santos
- Universidade Tiradentes (UNIT), Aracaju, SE - Brasil
- Hospital São Lucas Rede D'Or São Luis, Aracaju, SE - Brasil
| | | | - Denise Pellegrini
- Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS - Brasil
| | | | - Fabiana Goulart Marcondes Braga
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | | | | | - Lara Terra F Carreira
- Cardiologia Nuclear de Curitiba, Curitiba, PR - Brasil
- Hospital Pilar, Curitiba, PR - Brasil
| | | | | | | | | | | | | | | | | | | | | | - Marly Uellendahl
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
- DASA - Diagnósticos da América S/A, São Paulo, SP - Brasil
| | - Mucio Tavares de Oliveira Junior
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | - Ricardo Quental Coutinho
- Faculdade de Ciências Médicas da Universidade de Pernambuco (UPE), Recife, PE - Brasil
- Hospital Universitário Osvaldo Cruz da Universidade de Pernambuco (UPE), Recife, PE - Brasil
| | | | - Sílvia Marinho Martins
- Pronto Socorro Cardiológico de Pernambuco da Universidade de Pernambuco (PROCAPE/UPE), Recife, PE - Brasil
| | | | - Susimeire Buglia
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
| | | | | | - Thais Vieira
- Universidade Tiradentes (UNIT), Aracaju, SE - Brasil
- Rede D'Or, Aracaju, SE - Brasil
- Hospital Universitário da Universidade Federal de Sergipe (UFS), Aracaju, SE - Brasil
| | | | - Antonio Carlos Palandri Chagas
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
- Centro Universitário Faculdade de Medicina ABC, Santo André, SP - Brasil
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Palma CCSSV, Lopes PM, de Souza Bomfim A, Gomes MB. Pragmatic clinic-based investigation of echocardiogram parameters in asymptomatic patients with type 2 diabetes in routine clinical practice and its association with suggestive coronary artery disease: a pilot study. Diabetol Metab Syndr 2023; 15:162. [PMID: 37481586 PMCID: PMC10362725 DOI: 10.1186/s13098-023-01128-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Patients with diabetes mellitus (DM) have cardiovascular diseases (CVD) as a major cause of mortality and morbidity. The primary purpose of this study was to assess the echocardiographic parameters that showed alterations in patients with type 2 diabetes mellitus(T2DM) with suggestive coronary artery disease (CAD) determined by electrocardiography and the secondary was to assess the relationship of these alterations with established cardiovascular risk factors. METHODS This cross-sectional, observational pilot study included 152 consecutive patients with T2DM who attended a tertiary DM outpatient care center. All patients underwent clinical examination and history, anthropometric measurements, demographic survey, determination of the Framingham global risk score, laboratory evaluation, basal electrocardiogram, echocardiogram, and measurement of carotid intima-media thickness (CIMT). RESULTS From the overall sample, 134 (88.1%) patients underwent an electrocardiogram. They were divided into two groups: patients with electrocardiograms suggestive of CAD (n = 11 [8.2%]) and those with normal or non-ischemic alterations on electrocardiogram (n = 123 [91.79%]). In the hierarchical multivariable logistic model examining all selected independent factors that entered into the model, sex, high triglycerides levels, and presence of diabetic retinopathy were associated with CAD in the final model. No echocardiographic parameters were significant in multivariate analysis. The level of serum triglycerides (threshold) related to an increased risk of CAD was ≥ 184.5 mg/dl (AUC = 0.70, 95% IC [0.51-0.890]; p = 0.026. CONCLUSION Our pilot study demonstrated that no echocardiogram parameters could predict or determine CAD. The combination of CIMT and Framingham risk score is ideal to determine risk factors in asymptomatic patients with T2DM. Patients with diabetic retinopathy and hypertriglyceridemia need further investigation for CAD. Further prospective studies with larger sample sizes are needed to confirm our results.
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Affiliation(s)
- Catia Cristina Silva Sousa Vergara Palma
- Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Av. 28 de Setembro, No. 77, 3 Andar, Vila Isabel, Rio de Janeiro, 20551-030 Brazil
| | - Pablo Moura Lopes
- Department of Internal Medicine, Cardiology Unit, State University Hospital of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Av. 28 de Setembro, No. 77, 2 Andar, Vila Isabel, Rio de Janeiro, Brazil
| | - Alfredo de Souza Bomfim
- Department of Internal Medicine, Cardiology Unit, State University Hospital of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Av. 28 de Setembro, No. 77, 2 Andar, Vila Isabel, Rio de Janeiro, Brazil
| | - Marilia Brito Gomes
- Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Av. 28 de Setembro, No. 77, 3 Andar, Vila Isabel, Rio de Janeiro, 20551-030 Brazil
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Garzon S, Lemos PA. Improving Outcomes of Patients with Acute Coronary Disease in Real Life: The Case of Applying in Practice What We Already Know from Clinical Studies. Arq Bras Cardiol 2023; 120:e20230283. [PMID: 37341250 DOI: 10.36660/abc.20230283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Affiliation(s)
- Stefano Garzon
- Hospital Israelita Albert Einstein , São Paulo , SP - Brasil
| | - Pedro A Lemos
- Hospital Israelita Albert Einstein , São Paulo , SP - Brasil
- Instituto do Coração - InCor, HCFMUSP , São Paulo , SP - Brasil
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Meneguin S, Pollo CF, Jolo MF, Sartori MMP, de Morais JF, de Oliveira C. Impact of Care Interventions on the Survival of Patients with Cardiac Chest Pain. Healthcare (Basel) 2023; 11:1734. [PMID: 37372853 DOI: 10.3390/healthcare11121734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Chest pain is considered the second most frequent complaint among patients seeking emergency services. However, there is limited information in the literature about how the care provided to patients with chest pain, when being attended to in the emergency room, influences their clinical outcomes. AIMS To assess the relationship between care interventions performed on patients with cardiac chest pain and their immediate and late clinical outcomes and to identify which care interventions were essential to survival. METHODS In this retrospective study. We analyzed 153 medical records of patients presenting with chest pain at an emergency service center, São Paulo, Brazil. Participants were divided into two groups: (G1) remained hospitalized for a maximum of 24 h and (G2) remained hospitalized for between 25 h and 30 days. RESULTS Most of the participants were male 99 (64.7%), with a mean age of 63.2 years. The interventions central venous catheter, non-invasive blood pressure monitoring, pulse oximetry, and monitoring peripheral perfusion were commonly associated with survival at 24 h and 30 days. Advanced cardiovascular life support and basic support life (p = 0.0145; OR = 8053; 95% CI = 1385-46,833), blood transfusion (p < 0.0077; OR = 34,367; 95% CI = 6489-182,106), central venous catheter (p < 0.0001; OR = 7.69: 95% CI 1853-31,905), and monitoring peripheral perfusion (p < 0.0001; OR = 6835; 95% CI 1349-34,634) were independently associated with survival at 30 days by Cox Regression. CONCLUSIONS Even though there have been many technological advances over the past decades, this study demonstrated that immediate and long-term survival depended on interventions received in an emergency room for many patients.
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Affiliation(s)
- Silmara Meneguin
- Department of Nursing, Botucatu Medical School, Paulista State University-Unesp, São Paulo 18618687, SP, Brazil
| | - Camila Fernandes Pollo
- Department of Nursing, Botucatu Medical School, Paulista State University-Unesp, São Paulo 18618687, SP, Brazil
| | - Murillo Fernando Jolo
- Department of Nursing, Botucatu Medical School, Paulista State University-Unesp, São Paulo 18618687, SP, Brazil
| | - Maria Marcia Pereira Sartori
- Department of Plant Production, School of Agriculture, Paulista State University-Unesp, Botucatu 18610034, SP, Brazil
| | - José Fausto de Morais
- Faculty of Mathematics, Federal University of Uberlândia, Uberlândia 38400902, MG, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK
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Leite WF, dos Santos Povoa RM, Caixeta AM, Amodeo C, Szarf G, Bombig MTN, Izar MCO, Gioia LN, Ribeiro WN, Fonseca FAH. Chest Pain in Acute Myocardial Infarction and Its Association With the Culprit Artery and Fibrotic Segment Identified by Cardiac Magnetic Resonance. Cardiol Res 2023; 14:97-105. [PMID: 37091885 PMCID: PMC10116939 DOI: 10.14740/cr1468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/18/2023] [Indexed: 04/25/2023] Open
Abstract
Background It is still very controversial whether the characteristics of pain in the acute myocardial infarction could be related to the culprit coronary artery. There are no data about associations of pain with the ST-segment elevation myocardial infarction (STEMI) and left ventricular (LV) fibrotic segments. Methods Data from 328 participants who had STEMI and were included in the B and T Types of Lymphocytes Evaluation in Acute Myocardial Infarction (BATTLE-AMI) study were analyzed. The culprit artery was identified by coronary angiography and the injured myocardial segments by cardiac magnetic resonance. The statistical significance was established by P value < 0.05. Results A total of 223 patients (68%) were selected. Association was not observed between chest pain and the culprit artery (P = 0.237), as well as between pain irradiation and the culprit artery (P = 0.473). No significant difference was observed in the pain localization in relation to the segments in the short axis basal, mid, apical, and long axis, except for the mid inferior segment. The data were not considered clinically relevant because this association was observed in only one of 17 segments after multiple comparisons. Conclusions In patients with STEMI, no associations were observed between the location or irradiation of acute chest pain and/or adjacent areas and the culprit artery, or between pain and segmental myocardial fibrosis in the LV.
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Affiliation(s)
- Weverton Ferreira Leite
- Department of Hypertensive Heart Disease, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, SP, Brazil
- Corresponding Author: Weverton Ferreira Leite, Department of Hypertensive Heart Disease, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Paraiso, Sao Paulo - SP, CEP 01321-000, Brazil.
| | - Rui Manuel dos Santos Povoa
- Department of Hypertensive Heart Disease, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, SP, Brazil
| | - Adriano Mendes Caixeta
- Department of Hemodynamics, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, SP, Brazil
| | - Celso Amodeo
- Department of Hypertensive Heart Disease, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, SP, Brazil
| | - Gilberto Szarf
- Department of Magnetic Resonance, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, SP, Brazil
| | - Maria Teresa Nogueira Bombig
- Department of Hypertensive Heart Disease, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, SP, Brazil
| | - Maria Cristina Oliveira Izar
- Department of Lipids, Atherosclerosis and Vascular Biology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, SP, Brazil
| | | | - Wilma Noia Ribeiro
- Department of Coronary Artery Disease, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, SP, Brazil
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Rosignoli da Conceição A, da Silva A, Marcadenti A, Bersch-Ferreira ÂC, Weber B, Bressan J. Consumption of unprocessed or minimally processed foods and their association with cardiovascular events and cardiometabolic risk factors in Brazilians with established cardiovascular events. Int J Food Sci Nutr 2023; 74:107-119. [PMID: 36625034 DOI: 10.1080/09637486.2023.2164922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Consumption of food in its natural form has an inverse relationship with cardiometabolic risk factors; however, the relationship between consumption of unprocessed or minimally processed foods and the presence of cardiovascular diseases (CVD) remains unclear in individuals receiving secondary care for CVD. Thus, we aimed to evaluate the association between the consumption of unprocessed or minimally processed foods and the presence of CVD and cardiometabolic risk factors in individuals with established CVD. Baseline data from 2357 participants in a Brazilian multicentre study showed that the consumption of unprocessed or minimally processed foods corresponded to most of the daily caloric intake (69.3%). Furthermore, regression analyses showed that higher consumption of unprocessed or minimally processed foods (>78.0% of caloric intake) was associated with a lower prevalence of elevated waist circumference (WC1; PR: 0.889; CI: 0.822-0.961; WC2; PR: 0.914; CI: 0.873-0.957) and overweight (PR: 0.930; CI: 0.870-0.994), but also was associated with simultaneous occurrence of coronary and peripheral artery disease and stroke (OR: 2.802; CI: 1.241-6.325) when compared with a lower intake (<62.8% of caloric intake). These findings reinforce the importance of nutritional guidance that considers the profile of the target population and the composition and quality of the meals consumed.
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Affiliation(s)
| | - Alessandra da Silva
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Aline Marcadenti
- Hcor Research Institute, HCor (IP-Hcor), São Paulo, Brazil.,Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | | | | | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
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12
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Arroio LFG, Lopes JDL, Barros ALBLD, Lima EAD, Lopes CT, Santos VB. Development and content validity of a website for patients with coronary artery disease. Rev Bras Enferm 2023; 76:e20220302. [PMID: 36722650 PMCID: PMC9885361 DOI: 10.1590/0034-7167-2022-0302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/21/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES to develop and analyze content validity evidence of a website for patients with coronary artery disease. METHODS a methodological study, carried out in the phases: Definition - determined contents for inclusion in the website, architecture and design; Implementation - subjects included in the website; Assessment - website submitted to analysis by 13 experts and eight laypersons regarding organization, content and design, on a scale of 1 (no agreement) to 4 (complete agreement). Items that reached Content Validity Ratio (CVR) higher than the established critical values and Content Validity Index greater than 0.80 were considered valid. RESULTS eight domains related to secondary prevention in coronary heart disease were included on the website. Critical CVR and adequate CVI were obtained according to professional and lay experts. CONCLUSIONS the website was developed, achieving adequate content validity evidence, and can be used as an educational tool for this population.
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Arroio LFG, Lopes JDL, Barros ALBLD, Lima EAD, Lopes CT, Santos VB. Desenvolvimento e validação de conteúdo de um website para pacientes com doença arterial coronariana. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2022-0302pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
RESUMO Objetivos: desenvolver e analisar as evidências de validade de conteúdo de um website para pacientes com doença arterial coronariana. Métodos: estudo metodológico, realizado nas fases: Definição - determinado os conteúdos para inclusão no website, arquitetura e design; Implementação - assuntos incluídos no website; Avaliação - website submetido à análise por 13 especialistas e oito leigos quanto à organização, conteúdo e design, em uma escala de 1 (não concordância) a 4 (total concordância). Considerados válidos os itens que atingiram uma Razão de Validade de Conteúdo (CVR) superior aos valores críticos estabelecidos e um Índice de Validade de Conteúdo superior a 0,80. Resultados: incluídos no website oito domínios relacionados à prevenção secundária em coronariopatias. Um CVR crítico e um IVC adequado foram obtidos na opinião de especialistas profissionais e leigos. Conclusões: o website foi desenvolvido, alcançando adequadas evidências de validade de conteúdo, e pode ser utilizado como ferramenta educacional para esta população.
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14
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Fernandes BF, Kock KDS. Acute coronary syndrome in a hospital in southern Brazil: peak of hospitalizations on Mondays and severe cases on weekends and at night. Am J Cardiovasc Dis 2022; 12:307-314. [PMID: 36743513 PMCID: PMC9890198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/07/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Ischemic heart disease is the leading cause of death in Brazil and worldwide. The term acute coronary syndrome (ACS) generically represents the acute myocardial ischemic events. These events are clinically divided into three types: acute myocardial infarction (AMI) with ST-segment elevation, AMI without ST-segment elevation, and unstable angina. Although cardiovascular ischemic events occur acutely, studies describe cyclic patterns of ACS, mainly on circadian and weekly variation. OBJECTIVE The aim of this study was to analyze the circadian and weekly variation of hospitalizations for ACS in a hospital in southern Brazil in 2019. METHODS Observational, cross-sectional type study. The population was the patients hospitalized at the Nossa Senhora da Conceição Hospital (NSCH) in Tubarão (SC, Brazil) with the international classification of diseases (ICD) code referring to ACS in the year 2019, corresponding to 579 patients. RESULTS After applying the exclusion criteria, 512 patients hospitalized for ACS were analyzed, 55.1% were male with a median (p25-p75) age of 62.0 (56.0-69.0) years. The main ICDs of hospitalization were: I20.0 (76.2%), I21.9 (16.6%), I21.3 (3.1%) and the most prevalent comorbidities were high blood pressure (82.6%), diabetes (30.1%) and previous AMI (23.6%). The median (p25-p75) time of admission was 14 h (10-18) h and length of stay was 5 (3-9) days. Death occurred in 18 hospitalizations (3.5%) of cases. CONCLUSION We conclude that in the present study there was a peak of hospitalizations for ACS on Mondays, proportionally reducing throughout the week and with a significant decrease on the weekend.
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15
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Brant LCC, Passaglia LG. High Mortality for Myocardial Infarction in Latin America and the Caribbean: Making the Case for Systems of Care Implementation in Brazil. Arq Bras Cardiol 2022; 119:979-980. [PMID: 36541994 DOI: 10.36660/abc.20220825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Luisa C C Brant
- Departamento de Clínica Médica - Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
| | - Luiz G Passaglia
- Serviço de Cardiologia e Cirurgia Cardiovascular - Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
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16
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Genestreti PRR, Furtado RHM, Salsoso R, Dalçóquio TF, Franci A, Menezes FR, Caporrino C, Ferrari AG, Nakashima CAK, Scanavini Filho MA, Lima FG, Giraldez RRCV, Baracioli LM, Nicolau JC. Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction. J Clin Med 2022; 11:5776. [PMID: 36233642 PMCID: PMC9571017 DOI: 10.3390/jcm11195776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 12/01/2022] Open
Abstract
Background: The management of acute myocardial infarction (AMI) presents several challenges in patients with diabetes, among them the higher rate of recurrent thrombotic events, hyperglycemia and risk of subsequent heart failure (HF). The objective of our study was to evaluate effects of DPP-4 inhibitors (DPP-4i) on platelet reactivity (main objective) and cardiac risk markers. Methods: We performed a single-center double-blind randomized trial. A total of 70 patients with type 2 diabetes (T2DM) with AMI Killip ≤2 on dual-antiplatelet therapy (aspirin plus clopidogrel) were randomized to receive sitagliptin 100 mg or saxagliptin 5 mg daily or matching placebo. Platelet reactivity was assessed at baseline, 4 days (primary endpoint) and 30 days (secondary endpoint) after randomization, using VerifyNow Aspirin™ assay, expressed as aspirin reaction units (ARUs); B-type natriuretic peptide (BNP) in pg/mL was assessed at baseline and 30 days after (secondary endpoint). Results: Mean age was 62.6 ± 8.8 years, 45 (64.3%) male, and 52 (74.3%) of patients presented with ST-segment elevation MI. For primary endpoint, there were no differences in mean platelet reactivity (p = 0.51) between the DPP-4i (8.00 {−65.00; 63.00}) and placebo (−14.00 {−77.00; 52.00}) groups, as well in mean BNP levels (p = 0.14) between DPP-4i (−36.00 {−110.00; 15.00}) and placebo (−13.00 {−50.00; 27.00}). There was no difference between groups in cardiac adverse events. Conclusions: DPP4 inhibitor did not reduce platelet aggregation among patients with type 2 diabetes hospitalized with AMI. Moreover, the use of DPP-4i did not show an increase in BNP levels or in the incidence of cardiac adverse events. These findings suggests that DPP-4i could be an option for management of T2DM patients with acute MI.
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de Carvalho Costa IMNB, da Silva DG, Oliveira JLM, Silva JRS, Pereira LMC, Vieira Sousa Alves L, de Andrade FA, de Góes Jorge J, de Oliveira LMSM, de Almeida RR, Oliveira VB, Martins LS, Costa JO, de Souza MFC, Voci SM, Almeida-Santos MA, Aidar FJ, Baumworcele L, Sousa ACS. Adherence to Secondary Prevention Measures after Acute Coronary Syndrome in Patients Associated Exclusively with the Public and Private Healthcare Systems in Brazil. Prev Med Rep 2022; 29:101973. [PMID: 36161134 PMCID: PMC9502285 DOI: 10.1016/j.pmedr.2022.101973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/28/2022] [Accepted: 08/27/2022] [Indexed: 11/24/2022] Open
Abstract
Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS, in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1 % from SUS and 55.9 % from PHCS. PHCS users showed greater adherence to pharmacotherapy at both 30 and 180 (p = 0.001) days after ACS with better results in all classes of medications (p < 0.05) than SUS users did. They also showed better adherence to physical activity (p = 0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity.
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18
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Fayh APT, Guedes FFDO, Calado GCF, Queiroz SA, Anselmo MGGB, de Sousa IM. SARC-F Is a Predictor of Longer LOS and Hospital Readmission in Hospitalized Patients after a Cardiovascular Event. Nutrients 2022; 14:nu14153154. [PMID: 35956328 PMCID: PMC9370486 DOI: 10.3390/nu14153154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 12/15/2022] Open
Abstract
It is already established that sarcopenia is associated with adverse outcomes; however, few studies have focused on patients who have suffered an acute cardiovascular event. The use of SARC-F, a 5-item sarcopenia screening questionnaire, in these patients remains to be investigated. We aimed to investigate whether SARC-F can predict adverse outcomes in patients admitted to a hospital with a suspected infarction. This is a 1-year prospective cohort study. During hospitalization, patients completed the SARC-F questionnaire (scores ≥ 4 considered positive for the risk of sarcopenia). Length of hospital stay (LOS), new hospital admission, myocardial infarction, and cardiovascular mortality were collected via medical records and phone interviews. In total, 180 patients were evaluated. The median age was 60.6 years; 72.3% of the participants were men, and half of the sample had comorbidities. The median SARC-F score was 1.0 (interquartile range, 0–3.0), and 21.1% of the participants screened positive. Risk of sarcopenia was independently associated with longer LOS (odds ratio, 2.34; 95% CI, 1.09–5.04; p = 0.030) and hospital readmission (odds ratio, 3.73; 95% CI, 1.60–8.69; p = 0.002). One-fifth of post-acute cardiovascular event patients in this cohort screened positive for sarcopenia using the SARC-F screening questionnaire. Positive scores were associated with a longer LOS and hospital readmission.
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Affiliation(s)
- Ana Paula Trussardi Fayh
- Postgraduate Program in Nutrition and Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
- Correspondence:
| | - Francisco Felipe de Oliveira Guedes
- PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal 59012-570, Brazil; (F.F.d.O.G.); (G.C.F.C.); (M.G.G.B.A.)
| | - Guilherme Carlos Filgueira Calado
- PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal 59012-570, Brazil; (F.F.d.O.G.); (G.C.F.C.); (M.G.G.B.A.)
| | - Sandra Azevedo Queiroz
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil;
| | - Marina Gabriely Gomes Barbosa Anselmo
- PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal 59012-570, Brazil; (F.F.d.O.G.); (G.C.F.C.); (M.G.G.B.A.)
| | - Iasmin Matias de Sousa
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil;
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de Carvalho Costa IMNB, da Silva DG, Oliveira JLM, Silva JRS, de Andrade FA, de Góes Jorge J, de Oliveira LMSM, de Almeida RR, Oliveira VB, Martins LS, Costa JO, de Souza MFC, Pereira LMC, Alves LVS, Voci SM, Almeida-Santos MA, Aidar FJ, Baumworcel L, Sousa ACS. Quality of Life among Patients with Acute Coronary Syndromes Receiving Care from Public and Private Health Care Systems in Brazil. Clin Pract 2022; 12:513-26. [PMID: 35892441 DOI: 10.3390/clinpract12040055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 11/22/2022] Open
Abstract
(1) Background: Quality of life (QOL) is used as a health indicator to assess the effectiveness and impact of therapies in certain groups of patients. This study aimed to analyze the QOL of patients with acute coronary syndrome (ACS) who received medical treatment by a public or private health care system. (2) Methods: This observational, prospective, longitudinal study was carried out in four referral hospitals providing cardiology services in Sergipe, Brazil. QoL was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey. The volunteers were divided into two groups (public or private health care group) according to the type of health care provided. Multiple linear regression models were used to evaluate QoL at 180 days after ACS. (3) Results: A total of 581 patients were eligible, including 44.1% and 55.9% for public and private health care, respectively. At 180 days after ACS, the public health care group had lower QoL scores for all domains (functional capacity, physical aspects, pain, general health status, vitality, social condition, emotional profile, and health) (p < 0.05) than the private group. The highest QoL level was associated with male sex (p < 0.05) and adherence to physical activity (p ≤ 0.003) for all assessed domains. (4) Conclusions: This shows that social factors and health status disparities influence QoL after ACS in Sergipe.
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Moitinho MS, Silva Junior JRD, Cunha MDB, Barbosa DA, Caixeta AM, Pimpinato AG, Junglos AF, Belasco AGDS, Fonseca CDD. Contrast-induced acute kidney injury in patients submitted to coronary angioplasty: prospective cohort. Rev Esc Enferm USP 2022; 56:e20210435. [PMID: 35781323 DOI: 10.1590/1980-220x-reeusp-2021-0435en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/20/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the incidence, risk factors, and associations of clinical outcomes for contrast-induced acute kidney injury (CI-AKI) in patients with acute coronary syndrome (ACS) after coronary angioplasty. METHOD Prospective cohort of 182 patients followed for three months after undergoing angioplasty, from July 2020 to June 2021. The analyzed variables were sociodemographic, clinical, and those related to the procedure. RESULTS The incidence of CI-AKI was 35.7% (n = 65) and was associated with old age, diabetes mellitus, and chronic kidney disease (p = 0.004, p < 0.001, and p = 0.009, respectively). Out of the 17 patients who died within 90 days, 76.5% had CI-AKI (n = 13), the odds ratio between death and CI-AKI was approximately 7.2 times (95% confidence interval (CI), [2.41;26.36]; p = 0.001). The decrease of one unit in the patient's baseline hemoglobin showed a 6.5% increase for CI-AKI (95% CI, [-0.089; -0.040]; p < 0.0001). CONCLUSION CI-AKI is prevalent in patients with ACS after angioplasty and is related to diabetes mellitus and chronic kidney disease, showing high mortality rates.
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Affiliation(s)
- Matheus Santos Moitinho
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | - Jumar Reis Da Silva Junior
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | - Maximina De Barros Cunha
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | - Dulce Aparecida Barbosa
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | - Adriano Mendes Caixeta
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Cardiologia Intervencionista, São Paulo, SP, Brazil
| | - Attilio Galhardo Pimpinato
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Cardiologia Intervencionista, São Paulo, SP, Brazil
| | - Alana Francine Junglos
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | | | - Cassiane Dezoti da Fonseca
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil.,Universidade Federal de Sergipe, Programa de Pós-Graduação em Enfermagem, São Cristóvão, SE, Brazil
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21
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Bettencourt N. Papel da Tomografia Computorizada na Exclusão de Síndrome Coronária Aguda em Contexto de Urgência: A Anatomia é o Caminho? Arq Bras Cardiol 2022; 118:903-904. [PMID: 35613188 PMCID: PMC9368882 DOI: 10.36660/abc.20220273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Affiliation(s)
- David Le Bihan
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasilUniversidade de São Paulo Instituto do Coração, São Paulo, SP – Brasil
- Grupo FleurySão PauloSPBrasilGrupo Fleury, São Paulo, SP – Brasil
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Silva PGMDBE, Lopes RD. Risk Scores in Acute Coronary Syndrome: Current Applications and Future Perspectives. International Journal of Cardiovascular Sciences 2022. [DOI: 10.36660/ijcs.20220006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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24
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Calderaro D, Bichuette LD, Maciel PC, Cardozo FAM, Ribeiro HB, Gualandro DM, Baracioli LM, Soeiro ADM, Serrano CV, Costa RAD, Caramelli B. Update of the Brazilian Society of Cardiology's Perioperative Cardiovascular Assessment Guideline: Focus on Managing Patients with Percutaneous Coronary Intervention - 2022. Arq Bras Cardiol 2022; 118:536-547. [PMID: 35262593 PMCID: PMC8856674 DOI: 10.36660/abc.20220039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Daniela Calderaro
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Luciana Dornfeld Bichuette
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Pamela Camara Maciel
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Francisco Akira Malta Cardozo
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Henrique Barbosa Ribeiro
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Danielle Menosi Gualandro
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel - Suíça
| | - Luciano Moreira Baracioli
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital Sírio Libanês, São Paulo, SP - Brasil
| | - Alexandre de Matos Soeiro
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital BP Mirante, São Paulo, SP - Brasil
| | - Carlos Vicente Serrano
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | - Bruno Caramelli
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
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Moitinho MS, Silva Junior JRD, Cunha MDB, Barbosa DA, Caixeta AM, Pimpinato AG, Junglos AF, Belasco AGDS, Fonseca CDD. Lesão renal aguda induzida por contraste em pacientes submetidos à angioplastia coronariana: coorte prospectiva. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0435pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Analisar a incidência, os fatores de risco e as associações dos desfechos clínicos para Lesão Renal Aguda Induzida Por Contraste (LRA-IC) em pacientes com Síndrome Coronariana Aguda (SCA) após angioplastia coronariana. Método: Coorte prospectivo de 182 pacientes seguidos por três meses após angioplastia, entre julho de 2020 e junho de 2021. As variáveis foram sociodemográficas, clínicas e relacionadas ao procedimento. Resultados: A incidência de LRA-IC foi de 35,7% (n = 65) e esteve associada à idade avançada, diabetes mellitus e doença renal crônica (respectivamente p = 0,004, p < 0,001 e p = 0,009). Dos 17 pacientes que faleceram em até 90 dias, 76,5% tiveram LRA-IC (n = 13), a razão de chances entre óbito e LRA-IC foi de aproximadamente 7,2 vezes (intervalo de confiança (IC) 95%, [2,41;26,36]; p = 0.001). A diminuição de uma unidade na hemoglobina basal do paciente demonstrou um aumento de 6,5% para LRA-IC (IC 95%, [–0,089; –0,040]; p < 0,0001). Conclusão: Em pacientes com SCA após angioplastia, a LRA-IC tem alta incidência e está relacionada com diabetes mellitus e doença renal crônica, apresentando altos índices de mortalidade.
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de Souza Ramos JTG, Ferrari FS, Andrade MF, de Melo CS, Boas PJFV, Costa NA, Pereira AG, Dorna MS, Azevedo PS, Banerjee J, Phillips BE, Atherton PJ, Polegato BF, Okoshi K, Zanati SG, Paiva SAR, Zornoff LAM, Minicucci MF. Association between frailty and C-terminal agrin fragment with 3-month mortality following ST-elevation myocardial infarction. Exp Gerontol 2021; 158:111658. [PMID: 34920013 DOI: 10.1016/j.exger.2021.111658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/04/2022]
Abstract
The objective of this study was to evaluate the association between frailty, evaluated by the Clinical Frailty Scale (CFS) and FRAIL scale, and C-terminal agrin fragment (CAF) levels with 3-month mortality following ST-segment elevation myocardial infarction (STEMI). This was a prospective observational study that included patients over the age of 18 years with STEMI admitted to the coronary intensive care unit. Within 48 h of admission, the CFS and FRAIL scale were applied and blood samples collected for serum CAF evaluation. Patients were followed for 3 months after hospital discharge, and mortality was recorded. One hundred and eleven patients were included; mean age was 62.3 ± 12.4 years, 61.3% were male and 11.7% died during the 3 months of follow-up. According to the CFS, 79.3% of the patients were classified as not frail, 12.6% as pre-frail and 8.1% as frail. According to the FRAIL scale, 31.5% of the patients were classified as not frail, 53.2% as pre-frail and 15.3% as frail. In univariate analysis, the CFS but not FRAIL scale was associated with mortality. In multiple logistic regression analysis, pre-frail/frail according to CFS (odds ratio [OR]: 6.118; CI 95%: 1.344-27.848; p = 0.019) and CAF levels (OR: 0.943; CI 95%: 0.896-0.992; p = 0.024) were associated with increased 3-month mortality. In a sub-analysis of 53 patients ≥65 years, CFS and CAF levels were associated with 3-month mortality. In conclusion, CAF levels and frailty determined by the CFS were associated with 3-month mortality after STEMI in the general and older population.
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Affiliation(s)
- Juan Thomaz Gabriel de Souza Ramos
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Felipe Sanches Ferrari
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Morganna Freitas Andrade
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Caroline Souto de Melo
- Department of Anesthesiology, Complexo Hospitalar Santa Genoveva de Uberlândia, Minas Gerais, Brazil
| | - Paulo José Fortes Villas Boas
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Nara Aline Costa
- Faculty of Nutrition, UFG- Univ Federal de Goiás, Goiânia, Brazil
| | - Amanda Gomes Pereira
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Mariana Souza Dorna
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Paula Schmidt Azevedo
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Jay Banerjee
- Geriatric Emergency Medicine, University Hospitals of Leicester, School of Health Science, University of Leicester, Leicester, UK
| | - Bethan E Phillips
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Derby, UK
| | - Philip J Atherton
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Derby, UK
| | - Bertha Furlan Polegato
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Katashi Okoshi
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Silmeia Garcia Zanati
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Sergio Alberto Rupp Paiva
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Leonardo Antonio Mamede Zornoff
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Marcos Ferreira Minicucci
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
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