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Araujo GND, Machado GP, Moura M, Silveira AD, Bergoli LC, Fuchs FC, Wainstein RV, Goncalves SC, Lemos PA, Quadros ASD, Wainstein MV. Clinical outcomes with biodegradable versus durable polymer drug-eluting stents in patients with ST-elevation myocardial infarction. Cardiovasc Revasc Med 2024:S1553-8389(24)00078-2. [PMID: 38492976 DOI: 10.1016/j.carrev.2024.02.023] [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] [Received: 09/25/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Coronary drug-eluting stents (DES) built with either durable (DP) or biodegradable (BP) polymeric coatings have been largely tested and are extensively available for routine use. However, their comparative performance remains an open question, particularly in more complex subsets of patients. AIMS We evaluated the outcomes of patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI) using DP-DES versus BP-DES in a large multicenter real-world registry. METHODS The population comprised patients with STEMI treated with pPCI within 12 h of symptoms onset. Those treated with more than one DES who received different polymer types were excluded. The final cohort for analysis was selected after propensity score matching (PSM), computed to generate similar groups of DP DES versus BP DES. Primary endpoint was the incidence of major adverse cardiac events (MACE), defined as the composite of total death, myocardial infarction and target lesion revascularization at 2 years. RESULTS From January 2017 to April 2022, a total of 1527 STEMI patients underwent pPCI with a single DES type (587 DP-DES; 940 BP-DES). After PSM, 836 patients (418 patients in the DP-DES and 418 patients in the BP-DES groups), comprised the final study population. Both study groups had a similar baseline profile. Patients treated with BP-DES group had similar rates of MACE (15.3 % vs. 19.4 %, HR 0.69, 95 % CI 0.50-0.94, p = 0.022). Rates of target lesion revascularization was lower in BP DES group (0.7 % vs. 3.8 %, HR 0.17, 95 % CI 0.05-0.51, p = 0.006). CONCLUSION In a cohort of STEMI patients submitted to pPCI, BP and DP DES had similar rates of the primary outcome. Patients treated with BP DES, however, had a decreased incidence of TLR at after 2-year follow-up.
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Affiliation(s)
- Gustavo Neves de Araujo
- Instituto de Cardiologia de Santa Catarina, São Jose, Brazil; Hospital Unimed Grande Florianopolis, São Jose, Brazil.
| | | | - Marcia Moura
- Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | | | - Pedro A Lemos
- Heart Institute (InCor), Universidade de São Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Marco Vugman Wainstein
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Scolari FL, Machado GP, Pagnoncelli A, Chies A, de Araujo GN, da Silveira AD, Gonçalves SC, Truesdell AG, Billia F, Wainstein MV, Wainstein RV. Lung Ultrasound Evaluation of SCAI Shock Stages Predicts Mortality in ST-Segment Elevation Myocardial Infarction. JACC Cardiovasc Imaging 2023; 16:260-262. [PMID: 36648045 DOI: 10.1016/j.jcmg.2022.09.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022]
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Machado GP, Theobald AL, de Araujo GN, da Silveira AD, Wainstein RV, Fracasso JF, Niches M, Chies A, Goncalves SC, Pimentel M, Wainstein MV. Pre-percutaneous coronary intervention sudden cardiac arrest in ST-elevation myocardial infarction: Incidence, predictors, and related outcomes. Front Cardiovasc Med 2023; 10:1100187. [PMID: 36873399 PMCID: PMC9978146 DOI: 10.3389/fcvm.2023.1100187] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/09/2023] [Indexed: 02/18/2023] Open
Abstract
Background ST-segment elevation myocardial infarction (STEMI) is a frequent cause of sudden cardiac arrest (SCA) and early percutaneous coronary intervention (PCI) is associated with increased survival. Despite constant improvements in SCA management, survival remains poor. We aimed to assess pre-PCI SCA incidence and related outcomes in patients admitted with STEMI. Methods This was a prospective cohort study of patients admitted with STEMI in a tertiary university hospital over 11 years. All patients were submitted to emergency coronary angiography. Baseline characteristics, details of the procedure, reperfusion strategies, and adverse outcomes were assessed. The primary outcome was in-hospital mortality. The secondary outcome was 1-year mortality after hospital discharge. Predictors of pre-PCI SCA was also assessed. Results During the study period 1,493 patients were included; the mean age was 61.1 years (±12), and 65.3% were male. Pre-PCI SCA was present in 133 (8.9%) patients. In-hospital mortality was higher in the pre-PCI SCA group (36.8% vs. 8.8%, p < 0.0001). In multivariate analysis, anterior MI, cardiogenic shock, age, pre-PCI SCA and lower ejection fraction remained significantly associated with in-hospital mortality. When we analyzed the interaction between pre-PCI SCA and cardiogenic shock upon admission there is a further increase in mortality risk when both conditions are present. For predictors of pre-PCI SCA, only younger age and cardiogenic shock remained significantly associated after multivariate analysis. Overall 1-year mortality rates were similar between pre-PCI SCA survivors and non-pre-PCI SCA group. Conclusion In a cohort of consecutive patients admitted with STEMI, pre-PCI SCA was associated with higher in-hospital mortality, and its association with cardiogenic shock further increases mortality risk. However, long-term mortality among pre-PCI SCA survivors was similar to non-SCA patients. Understanding characteristics associated with pre-PCI SCA may help to prevent and improve the management of STEMI patients.
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Affiliation(s)
- Guilherme Pinheiro Machado
- Postgraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Andre Luiz Theobald
- Postgraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gustavo Neves de Araujo
- Imperial Hospital de Caridade, Florianópolis, Brazil.,Instituto de Cardiologia de Santa Catarina, São Jose, Brazil
| | - Anderson Donelli da Silveira
- Postgraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Rodrigo Vugman Wainstein
- Postgraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Matheus Niches
- School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Angelo Chies
- School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandro Cadaval Goncalves
- Postgraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Mauricio Pimentel
- Postgraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marco Vugman Wainstein
- Postgraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Mossmann M, Wainstein MV, Mariani S, Machado GP, de Araújo GN, Andrades M, Gonçalves SC, Bertoluci MC. Increased serum IL-6 is predictive of long-term cardiovascular events in high-risk patients submitted to coronary angiography: an observational study. Diabetol Metab Syndr 2022; 14:125. [PMID: 36028849 PMCID: PMC9419425 DOI: 10.1186/s13098-022-00891-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Interleukin-6 (IL-6) is an inflammation-related cytokine associated with an elevated risk of cardiovascular events. In a previous study, we demonstrated that increased IL-6 was predictive of sub-clinical atherosclerotic coronary disease in intermediate-risk patients undergoing coronary angiography. In the present study, we investigated whether increased serum IL-6 is predictive of cardiovascular events in high-risk patients. METHODS In this observational study, consecutive patients referred for elective coronary angiography due to stable chest pain/myocardial ischemia had IL-6 measured immediately before the procedure. Long-term follow-up was performed by phone call or e-mail, and their clinical registries were revised. The primary outcome was a composite of new myocardial infarction, new ischemic stroke, hospitalization due to heart failure, new coronary revascularization, cardiovascular death, and death due to all causes. RESULTS From 141 patients submitted to coronary angiography and IL-6 analysis, 100 had complete follow-up data for a mean of 5.7 years. The median age was 61.1 years, 44% were men, and 61% had type-2 diabetes. The median overall time-to-event for the primary outcome was 297 weeks (95% confidence interval [CI] 266.95-327.16). A receiver operator characteristic curve defined the best cut-off value of baseline serum IL-6 (0.44 pg/mL) with sensitivity (84.37%) and specificity (38.24%) to define two groups. High (> 0.44 pg/mL) IL-6 levels were predictive of cardiovascular events. (p for interaction = 0.015) (hazard ratio = 2.81; 95% CI 1.38-5.72, p = 0.01). Subgroup analysis did not find interactions between patients with or without diabetes, obesity, or hypertension. CONCLUSION In conclusion, an interleukin-6 level higher than 0.44 pg/mL, obtained just before elective coronary angiography, was associated with a poorer prognosis after a mean of 5,7-year. A pre-procedure IL-6 below 0.44 pg/mL, on the other hand, has a very good negative predictive value, suggesting a good prognosis, and may be useful to better indicate coronary angiography in high-risk patients. .
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Affiliation(s)
- Márcio Mossmann
- Post-Graduate Program in Medical Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marco Vugman Wainstein
- Post-Graduate Program in Medical Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Internal Medicine Department, School of Medicine, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Stéfani Mariani
- Post-Graduate Program in Medical Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Guilherme Pinheiro Machado
- Post-Graduate Program in Medical Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo Neves de Araújo
- Post-Graduate Program in Medical Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Michael Andrades
- Unidade de Análises Moleculares e de Proteínas (UAMP), Hospital de Clinicas de 17 Porto Alegre, Porto Alegre, Brazil
| | - Sandro Cadaval Gonçalves
- Post-Graduate Program in Medical Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marcello Casaccia Bertoluci
- Endocrinology Division, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal Do Rio Grande Do Sul (UFRGS), Ramiro Barcelos 2350, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil.
- Internal Medicine Department, School of Medicine, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil.
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Araujo GN, Beltrame R, Pinheiro Machado G, Luchese Custodio J, Zimerman A, Donelli da Silveira A, Scolari FL, Corsetti Bergoli LC, Gonçalves SC, Pereira Lima Marques F, Fuchs FC, Vugman Wainstein M, Vugman Wainstein R. Comparison of Admission Lung Ultrasound and Left Ventricular End-Diastolic Pressure in Patients Undergoing Primary Percutaneous Coronary Intervention. Circ Cardiovasc Imaging 2021; 14:e011641. [PMID: 33866795 DOI: 10.1161/circimaging.120.011641] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Gustavo Neves Araujo
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
- Imperial Hospital de Caridade, Florianópolis, Brazil (G.N.d.A.)
- Hospital SOS Cardio, Florianópolis, Brazil (G.N.d.A.)
| | - Rafael Beltrame
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
| | - Guilherme Pinheiro Machado
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
| | - Julia Luchese Custodio
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
| | - Andre Zimerman
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
| | - Anderson Donelli da Silveira
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, Brazil (A.D.d.S., L.C.C.B., S.C.G., F.C.F., M.V.W., R.V.W.)
| | - Fernado Luís Scolari
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
| | - Luiz Carlos Corsetti Bergoli
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, Brazil (A.D.d.S., L.C.C.B., S.C.G., F.C.F., M.V.W., R.V.W.)
| | - Sandro Cadaval Gonçalves
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, Brazil (A.D.d.S., L.C.C.B., S.C.G., F.C.F., M.V.W., R.V.W.)
| | - Felipe Pereira Lima Marques
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
| | - Felipe Costa Fuchs
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, Brazil (A.D.d.S., L.C.C.B., S.C.G., F.C.F., M.V.W., R.V.W.)
| | - Marco Vugman Wainstein
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, Brazil (A.D.d.S., L.C.C.B., S.C.G., F.C.F., M.V.W., R.V.W.)
| | - Rodrigo Vugman Wainstein
- Universidade Federal do Rio Grande do Sul, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Porto Alegre, Brazil (G.N.d.A., R.B., G.P.M., J.L.C., A.Z., A.D.d.S., F.L.S., L.C.C.B., S.C.G., F.P.L.M., F.C.F., M.V.W., R.V.W.)
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, Brazil (A.D.d.S., L.C.C.B., S.C.G., F.C.F., M.V.W., R.V.W.)
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de Araujo GN, Leiria TLL, Furtado MV, Matte BDS, Machado GP, Krepsky AM, Bergoli LCC, Goncalves SC, Wainstein MV, Polanczyk CA. Inter-observer variation of Syntax score among cardiac surgeons, clinical and interventional cardiologists. Ther Adv Cardiovasc Dis 2020; 14:1753944720924254. [PMID: 32438849 PMCID: PMC7249554 DOI: 10.1177/1753944720924254] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Despite the complexity of SYNTAX score (SS), guidelines recommend this tool to help choosing between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with left main of three-vessel coronary artery disease. The aim of this study was to compare the inter-observer variation in SS performed by clinical cardiologists (CC), interventional cardiologists (IC), and cardiac surgeons (CS). Methods: Seven coronary angiographies from patients with left main and/or three-vessel disease chosen by a heart team were analyzed by 10 CC, 10 IC and 10 CS. SS was calculated via SYNTAX website. Results: Kappa concordance was very low between CC and CS (k = 0.176), moderate between CS and IC (k = 0.563), and moderate between CC and IC (0.553). There was a statistically significant difference between CC, who classified more cases as low complexity (70%), and CS, who classified more cases as moderate complexity (80%) (p = 0.041). Conclusion: Concordance between SS analyzed by CC, CS and IC is low. The usefulness of SS in decision-making of revascularization strategy is undeniable and evidence supports its use. However, this study highlights the importance of well-trained professionals on calculating the SS. It could avoid misclassification of borderline cases.
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Affiliation(s)
- Gustavo Neves de Araujo
- Department of Cardiology, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil.,Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tiago Luiz Luz Leiria
- Department of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Bruno da Silva Matte
- Department of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Guilherme Pinheiro Machado
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Ana Maria Krepsky
- Department of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Luiz Carlos Corsetti Bergoli
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Sandro Cadaval Goncalves
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Marco Vugman Wainstein
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Carisi Anne Polanczyk
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
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Valle FH, Wainstein RV, Matte BS, Gonçalves SC, Bergoli LCC, Krepsky AMR, Pivatto Junior F, de Araujo GN, Machado GP, Wainstein MV. Ultrasound-guided antecubital vein approach for right heart catheterisation in a Brazilian tertiary centre. Open Heart 2020; 7:e001181. [PMID: 32153790 PMCID: PMC7046939 DOI: 10.1136/openhrt-2019-001181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/02/2020] [Accepted: 01/05/2020] [Indexed: 11/24/2022] Open
Abstract
Objective As a parallel to the radial approach for left heart catheterisation, forearm veins may be considered for the performance of right heart catheterisation. However, data regarding the application of this technique under ultrasound guidance are scarce. The current study aims to demonstrate the feasibility of right heart catheterisation through ultrasound-guided antecubital venous approach in the highly heterogeneous population usually referred for right heart catheterisation. Methods Data from consecutive right heart catheterisations performed at an academic centre in Brazil, between January 2016 and March 2017 were prospectively collected. Results Among 152 performed right heart catheterisations, ultrasound-guided antecubital venous approach was attempted in 127 (84%) cases and it was made feasible in 92.1% of those. Yet, there was no immediate vascular complication with the antecubital venous approach in this prospective series. Conclusions Ultrasound-guided antecubital venous approach for the performance of right heart catheterisation was feasible in the vast majority of cases in our study, without occurrence of vascular complications.
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Affiliation(s)
- Felipe Homem Valle
- Cardiology, St. Michael's Hospital, Toronto, Ontario, Canada.,Cardiology, Mount Sinai Hospital/University Health Network, Toronto, Ontario, Canada
| | - Rodrigo Vugman Wainstein
- Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Postgraduate Program in Cardiology and Cardiovascular Sciences, UFRGS, Porto Alegre, Brazil
| | - Bruno Silva Matte
- Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | | | | | - Gustavo Neves de Araujo
- Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Postgraduate Program in Cardiology and Cardiovascular Sciences, UFRGS, Porto Alegre, Brazil
| | | | - Marco Vugman Wainstein
- Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Postgraduate Program in Cardiology and Cardiovascular Sciences, UFRGS, Porto Alegre, Brazil
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8
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Santos SMD, Rabelo-Silva ER, Aliti GB, Romero PS, Corrêa CL, Valle FH, Gonçalves SC, Wainstein MV, Wainstein RV. Two HEmostasis Methods After TransradIal Catheterization: THEMATIC - protocol for a randomized clinical trial. Rev Gaucha Enferm 2018; 39:e20170257. [PMID: 30088607 DOI: 10.1590/1983-1447.2018.2017-0257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/26/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Randomized clinical trial protocol to evaluate the incidence of radial artery occlusion with two different arterial compression devices after transradial procedures. METHODS Barbeau's test will be performed in adults scheduled to undergo transradial interventional procedures. Those with A, B, or C plethysmographic patterns will be selected. At the end of the procedure, patients will be randomly assigned (1:1) to receive patent haemostasis with TR Band™ device or conventional haemostasis with an elastic adhesive bandage. The primary outcome is the incidence of radial artery occlusion. Secondary outcomes are Barbeau's test curve change, additional time to achieve haemostasis, incidence of bleeding at the puncture site, pain severity, development of arteriovenous fistula, radial pseudo aneurysm, any access-site complication requiring vascular surgery intervention and costs between the two devices. DISCUSSION The results of this trial should provide valuable additional information on the best approach for haemostasis after transradial percutaneous cardiovascular interventions.
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Affiliation(s)
| | - Eneida Rejane Rabelo-Silva
- Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil.,Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Graziella Badin Aliti
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Paola Severo Romero
- Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Felipe Homem Valle
- Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Marco Vugman Wainstein
- Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina. Porto Alegre, Rio Grande do Sul, Brasil
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9
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Cammerer MA, Gonçalves SC, de Araujo GN, Andrades ME, Lopes A, Wainstein MV. The Effects of a Flavonoid-Rich Diet on Oxidative Stress, Inflammation, and Lipid Profile after Elective Percutaneous Coronary Intervention: A Randomized Clinical Trial. Prev Nutr Food Sci 2018; 23:108-114. [PMID: 30018888 PMCID: PMC6047878 DOI: 10.3746/pnf.2018.23.2.108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/17/2018] [Accepted: 04/23/2018] [Indexed: 12/31/2022] Open
Abstract
Antioxidant-rich foods may decrease oxidative stress and have a direct impact on atherosclerosis by reducing low-density lipoprotein (LDL) oxidation. Our aim was to assess the impact of a flavonoid-rich diet on oxidative stress, inflammatory response, and lipid profile in patients with coronary artery disease submitted to elective percutaneous coronary intervention (PCI). Thirty-three patients submitted to elective PCI were randomly allocated to follow either a flavonoid rich antioxidant (AOX) diet or a control diet based on National Cholesterol Education Program Adult Treatment Panel III recommendations. Patients were followed for 6 months. Dietary intake was recorded at the start and at the end of the follow-up period, as were oxidative stress markers (ferric reducing ability of plasma and protein sulphydryl) and C-reactive protein (CRP). Patients randomized to follow the AOX diet had a reduction in energy, carbohydrate, and lipid intake, as well as increased flavonoid intake. Compared to the control group, there were no changes in oxidative stress markers or CRP in the patients following the AOX diet, but these patients had a significant decrease in LDL cholesterol levels. In conclusion, the findings of this study suggest that a flavonoid-based antioxidant-rich diet is not associated with reductions in oxidative stress or inflammatory markers 6 months after percutaneous coronary intervention. Nonetheless, patients in the intervention group experienced significant reductions in LDL cholesterol, which may indicate cardiovascular benefits of AOX diets despite of inflammation and oxidative stress markers.
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Affiliation(s)
- Magda Ambros Cammerer
- Post-Graduation Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90040-060,
Brazil
| | - Sandro Cadaval Gonçalves
- Post-Graduation Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90040-060,
Brazil
- Cardiology Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS 90035-903,
Brazil
| | - Gustavo Neves de Araujo
- Post-Graduation Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90040-060,
Brazil
- Cardiology Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS 90035-903,
Brazil
| | - Michael Everton Andrades
- Cardiology Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS 90035-903,
Brazil
- Experimental Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS 90035-903,
Brazil
| | - Amanda Lopes
- Experimental Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS 90035-903,
Brazil
| | - Marco Vugman Wainstein
- Post-Graduation Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90040-060,
Brazil
- Cardiology Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS 90035-903,
Brazil
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Machado GP, Pivatto Junior F, Wainstein R, Araujo GND, Carpes CK, Lech MC, Valle FH, Bergoli LCC, Gonçalves SC, Wainstein MV. An Overview of Care Changes in the Last 6 Year in Primary PCI in ST-Elevation
Myocardial Infarction in a Tertiary University Brazilian Hospital. International Journal of Cardiovascular Sciences 2018. [DOI: 10.5935/2359-4802.20180090] [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: 11/20/2022] Open
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11
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Wainstein RV, Homem Valle F, Pivatto Júnior F, Morzoletto Pedrollo I, Carlos Corsetti Bergoli L, Vugman Wainstein M. Guidewire Self-Extrusion After Entrapment of Distal Protection Device During Saphenous Vein Graft Angioplasty. JACC Cardiovasc Interv 2017; 10:e3-e5. [PMID: 28017316 DOI: 10.1016/j.jcin.2016.10.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 10/20/2016] [Indexed: 11/16/2022]
Affiliation(s)
| | - Felipe Homem Valle
- Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | | | - Marco Vugman Wainstein
- Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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12
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Pivatto Júnior F, Araújo GND, Valle FH, Bergoli LCC, Machado GP, Führ B, Cassol EP, Krepsky AMR, Wainstein RV, Wainstein MV. Comparison of Anatomical and Clinical Scores in Predicting Outcomes in Primary
Percutaneous Coronary Intervention. International Journal of Cardiovascular Sciences 2017. [DOI: 10.5935/2359-4802.20170087] [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: 11/20/2022] Open
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13
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Hackenhaar FS, Martinez D, Medeiros TM, Klein C, Alabarse PVG, Wainstein MV, Gonçalves SC, Benfato MS. Oxidized-LDL and paraoxonase-1 as biomarkers of coronary artery disease in patients with sleep-disordered breathing. Curr Med Chem 2013; 19:4359-66. [PMID: 22934769 DOI: 10.2174/092986712802884312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 07/28/2012] [Accepted: 07/30/2012] [Indexed: 11/22/2022]
Abstract
UNLABELLED Coronary Artery Disease (CAD) and OBJECTIVES Sleep Disordered Breathing (SDB) are both oxidative stress disorders. SDB intermittent hypoxia induces oxidative stress, and reduces NO(·) availability, causing endothelial dysfunction. Low-density lipoprotein (LDL) peroxidation is involved in atherosclerosis, and is reported in SDB. Oxidized LDL (ox-LDL) and malondialdehyde (MDA) are lipid peroxidation markers. High-density lipoprotein (HDL) presents antiatherosclerotic properties related to paraxonase-1 (PON-1) activity. PON-1 hydrolyseyses lipid peroxides as ox-LDL. This study compares the relationship of HDL and PON-1, the lipid peroxidation markers ox-LDL and MDA, and 8-OHdG DNA damage marker in the association of SDB and CAD. DESIGN AND METHODS 29 controls and 27 cases with CAD (defined as > 30% coronary narrowing) patients were included. The apnea-hypopnea index (AHI), and several lipid and oxidative stress parameters were measured in these patients. RESULTS AHI is increased in CAD patients, and PON-1 activity and HDL levels are decreased. Regression analyseyses showed that lower PON-1 activity and higher ox-LDL levels are important CAD predictors, compared to HDL or MDA levels and present an age-dependent increase. Nitrites and nitrates, indirect NO(·) markers, are positive vs correlated with PON-1 and are negatively correlated to ox-LDL. SDB is not correlated to PON-1 activity decrease or ox-LDL increase. AHI is inversely correlated to HDL levels. CONCLUSIONS These results indicate that PON-1 and ox-LDL are important predictors of CAD, however they may not be directly related to SDB.
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Affiliation(s)
- F S Hackenhaar
- Departamento de Biofísica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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14
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Fantin SDS, Wainstein MV, Polanczyk CA, Ledur P, Lazzari CM, Klein C, Hackenhaar FS, Benfato MS, Schaan BD. Inflammatory and oxidative stress markers after intravenous insulin in percutaneous coronary intervention with stent in type 2 diabetes mellitus: a randomized controlled trial. J Clin Endocrinol Metab 2011; 96:478-85. [PMID: 21084403 DOI: 10.1210/jc.2010-0256] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT/OBJECTIVE The objective of the study was to evaluate the effects of normalizing glycemia through iv insulin per 24 h on markers of oxidative stress and inflammation in patients with diabetes submitted to percutaneous coronary intervention (PCI) with stent. PATIENTS/METHODS This was a prospective, open-label, randomized controlled trial, comparing continuous iv insulin per 24 h targeting glycemia less than 110 mg/dl iv insulin treatment (IIT; n = 35) to standard treatment (ST; n = 35, regular insulin if glycemia was greater than 200 mg/dl). Blood samples for glycemia, glycated hemoglobin, lipids, inflammatory markers [C-reactive protein (CRP), soluble CD40 ligand, IL-6, and endothelin 1 (ET-1)] and oxidative stress (total antioxidant status, carbonyl) were collected immediately after and 24 h after PCI. RESULTS Seventy patients were included. Mean age was 60.5 ± 10 yr, 60% were men, glycated hemoglobin was 8.1 ± 1.8 (IIT) vs. 7.6 ± 1.6% (ST) (P = 0.39). The intensive insulin group had lower glycemia (P = 0.006) and higher insulinemia (P < 0.001). Insulin did not change CRP [4.5 (2.1-11.7) vs. 6.8 (2.4-10.3), P = 0.35], soluble CD40 ligand [402 (191-843) vs. 610 (230-1200), P = 0.68], IL-6 [6.21 (3.1.-10.4) vs. 10.37 (5.9-15.3), P = 0.09], and ET-1 [1.02 (0.7-1.8) vs. 1.10 (0.7-1.9), P = 0.657]. CRP, IL-6, and ET-1 increased after PCI in both groups (P < 0.05). No change was observed on protein oxidation (carbonyl, P = 0.70; total antioxidant status, P = 0.33). There was a positive correlation between CRP and glycemia (r = 0.29, P = 0.002). CONCLUSIONS Continuous iv insulin for 24 h increased insulin levels and prevented hyperglycemia. Insulin infusion did not prevent the rise in inflammatory and oxidative stress markers, and no differences were observed between IIT and ST after PCI with a stent.
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Affiliation(s)
- Simone de Souza Fantin
- Graduate Program in Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, Brazil
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15
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Picon PD, Gonçalves SC, Wainstein MV, Costa AF, Mengarda CV, Machado RP, Berlim GL, Edelweiss M, Edelweiss MI, Ribeiro JP. Atherosclerosis and acute arterial thrombosis in rabbits: a model using balloon desendothelization without dietary intervention. Braz J Med Biol Res 1997; 30:415-7. [PMID: 9246241 DOI: 10.1590/s0100-879x1997000300017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Acute thrombosis can be induced in rabbits by a triggering protocol using Russell's viper venom and histamine given after 8 months of a 1% cholesterol diet and balloon desendothelization. In the present study, we tested the hypothesis that aortic desendothelization performed 4 months before the triggering protocol without a high cholesterol diet is a highly effective and less expensive way of producing arterial atherosclerosis and thrombosis. Nineteen male New Zealand white rabbits on a normal diet were studied. The control group (N = 9) received no intervention during the 4-month observation period, while the other group (N = 10) was submitted to aortic balloon desendothelization using a 4F Fogarty catheter. At the end of this period, all animals were killed 48 h after receiving the first dose of the triggering treatment. Eight of 10 rabbits (80%) in the balloon-trauma group presented platelet-rich arterial thrombosis while none of the animals in the control group had thrombus formation (P < 0.01). Thus, this model, using balloon desendothelization without dietary manipulation, induces arterial atherosclerosis and thrombosis and may provide possibilities to test new therapeutic approaches.
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Affiliation(s)
- P D Picon
- Departamento de Farmacologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brasil
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16
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Fuchs FD, Maestri MK, Bredemeier M, Cardozo SE, Moreira FC, Wainstein MV, Moreira WD, Moreira LB. Study of the usefulness of optic fundi examination of patients with hypertension in a clinical setting. J Hum Hypertens 1995; 9:547-51. [PMID: 7562883] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The purpose of this study was to evaluate the usefulness of direct opthalmoscopy by non-opthalmologists in patients with hypertension. In a cross-sectional survey, we analysed the association between optic fundi abnormalities, individually and according to the criteria of Keith and Wagener (KW), with blood pressure and duration of known hypertension in 400 non-diabetic hypertensive patients. The optic fundi abnormalities were more frequent in patients with diastolic blood pressure (DBP) > 105 mm Hg (P = 0.002), SBP > 180 mm Hg (P < 0.0001) and with a duration of known hypertension > 3 years (P = 0.002). The severity of hypertension did not vary in parallel with the KW classes I and II: 34.5% of patients classified as KW I had a diastolic pressure of > 105 mm Hg compared with only 25.3% of those classified as KW II. Class III abnormalities were infrequent (2.5% of the whole cohort). In a logistic regression model, diffuse arteriolar narrowing was associated with DBP (P = 0.002) and age (P < 0.001). Abnormalities of the arteriovenous crossings were associated with SBP (P = 0.001) and duration of disease (P = 0.008). The positive predictive value of any fundoscopic abnormality to estimate the severity of hypertension was 59% and the negative value was 60%. The results of this study demonstrate that optic fundi examination by internists and cardiologists does not give an accurate assessment of the severity of hypertension in most patients, and that the Keith-Wagener classification of retinopathy has a limited applicability.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- F D Fuchs
- Division of Clinical Pharmacology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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17
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Wainstein MV, Wolffenbuttel L, Lopes DK, González HE, Golbspan L, Ferreira L, Sprinz E, Kronfeld M, Edelweiss MI. [The sensitivity and specificity of the clinical, serological and tomographic diagnosis of Toxoplasma gondii encephalitis in the acquired immunodeficiency syndrome (AIDS)]. Rev Soc Bras Med Trop 1993; 26:71-5. [PMID: 8128073 DOI: 10.1590/s0037-86821993000200001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Toxoplasmic encephalitis (TE) is among the most common neurologic affections and it is the most prevalent cause of intracerebral mass lesions in AIDS patients. All patients with AIDS hospitalized at the Hospital de Clínicas de Porto Alegre between May/85 and December/91 (516 cases) had their files revised to determinate TE prevalence, serology, sensitivity and specificity of the computed tomography (CT) brain scan, clinical findings and serology to make its diagnosis. The prevalence on CT was 13% (presumptive diagnosis). Blood serology and cerebrospinal (CSF) serology to toxoplasma were positive respectively in 65% and 49%. Autopsies of 125 patients were also revised with a prevalence of 22% (definite diagnosis). CT scan had 65% of sensitivity and 82% of specificity. Sensitivity and specificity of serology on blood was respectively 95% and 30%, while the cerebrospinal fluid (CSF) serology had 77% of sensitivity and 56% of specificity. The following clinical findings were considered: fever (sensitivity = 92%; specificity = 56%), neurological focal signs (sensitivity = 59%; specificity = 82%) and headache (sensitivity = 41%; specificity = 69%). We conclude that, based on the high serology sensitivity and high CT scan specificity, they constitute an useful approach to make TE diagnosis.
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Affiliation(s)
- M V Wainstein
- Unidade de Doenças Infecciosas, Hospital de Clínicas de Porto Alegre, HCPA, RS, Brasil
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18
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Wainstein MV, Ferreira L, Wolfenbuttel L, Golbspan L, Sprinz E, Kronfeld M, Edelweiss MI. [The neuropathological findings in the acquired immunodeficiency syndrome (AIDS): a review of 138 cases]. Rev Soc Bras Med Trop 1992; 25:95-9. [PMID: 1308945 DOI: 10.1590/s0037-86821992000200002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
This is an autopsy study performed in a retrospective fashion to determine the incidence of diseases that could affect the central nervous system in AIDS. For this purpose, 138 autopsies of patients with AIDS performed at the "Hospital de Clínicas de Porto Alegre", Brazil, between January/85 and December/90 were studied. All the brains were evaluated macroscopically and microscopically mainly through hematoxylin-eosin staining and if necessary special techniques like PAS, Grocott, Giemsa and Ziehl-Nielsen were done. Results have revealed 29 (21%) cases with cerebral toxoplasmosis; cryptococcosis in 17 (12%); tuberculosis in two (1%) and one case (0.7%) of candidiasis. Besides these inflammatory lesions, 15 (10%) presented vascular lesion; 8 (6%) had gliosis and 7 (5%) cases had suggestive findings of HIV encephalopathy. We can conclude that the CNS is a important target affected by AIDS and that cerebral toxoplasmosis is the principal disease in the CNS in AIDS patients.
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Affiliation(s)
- M V Wainstein
- Unidade de Doenças Infecciosas, Hospital de Clínicas de Porto Alegre, Brasil
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