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1.
Cells ; 13(4)2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38391913

RESUMO

COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is characterized by a wide range of clinical symptoms and a poorly predictable disease course. Although in-depth transcriptomic investigations of peripheral blood samples from COVID-19 patients have been performed, the detailed molecular mechanisms underlying an asymptomatic, mild or severe disease course, particularly in patients without relevant comorbidities, remain poorly understood. While previous studies have mainly focused on the cellular and molecular dissection of ongoing COVID-19, we set out to characterize transcriptomic immune cell dysregulation at the single-cell level at different time points in patients without comorbidities after disease resolution to identify signatures of different disease severities in convalescence. With single-cell RNA sequencing, we reveal a role for hypoxia-inducible factor 1-alpha (HIF1A) as a severity-sensitive long-term immunological scar in circulating monocytes of convalescent COVID-19 patients. Additionally, we show that circulating complexes formed by monocytes with either T cells or NK cells represent a characteristic cellular marker in convalescent COVID-19 patients irrespective of their preceding symptom severity. Together, these results provide cellular and molecular correlates of recovery from COVID-19 and could help in immune monitoring and in the design of new treatment strategies.


Assuntos
COVID-19 , Humanos , SARS-CoV-2 , Monócitos , Cicatriz , Análise de Sequência de RNA , Subunidade alfa do Fator 1 Induzível por Hipóxia
2.
Pflugers Arch ; 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38393416

RESUMO

Sclerostin (SOST) is produced by osteocytes and is known as a negative regulator of bone homeostasis. Parathyroid hormone (PTH) regulates calcium, phosphate as well as vitamin D metabolism, and is a strong inhibitor of SOST synthesis in vitro and in vivo. PTH has two methionine amino acids (positions 8 and 18) which can be oxidized. PTH oxidized at Met18 (Met18(ox)-PTH) continues to be bioactive, whereas PTH oxidized at Met8 (Met8(ox)-PTH) or PTH oxidized at Met8 and Met18 (Met8, Met18(di-ox)-PTH) has minor bioactivity. How non-oxidized PTH (n-oxPTH) and oxidized forms of PTH act on sclerostin synthesis is unknown. The effects of n-oxPTH and oxidized forms of PTH on SOST gene expression were evaluated in UMR106 osteoblast-like cells. Moreover, we analyzed the relationship of SOST with n-oxPTH and all forms of oxPTH in 516 stable kidney transplant recipients using an assay system that can distinguish in clinical samples between n-oxPTH and the sum of all oxidized PTH forms (Met8(ox)-PTH, Met18(ox)-PTH, and Met8, Met18(di-ox)-PTH). We found that both n-oxPTH and Met18(ox)-PTH at doses of 1, 3, 20, and 30 nmol/L significantly inhibit SOST gene expression in vitro, whereas Met8(ox)-PTH and Met8, Met18(di-ox)-PTH only have a weak inhibitory effect on SOST gene expression. In the clinical cohort, multivariate linear regression showed that only n-oxPTH, but not intact PTH (iPTH) nor oxPTH, is independently associated with circulating SOST after adjusting for known confounding factors. In conclusion, only bioactive PTH forms such as n-oxPTH and Met18(ox)-PTH, inhibit SOST synthesis.

3.
Cell Signal ; 116: 111063, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38242267

RESUMO

Chronic kidney disease (CKD) often culminates in hypercalcemia, instigating severe neurological injuries that are not yet fully understood. This study unveils a mechanism, where GSK343 ameliorates CKD-induced neural damage in mice by modulating macrophage polarization through the EZH2/MST1/YAP1 signaling axis. Specifically, GSK343 downregulated the expression of histone methyltransferase EZH2 and upregulated MST1, which suppressed YAP1, promoting M2 macrophage polarization and thereby, alleviating neural injury in hypercalcemia arising from renal failure. This molecular pathway introduced herein not only sheds light on the cellular machinations behind CKD-induced neurological harm but also paves the way for potential therapeutic interventions targeting the identified axis, especially considering the M2 macrophage polarization as a potential strategy to mitigate hypercalcemia-induced neural injuries.


Assuntos
Hipercalcemia , Piridonas , Insuficiência Renal Crônica , Camundongos , Animais , Macrófagos , Indazóis/farmacologia , Insuficiência Renal Crônica/complicações
4.
Zookeys ; 1181: 201-217, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37841026

RESUMO

Three new species belonging to the kinabaluensis group of the trachelid genus Utivarachna Kishida, 1940 are reported from China and Vietnam: U.linyejieisp. nov. (♂♀), U.tamdaosp. nov. (♂♀), and U.zhengguoisp. nov. (♂♀). Type specimens are deposited in the Institute of Zoology, Chinese Academy of Sciences (IZCAS) in Beijing, China and the Vietnam National Museum of Nature (VNMN) in Hanoi, Vietnam.

5.
Zookeys ; 1181: 219-240, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37841029

RESUMO

Four new species of the family Liocranidae are described from China and Vietnam. The new genus Sinocranumgen. nov., is erected to accommodate S.menghaisp. nov. (♂♀) from China. Further new species described include Koppeningersp. nov. (♀) from China, Xanthariabaizilongisp. nov. (♂♀) from China and X.cucphuongsp. nov. (♂) from Vietnam. In addition, Xantharia is transferred from Miturgidae to Liocranidae. Koppe and Xantharia are reported from China and Vietnam, respectively, for the first time.

7.
Diabetes Metab Res Rev ; 39(8): e3704, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37553983

RESUMO

BACKGROUND: Besides its established impact on bone and mineral metabolism, it was suggested that fibroblast growth factor 23 (FGF23) might play an important role in the pathogenesis of type 2 diabetes. The impact of FGF23 on gestational diabetes mellitus (GDM), however, is not well understood. iFGF23 ELISAs measure the intact FGF23 molecule, whereas cFGF23 assays measure intact FGF23 as well as degradation products of FGF23. OBJECTIVES: The aim of this study is to compare the association of maternal and foetal cFGF23 and iFGF23 with GDM in a German birth cohort. METHODS: cFGF23 and iFGF23 were analysed in 826 random mother/child pairs from the Berlin Birth Cohort. RESULTS: Mothers who developed GDM had higher concentrations of iFGF-23 compared to mothers who did not suffer from GDM (19.73 vs. 13.23 pg/mL, p < 0.0001), but not higher concentrations of cFGF-23. Multivariant regression analyses showed that gestational diabetes is associated with iFGF23 independently of confounding factors such as age, BMI, ethnic background, family history of diabetes, smoking during pregnancy, and recurrent pregnancy loss. This, however, was only seen when using an iFGF23 ELISA measuring just the full length FGF23 and not in addition FGF23 fragments. No differences in both iFGF23 and cFGF23 concentrations between the GDM and non-GDM groups were detected in cord blood samples of the offspring. CONCLUSIONS: This study of a representative German birth cohort showed that maternal but not foetal iFGF23 is independently associated with GDM.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Criança , Feminino , Humanos , Gravidez , Diabetes Mellitus Tipo 2/etiologia , Ensaio de Imunoadsorção Enzimática , Fator de Crescimento de Fibroblastos 23 , Fatores de Crescimento de Fibroblastos/metabolismo
8.
Zootaxa ; 5285(1): 176-186, 2023 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-37518711

RESUMO

Three new species of spiders belonging to the genera Oedignatha Thorell, 1881 and Paratus Simon, 1898 of the family Liocranidae Simon, 1897 are described from China and Nepal: Oedignatha shaanxi sp. nov. (female only; Shaanxi, China), Paratus bagmati sp. nov. (male only; Bagmati, Nepal), and P. ledong sp. nov. (both sexes; Hainan, China). In addition, Liocranidae is reported from Nepal for the first time.

9.
Zookeys ; 1165: 17-42, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37292579

RESUMO

Six species of the family Corinnidae Karsch, 1880 are described from China and Vietnam. Fengzhengen. nov. is erected to accommodate F.menglasp. nov. (♂♀) from China; Penggen. nov. is erected to accommodate P.birmanicus (Thorell, 1897), comb. nov., P.borneensis (Yamasaki, 2017), comb. nov. and P.taprobanicus (Simon, 1897), comb. nov., transferred from Sphecotypus O. Pickard-Cambridge, 1895. Further new species described include Allomedmassatamdaosp. nov. (♂), Echinaxbaishasp. nov. (♂), Medmassalingshuisp. nov. (♂), and Spinirtashaoguansp. nov. (♂). The male of P.birmanicus is described for the first time.

10.
Front Immunol ; 14: 1187880, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37377957

RESUMO

Due to rare but major adverse reactions to the AstraZeneca adenoviral ChAdOx1-S-nCoV-19 vaccine (ChAd), German health authorities recommended adults under 60 who received one dose of ChAd, to receive a second dose of the BioNTech mRNA BNT162b2 vaccine (BNT) as a booster. Studies in the general population suggest an enhanced efficacy of the heterologous (ChAd-BNT) compared to the homologous (BNT-BNT) vaccination regimen. However, an analysis of the efficacy in patient populations with a high risk of severe COVID-19 due to acquired immunodeficiency is still missing. We therefore compared both vaccination regimens in healthy controls, patients with gynecological tumors after chemotherapy, patients on dialysis and patients with rheumatic diseases concerning the humoral and cellular immune response. The humoral and cellular immune response differed substantially in healthy controls compared to patients with acquired immunodeficiency. Overall, the most significant differences between the two immunization regimens were found in neutralizing antibodies. These were always higher after a heterologous immunization. Healthy controls responded well to both vaccination regimens. However, the formation of neutralizing antibodies was more pronounced after a heterologous immunization. Dialysis patients, on the other hand, only developed an adequate humoral and particularly cellular immune response after a heterologous immunization. Tumor and rheumatic patients also - to a weaker extent compared to dialysis patients - benefited from a heterologous immunization. In conclusion, the heterologous COVID-19 vaccination regimens (ChAd-BNT) seem to have an advantage over the homologous vaccination regimens, especially in immunocompromised patients such as patients with end-stage kidney disease treated with hemodialysis.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Humanos , Vacinas contra COVID-19/efeitos adversos , Vacina BNT162 , COVID-19/prevenção & controle , Hospedeiro Imunocomprometido , Anticorpos Neutralizantes , Imunidade , RNA Mensageiro
11.
Front Med (Lausanne) ; 10: 1141646, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37153084

RESUMO

Background: Vitamin D deficiency (VDD) or vitamin D insufficiency is common in kidney transplant recipients (KTRs). The impact of VDD on clinical outcomes in KTRs remain poorly defined and the most suitable marker for assessing vitamin D nutritional status in KTRs is unknown so far. Methods: We conducted a prospective study including 600 stable KTRs (367 men, 233 women) and a meta-analysis to pool existing evidence to determine whether 25(OH)D or 1,25(OH)2D predicted graft failure and all-cause mortality in stable KTRs. Results: Compared with a higher 25(OH)D concentration, a low concentration of 25(OH)D was a risk factor for graft failure (HR 0.946, 95% CI 0.912-0.981, p = 0.003), whereas 1,25 (OH)2D was not associated with the study end-point graft loss (HR 0.993, 95% CI 0.977-1.009, p = 0.402). No association was found between either 25(OH)D or 1,25 (OH)2D and all-cause mortality. We furthermore conducted a meta-analysis including 8 studies regarding the association between 25(OH)D or 1,25(OH)2D and graft failure or mortality, including our study. The meta-analysis results were consistent with our study in finding that lower 25(OH)D levels were significantly associated with the risk of graft failure (OR = 1.04, 95% CI: 1.01-1.07), but not associated with mortality (OR = 1.00, 95% CI: 0.98-1.03). Lower 1,25(OH)2D levels were not associated with the risk of graft failure (OR = 1.01, 95% CI: 0.99-1.02) and mortality (OR = 1.01, 95% CI: 0.99-1.02). Conclusion: Baseline 25(OH)D concentrations but not 1,25(OH)2D concentrations were independently and inversely associated with graft loss in adult KTRs.

12.
Zookeys ; 1144: 197-215, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37234379

RESUMO

Liocranid spiders from the Xishuangbanna Tropical Botanical Garden in Yunnan, China are studied. Two new species of Oedignatha Thorell, 1881, O.dian Lu & Li, sp. nov. (♂♀) and O.menglun Lu & Li, sp. nov. (♂♀), are described, and the female of Jacaenamenglaensis Mu & Zhang, 2020 is described for the first time. The specimens studied are deposited in the Institute of Zoology, Chinese Academy of Sciences (IZCAS) in Beijing, China.

13.
Sci Rep ; 13(1): 3943, 2023 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-36894581

RESUMO

The role of Programmed Cell Death Ligand 1 (PD-L1) expression in predicting epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKIs) efficacy remains controversial. Recent studies have highlighted that tumor-intrinsic PD-L1 signaling can be modulated by STAT3, AKT, MET oncogenic pathway, epithelial-mesenchymal transition, or BIM expression. This study aimed to investigate whether these underlying mechanisms affect the prognostic role of PD-L1. We retrospectively enrolled patients with EGFR mutant advanced stage NSCLC who received first-line EGFR-TKI between January 2017 and June 2019, the treatment efficacy of EGFR-TKI was assessed. Kaplan-Meier analysis of progression-free survival (PFS) revealed that patients with high BIM expression had shorter PFS, regardless of PD-L1 expression. This result was also supported by the COX proportional hazard regression analysis. In vitro, we further proved that the knockdown of BIM, instead of PDL1, induced more cell apoptosis following gefitinib treatment. Our data suggest that among the pathways affecting tumor-intrinsic PD-L1 signaling, BIM is potentially the underlying mechanism that affects the role of PD-L1 expression in predicting response to EGFR TKI and mediates cell apoptosis under treatment with gefitinib in EGFR-mutant NSCLC. Further prospective studies are required to validate these results.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Antígeno B7-H1 , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Receptores ErbB/metabolismo , Gefitinibe/farmacologia , Gefitinibe/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Mutação , Prognóstico , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/uso terapêutico , Estudos Retrospectivos , Proteína 11 Semelhante a Bcl-2/metabolismo
14.
Nat Commun ; 14(1): 1639, 2023 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-36964130

RESUMO

Tuberculosis (TB) killed more people globally than any other single pathogen over the past decade. Where surveillance is weak, estimating TB burden estimates uses modeling. In many African countries, increases in HIV prevalence and antiretroviral therapy have driven dynamic TB epidemics, complicating estimation of burden, trends, and potential intervention impact. We therefore develop a novel age-structured TB transmission model incorporating evolving demographic, HIV and antiretroviral therapy effects, and calibrate to TB prevalence and notification data from 12 African countries. We use Bayesian methods to include uncertainty for all TB model parameters, and estimate age-specific annual risks of TB infection, finding up to 16.0%/year in adults, and the proportion of TB incidence from recent (re)infection, finding a mean across countries of 34%. Rapid reduction of the unacceptably high burden of TB in high HIV prevalence settings will require interventions addressing progression as well as transmission.


Assuntos
Epidemias , Infecções por HIV , Tuberculose , Adulto , Humanos , Incidência , Prevalência , Teorema de Bayes , Tuberculose/epidemiologia , Infecções por HIV/epidemiologia
16.
Zookeys ; 1187: 91-134, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38161714

RESUMO

Four new genera and 11 new species of Hahniidae Bertkau, 1878 are described. The new genera are Goblinia Lin & Li, gen. nov., with the type species G.tiane Lin & Li, sp. nov. (♂♀) from Guangxi, China; Myahnia Lin & Li, gen. nov., with the type species M.kanpetlet Lin & Li, sp. nov. (♂♀) from Chin, Myanmar; Troglohnia Lin & Li, gen. nov., with the type species Tr.qiubei Lin & Li, sp. nov. (♂♀) from Yunnan, China and Typhlohnia Lin & Li, gen. nov., with the type species Ty.rongshui Lin & Li, sp. nov. (♂♀) from Guangxi, China. Seven additional new species are described: Tr.dafang Lin & Li, sp. nov. (♂♀) from Guizhou, China; Tr.shidian Lin & Li, sp. nov. (♀) from Yunnan, China; Tr.wuding Lin & Li, sp. nov. (♂♀) from Yunnan, China; Ty.banlaksao Lin & Li, sp. nov. (♀) from Bolikhamxay, Laos; Ty.kaiyang Lin & Li, sp. nov. (♀) from Guizhou, China; Ty.sondoong Lin & Li, sp. nov. (♂♀) from Quang Binh, Vietnam and Ty.suiyang Lin & Li, sp. nov. (♀) from Guizhou, China.

17.
Kidney Dis (Basel) ; 9(3): 143-156, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-38306230

RESUMO

Background: Angiopoietins (Ang) are essential angiogenic factors involved in angiogenesis, vascular maturation, and inflammation. The most studied angiopoietins, angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2), behave antagonistically to each other in vivo to sustain vascular endothelium homeostasis. While Ang-1 typically acts as the endothelium-protective mediator, its context-dependent antagonist Ang-2 can promote endothelium permeability and vascular destabilization, hence contributing to a poor outcome in vascular diseases via endothelial injury, vascular dysfunction, and microinflammation. The pathogenesis of kidney diseases is associated with endothelial dysfunction and chronic inflammation in renal diseases. Summary: Several preclinical studies report overexpression of Ang-2 in renal tissues of certain kidney disease models; additionally, clinical studies show increased levels of circulating Ang-2 in the course of chronic kidney disease, implying that Ang-2 may serve as a useful biomarker in these patients. However, the exact mechanisms of Ang-2 action in renal diseases remain unclear. Key Messages: We summarized the recent findings on Ang-2 in kidney diseases, including preclinical studies and clinical studies, aiming to provide a systematic understanding of the role of Ang-2 in these diseases.

18.
Biodivers Data J ; 11: e103298, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38327311

RESUMO

Background: The spider genus Asceua Thorell, 1887 contains 34 species, almost entirely limited to Indochina, India, Sri Lanka and China, with a regional distribution. Eleven species of Asceua are currently only known from China, five of them are described only from one sex. New information: Two new spider species of the genus Asceua are reported from China, A.haocongi sp. n. (♂♀, Hainan) and A.zijin sp. n. (♂♀, Jiangsu). Photos and a morphological description of the new species are provided.

19.
Antioxidants (Basel) ; 11(10)2022 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-36290698

RESUMO

Oxidative stress (OS) presents even in the early chronic kidney disease (CKD) stage and is exacerbated in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis (MHD). There is still a debate over the association between oxidative stress and mortality. Our study aims to compare head-to-head the prognostic value of different oxidative markers for all-cause mortality in hemodialysis (HD) patients. We thus enrolled 347 patients on HD in this prospective study. Four OS biomarkers were measured (carbonyl proteins, myeloperoxidase (MPO), advanced oxidation protein products (AOPPs), and oxidized low-density lipoprotein (ox-LDL)). During the 60-month follow-up period, 9 patients have been lost to follow-up and 168 (48.4%) patients died. Concerning the oxidative stress (ox-stress) byproducts, carbonyl proteins were lower in survivors (105.40 ng/mL (IQR 81.30−147.85) versus 129.65 ng/mL (IQR 93.20−180.33); p < 0.001), with similar results for male patients (103.70 ng/mL (IQR 76.90−153.33) versus 134.55 ng/mL (IQR 93.95−178.68); p = 0.0014). However, there are no significant differences in MPO, AOPP, and ox-LDL between the two groups. Kaplan−Meier survival analysis indicated that patients in the higher carbonyl proteins concentration (>117.85 ng/mL group) had a significantly lower survival rate (log-rank test, p < 0.001). Univariate Cox regression analysis showed a positive correlation between carbonyl proteins and all-cause mortality in the higher and lower halves. Even after adjustment for conventional risk factors, it remained a statistically significant predictor of an increased risk of death in MHD. Univariate Cox regression analysis of MPO showed that continuous MPO and Log MPO were significantly associated with all-cause mortality, except for binary MPO (divided according to the median of MPO). Multivariate Cox analysis for MPO showed that the mortality prediction remains significant after adjusting for multiple factors. In conclusion, not all ox-stress biomarkers predict all-cause mortality in HD patients to a similar extent. In the present study, carbonyl proteins and MPO are independent predictors of all-cause mortality in HD patients, whereas AOPPs and oxLDL are clearly not associated with all-cause mortality in HD patients.

20.
BMC Emerg Med ; 22(1): 169, 2022 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-36280807

RESUMO

BACKGROUND: Sudden cardiac arrest (SCA) is a critical complication of acute myocardial infarction, especially ST-segment elevation myocardial infarction (STEMI). This study identified the risk factors for SCA in patients with STEMI before receiving catheterization. METHODS: We retrospectively analyzed the data of patients with STEMI and cardiac arrest who presented to a tertiary care center in Taiwan between January 1, 2016, and December 31, 2019. Only patients with coronary artery disease (CAD) confirmed by coronary angiography were included in this study. We collected the patients' demographic and clinical data, such as age, sex, medical history, estimated glomerular filtration rate (eGFR), and coronary angiographic findings. The primary outcome of this study was SCA in patients with STEMI. Continuous and nominal variables were compared using the two-sample Student's t-test and chi-squared test, respectively. The results of logistic regression were subjected to multivariate analysis with adjustment for possible confounders. RESULTS: A total of 920 patients with STEMI and coronary angiography-documented CAD and 108 patients with SCA who presented between January 1, 2016, and December 31, 2019, were included. The bivariate logistic regression analysis of patients' demographic data revealed that patients with STEMI and SCA were slightly younger, were more likely to have diabetes mellitus, and had a lower eGFR than did the patients without SCA. The coronary angiographic findings indicated a higher prevalence of left main CAD and three-vessel disease in patients with SCA than in patients without SCA. Multivariate logistic regression revealed that left main CAD (odds ratio [OR]: 3.77; 95% confidence interval [CI], 1.84 to 7.72), a lower eGFR (OR: 0.97; 95% CI, 0.96 to 0.98), and younger age (OR: 0.98; 95% CI, 0.96 to 0.99) were the risk factors for SCA in patients with STEMI. CONCLUSIONS: Left main CAD, lower eGFR, and younger age are the risk factors for cardiac arrest in patients with acute myocardial infarction.


Assuntos
Parada Cardíaca , Infarto do Miocárdio , Infarto do Miocárdio com Supradesnível do Segmento ST , Humanos , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Estudos Retrospectivos , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Fatores de Risco , Parada Cardíaca/complicações , Infarto do Miocárdio/complicações , Infarto do Miocárdio/epidemiologia , Resultado do Tratamento
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