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2.
Nutrients ; 10(7)2018 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-30037068

RESUMO

Sirtuin-1 (Sirt-1) and an endogenous secretory receptor for an advanced glycation end product (esRAGE) are associated with vascular protection. The purpose of this study was to examine the effects of resveratrol (RSV) and caloric restriction (CR) on gene expression of Sirt-1 and esRAGE on serum levels of Sirt1 and esRAGE in healthy and slightly overweight subjects. The study included 48 healthy subjects randomized to 30 days of RSV (500 mg/day) or CR (1000 cal/day). Waist circumference (p = 0.011), TC (p = 0.007), HDL (p = 0.031), non-HDL (p = 0.025), ApoA1 (p = 0.011), and ApoB (p = 0.037) decreased in the CR group. However, TC (p = 0.030), non-HDL (p = 0.010), ApoB (p = 0.034), and HOMA-IR (p = 0.038) increased in the RSV group. RSV and CR increased serum levels of Sirt-1, respectively, from 1.06 ± 0.71 ng/mL to 5.75 ± 2.98 ng/mL (p < 0.0001) and from 1.65 ± 1.81 ng/mL to 5.80 ± 2.23 ng/mL (p < 0.0001). esRAGE serum levels were similar in RSV (p = NS) and CR (p = NS) groups. Significant positive correlation was observed between gene expression changes of Sirt-1 and esRAGE in RSV (r = 0.86; p < 0.0001) and in CR (r = 0.71; p < 0.0001) groups, but not for the changes in serum concentrations. CR promoted increases in the gene expression of esRAGE (post/pre). Future long-term studies are needed to evaluate the impact of these outcomes on vascular health.


Assuntos
Regulação da Expressão Gênica/efeitos dos fármacos , Sobrepeso , Receptor para Produtos Finais de Glicação Avançada/metabolismo , Sirtuína 1/metabolismo , Estilbenos/farmacologia , Idoso , Restrição Calórica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Receptor para Produtos Finais de Glicação Avançada/genética , Resveratrol , Sirtuína 1/genética , Estilbenos/administração & dosagem
3.
Arq Bras Cardiol ; 108(4): 347-353, 2017 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-28380134

RESUMO

Background: The knowledge of the variables predicting mortality is important in clinical practice and for therapeutic monitoring in mitral valve disease. Objectives: To determine whether a quality of life score evaluated with the Functional Evaluation of Cardiac Health questionnaire would predict mortality in dogs with degenerative mitral valve disease (DMVD). Methods: Thirty-six client-owned dogs with mitral valve disease underwent clinical, laboratory, and echocardiographic evaluations at baseline and were monitored for 6 months. Cardiovascular death was the primary outcome. Results: The 36 dogs were classified as survivors or nonsurvivors. Higher values of the following variables were obtained at baseline in the nonsurviving group (12 dogs): amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, plasma norepinephrine, heart rate, quality of life score, diastolic left ventricular internal dimension to aortic root ratio, systolic left ventricular internal dimension to aortic root ratio, and left atrium to aortic root ratio. NT-proBNP levels and quality life score were independently associated with death in the multivariable analysis. Conclusion: The quality life score was an independent variable for cardiac death in dogs with DMVD. This result is encouraging, as this score is easy to apply and does not require any technology, only a veterinarian and an observant owner.


Assuntos
Doenças do Cão/mortalidade , Doenças das Valvas Cardíacas/veterinária , Valva Mitral/anormalidades , Qualidade de Vida , Animais , Cães , Feminino , Frequência Cardíaca , Doenças das Valvas Cardíacas/mortalidade , Masculino , Peptídeo Natriurético Encefálico/sangue , Norepinefrina/sangue , Fragmentos de Peptídeos/sangue , Estudos Prospectivos , Inquéritos e Questionários
4.
Arq. bras. cardiol ; 108(4): 347-353, Apr. 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-838728

RESUMO

Abstract Background: The knowledge of the variables predicting mortality is important in clinical practice and for therapeutic monitoring in mitral valve disease. Objectives: To determine whether a quality of life score evaluated with the Functional Evaluation of Cardiac Health questionnaire would predict mortality in dogs with degenerative mitral valve disease (DMVD). Methods: Thirty-six client-owned dogs with mitral valve disease underwent clinical, laboratory, and echocardiographic evaluations at baseline and were monitored for 6 months. Cardiovascular death was the primary outcome. Results: The 36 dogs were classified as survivors or nonsurvivors. Higher values of the following variables were obtained at baseline in the nonsurviving group (12 dogs): amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, plasma norepinephrine, heart rate, quality of life score, diastolic left ventricular internal dimension to aortic root ratio, systolic left ventricular internal dimension to aortic root ratio, and left atrium to aortic root ratio. NT-proBNP levels and quality life score were independently associated with death in the multivariable analysis. Conclusion: The quality life score was an independent variable for cardiac death in dogs with DMVD. This result is encouraging, as this score is easy to apply and does not require any technology, only a veterinarian and an observant owner.


Resumo Fundamento: O conhecimento das variáveis preditoras de mortalidade é importante para a prática clínica e para o acompanhamento terapêutico na doença da valva mitral. Objetivos: Determinar se um escore de qualidade de vida avaliado com o Functional Evaluation of Cardiac Health poderia auxiliar na predição de mortalidade em cães com doença degenerativa da valva mitral (DDVM). Métodos: Trinta e seis cães de estimação com doença valvar mitral foram submetidos a avaliação clínica, laboratorial e ecocardiográfica no início do estudo e monitorizados durante 6 meses. A morte cardiovascular foi o desfecho primário. Resultados: Os 36 cães foram classificados como sobreviventes ou não sobreviventes. Os valores mais elevados das seguintes variáveis foram obtidos no início do estudo no grupo de não sobreviventes (12 cães): fragmento N-terminal do peptídeo natriurético tipo B (NT-proBNP), norepinefrina plasmática, frequência cardíaca, escore de qualidade de vida, razão da dimensão interna diastólica do ventrículo esquerdo e raiz aórtica, razão da dimensão interna sistólica do ventrículo esquerdo e raiz aórtica e a relação da dimensão do átrio esquerdo e a raiz aórtica. Concentrações de NT-proBNP e o escore de qualidade de vida foram independentemente associados com morte na análise multivariada. Conclusão: O escore de qualidade de vida foi uma variável independente para a morte por doença cardíaca em cães com DDVM. Este resultado é encorajador, pois este escore é de fácil aplicação e não requer o emprego de tecnologia, necessitando apenas de um veterinário e um dono observador.

5.
Clin Res Cardiol ; 106(9): 676-685, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28255812

RESUMO

BACKGROUND: Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking. OBJECTIVE: To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life. DESIGN: A randomized controlled trial. METHODS: Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0.5 kg of peripheral muscle workload) or moderate-intensity training group (MIPRT, n = 13, 30% maximal inspiratory workload and 50% of one maximum repetition of peripheral muscle workload). The outcomes were: respiratory and peripheral muscle strength, pulmonary function, exercise tolerance by the 6-minute walk test, symptoms based on the NYHA functional class, and quality of life using the Minnesota Living with Heart Failure Questionnaire. RESULTS: All groups showed similar quality-of-life improvements. Low and moderate intensities training programs improved inspiratory muscle strength, peripheral muscle strength, and walking distance. However, only moderate intensity improved expiratory muscle strength and NYHA functional class in HF patients. CONCLUSIONS: The low-intensity inspiratory and peripheral resistance muscle training improved inspiratory and peripheral muscle strength and walking distance, demonstrating that LIPRT is an efficient rehabilitation method for debilitated HF patients. In addition, the moderate-intensity resistance training also improved expiratory muscle strength and NYHA functional class in HF patients.


Assuntos
Terapia por Exercício/métodos , Tolerância ao Exercício/fisiologia , Insuficiência Cardíaca/terapia , Força Muscular/fisiologia , Adulto , Teste de Esforço , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Capacidade Inspiratória/fisiologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários , Caminhada/fisiologia
6.
J Nutr Biochem ; 40: 219-227, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27951474

RESUMO

Cardiac remodeling in diabetes involves cardiac hypertrophy and fibrosis, and fibroblast growth factor 2 (FGF2) is an important mediator of this process. Resveratrol, a polyphenolic antioxidant, reportedly promotes the improvement of cardiac dysfunction in diabetic rats. However, little information exists linking the amelioration of the cardiac function promoted by resveratrol and the expression of FGF2 and its co-receptors, heparan sulfate proteoglycans (HSPGs: Glypican-1 and Syndecan-4), in cardiac muscle of Type 2 diabetic rats. Diabetes was induced experimentally by the injection of streptozotocin and nicotinamide, and the rats were treated with resveratrol for 6 weeks. According to our results, there is an up-regulation of the expression of genes and/or proteins of Glypican-1, Syndecan-4, FGF2, peroxisome proliferator-activated receptor gamma and AMP-activated protein kinase in diabetic rats. On the other hand, resveratrol treatment promoted the attenuation of left ventricular diastolic dysfunction and the down-regulation of the expression of all proteins under study. The trigger for the changes in gene expression and protein synthesis promoted by resveratrol was the presence of diabetes. The negative modulation conducted by resveratrol on FGF2 and HSPGs expression, which are involved in cardiac remodeling, underlies the amelioration of cardiac function.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Fator 2 de Crescimento de Fibroblastos/metabolismo , Coração/fisiopatologia , Proteoglicanas de Heparan Sulfato/metabolismo , Estilbenos/farmacologia , Animais , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/fisiopatologia , Regulação para Baixo/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Glipicanas/metabolismo , Coração/efeitos dos fármacos , Proteoglicanas de Heparan Sulfato/genética , Ratos Wistar , Resveratrol , Sindecana-4/metabolismo
8.
Clin Res Cardiol ; 106(9): 676-685, 2017.
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: ses-37189

RESUMO

BACKGROUND: Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking. OBJECTIVE: To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life. DESIGN: A randomized controlled trial.METHODS:Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0.5 kg of peripheral muscle workload) or moderate-intensity training group (MIPRT, n = 13, 30% maximal inspiratory workload and 50% of one maximum repetition of peripheral muscle workload). The outcomes were: respiratory and peripheral muscle strength, pulmonary function, exercise tolerance by the 6-minute walk test, symptoms based on the NYHA functional class, and quality of life using the Minnesota Living with Heart Failure Questionnaire...(AU)


Assuntos
Reabilitação Cardíaca , Insuficiência Cardíaca , Terapia por Exercício , Prática Profissional , Exercício , Músculos Respiratórios
9.
Arq. bras. cardiol ; 107(2): 137-146, Aug. 2016. tab, graf
Artigo em Inglês | LILACS-Express | ID: lil-794558

RESUMO

Abstract Background: Studies have shown different mortalities due to cardiovascular diseases (CVD), ischemic heart disease (IHD) and cerebrovascular diseases (CbVD) in the five Brazilian regions. Socioeconomic conditions of those regions are frequently used to justify differences in mortality due to those diseases. In addition, studies have shown a reduction in the differences between the mortality rates of the five Brazilian regions. Objective: To update CVD mortality data in women and men in the five Brazilian regions. Methods: Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and Ministry of Health. Risk of death was adjusted by use of the direct method, with the 2000 world standard population as reference. We analyzed trends in mortality due to CVD, IHD and CbVD in women and men aged ≥ 30 years in the five Brazilian regions from 1980 to 2012. Results: Mortality due to: 1) CVD: showed reduction in the Northern, West-Central, Southern and Southeastern regions; increase in the Northeastern region; 2) IHD: reduction in the Southeastern and Southern regions; increase in the Northeastern region; and unchanged in the Northern and West-Central regions; 3) CbVD: reduction in the Southern, Southeastern and West-Central regions; increase in the Northeastern region; and unchanged in Northern region. There was also a convergence in mortality trends due to CVD, IHD, and CbVD in the five regions. Conclusion: The West-Central, Northern and Northeastern regions had the worst trends in CVD mortality as compared to the Southeastern and Southern regions. (Arq Bras Cardiol. 2016; [online].ahead print, PP.0-0).


Resumo Fundamento: Estudos mostraram diferentes mortalidades por doenças cardiovasculares (DCV), doença isquêmica do coração (DIC) e doenças cerebrovasculares (DCbV) nas cinco regiões do Brasil. Particularidades socioeconômicas entre as cinco regiões são frequentemente usadas para justificar diferenças na mortalidade por essas doenças. Estudos também mostraram redução das diferenças entre as taxas de mortalidade das cinco regiões do Brasil. Objetivo: Atualizar os dados de mortalidade por DCV em mulheres e homens nas cinco regiões do país. Métodos: Os dados populacionais e de mortalidade foram obtidos do Instituto Brasileiro de Geografia e Estatística e do Ministério da Saúde. O risco de morte foi ajustado pelo método da padronização direta, tendo como referência a população mundial em 2000. Foram analisadas as tendências da mortalidade por DCV, DIC e DCbV em mulheres e homens com ≥ 30 anos de idade nas cinco regiões do Brasil no período de 1980-2012. Resultados: Observou-se na mortalidade: 1) por DCV: redução nas regiões Norte, Centro-Oeste, Sul e Sudeste; aumento na região Nordeste; 2) por DIC: redução nas regiões Sudeste e Sul; aumento na região Nordeste; e inalterada nas regiões Norte e Centro-Oeste; 3) por DCbV: redução nas regiões Sul, Sudeste e Centro-Oeste; aumento na região Nordeste; e inalterada na região Norte. Observou-se também convergência das tendências da mortalidade por DCV, DIC e DCbV nas cinco regiões. Conclusão: As regiões Centro-Oeste, Norte e Nordeste tiveram as maiores taxas de mortalidade por DCV comparadas às regiões Sudeste e Sul. (Arq Bras Cardiol. 2016; [online].ahead print, PP.0-0).

10.
Arq Bras Cardiol ; 107(2): 137-46, 2016 Aug.
Artigo em Inglês, Português | MEDLINE | ID: mdl-27437866

RESUMO

BACKGROUND: Studies have shown different mortalities due to cardiovascular diseases (CVD), ischemic heart disease (IHD) and cerebrovascular diseases (CbVD) in the five Brazilian regions. Socioeconomic conditions of those regions are frequently used to justify differences in mortality due to those diseases. In addition, studies have shown a reduction in the differences between the mortality rates of the five Brazilian regions. OBJECTIVE: To update CVD mortality data in women and men in the five Brazilian regions. METHODS: Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and Ministry of Health. Risk of death was adjusted by use of the direct method, with the 2000 world standard population as reference. We analyzed trends in mortality due to CVD, IHD and CbVD in women and men aged ≥ 30 years in the five Brazilian regions from 1980 to 2012. RESULTS: Mortality due to: 1) CVD: showed reduction in the Northern, West-Central, Southern and Southeastern regions; increase in the Northeastern region; 2) IHD: reduction in the Southeastern and Southern regions; increase in the Northeastern region; and unchanged in the Northern and West-Central regions; 3) CbVD: reduction in the Southern, Southeastern and West-Central regions; increase in the Northeastern region; and unchanged in Northern region. There was also a convergence in mortality trends due to CVD, IHD, and CbVD in the five regions. CONCLUSION: The West-Central, Northern and Northeastern regions had the worst trends in CVD mortality as compared to the Southeastern and Southern regions. (Arq Bras Cardiol. 2016; [online].ahead print, PP.0-0).


Assuntos
Doenças Cardiovasculares/mortalidade , Adulto , Brasil , Transtornos Cerebrovasculares/mortalidade , Feminino , Humanos , Modelos Lineares , Masculino , Mortalidade/tendências , Isquemia Miocárdica/mortalidade , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos
11.
Arq. bras. cardiol ; 107(1): 20-25, July 2016. tab, graf
Artigo em Inglês | LILACS-Express | ID: lil-792501

RESUMO

Abstract Background: Studies have questioned the downward trend in mortality from cardiovascular diseases (CVD) in Brazil in recent years. Objective: to analyze recent trends in mortality from ischemic heart disease (IHD) and stroke in the Brazilian population. Methods: Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. Risk of death was adjusted by the direct method, using as reference the world population of 2000. We analyzed trends in mortality from CVD, IHD and stroke in women and men in the periods of 1980-2006 and 2007-2012. Results: there was a decrease in CVD mortality and stroke in women and men for both periods (p < 0.001). Annual mortality variations for periods 1980-2006 and 2007-2012 were, respectively: CVD (total): -1.5% and -0.8%; CVD men: -1.4% and -0.6%; CVD women: -1.7% and -1.0%; DIC (men): -1.1% and 0.1%; stroke (men): -1.7% and -1.4%; DIC (women): -1.5% and 0.4%; stroke (women): -2.0% and -1.9%. From 1980 to 2006, there was a decrease in IHD mortality in men and women (p < 0.001), but from 2007 to 2012, changes in IHD mortality were not significant in men [y = 151 + 0.04 (R2 = 0.02; p = 0.779)] and women [y = 88-0.54 (R2 = 0.24; p = 0.320). Conclusion: Trend in mortality from IHD stopped falling in Brazil from 2007 to 2012.


Resumo Fundamento: Estudos questionaram a tendência de queda da mortalidade por doenças cardiovasculares (DCV) no Brasil nos últimos anos. Objetivo: analisar as tendências recentes na mortalidade por doença isquêmica do coração (DIC) e doenças cerebrovasculares (DCbV) na população brasileira. Métodos: dados de mortalidade e população foram obtidos do Instituto Brasileiro de Geografia e Estatística e Ministério da Saúde. O risco de morte foi ajustado pelo método direto, tendo como referência a população mundial de 2000. Foram analisadas, nos períodos de 1980-2006 e 2007-2012, as tendências da mortalidade em mulheres e homens. Resultados: houve diminuição da mortalidade por DCV e DCbV em mulheres e homens para ambos os períodos (p < 0,001). As variações anuais de mortalidade para os períodos de 1980-2006 e 2007-2012 foram, respectivamente: DCV total: -1,5% e -0,8%; DCV homens: -1,4% e -0,6%; DCV mulheres: -1,7% e -1,0%; DIC homens: -1,1% e 0,1%; DIC mulheres: -1,5% e 0,4%; DCbV homens: -1,7% e -1,4%; DCbV mulheres: -2,0% e -1,9%. De 1980 a 2006, houve diminuição da mortalidade por DIC em homens e mulheres (p < 0,001), mas de 2007-2012, as mudanças na mortalidade por DIC não foram significativas em homens [y = 151 + 0.04 (R2 = 0.02; p = 0,779)] e mulheres [y = 88-0.54 (R2 = 0,24; p = 0,320)]. Conclusão: A tendência da mortalidade por DIC parou de cair no Brasil de 2007 a 2012.

12.
Säo Paulo med. j ; 134(3): 199-204, tab
Artigo em Inglês | LILACS-Express | ID: lil-785805

RESUMO

CONTEXT AND OBJECTIVES: Glycoprotein inhibitors (abciximab, eptifibatide and tirofiban) are used in patients with unstable angina and non-ST-segment elevation myocardial infarction before percutaneous coronary intervention. Of these, tirofiban is the least effective. We hypothesized that the response to tirofiban might be associated with glycoprotein gene mutations. DESIGN AND SETTING: Prospective study at Emergency Unit, Heart Institute (InCor), University of São Paulo. METHOD: Intrahospital evolution and platelet aggregation in response to tirofiban were analyzed in relation to four glycoprotein mutations in 50 patients indicated for percutaneous coronary intervention: 17 (34%) with unstable angina and 33 (66%) with non-ST-segment elevation myocardial infarction. Platelet aggregation was analyzed using the Born method. Blood samples were obtained before and one hour after tirofiban infusion. Glycoproteins Ia (807C/T ), Ib (Thr/Met) , IIb (Ile/Ser ) and IIIa (PIA ) were the mutations selected. RESULTS: Hypertension, dyslipidemia, diabetes, smoking, previous coronary artery disease and stroke were similar between the groups. Mutant glycoprotein IIIa genotypes had lower platelet aggregation before tirofiban administration than that of the wild genotype (41.0% ± 22.1% versus 55.9% ± 20.8%; P = 0.035). Mutant glycoprotein IIIa genotypes correlated moderately with lower platelet inhibition (r = -0.31; P = 0.030). After tirofiban administration, platelet glycoprotein Ia, Ib, IIb and IIIa mutations did not influence the degree of inhibition of platelet aggregation or intrahospital mortality. CONCLUSIONS: Mutations of glycoproteins Ia, Ib, IIb and IIIa did not influence platelet aggregation in response to tirofiban in patients with unstable angina and non-ST-segment elevation myocardial infarction.


RESUMO CONTEXTO E OBJETIVOS: Inibidores da glicoproteína (abciximab, eptifibatide, tirofiban) são utilizados em pacientes com angina instável e infarto do miocárdio sem elevação do segmento ST (IAMSSST) antes da intervenção coronária percutânea. Dentre eles, o tirofiban é o menos eficaz. Nossa hipótese é que a resposta ao tirofiban possa estar associada a mutações no gene da glicoproteína. DESENHO E LOCAL: Estudo prospectivo na Unidade de Emergência do Instituto do Coração (InCor), Universidade de São Paulo (USP). MÉTODOS: Foram analisadas a evolução intra-hospitalar e agregabilidade plaquetária em resposta ao tirofiban de 4 mutações da glicoproteína em 50 pacientes com indicação para intervenção coronária percutânea, 17 (34%) com angina instável e 33 (66%) com IAMSSST. A agregação plaquetária foi analisada pelo método de Born. Amostras de sangue foram obtidas antes e uma hora após infusão do tirofiban. As glicoproteínas Ia (807C/T ), Ib (Thr/Met ), IIb (Ile/Ser ) e IIIa (PIA ) foram as mutações selecionadas. RESULTADOS: Hipertensão, dislipidemia, diabetes, tabagismo, doença coronariana e acidente vascular cerebral prévios foram semelhantes entre os grupos. Observou-se menor agregabilidade plaquetária dos genótipos mutantes da glicoproteína IIIa antes da administração de tirofiban do genótipo selvagem (41% ± 22% versus 56% ± 21%; P = 0,035). Genótipos mutantes da glicoproteína IIIa correlacionaram-se moderadamente com menor inibição plaquetária (r = -0,31; P = 0,030). Após a administração tirofiban, as mutações das glicoproteínas Ia, Ib, IIb, e IIIa não influenciaram o grau de inibição da agregação plaquetária e mortalidade intra-hospitalar. CONCLUSÕES: Mutações das glicoproteínas Ia, Ib, IIb e IIIa não influenciaram a agregação plaquetária em resposta ao tirofiban nos pacientes com angina instável e IAMSSST.

13.
Arq Bras Cardiol ; 107(1): 20-5, 2016 Jul.
Artigo em Inglês, Português | MEDLINE | ID: mdl-27223642

RESUMO

BACKGROUND: Studies have questioned the downward trend in mortality from cardiovascular diseases (CVD) in Brazil in recent years. OBJECTIVE: to analyze recent trends in mortality from ischemic heart disease (IHD) and stroke in the Brazilian population. METHODS: Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. Risk of death was adjusted by the direct method, using as reference the world population of 2000. We analyzed trends in mortality from CVD, IHD and stroke in women and men in the periods of 1980-2006 and 2007-2012. RESULTS: there was a decrease in CVD mortality and stroke in women and men for both periods (p < 0.001). Annual mortality variations for periods 1980-2006 and 2007-2012 were, respectively: CVD (total): -1.5% and -0.8%; CVD men: -1.4% and -0.6%; CVD women: -1.7% and -1.0%; DIC (men): -1.1% and 0.1%; stroke (men): -1.7% and -1.4%; DIC (women): -1.5% and 0.4%; stroke (women): -2.0% and -1.9%. From 1980 to 2006, there was a decrease in IHD mortality in men and women (p < 0.001), but from 2007 to 2012, changes in IHD mortality were not significant in men [y = 151 + 0.04 (R2 = 0.02; p = 0.779)] and women [y = 88-0.54 (R2 = 0.24; p = 0.320). CONCLUSION: Trend in mortality from IHD stopped falling in Brazil from 2007 to 2012.


Assuntos
Isquemia Miocárdica/mortalidade , Acidente Vascular Cerebral/mortalidade , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Causas de Morte , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Taxa de Sobrevida , Fatores de Tempo
14.
Sao Paulo Med J ; 134(3): 199-204, 2016 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-26786608

RESUMO

CONTEXT AND OBJECTIVES: Glycoprotein inhibitors (abciximab, eptifibatide and tirofiban) are used in patients with unstable angina and non-ST-segment elevation myocardial infarction before percutaneous coronary intervention. Of these, tirofiban is the least effective. We hypothesized that the response to tirofiban might be associated with glycoprotein gene mutations. DESIGN AND SETTING: Prospective study at Emergency Unit, Heart Institute (InCor), University of São Paulo. METHOD: Intrahospital evolution and platelet aggregation in response to tirofiban were analyzed in relation to four glycoprotein mutations in 50 patients indicated for percutaneous coronary intervention: 17 (34%) with unstable angina and 33 (66%) with non-ST-segment elevation myocardial infarction. Platelet aggregation was analyzed using the Born method. Blood samples were obtained before and one hour after tirofiban infusion. Glycoproteins Ia (807C/T ), Ib (Thr/Met) , IIb (Ile/Ser ) and IIIa (PIA ) were the mutations selected. RESULTS: Hypertension, dyslipidemia, diabetes, smoking, previous coronary artery disease and stroke were similar between the groups. Mutant glycoprotein IIIa genotypes had lower platelet aggregation before tirofiban administration than that of the wild genotype (41.0% ± 22.1% versus 55.9% ± 20.8%; P = 0.035). Mutant glycoprotein IIIa genotypes correlated moderately with lower platelet inhibition (r = -0.31; P = 0.030). After tirofiban administration, platelet glycoprotein Ia, Ib, IIb and IIIa mutations did not influence the degree of inhibition of platelet aggregation or intrahospital mortality. CONCLUSIONS: Mutations of glycoproteins Ia, Ib, IIb and IIIa did not influence platelet aggregation in response to tirofiban in patients with unstable angina and non-ST-segment elevation myocardial infarction.


Assuntos
Síndrome Coronariana Aguda/tratamento farmacológico , Mutação , Inibidores da Agregação de Plaquetas/uso terapêutico , Glicoproteínas da Membrana de Plaquetas/genética , Tirosina/análogos & derivados , Abciximab , Síndrome Coronariana Aguda/genética , Idoso , Angina Instável/tratamento farmacológico , Angina Instável/genética , Anticorpos Monoclonais/uso terapêutico , Eptifibatida , Feminino , Genótipo , Humanos , Fragmentos Fab das Imunoglobulinas/uso terapêutico , Masculino , Pessoa de Meia-Idade , Peptídeos/uso terapêutico , Agregação Plaquetária/efeitos dos fármacos , Agregação Plaquetária/genética , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/antagonistas & inibidores , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/genética , Reação em Cadeia da Polimerase , Estudos Prospectivos , Tirofibana , Tirosina/uso terapêutico
15.
Arq. bras. cardiol ; 105(6): 560-565, Dec. 2015. tab, graf
Artigo em Português | LILACS | ID: lil-769536

RESUMO

Abstract Background: Truck driver sleepiness is a primary cause of vehicle accidents. Several causes are associated with sleepiness in truck drivers. Obesity and metabolic syndrome (MetS) are associated with sleep disorders and with primary risk factors for cardiovascular diseases (CVD). We analyzed the relationship between these conditions and prevalence of sleepiness in truck drivers. Methods: We analyzed the major risk factors for CVD, anthropometric data and sleep disorders in 2228 male truck drivers from 148 road stops made by the Federal Highway Police from 2006 to 2011. Alcohol consumption, illicit drugs and overtime working hours were also analyzed. Sleepiness was assessed using the Epworth Sleepiness Scale. Results: Mean age was 43.1 ± 10.8 years. From 2006 to 2011, an increase in neck (p = 0.011) and abdominal circumference (p < 0.001), total cholesterol (p < 0.001), triglyceride plasma levels (p = 0.014), and sleepiness was observed (p < 0.001). In addition, a reduction in hypertension (39.6% to 25.9%, p < 0.001), alcohol consumption (32% to 23%, p = 0.033) and overtime hours (52.2% to 42.8%, p < 0.001) was found. Linear regression analysis showed that sleepiness correlated closely with body mass index (β = 0.19, Raj2 = 0.659, p = 0.031), abdominal circumference (β = 0.24, Raj2 = 0.826, p = 0.021), hypertension (β = -0.62, Raj2 = 0.901, p = 0.002), and triglycerides (β = 0.34, Raj2 = 0.936, p = 0.022). Linear multiple regression indicated that hypertension (p = 0.008) and abdominal circumference (p = 0.025) are independent variables for sleepiness. Conclusions: Increased prevalence of sleepiness was associated with major components of the MetS.


Resumo Fundamento: A sonolência de motoristas de caminhão, que pode resultar de diferentes causas, é a principal causa de acidentes com veículos. Obesidade e síndrome metabólica (SMet) estão associadas a distúrbios do sono e fatores de risco primários para doença cardiovascular (DCV). Este estudo verificou a relação entre essas condições e a prevalência de sonolência em motoristas de caminhão. Métodos: Este estudo analisou os principais fatores de risco para DCV, dados antropométricos e distúrbios do sono em 2.228 motoristas de caminhão do sexo masculino a partir de informação coletada de 148 paradas efetuadas em rodovias pela Polícia Rodoviária Federal entre 2006 e 2011. Consumo de álcool e de drogas ilícitas e excesso de horas trabalhadas também foram analisados. Sonolência foi avaliada com a Escala de Sonolência de Epworth. Resultados: A idade média foi de 43,1 ± 10,8 anos. De 2006 a 2011, observou-se aumento de: circunferências cervical (p = 0,011) e abdominal (p < 0,001); colesterol total (p < 0,001); níveis séricos de triglicerídeos (p = 0,014); sonolência (p < 0,001). Além disso, houve redução de hipertensão (de 39,6% para 25,9%, p < 0,001), consumo de álcool (de 32% para 23%, p = 0,033) e excesso de horas trabalhadas (de 52,2% para 42,8%, p < 0,001). A análise de regressão linear mostrou correlação íntima de sonolência com índice de massa corporal (β = 0,19, Raj2 = 0,659, p = 0,031), circunferência abdominal (β = 0,24, Raj2 = 0,826, p = 0,021), hipertensão (β = -0,62, Raj2 = 0,901, p = 0,002) e triglicerídeos (β = 0,34, Raj2 = 0,936, p = 0,022). Regressão linear múltipla indicou que hipertensão (p = 0,008) e circunferência abdominal (p = 0,025) são variáveis independentes para sonolência. Conclusões: Elevada prevalência de sonolência foi associada com os principais componentes da SMet.


Assuntos
Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Condução de Veículo/estatística & dados numéricos , Doenças Cardiovasculares/etiologia , Distúrbios do Sono por Sonolência Excessiva/etiologia , Síndrome Metabólica/etiologia , Antropometria , Acidentes de Trânsito/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Doenças Cardiovasculares/epidemiologia , Colesterol/sangue , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Síndrome Metabólica/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Fatores de Risco , Comportamento Sedentário , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Fatores de Tempo , Triglicerídeos/sangue , Tolerância ao Trabalho Programado , Carga de Trabalho
17.
Arq Bras Cardiol ; 105(2 Suppl 1): 1-105, 2015 Aug.
Artigo em Português | MEDLINE | ID: mdl-26375058
18.
Arq Bras Cardiol ; 105(6): 560-5, 2015 Dec.
Artigo em Inglês, Português | MEDLINE | ID: mdl-26761367

RESUMO

BACKGROUND: Truck driver sleepiness is a primary cause of vehicle accidents. Several causes are associated with sleepiness in truck drivers. Obesity and metabolic syndrome (MetS) are associated with sleep disorders and with primary risk factors for cardiovascular diseases (CVD). We analyzed the relationship between these conditions and prevalence of sleepiness in truck drivers. METHODS: We analyzed the major risk factors for CVD, anthropometric data and sleep disorders in 2228 male truck drivers from 148 road stops made by the Federal Highway Police from 2006 to 2011. Alcohol consumption, illicit drugs and overtime working hours were also analyzed. Sleepiness was assessed using the Epworth Sleepiness Scale. RESULTS: Mean age was 43.1 ± 10.8 years. From 2006 to 2011, an increase in neck (p = 0.011) and abdominal circumference (p < 0.001), total cholesterol (p < 0.001), triglyceride plasma levels (p = 0.014), and sleepiness was observed (p < 0.001). In addition, a reduction in hypertension (39.6% to 25.9%, p < 0.001), alcohol consumption (32% to 23%, p = 0.033) and overtime hours (52.2% to 42.8%, p < 0.001) was found. Linear regression analysis showed that sleepiness correlated closely with body mass index (ß = 0.19, Raj2 = 0.659, p = 0.031), abdominal circumference (ß = 0.24, Raj2 = 0.826, p = 0.021), hypertension (ß = -0.62, Raj2 = 0.901, p = 0.002), and triglycerides (ß = 0.34, Raj2 = 0.936, p = 0.022). Linear multiple regression indicated that hypertension (p = 0.008) and abdominal circumference (p = 0.025) are independent variables for sleepiness. CONCLUSIONS: Increased prevalence of sleepiness was associated with major components of the MetS.


Assuntos
Condução de Veículo/estatística & dados numéricos , Doenças Cardiovasculares/etiologia , Distúrbios do Sono por Sonolência Excessiva/etiologia , Síndrome Metabólica/etiologia , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Antropometria , Brasil/epidemiologia , Doenças Cardiovasculares/epidemiologia , Colesterol/sangue , Estudos Transversais , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Fatores de Risco , Comportamento Sedentário , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Fatores de Tempo , Triglicerídeos/sangue , Tolerância ao Trabalho Programado , Carga de Trabalho
19.
Interact Cardiovasc Thorac Surg ; 19(6): 997-1001, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25183741

RESUMO

OBJECTIVES: Coronary artery disease is the leading cause of death in women. The proposed treatments for women are similar to those for men. However, in women with multivessel stable coronary artery disease and normal left ventricular function, the best treatment is unknown. METHODS: A post hoc analysis of the MASS II study with 10 years of follow-up, mean (standard deviation) 6.8 (3.7) years, enrolled between May 1995 and May 2000, evaluated 188 women with chronic stable multivessel coronary artery disease who underwent medical treatment, percutaneous coronary intervention or coronary artery bypass graft surgery. Primary end-points were incidence of total mortality, Q-wave myocardial infarction, or refractory angina. Data were analysed according to the intention-to-treat principle. RESULTS: Women treated with percutaneous coronary intervention and medical treatment had more primary events than those treated with coronary artery bypass graft surgery, respectively, of 34, 44 and 22% (P = 0.003). Survival rates at 10 years were 72% for coronary artery bypass graft surgery, 72% for percutaneous coronary intervention and 56% for medical treatment (P = 0.156). For the composite end-point, Cox regression analysis adjusted for age, diabetes, hypertension, treatment allocation, prior myocardial infarction, smoking, number of vessels affected and total cholesterol, had a higher incidence of primary events with medical treatment than with coronary artery bypass graft surgery [hazard ratio (HR) = 2.38 (95% confidence interval (CI): 1.40-4.05); P = 0.001], a lower incidence with percutaneous coronary intervention than with medical treatment [HR = 0.60 (95% CI: 0.38-0.95); P = 0.031] but no differences between coronary artery bypass graft surgery and percutaneous coronary intervention. Regarding death, a protective effect was observed with percutaneous coronary intervention compared with medical treatment [HR = 0.44 (95% CI: 0.21-0.90); P = 0.025]. CONCLUSIONS: Percutaneous coronary intervention and coronary artery bypass graft surgery compared with medical treatment had better results after 10 years of follow-up.


Assuntos
Fármacos Cardiovasculares/uso terapêutico , Ponte de Artéria Coronária , Doença da Artéria Coronariana/terapia , Intervenção Coronária Percutânea , Idoso , Angina Pectoris/etiologia , Fármacos Cardiovasculares/efeitos adversos , Distribuição de Qui-Quadrado , Doença Crônica , Ponte de Artéria Coronária/efeitos adversos , Ponte de Artéria Coronária/mortalidade , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/mortalidade , Doença da Artéria Coronariana/fisiopatologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Análise Multivariada , Infarto do Miocárdio/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores Sexuais , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Função Ventricular Esquerda
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