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Zorzo RA, Suen VMM, Santos JE, Silva-Jr WA, Suazo VK, Honorato ALSC, Santos RD, Jannes CE, Pereira A, Krieger JE, Liberatore-Jr RDR. LDLR gene's promoter region hypermethylation in patients with familial hypercholesterolemia. Sci Rep 2023; 13:9241. [PMID: 37286669 DOI: 10.1038/s41598-023-34639-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
Familial hypercholesterolemia (FH) is characterized by high low-density lipoprotein cholesterol (LDL-C) levels and a high risk of early coronary heart disease. Structural alterations in the LDLR, APOB, and PCSK9 genes were not found in 20-40% of patients diagnosed using the Dutch Lipid Clinic Network (DCLN) criteria. We hypothesized that methylation in canonical genes could explain the origin of the phenotype in these patients. This study included 62 DNA samples from patients with a clinical diagnosis of FH according to the DCLN criteria, who previously tested negative for structural alterations in the canonical genes, and 47 DNA samples from patients with normal blood lipids (control group). All DNA samples were tested for methylation in the CpG islands of the three genes. The prevalence of FH relative to each gene was determined in both groups and the respective prevalence ratios (PRs) were calculated. The methylation analysis of APOB and PCSK9 was negative in both groups, showing no relationship between methylation in these genes and the FH phenotype. As the LDLR gene has two CpG islands, we analyzed each island separately. The analysis of LDLR-island1 showed PR = 0.982 (CI 0.33-2.95; χ2 = 0.001; p = 0.973), also suggesting no relationship between methylation and the FH phenotype. Analysis of LDLR-island2 showed a PR of 4.12 (CI 1.43-11.88; χ2 = 13,921; p = 0.00019), indicating a possible association between methylation on this island and the FH phenotype.
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Affiliation(s)
- R A Zorzo
- Teaching Institute "Saúde Com Evidência", Ribeirão Preto, Brazil.
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil.
| | - V M M Suen
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
| | - J E Santos
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
| | - W A Silva-Jr
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
| | - V K Suazo
- Pediatrics Department, Pediatric Endocrinology, Ribeirão Preto Medical School, São Paulo University, São Paulo, Brazil
| | - A L S C Honorato
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
| | - R D Santos
- Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - C E Jannes
- Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - A Pereira
- Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - J E Krieger
- Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - R D R Liberatore-Jr
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
- Pediatrics Department, Pediatric Endocrinology, Ribeirão Preto Medical School, São Paulo University, São Paulo, Brazil
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Wiegman A, Ruzza A, Hovingh GK, Santos RD, Mach F, Stefanutti C, Luirink I, Bridges I, Wang B, Bhatia AK, Raal FJ, Kastelein JJP, Gaudet D. Evolocumab treatment reduces carotid intima-media thickness in paediatric patients with heterozygous familial hypercholesterolaemia. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Familial hypercholesterolemia (FH) is characterised by high plasma levels of low-density lipoprotein cholesterol (LDL-C) and increased risk of premature atherosclerotic cardiovascular disease (ASCVD). Previous studies show that carotid intima-media thickness (cIMT) is increased in children with FH, an indicator of early ASCVD. Add-on treatment with the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, evolocumab, substantially reduced atherosclerotic lipid levels in children with heterozygous FH (HeFH) and was safe and well tolerated. The effect of evolocumab on cIMT in paediatric patients (pts) has not been investigated.
Purpose
To investigate the effect of evolocumab treatment on cIMT progression in paediatric pts with HeFH.
Methods
HAUSER-RCT was a multicenter, randomised, placebo-controlled study in which paediatric FH pts (ages 10–17 years) received monthly subcutaneous injections of evolocumab 420 mg or placebo. Of 157 pts, 150 continued to an open-label extension study (HAUSER-OLE) during which all received up to 80 weeks of monthly evolocumab 420 mg on top of stable background statin therapy. cIMT was measured by B-mode ultrasound scanning at baseline, week 24 of the RCT, and weeks 24, 48, and 80 of the OLE. cIMT was measured on anterior, lateral, and posterior imaging angles of the right and left common carotid artery. Mean thickness at each visit and mean changes from baseline were summarised by treatment received during the RCT and artery location. In addition, the largest measurements (anterior, lateral, or posterior) from a patient's left and right carotid artery were averaged to calculate a summary score.
Results
Mean baseline cIMT summary score was 0.568 mm (SD=0.06) for 46 placebo pts and 0.586 mm (SD=0.06) for 82 evolocumab pts. During the RCT, 37 placebo pts had a mean increase of 0.006 mm (SD=0.05) from baseline to week 24; in contrast, 76 evolocumab pts had a mean decrease of 0.003 mm (SD=0.05). Although this treatment group difference was not statistically significant (P=0.403), the pattern of increased cIMT for placebo and decreased cIMT for evolocumab was consistent across artery locations (Table). During the OLE, for pts who initially received placebo, mean cIMT summary score decreased by 0.019 mm (SD=0.04, n=34) from baseline to week 80 (P=0.007) (Figure). Pts who received evolocumab in both the RCT and OLE showed continued improvement during the OLE; at week 80, mean cIMT summary score decreased by 0.012 mm (SD=0.05, n=59) from baseline (P=0.067). For all pts at week 80 (n=128), the mean decrease in LDL-C from baseline was 35.3% (SD=28.0).
Conclusions
Open-label evolocumab treatment for up to 80 weeks led to reductions in mean cIMT. In this small sample of pts with FH, the data suggest that the addition of PCSK9 inhibition to background lipid-lowering therapy has the potential to reduce the risk of ASCVD progression and future cardiovascular events in this vulnerable paediatric population.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Amgen, Inc.
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Affiliation(s)
- A Wiegman
- Amsterdam UMC, Department of Paediatrics, Location AMC , Amsterdam , The Netherlands
| | - A Ruzza
- Amgen , Thousand Oaks , United States of America
| | - G K Hovingh
- Amsterdam UMC, Department of Vascular Medicine, Location AMC , Amsterdam , The Netherlands
| | - R D Santos
- University of Sao Paulo Medical School Hospital and Hospital Israelita Albert Einstein, Lipid Clinic at the Heart Institute (InCor) , Sao Paulo , Brazil
| | - F Mach
- Geneva University Hospitals, Cardiology Department , Geneva , Switzerland
| | - C Stefanutti
- Umberto I Hospital, Sapienza University of Rome, Department of Molecular Medicine , Rome , Italy
| | - I Luirink
- Amsterdam UMC, Department of Paediatrics, Location AMC , Amsterdam , The Netherlands
| | - I Bridges
- Amgen Ltd, Biostatistics Department , Cambridge , United Kingdom
| | - B Wang
- Amgen , Thousand Oaks , United States of America
| | - A K Bhatia
- Amgen , Thousand Oaks , United States of America
| | - F J Raal
- University of the Witwatersrand, Division of Endocrinology & Metabolism, Faculty of Health Sciences , Johannesburg , South Africa
| | - J J P Kastelein
- Amsterdam UMC, Department of Vascular Medicine , Amsterdam , The Netherlands
| | - D Gaudet
- Universite de Montreal, Clinical Lipidology and Rare Lipid Disorders Unit, Community Genomic Medicine Centre and ECOGENE-21 , Quebec , Canada
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Jamialahmadi T, Reiner Z, Alidadi M, Kroh M, Almahmeed W, Ruscica M, Sirtori C, Santos RD, Banach M, Sahebkar A. The effect of bariatric surgery on circulating levels of lipoprotein(a): a systematic review and meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Obesity, and especially severe obesity, are strongly related to higher risk of atherosclerotic cardiovascular disease (ASCVD) morbidity and mortality. Bariatric surgery is an effective weight loss therapy for people with severe obesity and weight-related co-morbid conditions. Elevated plasma level of lipoprotein(a) [Lp(a)] is causally associated with ASCVD.
Purpose
The aim of the present meta-analysis was to analyze whether bariatric surgery could influence Lp(a) concentrations.
Methods
A systematic literature search in PubMed, Scopus, Embase, and Web of Science was performed from inception to May 1st, 2021. A random-effects model and the generic inverse variance weighting method were used to compensate for the heterogeneity of studies in terms of study design, treatment duration, and the characteristics of the studied populations. A random-effect meta-regression model was used to explore the association with an estimated effect size. Evaluation of funnel plot, Begg's rank correlation and Egger's weighted regression tests were used to assess the presence of publication bias in the meta-analysis.
Results
Meta-analysis of 13 studies including 1,551 patients showed a significant decrease of circulating Lp(a) after bariatric surgery (SMD: −0.438, 95% CI: −0.702, −0.174, p<0.001, I2: 94.05%). The results of meta-regression did not indicate any significant association between the changes in Lp(a) and duration of follow up from surgery, reduction in body mass index, or baseline Lp(a) concentration. The reduction in circulating Lp(a) was robust in the leave-one-out sensitivity analysis.
Conclusions
Based on the results of the Mata-analysis we showed that bariatric surgery significantly decreases circulating Lp(a) concentrations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Jamialahmadi
- Mashhad University of Medical Sciences, Surgical Oncology Research Center , Mashhad , Iran (Islamic Republic of)
| | - Z Reiner
- University Hospital Centre Zagreb, Department of Internal Medicine , Zagreb , Croatia
| | - M Alidadi
- Mashhad University of Medical Sciences, Surgical Oncology Research Center , Mashhad , Iran (Islamic Republic of)
| | - M Kroh
- Cleveland Clinic, Digestive Disease and Surgery Institute , Cleveland , United States of America
| | - W Almahmeed
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute , Abu Dhabi , United Arab Emirates
| | - M Ruscica
- University of Milan, Department of Pharmacological and Biomolecular Sciences , Milan , Italy
| | - C Sirtori
- University of Milan, Department of Pharmacological and Biomolecular Sciences , Milan , Italy
| | - R D Santos
- University of Sao Paulo, Lipid Clinic Heart Institute (Incor) , Sao Paulo , Brazil
| | - M Banach
- Medical University of Lodz and Polish Mother's Memorial Hospital Research Institute, Department of Preventive Cardiology and Lipidology , Lodz , Poland
| | - A Sahebkar
- Mashhad University of Medical Sciences, Biotechnology Research Center, Pharmaceutical Technology Institute , Mashhad , Iran (Islamic Republic of)
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Alves ST, Nepomuceno LS, Bessa AKM, Araújo LMDSR, Santos RD, Silva ADG, Cruz AC, Alves ECF, Oliveira JSR. ANÁLISE DO PERFIL DOS DOADORES E DOS PROCEDIMENTOS DE PLAQUETAFÉRESE NO BANCO DE SANGUE SANTA MARCELINA REALIZADOS EM 2021. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.854] [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: 11/11/2022] Open
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5
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Custódio IJO, Dos Santos R, de Oliveira Ildefonso R, Andrade A, Diniz R, Peixoto G, Bredt S, Praça GM, Chagas MH. Effect of Small-Sided Games with and without the Offside Rule on Young Soccer Players: Reliability of Physiological Demands. Int J Environ Res Public Health 2022; 19:10544. [PMID: 36078260 PMCID: PMC9518382 DOI: 10.3390/ijerph191710544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to compare the physiological demand between three vs. three small-sided games (SSGs) with (3vs.3WITH) and without (3vs.3WITHOUT) the offside rule, as well as the within- and between-session reliability of this demand. Twenty-four U-17 soccer athletes performed various three vs. three (plus goalkeepers) SSGs with and without the offside rule. The data collection was performed within an eight-week period. Athletes' heart rate was monitored during the SSG. The variables analyzed were the percentage mean heart rate (HRMEAN%) and the percentage peak heart rate (HRPEAK%). For the analysis of within-session reliability, the mean value of the first two and last two SSG bouts performed within one day were used. The between-session reliability was calculated using the mean value of the four SSG bouts of each SSG type performed on two different days. In both SSGs, the values for reliability were significant and were classified as moderate to excellent. There were no significant differences in the physiological demand among SSG types. We concluded that the offside rule does not influence the physiological demand in a three vs. three SSG and the HRMEAN% and HRPEAK% present moderate to excellent reliability in a three vs. three SSG with and without the offside rule.
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Nakazawa CY, Freitas EMS, Santos RD, Cremasco BCC, Braga PM, Kamioka PE, Sakashita AM, Bousso A, Nobrega D, Paula TAO. IMPACTO NAS SOLICITAÇÕES DE TRANSFUSÕES ALOGÊNICAS NOS PACIENTES SUBMETIDOS À TRANSPLANTE HEPÁTICO DE DOADOR CADÁVER COM O USO DE RECUPERAÇÃO INTRA-OPERATÓRIA NO HOSPITAL MUNICIPAL VILA SANTA CATARINA (HMVSC). Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.674] [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: 11/30/2022] Open
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7
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Dias GD, Cartolano FC, Freitas MCP, Santa-Helena E, Markus MRP, Santos RD, Damasceno NRT. Adiponectin predicts the antioxidant capacity and size of high-density lipoprotein (HDL) in individuals with diabetes mellitus. J Diabetes Complications 2021; 35:107856. [PMID: 33627254 DOI: 10.1016/j.jdiacomp.2021.107856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Received: 09/19/2020] [Revised: 12/09/2020] [Accepted: 01/03/2021] [Indexed: 01/13/2023]
Abstract
AIMS The relationship between adiponectin and type 2 diabetes mellitus (T2DM) is established; however the evidence on its role in high-density lipoprotein (HDL) functionality is still scant. The aim of this study was to assess the association of adiponectin with HDL functionality especially on the antioxidant capacity and HDL subfractions in individuals with T2DM. METHODS This case-control study enrolled 356 individuals who were divided into two groups: diabetics [T2DM (n = 188)] and non-diabetic [nT2DM (n = 168)]. The association of adiponectin level on HDL functionality parameters was done in function of the cut-off point for adiponectin [percentile p < 75 = 12.9 μg/mL versus p ≥ 75 = 12.9 μg/mL] and multiple adjustments applied in the logistic regression models. RESULTS Body mass index (BMI), waist circumference (WC) and body fat mass (FM) were higher in T2DM. The larger HDL particles (HDLLARGE) were lower in T2DM group in comparison with nT2DM (28.20% versus 30.40%; p = 0.016). Individuals with T2DM and simultaneous highest adiponectin (p ≥ 75) had 2.25 OR (95% CI = 1.03-4.91) and 5.14 OR (95% CI = 2.37-11.15) to present higher HDL-C and HDLLARGE concentrations. After adjustment for multiple confounders, high level of adiponectin was independently related with improvement of the HDL antioxidant capacity (OR = 2.78; 95% CI = 1.16-6.67). CONCLUSIONS High adiponectin level associates with a lesser negative impact of T2DM on HDL functionality by increase in APO AI, particles size, and cholesterol content. On the same token, higher adiponectin was associated with greater odds to have high antioxidant capacity.
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Affiliation(s)
- G D Dias
- Department of Nutrition, Faculty of Public Health, University of Sao Paulo (FSP-USP), Sao Paulo, Brazil
| | - F C Cartolano
- Department of Nutrition, Faculty of Public Health, University of Sao Paulo (FSP-USP), Sao Paulo, Brazil
| | - M C P Freitas
- Department of Nutrition, Faculty of Public Health, University of Sao Paulo (FSP-USP), Sao Paulo, Brazil
| | | | - M R P Markus
- Universitatsklinikum Greifswald, Greifswald, Germany
| | - R D Santos
- Lipid Clinic, Heart Institute (InCor), University of Sao Paulo Medical School Hospital (HC-FMUSP), Sao Paulo, Brazil
| | - N R T Damasceno
- Department of Nutrition, Faculty of Public Health, University of Sao Paulo (FSP-USP), Sao Paulo, Brazil.
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Souza DM, Santos RD, Torres WS, Nunes WC. Structural and magnetic properties of ultra-low density BiFeO 3 nanoparticles produced by pulsed laser deposition. Nanotechnology 2020; 31:485711. [PMID: 32756032 DOI: 10.1088/1361-6528/abac7a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Ultra-low-density BiFeO3 nanoparticles have been prepared by pulsed laser deposition and their structure and magnetic properties have been studied. Annealing increases crystallinity and the size of the particles leading to an alteration of magnetic properties, observed from magnetic studies and evaluated using high-resolution transmission electron microscopy , selected area electron diffraction and x-ray diffraction patterns analysis. Transmission electron microscopy results show that the BiFeO3 as-deposited nanoparticles annealed up to 400 °C exhibit a orthorhombic distorted perovskite structure without secondary phase and with diameters varying from 9 nm (as-deposited) to 17 nm (annealed at 400 °C). Magnetic data exhibit exchange bias and magnetic blocking effects at low temperatures and typical superparamagnetic behavior at high temperatures. Meanwhile, the BiFeO3 nanoparticles annealed at 500 °C exhibit a rhombohedrally distorted perovskite structure with typical antiferromagnetic properties and diameter of about 56 nm. The analysis of magnetic relaxation time using the Arrhenius equation suggests a superparamagnetic blocking process of ferromagnetic clusters on the surface of the nanoparticles at low temperature. The magnetic properties are discussed considering the interactions between nanoparticles and the co-existence of different magnetic phases within the nanoparticles: an ordered antiferromagnetic core and ferromagnetic clusters on the surface.
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Affiliation(s)
- D M Souza
- Instituto de Física, Universidade Federal Fluminense, 24210-346, Niterói, Rio de Janeiro, Brazil
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Souto AC, Coutinho E, Miname MH, Jannes CE, Pereira A, Santos RD. P4397Health related quality of life is not reduced in elder familial hypercholesterolemia patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Familial hypercholesterolemia (FH) is a genetic disorder associated with high risk of early major cardiovascular events (MACE) that can impact on elderly's self-appraisal of health-related quality of life (HRQoL), however, this association is unclear.
Purpose
This study evaluated HRQoL of elder individuals (from 60 to 88 years old), index cases (IC) and first-degree relatives (FDR) at high risk of FH.
Methods
From 1030 participants of FH genetic cascade screening, 250 were ≥60 and 205 were eligible for this study. Data collection was performed before awareness of molecular diagnosis results. Individuals were divided into 4 groups according to molecular diagnosis: IC with (IC+) and without (IC-) identified mutations (n=38 and n=54, respectively), and their affected (FDR+, n=74) and non-affected (FDR-, n=39) FDR. HRQoL measurements, mental (MCS) and physical component (PCS) scores, were carried out with the SF-12 questionnaire. Associations were tested by multivariate models.
Results
The mean age was 68±7 years, 32.2% were men, MACE had occurred in 47.8%. HRQoL dimensions measure (variance of physical, mental and health quality component scores) did not differ between FH and non-FH individuals. Lower PCS were associated with female sex (p=0.043), lower education (p=0.047), previous MACE occurrence (p<0.001), arterial hypertension (p=0.005), depression (p=0.004) and Alzheimer's disease (p=0.016). Lower MCS were associated with the previous diagnosis of depression (p<0.001) and Alzheimer's disease (p=0.011). Lower HQS were associated with lower education level (p=0.001), previous MACE (p<0.001), arterial hypertension (p<0.001), depression and Alzheimer (p=0.004 and p=0.006). MACE and hypertension were predictive of lower PCS (p=0.003 and p=0.035). Depression was predictive of lower MCS (p<0.001). Education, MACE and depression were predictive of health quality self-appraisal. No association was found with either molecular defect or lipid-lowering therapy.
Conclusion
HRQol in elder suspected FH individuals relates more to a consequence of elevated cholesterol levels i.e. MACE and co-morbidities rather than molecular defects or pharmacological treatment.
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Affiliation(s)
- A C Souto
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - E Coutinho
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - M H Miname
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - C E Jannes
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - A Pereira
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - R D Santos
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
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Liu H, Zhu CG, Cui CJ, Cao YX, Sun DI, Wu NQ, Guo YL, Gao Y, Dong QT, Santos RD. P650Lipopolysaccharide-nuclear factor-kappa B pathway and lipoprotein apheresis effects in patients with familial hypercholesterolemia and coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0257] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Abstract
Background
Inflammation may play an important role in atherosclerosis in familial hypercholesterolemia (FH). Lipopolysaccharide (LPS)-nuclear factor-kappa B (NF-κB) pathway is a routine signal process activated in inflammatory status.
Purpose
This study aimed to examine the LPS-NF-κB axis status and the impact of lipoprotein apheresis (LA) on this pathway in patients with FH and coronary artery disease (CAD).
Methods
In this matched case-control study a genetically diagnosed FH cohort who presented stable CAD (n=63) was compared with 63 non-FH CAD and 63 non-FH non-CAD controls matched by sex and age. Plasma LPS levels and NF-κB activity were compared among the three groups. In addition, we studied in vitro LPS-induced interleukin-6 (IL-6) production by mononuclear cells from 16 FH cases without previous statin use and compared them with their respective matched control groups. Subsequently, these 16 FH patients underwent LA. Blood samples were taken immediately before and regularly after LA for measuring LPS and NF-κB.
Results
FH plus CAD had higher LPS levels and NF-κB activity than CAD and non-CAD controls (all p values <0.01). LPS-induced IL-6 production by mononuclear cells of FH plus CAD was also much higher compared with CAD and non-CAD controls (both p values <0.01). Moreover, plasma LPS levels (p<0.001) and NF-κB activity (p<0.01) were dramatically reduced after apheresis in FH patients.
Conclusion
Genetically confirmed FH patients with CAD had a marked activation of LPS-NF-κB axis, while LA significantly attenuated this key inflammatory pathway, suggesting that inflammation may be an important therapeutic target for FH patients.
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Affiliation(s)
- H Liu
- Fu Wai Hospital, Beijing, China
| | - C G Zhu
- Fu Wai Hospital, Beijing, China
| | - C J Cui
- Fu Wai Hospital, Beijing, China
| | - Y X Cao
- Fu Wai Hospital, Beijing, China
| | - D I Sun
- Fu Wai Hospital, Beijing, China
| | - N Q Wu
- Fu Wai Hospital, Beijing, China
| | - Y L Guo
- Fu Wai Hospital, Beijing, China
| | - Y Gao
- Fu Wai Hospital, Beijing, China
| | | | - R D Santos
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
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Macchi C, Sirtori CR, Corsini A, Santos RD, Watts GF, Ruscica M. A new dawn for managing dyslipidemias: The era of rna-based therapies. Pharmacol Res 2019; 150:104413. [PMID: 31449975 DOI: 10.1016/j.phrs.2019.104413] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/08/2019] [Accepted: 08/22/2019] [Indexed: 12/24/2022]
Abstract
The high occurrence of atherosclerotic cardiovascular disease (ASCVD) events is still a major public health issue. Although a major determinant of ASCVD event reduction is the absolute change of low-density lipoprotein-cholesterol (LDL-C), considerable residual risk remains and new therapeutic options are required, in particular, to address triglyceride-rich lipoproteins and lipoprotein(a) [Lp(a)]. In the era of Genome Wide Association Studies and Mendelian Randomization analyses aimed at increasing the understanding of the pathophysiology of ASCVD, RNA-based therapies may offer more effective treatment options. The advantage of oligonucleotide-based treatments is that drug candidates are targeted at highly specific regions of RNA that code for proteins that in turn regulate lipid and lipoprotein metabolism. For LDL-C lowering, the use of inclisiran - a silencing RNA that inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9) synthesis - has the advantage that a single s.c. injection lowers LDL-C for up to 6 months. In familial hypercholesterolemia, the use of the antisense oligonucleotide (ASO) mipomersen, targeting apolipoprotein (apoB) to reduce LDL-C, has been a valuable therapeutic approach, despite unquestionable safety concerns. The availability of specific ASOs lowering Lp(a) levels will allow rigorous testing of the Lp(a) hypothesis; by dramatically reducing plasma triglyceride levels, Volanesorsen (APOC3) and angiopoietin-like 3 (ANGPTL3)-LRx will further clarify the causality of triglyceride-rich lipoproteins in ASCVD. The rapid progress to date heralds a new dawn in therapeutic lipidology, but outcome, safety and cost-effectiveness studies are required to establish the role of these new agents in clinical practice.
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Affiliation(s)
- C Macchi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - C R Sirtori
- Dyslipidemia Center, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - A Corsini
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy; IRCCS Multimedica, Milan, Italy
| | - R D Santos
- Lipid Clinic, Heart Institute (InCor), University of Sao Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - G F Watts
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia; Lipid Disorders Clinic, Cardiometabolic Services, Department of Cardiology, Royal Perth Hospital, Australia.
| | - M Ruscica
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
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Ritti-Dias RM, Cucato GG, do Prado WL, Conceição RDO, Santos RD, Bittencourt MS. Self-initiated changes in physical activity levels improve cardiometabolic profiles: A longitudinal follow-up study. Nutr Metab Cardiovasc Dis 2017; 27:48-53. [PMID: 27956022 DOI: 10.1016/j.numecd.2016.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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] [Received: 10/21/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS While studies have described the importance of higher physical activity levels (PAL) in weight loss, the impact of self-initiated PAL on health status warrants further study. We aimed to prospectively examine the effects of self-initiated longitudinal PAL changes on body mass index (BMI) and cardiometabolic parameters in normal weight, overweight and obese adults. METHODS AND RESULTS We included 4840 adults (mean age 41.6 ± 7.9 years, 79% male) undergoing routine health screening examinations. Self-reported PAL, height, weight, blood pressure and blood samples were collected at baseline and after a mean (95% confidence interval) follow up of 536 (531-541) days. Subjects were stratified according to BMI [39.8% normal weight (<25 kg/m2), 45.1% overweight (25.0-29.9 kg/m2), and 19.1% obese (≥30 kg/m2)]. In normal weight individuals, BMI increased from baseline to follow-up, irrespective of PAL changes. On the other hand, overweight and obese individuals that increased PAL experienced a decrease in BMI by -0.9% and -3.1%, respectively (p < 0.05). Overweight and obese individuals that increased PAL also experienced a decrease in -5.8% -4.6% in non-HDL concentrations from baseline to follow-up (p < 0.05). Finally, in overweight individuals, LDL cholesterol concentrations decreased from baseline to follow-up, irrespective of PAL changes whereas in obese individuals, a maintenance or increased PAL were associated with a decrease in -4.7% and -6.1% (p < 0.05), respectively. CONCLUSIONS In a large cohort of screening patients, longitudinal self-initiated PAL is associated with improved BMI and cardiometabolic profile in overweight and obese individuals.
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Affiliation(s)
- R M Ritti-Dias
- Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
| | - G G Cucato
- Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - W L do Prado
- Federal University of Sao Paulo, Sao Paulo, Brazil
| | - R D O Conceição
- Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - R D Santos
- Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Lipid Clinic Heart Institute (InCor), University of Sao Paulo, Medical School Hospital, Sao Paulo, Brazil
| | - M S Bittencourt
- Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
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Laurinavicius AG, Bittencourt MS, Blaha MJ, Nary FC, Kashiwagi NM, Conceiçao RD, Meneghelo RS, Prado RR, Carvalho JAM, Nasir K, Blumenthal RS, Santos RD. Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise treadmill test. QJM 2016; 109:531-7. [PMID: 26792853 PMCID: PMC4986427 DOI: 10.1093/qjmed/hcw003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Received: 11/17/2015] [Indexed: 12/28/2022] Open
Abstract
AIMS Non-alcoholic hepatic steatosis (HS) is associated with hypertension and increased cardiovascular risk. While Blood pressure hyper-reactive response (HRR) during peak exercise indicates an increased risk of incident hypertension and increased cardiovascular risk, no data on the association of non-alcoholic HS and HRR exists. In this study, we have evaluated the association of HS with HRR. METHODS We included 13 410 consecutive individuals with a mean age: 42.4 ± 8.9 years, 3561 (26.6%) female with normal resting blood pressure and without a previous diagnosis of hypertension, who underwent symptom limited exercise treadmill test, abdominal ultrasonography and clinical and laboratory evaluation. HS was detected by abdominal ultrasonography. HRR was defined by a peak exercise systolic blood pressure >220 mmHg and/or elevation of 15 mmHg or more in diastolic blood pressure from rest to peak exercise. RESULTS The prevalence of HS was 29.5% (n = 3956). Overall, 4.6% (n = 619) of the study population presented a HRR. Subjects with HS had a higher prevalence of HRR (8.1 vs. 3.1%, odds ratio 2.8, 95% CI 2.4-3.3, P < 0.001). After adjustment for body mass index, waist circumference, fasting plasma glucose and low density lipoprotein cholesterol, HS (odds ratio 1.4, 95% CI 1.1-1.6, P = 0.002) remained independently associated with HRR. HS was additive to obesity markers in predicting exercise HRR. CONCLUSIONS Non-alcoholic HS is independently associated with hyper-reactive exercise blood pressure response.
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Affiliation(s)
- A G Laurinavicius
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil, Lipid Clinic Heart Institute (InCor) University of Sao Paulo, Medical School Hospital, Av. Eneas de Carvalho Aguiar, 44, CEP-05403-900, Säo Paulo, Brazil
| | - M S Bittencourt
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil, Center for Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, Av. Lineu Prestes, 2565, CEP-05508-000, Säo Paulo, Brazil
| | - M J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, 601 North Caroline Street,Suite 7200, Baltimore, MD 21287, USA and
| | - F C Nary
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil
| | - N M Kashiwagi
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil
| | - R D Conceiçao
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil
| | - R S Meneghelo
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil
| | - R R Prado
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil
| | - J A M Carvalho
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil
| | - K Nasir
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, 601 North Caroline Street,Suite 7200, Baltimore, MD 21287, USA and Preventive Cardiology and Wellness Center, Baptist Hospital, 1691 Michigan Ave Suite 500, Miami Beach, FL 33139, United States
| | - R S Blumenthal
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, 601 North Caroline Street,Suite 7200, Baltimore, MD 21287, USA and
| | - R D Santos
- From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil, Lipid Clinic Heart Institute (InCor) University of Sao Paulo, Medical School Hospital, Av. Eneas de Carvalho Aguiar, 44, CEP-05403-900, Säo Paulo, Brazil,
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Cesar LA, Ferreira JF, Armaganijan D, Gowdak LH, Mansur AP, Bodanese LC, Sposito A, Sousa AC, Chaves AJ, Markman B, Caramelli B, Vianna CB, Oliveira CC, Meneghetti C, Albuquerque DC, Stefanini E, Nagib E, Pinto IMF, Castro I, Saad JA, Schneider JC, Tsutsui JM, Carneiro JKR, Torres K, Piegas LS, Dallan LA, Lisboa LAF, Sampaio MF, Moretti MA, Lopes NH, Coelho OR, Lemos P, Santos RD, Botelho R, Staico R, Meneghello R, Montenegro ST, Vaz VD. Guideline for stable coronary artery disease. Arq Bras Cardiol 2015; 103:1-56. [PMID: 25410086 DOI: 10.5935/abc.2014s004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sousa MRD, Feitosa GS, Paola AAVD, Schneider JC, Feitosa-Filho GS, Nicolau JC, Ferreira JFM, Carvalho RCMD, Chalela WA, Malachias MVB, Pena JLB, Somaio-Neto F, Montera MW, Barbosa GV, Bacal F, Jatene IB, Santos RD, Miranda RD, Peixoto JM, Barbosa MR, Fenelon G, Assef AH, Naccarato AFP, Rodrigues Sobrinho CRM, Kohler I, Vasconcelos JNGD, Magalhães MJG, Morais NSD, Rocha RM, Giraldez RRCV, Silva GCD. [First guidelines of the Brazilian Society of Cardiology on processes and skills for education in cardiology in Brazil]. Arq Bras Cardiol 2014; 96:4-24. [PMID: 24043332 DOI: 10.5935/abc.2013s008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Polli RS, Malheiros JM, Dos Santos R, Hamani C, Longo BM, Tannús A, Mello LE, Covolan L. Changes in Hippocampal Volume are Correlated with Cell Loss but Not with Seizure Frequency in Two Chronic Models of Temporal Lobe Epilepsy. Front Neurol 2014; 5:111. [PMID: 25071699 PMCID: PMC4076745 DOI: 10.3389/fneur.2014.00111] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 03/11/2014] [Accepted: 06/13/2014] [Indexed: 11/17/2022] Open
Abstract
Kainic acid (KA) or pilocarpine (PILO) have been used in rats to model human temporal lobe epilepsy (TLE) but the distribution and severity of structural lesions between these two models may differ. Magnetic resonance imaging (MRI) studies have used quantitative measurements of hippocampal T2 (T2HP) relaxation time and volume, but simultaneous comparative results have not been reported yet. The aim of this study was to compare the MRI T2HP and volume with histological data and frequency of seizures in both models. KA- and PILO-treated rats were imaged with a 2 T MRI scanner. T2HP and volume values were correlated with the number of cells, mossy fiber sprouting, and spontaneous recurrent seizures (SRS) frequency over the 9 months following status epilepticus (SE). Compared to controls, KA-treated rats had unaltered T2HP, pronounced reduction in hippocampal volume and concomitant cell reduction in granule cell layer, CA1 and CA3 at 3 months post SE. In contrast, hippocampal volume was unchanged in PILO-treated animals despite detectable increased T2HP and cell loss in granule cell layer, CA1 and CA3. In the following 6 months, MRI hippocampal volume remained stable with increase of T2HP signal in the KA-treated group. The number of CA1 and CA3 cells was smaller than age-matched CTL group. In contrast, PILO group had MRI volumetric reduction accompanied by reduction in the number of CA1 and CA3 cells. In this group, T2HP signal was unaltered at 6 or 9 months after status. Reductions in the number of cells were not progressive in both models. Notably, the SRS frequency was higher in PILO than in the KA model. The volumetry data correlated well with tissue damage in the epileptic brain, suggesting that MRI may be useful for tracking longitudinal hippocampal changes, allowing the assessment of individual variability and disease progression. Our results indicate that the temporal changes in hippocampal morphology are distinct for both models of TLE and that these are not significantly correlated to the frequency of SRS.
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Affiliation(s)
- Roberson S Polli
- Departamento de Fisiologia, Universidade Federal de São Paulo - UNIFESP , São Paulo , Brazil ; Centro de Imagens e Espectroscopia in vivo por Ressonância Magnética (CIERMag), Instituto de Física de São Carlos, Universidade de São Paulo (IFSC-USP) , São Carlos , Brazil
| | - Jackeline M Malheiros
- Departamento de Fisiologia, Universidade Federal de São Paulo - UNIFESP , São Paulo , Brazil ; Centro de Imagens e Espectroscopia in vivo por Ressonância Magnética (CIERMag), Instituto de Física de São Carlos, Universidade de São Paulo (IFSC-USP) , São Carlos , Brazil
| | - Renan Dos Santos
- Departamento de Farmacologia, Universidade Federal de São Paulo - UNIFESP , São Paulo , Brazil
| | - Clement Hamani
- Departamento de Fisiologia, Universidade Federal de São Paulo - UNIFESP , São Paulo , Brazil ; Division of Neurosurgery, Toronto Western Hospital, University of Toronto , Toronto, ON , Canada
| | - Beatriz M Longo
- Departamento de Fisiologia, Universidade Federal de São Paulo - UNIFESP , São Paulo , Brazil
| | - Alberto Tannús
- Centro de Imagens e Espectroscopia in vivo por Ressonância Magnética (CIERMag), Instituto de Física de São Carlos, Universidade de São Paulo (IFSC-USP) , São Carlos , Brazil
| | - Luiz E Mello
- Departamento de Fisiologia, Universidade Federal de São Paulo - UNIFESP , São Paulo , Brazil
| | - Luciene Covolan
- Departamento de Fisiologia, Universidade Federal de São Paulo - UNIFESP , São Paulo , Brazil
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Santos RD, Gagliardi ACM, Xavier HT, Casella Filho A, Araújo DB, Cesena FY, Alves RJ, Pereira AC, Lottemberg AMP, Chacra APM, Faludi AA, Sposito AC, Ribeiro Filho FF, Helfenstein Fonseca FA, de Carlos Back Giuliano I, Catani LH, Bertolami MC, Hiroshi Miname M, Izar MC, Monte O, Maranhão RC, Martinez TLR, Arruda Machado V, Zorzanelli Rocha V, Salgado Filho W. [First Brazilian Guidelines for Familial Hypercholesterolemia]. Arq Bras Cardiol 2013; 99:1-28. [PMID: 23532256 DOI: 10.5935/abc.20120202] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Santos RD, Gagliardi ACM, Xavier HT, Magnoni CD, Cassani R, Lottenberg AM, Arpadi Faludi A, Geloneze B, Scherr C, Kovacs C, Tomazzela C, Carla C, Barrera-Arellano D, Cintra D, Quintão E, Nakandakare ER, Fonseca FAH, Pimentel I, Ernesto dos Santos J, Bertolami MC, Rogero M, Izar MC, Nakasato M, Teixeira Damasceno NR, Maranhão R, Cassani RSL, Perim R, Ramos S. [First guidelines on fat consumption and cardiovascular health]. Arq Bras Cardiol 2013; 100:1-40. [PMID: 23598539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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19
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Santos RD, Gagliardi ACM, Xavier HT, Magnoni CD, Cassani R, Lottenberg AMP, Casella Filho A, Araújo DB, Cesena FY, Alves RJ, Fenelon G, Nishioka SAD, Faludi AA, Geloneze B, Scherr C, Kovacs C, Tomazzela C, Carla C, Barrera-Arellano D, Cintra D, Quintão E, Nakandakare ER, Fonseca FAH, Pimentel I, Santos JE, Bertolami MC, Rogero M, Izar MCO, Nakasato M, Damasceno NRT, Maranhão R, Cassani RSL, Perim R, Ramos S. I Diretriz sobre o consumo de Gorduras e Saúde Cardiovascular. Arq Bras Cardiol 2013. [DOI: 10.5935/abc.2013s003] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [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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Miname MH, Bortolotto LA, Parga J, Ávila LF, Martinez LCR, Salgado Filho W, Marte AP, Rochitte CE, Santos RD. IA 003 Correlation between Carotid Intima-media Thickness and Parameters of Arterial Stiffness, with Coronary Obstruction Assessed by Multislice Computed Tomography Angiography in Patients with Familial Hypercholesterolemia. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71741-6] [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: 10/20/2022]
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Gagliardi ACM, Pavão BL, Barbeiro DF, Maranhão RC, Souza HP, Santos RD. L 020 Correlations Between Food Intake, Lipid Profile and Inflammation in Patients with Metabolic Syndrome. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71786-6] [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: 10/20/2022]
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Gagliardi ACM, Pavão BL, Barbeiro DF, Maranhão RC, Souza HP, Santos RD. L 021 Consumption of Margarine and Butter and Lipid Profiles and Inflammatory of Patients with Metabolic Syndrome. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71787-8] [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: 10/20/2022]
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Abstract
A major barrier to progress in systems biology is the absence of suitable infrastructure for data and software integration, which would enable working biologists to use and manipulate the techniques directly. We describe the incremental development of key components of such an infrastructure for a research community focused on a specific (but important) biological system. EUCLOCK combines the expertise of 34 chronobiology laboratories from 29 institutions in 11 European countries in a 5-year effort to understand how circadian clocks are synchronised to their specific cyclic environment (entrainment). We envision that the EUCLOCK Information System (EUCLIS) will subsequently evolve to support the worldwide chronobiology community. The architecture of EUCLIS integrates a database for circadian systems biology, containing modules for experimental data (Clock Experiments) and models (Clock Models) with a digital library (Clock KnowledgeBase) for the research community. The digital library paradigm is superior to the simple 'access' or 'mining' as well as the 'data warehouse' approaches currently used in other systems as it provides a flexible framework for community information needs and the potential to use emerging reference models and standards, which will enable easier integration with other systems in the future. The main Clock KnowledgeBase components for EUCLIS V1.0, Clock Genes and Clock Library, are described in detail. An important aspect this work will need to address in the future is the integration of the database and digital library management functions.
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Affiliation(s)
- R T B Batista
- Department of Computer Science, University of the Philippines, Diliman
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Pereira AC, Pereira A, Martinez TLR, Santos RD, Krieger JE. L 067 HERITABILITIES FOR CARDIOVASCULAR RISK FACTORS IN CHILDREN: RESULTS FROM A FAMILY-BASED STUDY IN THE BRAZILIAN POPULATION. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)72011-1] [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: 10/22/2022]
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Orakzai RH, Orakzai SH, Nasir K, Santos RD, Rana JS, Pimentel I, Carvalho JAM, Meneghello R, Blumenthal RS. Association of white blood cell count with systolic blood pressure within the normotensive range. J Hum Hypertens 2006; 20:341-7. [PMID: 16511508 DOI: 10.1038/sj.jhh.1001992] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 11/09/2022]
Abstract
Hypertension and inflammation promote cardiovascular disease (CVD). Even high normal systolic blood pressure (SBP) is associated with increased CVD risk. We assessed the relationship of elevated SBP within the normotensive range and white blood cell (WBC) count. This is a cross-sectional study of 3484 white asymptomatic individuals (mean age: 43+/-8 years, 79% males) without hypertension with SBP<140 mm Hg. White blood cell count >or=75th percentile (8.35 x 10(9) cells/l) was considered cutoff for elevated WBC. Subjects were classified into three levels of SBP (first: <120 mm Hg, n=1,176, 34%; second: 120-129 mm Hg, n=1,654, 47%; third: 130-139 mm Hg, n=654, 19%). Mean WBC count increased linearly across SBP categories (first: 6.14+/-1.54, second: 6.20+/-1.52, third: 6.41+/-1.62, P=0.02 for trend). There was a linear increase in prevalence of elevated WBC across higher SBP categories (22, 24 and 28%, P=0.02). As compared to those with SBP<120 mm Hg, in multivariate linear regression analyses (adjusting for age, gender, smoking status, diabetes, body mass index, physical activity, cholesterol/high-density lipoprotein cholesterol ratio) WBC count was significantly higher among participants with SBP 130-139 mm Hg (regression coefficient: 2.64, 95% confidence interval: 1.04-4.24, P=0.001). Odds ratio for prevalence of elevated WBC with SBP<120 mm Hg as reference group was 1.14 (0.92-1.41) for SBP 120-129 mm Hg and 1.50 (1.15-1.92) for SBP 130-139 mm Hg. In conclusion, Higher SBP within the normotensive range is also associated with elevated WBC count. Further studies are needed to clarify the role of inflammation in high normal SBP and associated CVD risk.
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Affiliation(s)
- R H Orakzai
- Department of Medicine, University of Pittsburgh, PA, USA
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Santos RD, Meneghelo RS, Chacra APM, Martinez TLR, Ramires JA, Carvalho JAM. Detection of subclinical atherosclerosis by electron beam tomography in females with heterozygous familial hypercholesterolaemia. Heart 2004; 90:92-4. [PMID: 14676254 PMCID: PMC1768026 DOI: 10.1136/heart.90.1.92] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Caramelli B, de Bernoche CY, Sartori AM, Sposito AC, Santos RD, Monachini MC, Strabelli T, Uip D. Hyperlipidemia related to the use of HIV-protease inhibitors: natural history and results of treatment with fenofibrate. Braz J Infect Dis 2001; 5:332-8. [PMID: 11980596 DOI: 10.1590/s1413-86702001000600007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hyperlipidemia has been frequently recorded as a side effect of treating HIV patients with protease inhibitors (PI). This study was initiated to analyze the modifications on blood lipids in HIV-patients receiving PI and the safety and efficacy of the treatment with fenofibrate. Total (TC) and HDL-cholesterol, triglycerides (TG), and CD(4)(+) T-cell counts were measured in 30 HAART-naive patients (Group I) before and after PI introduction. In a second phase of the study, the effects of fenofibrate on lipids, CPK, CD(4)(+), and viral load were determined in 13 patients (Group II) with elevated TC or TG. In Group I, 60% of the patients showed TC or TG elevations. Average increments of 31% and 146% in TC and TG respectively (p<0.0006 and p<0.0001) were observed. In Group II, fenofibrate treatment was associated with decrements of 6.6% (TC) and 45.7% (TG) (p=0.07 and 0.0002) and no modifications on CPK, CD(4)(+), and viral load. In conclusion, hyperlipidemia is common during the treatment of HIV with protease inhibitors, and fenofibrate appears to be an effective and safe choice for its treatment.
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Affiliation(s)
- B Caramelli
- Heart Institute (InCor) and AIDS Clinic, University of São Paulo Medical School, São Paulo, Brazil.
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Marinho de Souza MF, Timerman A, Serrano CV, Santos RD, de Pádua Mansur A. Trends in the risk of mortality due to cardiovascular diseases in five Brazilian geographic regions from 1979 to 1996. Arq Bras Cardiol 2001; 77:562-75. [PMID: 11799431 DOI: 10.1590/s0066-782x2001001200007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE - To analyze the trends in risk of death due to cardiovascular diseases in the northern, northeastern, southern, southeastern, and central western Brazilian geographic regions from 1979 to 1996. METHODS - Data on mortality due to cardiovascular, cardiac ischemic, and cerebrovascular diseases in 5 Brazilian geographic regions were obtained from the Ministry of Health. Population estimates for the time period from 1978 to 1996 in the 5 Brazilian geographic regions were calculated by interpolation with the Lagrange method, based on the census data from 1970, 1980, 1991, and the population count of 1996, for each age bracket and sex. Trends were analyzed with the multiple linear regression model. RESULTS - Cardiovascular diseases showed a declining trend in the southern, southeastern, and northern Brazilian geographic regions in all age brackets and for both sexes. In the northeastern and central western regions, an increasing trend in the risk of death due to cardiovascular diseases occurred, except for the age bracket from 30 to 39 years, which showed a slight reduction. This resulted from the trends of cardiac ischemic and cerebrovascular diseases. The analysis of the trend in the northeastern and northern regions was impaired by the great proportion of poorly defined causes of death. CONCLUSION - The risk of death due to cardiovascular, cerebrovascular, and cardiac ischemic diseases decreased in the southern and southeastern regions, which are the most developed regions in the country, and increased in the least developed regions, mainly in the central western region.
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Santos RD. [III Brazilian Guidelines on Dyslipidemias and Guideline of Atherosclerosis Prevention from Atherosclerosis Department of Sociedade Brasileira de Cardiologia]. Arq Bras Cardiol 2001; 77 Suppl 3:1-48. [PMID: 11781591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Affiliation(s)
- R D Santos
- Departamento de Aterosclerose, Sociedade Brasileira de Cardiologia, Brasil
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Santos RD, Ventura LI, Spósito AC, Schreiber R, Ramires JA, Maranhão RC. The effects of gemfibrozil upon the metabolism of chylomicron-like emulsions in patients with endogenous hypertriglyceridemia. Cardiovasc Res 2001; 49:456-65. [PMID: 11164856 DOI: 10.1016/s0008-6363(00)00274-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the effects of gemfibrozil upon the intravascular metabolism of chylomicron-like emulsions in endogenous hypertriglyceridemia. METHODS We evaluated the plasma kinetics of a chylomicron-like emulsion in 39 subjects: 27 hypertriglyceridemics, total cholesterol (TC) expressed as median (%25; %75) 7.47 (6.1; 8.19) mmol/l and plasma triglycerides (TG) 4.28 (3.6; 18.5) mmol/l and in 12 normolipidemics, TC 4.7 (3.85; 5.37) mmol/l and TG 0.91 (0.64; 1.75) mmol/l. Hypertriglyceridemics were evaluated at baseline and after a 30-day 1200-mg/day gemfibrozil (n=8) or placebo treatment (n=7). The emulsion labelled with 14C-cholesteryl oleate (14C-CO) and 3H-triolein (3H-TO) was injected intravenously after a 12-h fast. The plasma kinetics of 3H-TO and 14C-CO were determined to assess, respectively, lipolysis and clearance of chylomicron and remnants by compartmental analysis. RESULTS The residence times (in minutes) of 3H-TO and 14C-CO of hypertriglyceridemics were roughly twice the values of normolipidemics, i.e. 8.0 (5.5; 12.0) versus 15.0 (11.0; 24.0) and 21.5 (14.0; 33.0) versus 44.0 (32.0; 72.0), P=0.001. Gemfibrozil treatment of hypertriglyceridemic patients reduced the residence times of 3H-TO and 14C-CO, respectively, by 46% (P=0.003) and 53% (P=0.008). Effects were noted on the slow phase of emulsion plasma removal, which was reduced in hypertriglyceridemics. After treatment, the emulsion residence times determined in hypertriglyceridemics attained the values of the normolipidemic group. CONCLUSIONS Gemfibrozil treatment normalised the defects in chylomicron-like emulsion catabolism observed in endogenous hypertriglyceridemia patients.
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Affiliation(s)
- R D Santos
- The Heart Institute of the Medical School Hospital (InCor), University of São Paulo, São Paulo, Brazil
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Spósito AC, Maranhão RC, Vinagre CG, Santos RD, Ramires JA. Effects of etofibrate upon the metabolism of chylomicron-like emulsions in patients with coronary artery disease. Atherosclerosis 2001; 154:455-61. [PMID: 11166779 DOI: 10.1016/s0021-9150(00)00491-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/15/2022]
Abstract
Slow chylomicron intravascular catabolism has been associated with coronary artery disease and screening for drugs that can speed-up this process can be important. In this study, the effects of etofibrate upon chylomicron metabolism was tested by determination of the plasma kinetics of a chylomicron-like emulsion model in 12 patients with coronary artery disease, aged 59+/-11 years, (total cholesterol: 240+/-41 mg/dl; triglycerides: 188+/-42 mg/dl) submitted to a randomized, crossover, double-blind, placebo-controlled study with administration of 1 g per day etofibrate or placebo for 1-month. A 1-month washout period was inserted between the treatment periods. Patients were intravenously injected a chylomicron-like emulsion doubly labeled with 14C-cholesteryl oleate and 3H-triolein at baseline and after treatments. After etofibrate treatment, there was decrease of total cholesterol and triglyceride plasma levels and a trend to increase high-density lipoprotein cholesterol plasma levels. Etofibrate elicited 62% enhancement of post-heparin lipolytic activity and 100% increase of 3H-triglyceride fractional clearance rate compared with placebo treatment. 14C-cholesterol ester fractional clearance rate was 260% greater after etofibrate than after placebo. Therefore, a potent effect of etofibrate on both chylomicron lipolysis and remnant removal was achieved, indicating that this drug can be used to improve this metabolism in future prospective studies.
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Affiliation(s)
- A C Spósito
- Heart Institute (InCor), Laboratório de Metabolismo Lipídico, Instituto do Coração do Hospital das Clínicas da U.S.P., University of São Paulo Medical School, University of São Paulo, Av. Dr. Eneas C. Aguiar, Brazil
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Abstract
We compared the levels of lipoprotein (a) in 48 Caucasian patients with pulmonary arterial hypertension, comprising 32 females and 16 males, aged 28.0 +/- 12.0 years, with a range from 4 through 52 years, with 48 normal Caucasian subjects matched for age and sex. Pulmonary hypertension was secondary in 41 patients with Eisenmenger's syndrome, these comprising 27 females and 14 males aged 27.0 +/- 12.0 years, with a range from 4 through 51 years, and primary in the other 7 patients, 5 females and 2 males, whose age was 30.0 +/- 14.0 years, with a range from 9 through 52 years. Lipoprotein (a) was measured using an immunoprecipitation and turbidimetric assay after a 12 hour fast. Levels of the protein, expressed as the median (% 25; % 75), were higher in those with Eisenmenger's syndrome than in normal controls (p=0.003). In addition, there was a greater prevalence of levels of lipoprotein greater than 30.0 mg/dl in those with secondary pulmonary arterial hypertension patients than in our normal population (p = 0.03). We have found no differences, however, in the levels of lipoprotein(a) in those who had primary pulmonary arterial hypertension when compared with their matched controls, albeit that the number of patients studied was small. We conclude that increased levels of lipoprotein (a) may be secondary to pulmonary arterial hypertension as a marker of tissue damage or may be genetically determined. In either way, the increase in lipoprotein (a) could be an additional factor predisposing to the vascular alterations known to occur in this disease.
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Affiliation(s)
- R D Santos
- Heart Institute (InCor) of the Medical School Hospital, University of Sao Paulo-Sao Paul, Brazil
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Santos RD, Spósito AC, dos Santos JE, Fonseca FH, Moriguchi EH, Martinez TL, Armaganijam D, Timerman S, Timerman A, Nicolau JC, Ramires JA. PANDORA - Survey of Brazilian cardiologists about cholesterol reduction. Arq Bras Cardiol 2000; 75:289-302. [PMID: 11058926 DOI: 10.1590/s0066-782x2000001000004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/22/2022] Open
Abstract
OBJECTIVE To report about a group of physicians' understanding of the recommendations of the II Brazilian Guidelines Conference on Dyslipidemias, and about the state of the art of primary and secondary prevention of atherosclerosis. METHODS Through the use of a questionnaire on dyslipidemia, atherosclerosis prevention, and recommendations for lipid targets established by the II Brazilian Guidelines Conference on Dyslipidemias, 746 physicians, 98% cardiologists, were evaluated. RESULTS Eighty-seven percent of the respondents stated that the treatment of dyslipidemia changes the natural history of coronary disease. Although most of the participants followed the total cholesterol recommendations (<200mg/dL for atherosclerosis prevention), only 55.8% would adopt the target of LDL-C <100 mg/dL for secondary prevention. Between 30.5 and 36.7% answered, in different questions, that the recommended level for HDL-C should be <35mg/dL. Only 32.7% would treat their patients indefinitely with lipid- lowering drugs. If the drug treatment did not reach the proposed target, only 35.5% would increase the dosage, and 29.4% would change the medication. Participants did not know the targets proposed for diabetics. CONCLUSION Although the participating physicians valued the role played by lipids in the prevention of atherosclerosis, serious deficiencies exist in their knowledge of the recommendations given during the II Brazilian Guidelines Conference on Dyslipidemias.
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Affiliation(s)
- R D Santos
- Department of Atherosclerosis, Brazilian Society of Cardiology, São Paulo, SP, Brazil.
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Santos RD, Sposito AC, Ventura LI, Cesar LA, Ramires JA, Maranhão RC. Effect of pravastatin on plasma removal of a chylomicron-like emulsion in men with coronary artery disease. Am J Cardiol 2000; 85:1163-6. [PMID: 10801994 DOI: 10.1016/s0002-9149(00)00721-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [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: 11/25/2022]
Abstract
The speed of the plasma removal of chylomicrons, the lipoproteins that carry dietary lipids absorbed in the intestine, may influence atherogenesis. Thus, the effects of a 30-day pravastatin or placebo treatment on the plasma kinetics of chylomicron-like emulsions were evaluated in 25 patients with coronary artery disease who were not hypertriglyceridemic in a randomized, single-blinded study. Eleven patients (53 +/- 4 years, 10 men) received pravastatin 40 mg/day and 14 received placebo (52 +/- 3 years, 13 men). Emulsions labeled with triolein ((3)H-TO) and cholesteryl oleate ((14)C-CO) to assess lipolysis and clearance of chylomicron and remnants, respectively, were injected intravenously in a bolus after a 12-hour fast. Blood samples were collected during 60 minutes to determine radio isotope decaying curves and fractional catabolic rates. Subjects were studied at baseline and after the treatment period. Compared with placebo (data expressed as mean +/- SEM), pravastatin treatment increased the (14)C-CO fractional catabolic rates (70 +/- 45% vs 18 +/- 10%, p = 0.01), reduced total cholesterol (-21 +/- 3% vs -3 +/- 2% p = 0.0001), low-density lipoprotein (LDL) cholesterol (-25 +/- 5% vs 4 +/- 6%, p = 0.0001), and apolipoprotein B levels (-22 +/- 3% vs -7 +/- 3% p = 0.01). (3)H-TO fractional catabolic rates, plasma triglycerides, very-low-density lipoprotein (VLDL) cholesterol and high-density lipoprotein (HDL) cholesterol variations did not differ between the groups. The fractional catabolic rate of (14)C-CO was inversely correlated with plasma apolipoprotein B levels (r = -0.7, p = 0.04). This suggests that besides reducing LDL cholesterol, pravastatin also increases chylomicron remnant clearance, with possible antiatherogenic implications.
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Affiliation(s)
- R D Santos
- Heart Institute (INCOR) of the Medical School Hospital, São Paulo, Brazil
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Santos RD, Maranhão RC. [Comparison of hypercholesterolemic men and women at high risk for atherosclerosis. Study of risk factors and response to pravastatin treatment]. Arq Bras Cardiol 1998; 70:383-7. [PMID: 9713078 DOI: 10.1590/s0066-782x1998000600001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 02/08/2023] Open
Abstract
PURPOSE To compare the prevalence of risk factors, and the response to pravastatin treatment between men and women. METHODS We evaluated 486 men and 386 women, of these 230 men and 187 women received 10 mg of pravastatin for three months. RESULTS There were differences between women and men in respectively: arterial hypertension (45.5% vs 40.8%; p = 0.0012), left ventricular hypertrophy (33.0% vs 22.0%; p = 0.0041), sedentarism (94.8% vs 87.8%; p = 0.0005), smoking (43.0% vs 61.8%; p < 0.0001), Framingham scores (20.0 +/- 7.1 vs 16.0 +/- 7.6 p < 0.0001), HDL-C (43.0 +/- 11.0 vs 38.0 +/- 9.0 mg/dL; p 0.001), triglycerides-TG (216.0 +/- 115.0 vs 271.0 +/- 172.0 mg/dL; p < 0.001) and Castelli's indexes (CI) I and II (7.7 +/- 2.6 vs 8.6 +/- 3.2; p = 0.002 and 5.0 +/- 1.5 vs 5.5 +/- 2.0; p = 0.015). In men under pravastatin treatment there was a greater reduction in TG (32.0 vs 21.0% p < 0.05) and CI I (-41.0% vs -37.0%; p < 0.05) and II (-40.0% vs -38.0%; p < 0.05). CONCLUSION Men and women differed in risk factors prevalence and response to treatment with pravastatin.
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Affiliation(s)
- R D Santos
- Instituto do Coração, Hospital das Clínicas, FMUSP
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Santos RD, do Nascimento LO, Maranhão e Pesquisadores RC. [Assessment of short-term effects of awareness programs and pravastatin therapy on subjects from private clinics at high risk for cardiovascular disease]. Arq Bras Cardiol 1997; 69:225-30. [PMID: 9595713 DOI: 10.1590/s0066-782x1997001000001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To evaluate short-term efficacy of awareness programs (AP) in reducing coronary heart disease risk factors (CHDRF). METHODS High risk hypercholesterolemic patients were divided in 2 groups during 16 weeks. Group A (n = 417, 54.3 +/- 10.0 years, 55% males) received verbal and written orientation on CHDRF control, and group B (n = 180, 54.4 +/- 10.9 years, 45% males) received only verbal orientation. All participants received pravastatin 10 mg q.d. for 12 weeks. The evolution of body weight, arterial pressure, lipid profile, Castelli's I and II indexes (TC/HDL and LDL/HDL), and Framingham scores were evaluated. RESULTS At baseline, A had a lower HDL-C (40.0 +/- 11.0 vs 43.0 +/- 11.0 mg/dl, p = 0.013) and a higher index I (8.2 +/- 3.0 vs 7.6 +/- 2.3, p = 0.008) than B. After 16 weeks, A had greater change than B in TC (-28.0 vs -25.0, p < 0.05), LDL-C (-29.0 vs -27.6, p < 0.05), HDL-C levels (+13.7 vs +10.8, p < 0.05) and in the Castelli's Index (-39.0 vs -33.0; p < 0.05). In both groups pravastatin use potentialized the effects of diet on the lipid profile. CONCLUSION The AP seemed to be more effective than verbal orientation alone in CHDRF reduction at short-term.
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Affiliation(s)
- R D Santos
- Instituto do Coração do Hospital das Clínicas, FMUSP
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Santos RD, Mansur AP, Safi Júnior J, Giraldez RR, Maranhão RC, Pileggi F, Ramires JA. [Comparative study of gemfibrozil versus pravastatin in the treatment of patients with coronary artery disease and low HDL cholesterol levels]. Arq Bras Cardiol 1995; 65:181-3. [PMID: 8554498] [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: 01/31/2023] Open
Abstract
PURPOSE To evaluate the effects of gemfibrozil and pravastatin in coronary artery disease patients with HDL-cholesterol (HDL-C) < 35 mg/dl). METHODS Twenty-nine patients (20 males, 60 +/- 9) were divided in a gemfibrozil group (G) (1200 mg/day n = 15) and a pravastatin group (P) (10 or 20 mg n = 10 and 4, respectively). The plasma lipid profile (LP) e.g. total cholesterol (TC), fractions and triglycerides (TG) was determined at 4 and 12 weeks of treatment. RESULTS HDL-C was not affected in P, TC and LDL-cholesterol (LDL-C) reductions were superior to those in G (31.3% vs 13.4% and 38.7 and 11.5%, p < 0.05 and < 0.01 respectively). In G HDL-C raised by 50% (12th week p < 0.01). Gemfibrozil reduced TG levels in 44.7% while in P it varied -32.2% (12th week p < 0.01 and < 0.05 respectively). CONCLUSION Gemfibrozil is more effective in reducing TG and raising HDL-C than pravastatin. On the other hand, pravastatin was more potent in reducing LDL-C levels.
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Affiliation(s)
- R D Santos
- Instituto do Coração do Hospital das Clínicas, FMUSP
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Maranhão R, Santos RD, Furlaneto C, Graziosi P, Stolf N, Vinagre C, Bocchi E, Belotti G, Jatene A, Pileggi F. [Lipoprotein (a), apolipoproteins and the lipid profile late after heart transplantation]. Arq Bras Cardiol 1994; 63:465-8. [PMID: 7605229] [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] Open
Abstract
PURPOSE--To evaluate if the levels of lipoprotein (a) [Lp(a)], apolipoproteins (apo) A1, B and the lipid profile (LP) differ among heart transplantation (HT) patients, with coronary artery disease (CAD) and patients without CAD (NL) and if LP discriminates patients with graft vascular disease (GVD). METHODS--A hundred and seventy patients separated in 3 groups: I) HT [n = 43 46 +/- 15 years, 24 months (median) after transplantation], of these 28 were submitted to serial angiography after the first year of transplantation subgroups with GVD (n = 9) and without GVD (NGVD) (n = 19); II) CAD (n = 72, 48 +/- 6 years); III) NL (n = 45, 50 +/- 6 years). RESULTS--HT presented higher apo A1 levels than CAD and NL (1.5 +/- 0.5 vs 1.2 +/- 0.05 vs 1.1 +/- 0.06 g/l p < 0.05 respectively). Apo B was higher on CAD than in HT and NL (1.5 +/- 0.05 vs 1.2 +/- 0.07 vs 1.3 +/- 0.09 g/l p < 0.05). Lp (a) presented a trend to higher levels in HT and CAD than in NL [25(2-97), 24(1-130) and 15 (1-100) mg/dl, p = 0.05)]. However, when individually evaluated against NL Lp(a) levels were higher in HT and CAD (p = 0.019 and 0.03 respectively). LP did not differ between GVD and NGVD. CONCLUSION--Increased Lp(a) levels after transplantation might be related to the high prevalence of GVD. The LP did not discriminate GVD.
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Affiliation(s)
- R Maranhão
- Instituto do Coração do Hospital das Clínicas, FMUSP
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da Luz PL, Santos RD. [Menopause and risk factors for coronary disease]. Rev Assoc Med Bras (1992) 1994; 40:121-4. [PMID: 7820149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- P L da Luz
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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Borba EF, Santos RD, Bonfa E, Vinagre CG, Pileggi FJ, Cossermelli W, Maranhão RC. Lipoprotein(a) levels in systemic lupus erythematosus. J Rheumatol 1994; 21:220-3. [PMID: 8182628] [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: 01/29/2023]
Abstract
OBJECTIVE To determine lipoprotein(a) [Lp(a)] levels in systemic lupus erythematosus (SLE) and its possible correlation with thrombosis, disease activity, anticardiolipin antibodies (aCL) and steroid therapy. METHODS Serum Lp(a) levels were determined by radioimmunoassay (RIA) in 34 Caucasian patients with SLE and compared to 66 healthy subjects. RESULTS In patients with SLE Lp(a) levels were higher than in controls (42 +/- 35 vs 26 +/- 25 mg/dl, p = 0.01). Lp(a) levels were high (> or = 30 mg/dl) in 56% of the patients with SLE and in 30% of controls (p = 0.02) but were not correlated with the clinical and laboratory findings. CONCLUSIONS Lp(a) levels are significantly higher in patients with SLE and are not influenced by disease activity, thrombosis, aCL and steroid therapy.
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Affiliation(s)
- E F Borba
- Rheumatology Division, University Medical School Hospital, São Paulo, Brazil
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Tranchesi Júnior B, Santos RD, Caramelli B, Gebara O, Barbosa V, Bellotti G, Pileggi F. Early administration of captopril and nitroglycerin in combination after acute myocardial infarction: an invasive haemodynamic study. Eur Heart J 1993; 14:90-5. [PMID: 8432299 DOI: 10.1093/eurheartj/14.1.90] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 01/30/2023] Open
Abstract
The combination of captopril and nitroglycerin early after acute myocardial infarction (AMI) could lead to a dangerous decrease in blood pressure coronary perfusion. To evaluate the safety aspects and haemodynamic effects of this combination, we studied 36 first 'Q wave' thrombolysed anterior wall AMI patients during the 24 h following the onset of symptoms. Afterwards, thrombolysis patients received a continuous infusion of nitroglycerin and were submitted to pulmonary artery catheterization. Those patients with mean arterial pressure (MAP) > or = 70 mmHg, cardiac index > or = 2.2 l.min-1.m-2, and wedge pressure > or = 10 mmHg were included and randomized to receive 6.25 mg of captopril every 6 h on the first day and 12.5 mg qid on the second if MAP > or = 70 mmHg (group 1). A second group (group 2) received a placebo. Haemodynamic parameters were determined after 1, 6 and then every 6 h up to 48 h after basal measurements. Significant differences were observed only for the MAP and the rate-pressure product (reduction in group 1 values, P < 0.05). However, MAP was maintained within acceptable limits. Our data support the fact that the combination of captopril and nitroglycerin in the early hours of a non-complicated anterior wall AMI is safe, and could guarantee its use in large clinical trials to determine the effects on left ventricle remodelling and survival after AMI.
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Santos RD, Kasinsky N, Mitre N, Telles F JS, Ferreira C, Velludo E, Stefanini E, Murad N, Ferreira H, Barcellini A. [Critical study of rheumatic activity tests in normal puerperium]. Arq Bras Cardiol 1976; 29:375-8. [PMID: 1087874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Reibscheid S, Miszputen SJ, Ganc AJ, Santos RD, Marlet JM, Vilela MP. [Oral ammonium chloride overload test in normal persons, and cirrhotic and jaundice patients due to mechanical obstruction of the ducts. Comparative study]. Rev Assoc Med Bras 1967; 13:375-8. [PMID: 5258174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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