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Germano DB, Silveira ALPA, Kim YJ, do Amaral JB, Shio MT, da Silva Nali LH, Dos Santos Ferreira CE, Miyahira A, Fonseca FAH, Bachi ALL, Pallos D, França CN. Expression of monocyte chemokine receptors in diabetes after non-surgical periodontal treatment: A pilot study. Cytokine 2024; 178:156579. [PMID: 38471419 DOI: 10.1016/j.cyto.2024.156579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/29/2024] [Accepted: 03/06/2024] [Indexed: 03/14/2024]
Abstract
The aim of this study was to evaluate the effect of non-surgical periodontal treatment in the expression of chemokine receptors, in individuals with Periodontitis, associated or not with Diabetes. Pilot study, which included patients (n = 45) with Periodontitis, associated (n = 25) or not (n = 20) with Diabetes, submitted to the non-surgical periodontal treatment for one month. The expression of chemokine receptors CCR2, CCR5, and CX3CR1 at the mRNA level was evaluated in the peripheral mononuclear cells, as well as the expression of these receptors at the protein level was verified in monocyte subtypes (classical, intermediate, and non-classical monocytes). There was higher expression of CCR2 and CCR5 receptors at the initial visit in the group with Diabetes, with no differences for CX3CR1 (p = 0.002; p = 0.018, and p = 0.896, respectively), without differences after treatment. There was higher expression of CCR2 and CCR5 proteins in the group with Diabetes at the initial visit for classical, intermediate, and nonclassical monocytes, with no differences for CX3CR1 (CCR2: p = 0.004; p = 0.026; p = 0.024; CCR5: 0.045; p = 0.045; p = 0.013; CX3CR1: p = 0.424; p = 0.944; p = 0.392, respectively), without differences after the end of treatment. Concerning each group separately, there were reductions in the expression of CCR2 as well as CCR5 in classical, intermediate, and nonclassical monocytes, and reduction of CX3CR1 in classical monocytes after treatment in the group with Diabetes (p = 0.003; p = 0.006; p = 0.039; p = 0.007; p = 0.006; p = 0.004; p = 0.019, respectively), without differences in the group without Diabetes. The expression of the chemokine receptors CCR2 and CCR5, in patients with Periodontitis associated with Diabetes, is favorably modified after the end of the non-surgical periodontal treatment.
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Affiliation(s)
| | | | - Yeon Jung Kim
- Odontology Post Graduation, Santo Amaro University, Sao Paulo, Brazil
| | - Jônatas Bussador do Amaral
- Federal University of Sao Paulo, ENT Research Laboratory, Otorhinolaryngology-Head and Neck Surgery Department, Sao Paulo, Brazil
| | - Marina Tiemi Shio
- Health Sciences Post Graduation, Santo Amaro University, Sao Paulo, Brazil
| | | | | | | | | | | | - Débora Pallos
- Odontology Post Graduation, Santo Amaro University, Sao Paulo, Brazil.
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Fonseca HAR, Bittencourt CR, Monteiro AM, Fonseca FA, Sanches LR, Ferreira CEDS, Neto AMF, Gidlund M, Izar MC. Immunometabolic and Vascular Health Responses among High Endurance Trained Subjects. Int J Sports Med 2024; 45:245-252. [PMID: 37793434 DOI: 10.1055/a-2186-2717] [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: 10/06/2023]
Abstract
In this study, we aimed to examine the impact of high endurance training on vascular health parameters and immune-endocrine responses against modified low-density lipoprotein (LDL) particles. This observational, cross-sectional study included high endurance-trained and healthy non-trained subjects. Vascular ultrasound was used to assess vascular health parameters based on carotid intima-media thickness and endothelial function (flow-mediated dilation). Enzyme-linked immunosorbent assays were used to measure interleukin (IL)-8 and IL-10, autoantibody isotypes anti-oxidized LDL (oxLDL) and anti-apolipoprotein B (ApoB-D) peptide. Plasma levels of the corticosterone and 17 α-hydroxyprogesterone hormones were analyzed by mass spectrometry. This study enrolled 96 subjects, of whom 44 were high endurance trained and 52 were healthy non-trained individuals. Smaller carotid intima-media thickness values were observed in the high-endurance trained than in the healthy non-trained males, while no differences were observed between female groups. Flow-mediated dilation measurements did not differ by training or sex. The humoral immune responses to IgG anti-oxLDL and IgM anti-ApoB-D autoantibodies showed an isotype imbalance between the high-endurance trained and the non-trained groups. Immunoendocrine parameters showed inverse correlations between 17 α-hydroxyprogesterone concentrations and carotid intima-media thickness measurements. Direct correlations were found between IL-10 concentrations and flow-mediated dilation measurements. Chronic high-endurance exercise modulates immune-endocrine and vascular health parameters, in a sex-dependent manner.
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Affiliation(s)
- Henrique A R Fonseca
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil
- Department of Immunology, Institute Biomedical Science IV, University of Sao Paulo, São Paulo, SP, Brazil
- National Institute of Technology in Complex Fluids, Physics Institute, University of Sao Paulo, São Paulo, SP, Brazil
| | - Celia Regina Bittencourt
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil
| | - Andrea Moreira Monteiro
- Department of Immunology, Institute Biomedical Science IV, University of Sao Paulo, São Paulo, SP, Brazil
- National Institute of Technology in Complex Fluids, Physics Institute, University of Sao Paulo, São Paulo, SP, Brazil
| | - Francisco Antonio Fonseca
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil
- National Institute of Technology in Complex Fluids, Physics Institute, University of Sao Paulo, São Paulo, SP, Brazil
| | | | | | | | - Magnus Gidlund
- Department of Immunology, Institute Biomedical Science IV, University of Sao Paulo, São Paulo, SP, Brazil
| | - Maria Cristina Izar
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil
- National Institute of Technology in Complex Fluids, Physics Institute, University of Sao Paulo, São Paulo, SP, Brazil
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Holdenrieder S, Dos Santos Ferreira CE, Izopet J, Theel ES, Wieser A. Clinical and laboratory considerations: determining an antibody-based composite correlate of risk for reinfection with SARS-CoV-2 or severe COVID-19. Front Public Health 2023; 11:1290402. [PMID: 38222091 PMCID: PMC10788057 DOI: 10.3389/fpubh.2023.1290402] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024] Open
Abstract
Much of the global population now has some level of adaptive immunity to SARS-CoV-2 induced by exposure to the virus (natural infection), vaccination, or a combination of both (hybrid immunity). Key questions that subsequently arise relate to the duration and the level of protection an individual might expect based on their infection and vaccination history. A multi-component composite correlate of risk (CoR) could inform individuals and stakeholders about protection and aid decision making. This perspective evaluates the various elements that need to be accommodated in the development of an antibody-based composite CoR for reinfection with SARS-CoV-2 or development of severe COVID-19, including variation in exposure dose, transmission route, viral genetic variation, patient factors, and vaccination status. We provide an overview of antibody dynamics to aid exploration of the specifics of SARS-CoV-2 antibody testing. We further discuss anti-SARS-CoV-2 immunoassays, sample matrices, testing formats, frequency of sampling and the optimal time point for such sampling. While the development of a composite CoR is challenging, we provide our recommendations for each of these key areas and highlight areas that require further work to be undertaken.
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Affiliation(s)
- Stefan Holdenrieder
- Institute of Laboratory Medicine, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | | | - Jacques Izopet
- Laboratory of Virology, Toulouse University Hospital and INFINITY Toulouse Institute for Infections and Inflammatory Diseases, INSERM UMR 1291 CNRS UMR 5051, University Toulouse III, Toulouse, France
| | - Elitza S. Theel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Munich, Germany
- Faculty of Medicine, Max Von Pettenkofer Institute, LMU Munich, Munich, Germany
- Immunology, Infection and Pandemic Research, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Munich, Germany
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Dos Santos TOC, Dos Santos Ferreira CE, Mangueira CLP, Ammirati AL, Scherer PF, Doher MP, Matsui TN, Dos Santos BFC, Pereira VG, Batista MC, Monte JCM, Santos OFP, de Souza Durão M. Hypercitratemia is a mortality predictor among patients on continuous venovenous hemodiafiltration and regional citrate anticoagulation. Sci Rep 2023; 13:20176. [PMID: 37978209 PMCID: PMC10656486 DOI: 10.1038/s41598-023-47644-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/16/2023] [Indexed: 11/19/2023] Open
Abstract
The use of regional citrate anticoagulation (RCA) in liver failure (LF) patients can lead to citrate accumulation. We aimed to evaluate serum levels of citrate and correlate them with liver function markers and with the Cat/Cai in patients under intensive care and undergoing continuous venovenous hemodiafiltration with regional citrate anticoagulation (CVVHDF-RCA). A prospective cohort study in an intensive care unit was conducted. We compared survival, clinical, laboratorial and dialysis data between patients with and without LF. Citrate was measured daily. We evaluated 200 patients, 62 (31%) with LF. Citrate was significantly higher in the LF group. Dialysis dose, filter lifespan, systemic ionized calcium and Cat/Cai were similar between groups. There were weak to moderate positive correlations between Citrate and indicators of liver function and Cat/Cai. The LF group had higher mortality (70.5% vs. 51.8%, p = 0.014). Citrate was an independent risk factor for death, OR 11.3 (95% CI 2.74-46.8). In conclusion, hypercitratemia was an independent risk factor for death in individuals undergoing CVVHDF-ARC. The increase in citrate was limited in the LF group, without clinical significance. The correlation between citrate and liver function indicators was weak to moderate.
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Affiliation(s)
- Thais Oliveira Claizoni Dos Santos
- Nephrology Division, Universidade Federal de São Paulo, Rua Botucatu, 740, São Paulo, SP, 04023-062, Brazil
- School of Medicine, Universidade de Pernambuco, Recife, PE, Brazil
| | | | | | - Adriano Luiz Ammirati
- Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Dialysis Center, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Patricia Faria Scherer
- Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Thais Nemoto Matsui
- Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Bento Fortunato Cardoso Dos Santos
- Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Dialysis Center, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Marcelo Costa Batista
- Nephrology Division, Universidade Federal de São Paulo, Rua Botucatu, 740, São Paulo, SP, 04023-062, Brazil
- Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Julio Cesar Martins Monte
- Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- School of Medicine, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil
| | - Oscar Fernando Pavão Santos
- Nephrology Division, Universidade Federal de São Paulo, Rua Botucatu, 740, São Paulo, SP, 04023-062, Brazil
- Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Marcelino de Souza Durão
- Nephrology Division, Universidade Federal de São Paulo, Rua Botucatu, 740, São Paulo, SP, 04023-062, Brazil.
- Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
- School of Medicine, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil.
- Kidney Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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de Barros E Silva PGM, Ferreira AA, Malafaia F, Tavares Reis AFM, Sznejder H, Lopes Junior ACDA, Agostinho CA, Fonseca LHDO, Okitoi DVD, Correa CM, Zincone E, Cury MP, Rosa GAL, Ribeiro HB, Soeiro ADM, de Oliveira CAL, Kuusberg GC, Ohe LN, Souza DDO, Manfredi AB, Martins AF, Sampaio PPN, Vaz TB, Franco LF, Ferreira CEDS, Lopes RD. Potential performance of a 0 h/1 h algorithm and a single cut-off measure of high-sensitivity troponin T in a diverse population: main results of the IN-HOPE study. Eur Heart J Acute Cardiovasc Care 2023; 12:755-764. [PMID: 37450613 DOI: 10.1093/ehjacc/zuad082] [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] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
AIMS Chest pain is a major cause of medical evaluation at emergency department (ED) and demands observation to exclude the diagnosis of acute myocardial infarction (AMI). High-sensitivity cardiac troponin assays used as isolated measure and by 0- and 1-h algorithms are accepted as a rule-in/rule-out strategy, but there is a lack of validation in specific populations. METHODS AND RESULTS The IN-HOspital Program to systematizE Chest Pain Protocol (IN-HOPE study) is a multicentre study that prospectively included patients admitted to the ED due to suspected symptoms of AMI at 16 sites in Brazil. Medical decisions of all patients followed the standard approach of 0 h/3 h protocol, but, in addition, blood samples were also collected at 0 and 1 h and sent to a central laboratory (core lab) to measure high-sensitivity cardiac troponin T (hs-cTnT). To assess the theoretical performance of 0 h/1 h algorithm, troponin < 12 ng/L with a delta < 3 was considered rule-out while a value ≥ 52 or a delta ≥ 5 was considered a rule-in criterion (the remaining were considered as observation group). The main objective of the study was to assess, in a population managed by the 0 h/3 h protocol, the accuracy of 0 h/1 h algorithm overall and in groups with a higher probability of AMI. All patients were followed up for 30 days, and potential events were adjudicated. In addition to the prospective cohort, a retrospective analysis was performed assessing all patients with hs-cTnT measured during the year of 2021 but not included in the prospective cohort, regardless of the indication of the test. A total of 5.497 patients were included (583 in the prospective and 4.914 in the retrospective analysis). The prospective cohort had a mean age of 57.3 (± 14.8) and 45.6% of females with a mean HEART score of 4.0 ± 2.2. By the core lab analysis, 74.4% would be eligible for a rule-out approach (45.3% of them with a HEART score > 3) while 7.3% would fit the rule-in criteria. In this rule-out group, the negative predictive value for index AMI was 100% (99.1-100) overall and regardless of clinical scores. At 30 days, no death or AMI occurred in the rule-out group of both 0/1 and 0/3 h algorithms while 52.4% of the patients in the rule-in group (0 h/1 h) were considered as AMI by adjudication. In the observation group (grey zone) of 0 h/1 h algorithm, GRACE discriminated the risk of these patients better than HEART score. In the retrospective analysis, 1.091 patients had a troponin value of <5 ng/L and there were no cardiovascular deaths at 30 days in this group. Among all 4.914 patients, the 30-day risk of AMI or cardiovascular death increased according to the level of troponin: 0% in the group < 5 ng/L, 0.6% between 5 and 14 ng/L, 2.2% between 14 and 42 ng/L, 6.3% between 42 and 90 ng/L, and 7.7% in the level ≥ 90 ng/L. CONCLUSION In this large multicentre study, a 0 h/1 h algorithm had the potential to classify as rule-in or rule-out in almost 80% of the patients. The rule-out protocol had high negative predictive value regardless of clinical risk scores. Categories of levels of hs-cTn T also showed good accuracy in discriminating risk of the patients with a very favourable prognosis for cardiovascular death in the group with value < 5 ng/L. CLINICALTRIALS.GOV NCT04756362.
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Affiliation(s)
- Pedro G M de Barros E Silva
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Hospital Samaritano Paulista, São Paulo, Brazil
- Brazilian Clinical Research Institute, São Paulo, Brazil
- Centro Universitário São Camilo, São Paulo, Brazil
| | - Ana Amaral Ferreira
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Hospital Pró-Cardíaco, Rio de Janeiro, Brazil
- Instituto Nacional de Cardiologia (INC), Rio de Janeiro, Brazil
| | - Felipe Malafaia
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Hospital Samaritano Paulista, São Paulo, Brazil
| | | | - Henry Sznejder
- Cardiologia Americas/United Health Group, São Paulo, Brazil
| | | | | | | | | | - Celso Musa Correa
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Hospital Vitória-Américas Medical City, Rio de Janeiro, Brazil
- Hospital Samaritano Barra, Rio de Janeiro, Brazil
| | | | - Marcelo Paiva Cury
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Hospital e Maternidade Metropolitano Lapa, São Paulo, Brazil
- Imed Group Brasil, São Paulo, Brazil
| | | | - Henrique Barbosa Ribeiro
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Hospital Samaritano Paulista, São Paulo, Brazil
- InCor-Instituto do Coração do Hospital das Clínicas da FMUSP, São Paulo, Brazil
| | | | | | | | | | | | - Adriana Bertolami Manfredi
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
- Hospital Alvorada Moema, São Paulo, Brazil
| | - Amanda Francisco Martins
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Imed Group Brasil, São Paulo, Brazil
- Hospital Alvorada Moema, São Paulo, Brazil
| | | | - Thiago Baganha Vaz
- Cardiologia Americas/United Health Group, São Paulo, Brazil
- Hospital Samaritano Paulista, São Paulo, Brazil
- Hospital Vitória Anália Franco, São Paulo, Brazil
| | | | | | - Renato Delascio Lopes
- Brazilian Clinical Research Institute, São Paulo, Brazil
- Duke Medical Center, Durham, NC, USA
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Rosseto-Welter EA, Rodrigues SS, de Figueiredo AB, França CN, Oliveira DBL, Bachi ALL, do Amaral JB, Siqueira RA, Bento LC, da Silva AP, Bacal NS, Dos Santos Ferreira CE, Mangueira CLP, Pinho JRR. Cellular and Humoral Immune Responses to Vaccination for COVID-19 Are Negatively Impacted by Senescent T Cells: A Case Report. Vaccines (Basel) 2023; 11:vaccines11040840. [PMID: 37112752 PMCID: PMC10143893 DOI: 10.3390/vaccines11040840] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/04/2023] [Accepted: 03/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Herein, we aimed to follow up on the cellular and humoral immune responses of a group of individuals who initially received the CoronaVac vaccine, followed by a booster with the Pfizer vaccine. METHODS Blood samples were collected: before and 30 days after the first CoronaVac dose; 30, 90, and 180 days after the second CoronaVac dose, and also 20 days after the booster with the Pfizer vaccine. RESULTS Whilst the positivity to gamma interferon-type cellular response increased after the first CoronaVac dose, neutralizing and IgG antibody levels only raised 30 days after the second dose, followed by a drop in these responses after 90 and 180 days. The booster with the Pfizer vaccine elicited a robust cellular and humoral response. A higher number of double-negative and senescent T cells, as well as increased pro-inflammatory cytokines levels were found in the participants with lower humoral immune responses. CONCLUSION CoronaVac elicited an early cellular response, followed by a humoral response, which dropped 90 days after the second dose. The booster with the Pfizer vaccine significantly enhanced these responses. Furthermore, a pro-inflammatory systemic status was found in volunteers who presented senescent T cells, which could putatively impair the immune response to vaccination.
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Affiliation(s)
| | | | | | - Carolina Nunes França
- Post-Graduation Program in Health Sciences, Santo Amaro University, São Paulo 04829-300, Brazil
| | - Danielle Bruna Leal Oliveira
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
- Departmento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo 05508-900, Brazil
| | | | - Jônatas Bussador do Amaral
- ENT Research Lab., Department of Otorhinolaryngology Head and Neck Surgery, Federal University of Sao Paulo (UNIFESP), São Paulo 04021-001, Brazil
| | | | | | | | | | | | | | - João Renato Rebello Pinho
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
- LIM 03/07, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil
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7
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Izar MCDO, Santos Filho RDD, Assad MHV, Chagas ACP, Toledo Júnior ADO, Nogueira ACC, Souto ACCF, Lottenberg AMP, Chacra APM, Ferreira CEDS, Lourenço CM, Valerio CM, Cintra DE, Fonseca FAH, Campana GA, Bianco HT, Lima JGD, Castelo MHCG, Scartezini M, Moretti MA, Barreto NSF, Maia RE, Montenegro Junior RM, Alves RJ, Figueiredo RMM, Fock RA, Martinez TLDR. Brazilian Position Statement for Familial Chylomicronemia Syndrome - 2023. Arq Bras Cardiol 2023; 120:e20230203. [PMID: 37075362 PMCID: PMC10348387 DOI: 10.36660/abc.20230203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | - Ana Maria Pitta Lottenberg
- Laboratório de Lípides (LIM 10) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital Israelita Albert Einstein (HIAE), São Paulo, SP - Brasil
| | - Ana Paula Marte Chacra
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | - Cynthia Melissa Valerio
- Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE-RJ), Rio de Janeiro, RJ - Brasil
| | | | | | | | | | - Josivan Gomes de Lima
- Hospital Universitário Onofre Lopes da Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN - Brasil
| | | | | | - Miguel Antonio Moretti
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | - Renan Magalhães Montenegro Junior
- Complexo Hospitalar da Universidade Federal do Ceará (UFCE), Empresa Brasileira de Serviços Hospitalares (EBSERH), Fortaleza, CE - Brasil
| | - Renato Jorge Alves
- Hospital Santa Casa de Misericórdia de São Paulo, São Paulo, SP - Brasil
| | - Roberta Marcondes Machado Figueiredo
- Hospital Israelita Albert Einstein (HIAE), São Paulo, SP - Brasil
- Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo, SP - Brasil
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8
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Dias VMDCH, Oliveira AF, Marinho AKBB, Santos Ferreira CED, Domingues CEF, Fortaleza CMCB, Vidal CFDL, Carrilho CMDDM, Pinheiro DOBP, de Assis DB, Medeiros EA, Morejón KML, Weissmann L, Michelin L, Carneiro M, Nogueira MDSDP, de Oliveira PRD, Buralli RJ, Stucchi RSB, Lins RS, Costa SF, Chebabo A. COVID-19 and isolation: Risks and implications in the scenario of new variants. Braz J Infect Dis 2022; 26:102703. [PMID: 36100081 PMCID: PMC9444891 DOI: 10.1016/j.bjid.2022.102703] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/01/2022] [Accepted: 08/14/2022] [Indexed: 01/08/2023] Open
Abstract
With the emergence of new variants of SARS-CoV-2, questions about transmissibility, vaccine efficacy, and impact on mortality are important to support decision-making in public health measures. Modifications related to transmissibility combined with the fact that much of the population has already been partially exposed to infection and/or vaccination, have stimulated recommendations to reduce the isolation period for COVID-19. However, these new guidelines have raised questions about their effectiveness in reducing contamination and minimizing impact in work environments. Therefore, a collaborative task force was developed to review the subject in a non-systematic manner, answering questions about SARS-CoV-2 variants, COVID-19 vaccines, isolation/quarantine periods, testing to end the isolation period, and the use of masks as mitigation procedures. Overall, COVID-19 vaccines are effective in preventing severe illness and death but are less effective in preventing infection in the case of the Omicron variant. Any strategy that is adopted to reduce the isolation period should take into consideration the epidemiological situation of the geographical region, individual clinical characteristics, and mask for source control. The use of tests for isolation withdrawal should be evaluated with caution, due to results depending on various conditions and may not be reliable.
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Affiliation(s)
- Viviane Maria de Carvalho Hessel Dias
- Associação Brasileira dos Profissionais em Controle de Infecções e Epidemiologia Hospitalar, São Paulo, SP, Brazil; Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil; Hospital Marcelino Champagnat, Curitiba, PR, Brazil.
| | | | - Ana Karolina Barreto Berselli Marinho
- Associação Brasileira de Alergia e Imunologia, São Paulo, SP, Brazil; Serviço de Imunologia Clínica e Alergia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carlos Eduardo Dos Santos Ferreira
- Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial, São Paulo, SP, Brazil; Laboratório Clínico ‒ Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Laboratório Central ‒ Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | - Claudia Fernanda de Lacerda Vidal
- Associação Brasileira dos Profissionais em Controle de Infecções e Epidemiologia Hospitalar, São Paulo, SP, Brazil; Hospital das Clínicas da Universidade Federal de Pernambuco (HCUFPE), Recife, PE, Brazil
| | | | - Debora Otero Britto Passos Pinheiro
- Associação Brasileira dos Profissionais em Controle de Infecções e Epidemiologia Hospitalar, São Paulo, SP, Brazil; Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil; Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Denise Brandão de Assis
- Divisão de Infecção Hospitalar/Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac/Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brazil
| | - Eduardo Alexandrino Medeiros
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Karen Mirna Loro Morejón
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Leonardo Weissmann
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brazil; Faculdade de Medicina, Universidade de Ribeirão Preto (UNAERP), Guarujá, SP, Brazil
| | - Lessandra Michelin
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade de Caxias do Sul (UCS), Rio Grande do Sul, RS, Brazil
| | - Marcelo Carneiro
- Associação Brasileira dos Profissionais em Controle de Infecções e Epidemiologia Hospitalar, São Paulo, SP, Brazil; Programa de Pós-Graduação Promoção da Saúde, Universidade de Santa Cruz do Sul (UNISC), Hospital Santa Cruz, Santa Cruz do Sul, RS, Brazil
| | | | - Priscila Rosalba Domingos de Oliveira
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rafael Junqueira Buralli
- Coordenação Geral de Saúde do Trabalhador, Departamento de Saúde Ambiental, do Trabalhador e Vigilância das Emergências em Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil
| | - Raquel Silveira Bello Stucchi
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Departamento de Clínica Médica, Área de Infectologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Rodrigo Schrage Lins
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Hospital Naval Marcílio Dias, Rio de Janeiro, RJ, Brazil
| | - Silvia Figueiredo Costa
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alberto Chebabo
- Sociedade Brasileira de Infectologia, São Paulo, SP, Brazil; Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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9
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Klassen A, Faccio AT, Picossi CRC, Derogis PBMC, Dos Santos Ferreira CE, Lopes AS, Sussulini A, Cruz ECS, Bastos RT, Fontoura SC, Neto AMF, Tavares MFM, Izar MC, Fonseca FAH. Evaluation of two highly effective lipid-lowering therapies in subjects with acute myocardial infarction. Sci Rep 2021; 11:15973. [PMID: 34354179 PMCID: PMC8342504 DOI: 10.1038/s41598-021-95455-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 07/23/2021] [Indexed: 01/07/2023] Open
Abstract
For cardiovascular disease prevention, statins alone or combined with ezetimibe have been recommended to achieve low-density lipoprotein cholesterol targets, but their effects on other lipids are less reported. This study was designed to examine lipid changes in subjects with ST-segment elevation myocardial infarction (STEMI) after two highly effective lipid-lowering therapies. Twenty patients with STEMI were randomized to be treated with rosuvastatin 20 mg QD or simvastatin 40 mg combined with ezetimibe 10 mg QD for 30 days. Fasting blood samples were collected on the first day (D1) and after 30 days (D30). Lipidomic analysis was performed using the Lipidyzer platform. Similar classic lipid profile was obtained in both groups of lipid-lowering therapies. However, differences with the lipidomic analysis were observed between D30 and D1 for most of the analyzed classes. Differences were noted with lipid-lowering therapies for lipids such as FA, LPC, PC, PE, CE, Cer, and SM, notably in patients treated with rosuvastatin. Correlation studies between classic lipid profiles and lipidomic results showed different information. These findings seem relevant, due to the involvement of these lipid classes in crucial mechanisms of atherosclerosis, and may account for residual cardiovascular risk. Randomized clinical trial: ClinicalTrials.gov, NCT02428374, registered on 28/09/2014.
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Affiliation(s)
- Aline Klassen
- Department of Chemistry, Federal University of Sao Paulo (UNIFESP), Diadema, SP, Brazil.
| | - Andrea Tedesco Faccio
- Center for Multiplatform Metabolomics Studies (CEMM), Institute of Chemistry, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - Carolina Raissa Costa Picossi
- Center for Multiplatform Metabolomics Studies (CEMM), Institute of Chemistry, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | | | | | - Aline Soriano Lopes
- Department of Chemistry, Federal University of Sao Paulo (UNIFESP), Diadema, SP, Brazil
| | - Alessandra Sussulini
- Department of Analytical Chemistry, Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), P.O. Box 6154, Campinas, SP, 13083-970, Brazil
| | - Elisa Castañeda Santa Cruz
- Department of Analytical Chemistry, Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), P.O. Box 6154, Campinas, SP, 13083-970, Brazil
| | - Rafaela Tudela Bastos
- Department of Chemistry, Federal University of Sao Paulo (UNIFESP), Diadema, SP, Brazil
| | | | | | - Marina Franco Maggi Tavares
- Center for Multiplatform Metabolomics Studies (CEMM), Institute of Chemistry, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - Maria Cristina Izar
- Division of Cardiology, Department of Medicine, Federal University of Sao Paulo (UNIFESP), Rua Loefgren 1350, São Paulo, SP, CEP 04040-001, Brazil
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10
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Sitnik R, Maluf MM, Oliveira KG, Siqueira RA, Ferreira CEDS, Mangueira CLP, Azevedo RS, Ferraz MLCG, Correa MCJM, Ferreira PRA, Mendes Pereira GF, de Souza FMA, Pimenta C, Pinho JRR. Study protocol: epidemiological and clinical characteristics of acute viral hepatitis in Brazilian health services. BMJ Open 2021; 11:e045852. [PMID: 34244259 PMCID: PMC8273480 DOI: 10.1136/bmjopen-2020-045852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Acute viral hepatitis is a disease of great clinical importance. This study proposes actions to better characterise cases of acute hepatitis in Brazil and to provide relevant information to institutionalised health policies within the Unified Health System. Available data on acute hepatitis in Brazil need to be re-evaluated regarding the different hepatotropic agent (hepatitis A to E virus) frequencies, as well as other agents that can cause similar clinical conditions, such as Herpes Simplex Virus 1 and 2(HSV1, HSV2), Varicella Zoster Virus (VZV), Cytomegalovirus (CMV), Epstein Barr Virus (EBV), Human Herpes Virus 6 and 7 (HHV6, HHV7), arbovirus (yellow fever, dengue, chikungunya, Zika), parvovirus B19, adenovirus, parechovirus, enterovirus, HIV, leptospirosis, toxoplasmosis and syphilis, in addition to autoimmune hepatitis. In this context, the primary aim of this study is the clinical-epidemiological and molecular characterisation of acute viral hepatitis in Brazilian health services from all geographical regions of the country. The present article describes the study protocol. METHODS AND ANALYSIS This study will evaluate 2280 patients with symptoms and/or signs suggestive of acute liver disease in Brazilian health institutions in all five geographic Brazilian regions. Demographic, epidemiological and clinical data will be collected, as well as blood samples to be analysed at Hospital Israelita Albert Einstein Clinical Laboratory. ETHICS AND DISSEMINATION Ethics approval was obtained at the national research ethics committee (Conselho Nacional de Ética em Pesquisa- CONEP-CAAE 00952818.4.1001.0071) and at all participating sites. Results will be published in journals and presented at scientific meetings.
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Affiliation(s)
- Roberta Sitnik
- Laboratório de Patologia Clínica e de Anatomia Patológica, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Maira Marranghello Maluf
- Laboratório de Patologia Clínica e de Anatomia Patológica, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Ketti G Oliveira
- Laboratório de Patologia Clínica e de Anatomia Patológica, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Ricardo Andreotti Siqueira
- Laboratório de Patologia Clínica e de Anatomia Patológica, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | | | | | - Raymundo Soares Azevedo
- Department of Pathology, LIM01, Universidade de São Paulo Faculdade de Medicina, Sao Paulo, Brazil
| | | | | | | | - Gerson Fernando Mendes Pereira
- Department of Chronic Conditions Diseases and Sexually Transmitted Infections, Secretariat for Health Surveillance, Ministry of Health of Brazil, Brasilia, Brazil
| | - Flávia Moreno Alves de Souza
- Department of Chronic Conditions Diseases and Sexually Transmitted Infections, Secretariat for Health Surveillance, Ministry of Health of Brazil, Brasilia, Brazil
| | - Cristina Pimenta
- Department of Chronic Conditions Diseases and Sexually Transmitted Infections, Secretariat for Health Surveillance, Ministry of Health of Brazil, Brasilia, Brazil
| | - João Renato Rebello Pinho
- Laboratório de Patologia Clínica e de Anatomia Patológica, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
- Department of Pathology, LIM03 and Department of Gastroenterology, LIM07, Universidade de São Paulo Faculdade de Medicina, Sao Paulo, Brazil
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11
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Izar MCDO, Fonseca HARD, França CN, Machado VA, Ferreira CEDS, Fonseca FAH. Rare Presentation of Dercum's Disease in a Child with Abnormalities in Lipoprotein Metabolism. Arq Bras Cardiol 2019; 111:755-757. [PMID: 30484519 PMCID: PMC6248242 DOI: 10.5935/abc.20180191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 04/10/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
| | | | - Carolina Nunes França
- Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo, SP - Brazil
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12
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Faludi AA, Izar MCDO, Saraiva JFK, Chacra APM, Bianco HT, Afiune A, Bertolami A, Pereira AC, Lottenberg AM, Sposito AC, Chagas ACP, Casella A, Simão AF, Alencar ACD, Caramelli B, Magalhães CC, Negrão CE, Ferreira CEDS, Scherr C, Feio CMA, Kovacs C, Araújo DBD, Magnoni D, Calderaro D, Gualandro DM, Mello EPD, Alexandre ERG, Sato EI, Moriguchi EH, Rached FH, Santos FCD, Cesena FHY, Fonseca FAH, Fonseca HARD, Xavier HT, Mota ICP, Giuliano IDCB, Issa JS, Diament J, Pesquero JB, Santos JED, Faria JR, Melo JXD, Kato JT, Torres KP, Bertolami MC, Assad MHV, Miname MH, Scartezini M, Forti NA, Coelho OR, Maranhão RC, Santos RDD, Alves RJ, Cassani RL, Betti RTB, Carvalho TD, Martinez TLDR, Giraldez VZR, Salgado W. ATUALIZAÇÃO DA DIRETRIZ BRASILEIRA DE DISLIPIDEMIAS E PREVENÇÃO DA ATEROSCLEROSE - 2017. Arq Bras Cardiol 2017; 109:1-76. [PMID: 28813069 DOI: 10.5935/abc.20170121] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [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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13
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Scartezini M, Ferreira CEDS, Izar MCO, Bertoluci M, Vencio S, Campana GA, Sumita NM, Barcelos LF, Faludi AA, Santos RD, Malachias MVB, Aquino JL, Galoro CADO, Sabino C, Gurgel MHC, Turatti LAA, Hohl A, Martinez TLDR. Positioning about the Flexibility of Fasting for Lipid Profiling. Arq Bras Cardiol 2017; 108:195-197. [PMID: 28443960 PMCID: PMC5389867 DOI: 10.5935/abc.20170039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
| | | | | | - Marcello Bertoluci
- Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brazil
| | - Sergio Vencio
- Sociedade Brasileira de Diabetes, São Paulo, SP, Brazil
| | - Gustavo Aguiar Campana
- Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial, Rio de Janeiro, RJ, Brazil
| | - Nairo Massakazu Sumita
- Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial, Rio de Janeiro, RJ, Brazil
| | | | - André A Faludi
- Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ, Brazil
| | - Raul D Santos
- Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Cleide Sabino
- Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brazil
| | | | | | - Alexandre Hohl
- Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brazil
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Curiati MNC, Silvestre OM, Pires LJT, Mangini S, Pires PV, Gaiotto FA, Laurino AM, Pêgo-Fernandes PM, Ferreira CEDS, Bacal F. Agreement of BNP and NT-proBNP and the influence of clinical and laboratory variables. Einstein (Sao Paulo) 2014; 11:273-7. [PMID: 24136751 PMCID: PMC4878583 DOI: 10.1590/s1679-45082013000300003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 08/24/2013] [Indexed: 12/01/2022] Open
Abstract
Objective: To correlate the serum levels of B type natriuretic peptide and the N-terminal fraction of the pro-B type natriuretic peptide, as well as to analyze the influence of age, obesity, renal failure, left ventricle ejection fraction, diastolic dysfunction, and anemia on serum levels of both markers. Methods: An observational study in which the agreement was compared between these markers in consecutive samples of 138 patients. For the correlation, Pearson's test was used, and p<0.05 was considered statistically significant. Results: A linear association was observed between the B type natriuretic peptide and N-terminal fraction of the pro-B type natriuretic peptide (r = 0.907; p<0.001). When evaluating the categorized measurements as normal and altered, there was good agreement, with 90.6% of agreement classifications (p<0.001) in which altered values of the N-terminal fraction of the pro-B type natriuretic peptide and normal values of the B type natriuretic peptide represented 8.7% of the total; the opposite situation represented 1% of the total. Assessment of the influence of the clinical and laboratorial factors on the levels of natriuretic peptides showed that they rise according to age, but that they fall as the ejection fraction increases. Patients with anemia (p<0.001) or with renal failure (p=0.007) had higher values of both markers. There was no association between obesity and the B type natriuretic peptide. Conclusion: There was satisfactory agreement between the B type natriuretic peptide and the N-terminal fraction of the pro-B type natriuretic peptide. Age, creatinine levels, and hemoglobin, as well as ventricular function, influence the serum levels of both natriuretic peptides.
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