Showing papers by "Remo H.M. Furtado published in 2021"
TL;DR: In this paper, the authors compared the efficacy and safety of therapeutic versus prophylactic anticoagulation in patients hospitalised with COVID-19 in 31 sites in Brazil, and found that in the case of stable patients, in-hospital oral rivaroxaban (20 mg or 15 mg daily) or initial subcutaneous enoxaparin (1 mg/kg twice per day) or intravenous unfractionated heparin (to achieve a 0·3-0·7 IU/mL anti-Xa concentration) for clinically unstable patients, followed
326 citations
University of Missouri–Kansas City1, The George Institute for Global Health2, AstraZeneca3, University of São Paulo4, University of North Carolina at Chapel Hill5, National University of Cordoba6, University of Cambridge7, St. Michael's Hospital8, University of Toronto9, Max Super Speciality Hospital10, University of Mississippi Medical Center11, NorthShore University HealthSystem12, Washington University in St. Louis13, Universidade Federal de Goiás14, Hospital de Base15
TL;DR: The DARE-19 trial as discussed by the authors was a randomized, double-blind, placebo-controlled trial of patients hospitalised with COVID-19 and with at least one cardiometabolic risk factor (i.e., hypertension, type 2 diabetes, atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease).
118 citations
University of São Paulo1, Escola Bahiana de Medicina e Saúde Pública2, Duke University3, Federal University of Rio de Janeiro4, Federal University of Pernambuco5, Federal University of Bahia6, Federal University of São Paulo7, Federal University of Maranhão8, Federal University of Ceará9, Faculdade de Medicina de São José do Rio Preto10, Pontifícia Universidade Católica do Rio Grande do Sul11, Universidade Estadual de Londrina12, Rio de Janeiro State University13, Universidade Salvador14, State University of Campinas15, Mackenzie Investments16, Universidade Federal de Ciências da Saúde de Porto Alegre17, University of Fortaleza18
TL;DR: Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instavel and Infarto Agudo do Miocardio sem Supradesnivel do Segmento ST.
Abstract: Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instavel e Infarto Agudo do Miocardio sem Supradesnivel do Segmento ST – 2021
63 citations
TL;DR: In this article, the authors evaluated platelet reactivity in stable patients diagnosed with COVID-19 and hospitalized with respiratory symptoms (mainly dyspnoea and dry cough), in comparison with a control group comprised of non-hospitalized healthy controls.
Abstract: COVID-19 is associated with an increased risk of thrombotic events. However, the contribution of platelet reactivity (PR) to the aetiology of the increased thrombotic risk associated with COVID-19 remains unclear. Our aim was to evaluate PR in stable patients diagnosed with COVID-19 and hospitalized with respiratory symptoms (mainly dyspnoea and dry cough), in comparison with a control group comprised of non-hospitalized healthy controls. Observational, case control study that included patients with confirmed COVID-19 (COVID-19 group, n = 60) and healthy individuals matched by age and sex (control group, n = 60). Multiplate electrode aggregometry (MEA) tests were used to assess PR with adenosine diphosphate (MEA-ADP, low PR defined as < 53 AUC), arachidonic acid (MEA-ASPI, low PR < 86 AUC) and thrombin receptor-activating peptide 6 (MEA-TRAP, low PR < 97 AUC) in both groups. The rates of low PR with MEA-ADP were 27.5% in the COVID-19 group and 21.7% in the control group (OR = 1.60, p = 0.20); with MEA-ASPI, the rates were, respectively, 37.5% and 22.5% (OR = 3.67, p < 0.001); and with MEA-TRAP, the incidences were 48.5% and 18.8%, respectively (OR = 9.58, p < 0.001). Levels of d-dimer, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) were higher in the COVID-19 group in comparison with the control group (all p < 0.05). Thromboelastometry was utilized in a subgroup of patients and showed a hypercoagulable state in the COVID-19 group. Patients hospitalized with non-severe COVID-19 had lower PR compared to healthy controls, despite having higher levels of d-dimer, fibrinogen, and PAI-1, and hypercoagulability by thromboelastometry. ClinicalTrials.gov identifier, NCT04447131.
19 citations
TL;DR: Adding evolocumab to statin therapy significantly reduced the risk of developing complex coronary disease requiring revascularization, including complex PCI and CABG individually.
19 citations
TL;DR: Action as discussed by the authors is an academic-led, pragmatic, multicenter, open-label, randomized, phase IV clinical trial that aims to enroll around 600 patients at 40 sites participating in the Coalition COVID-19 Brazil initiative.
15 citations
TL;DR: In this paper, the authors evaluated if a platelet reactivity-based strategy is non-inferior to standard of care for 24-day post-CABG bleeding.
10 citations
TL;DR: A terapia precoce com estatina associou-se independentemente com menor incidência of hiperglicemia durante a internação hospitalar.
Abstract: Resumo Fundamento O maior risco de se desenvolver diabetes com o uso de estatinas e um desafio para a seguranca do uso dessa classe de medicamentos em longo prazo. No entanto, poucos estudos analisaram essa questao durante sindromes coronarianas agudas (SCA). Objetivos Investigar a associacao entre inicio precoce da terapia com estatina e niveis de glicemia em pacientes admitidos com SCA. Metodos Este foi um estudo retrospectivo de pacientes hospitalizados por SCA. Pacientes que nunca haviam usado estatinas foram incluidos e divididos segundo uso ou nao de estatina nas primeiras 24 horas de internacao. O desfecho primario foi a incidencia de hiperglicemia na internacao (definida como pico de glicemia > 200mg/dL). Modelos de regressao logistica e modelos lineares multivariados foram usados para ajuste quanto a fatores de confusao e um modelo de pareamento por escore de propensao foi desenvolvido para comparacoes entre os dois grupos de interesses. Um valor de p menor que 0,05 foi considerado estatisticamente significativo. Resultados Um total de 2357 pacientes foram incluidos, 1704 deles alocados no grupo que receberam estatinas e 653 no grupo que nao receberam estatinas nas primeiras 24 horas de internacao. Apos os ajustes, uso de estatina nas primeiras 24 horas foi associado com uma menor incidencia de hiperglicemia durante a internacao (OR ajustado = 0,61, IC95% 0,46-0,80; p < 0,001) e menor necessidade de uso de insulina (OR ajustado = 0,56, IC 95% 0,41-0,76; p < 0,001). Essas associacoes mantiveram-se similares nos modelos de pareamento por escore de propensao, bem como apos analises de sensibilidade, como exclusao de pacientes que desenvolveram choque cardiogenico, infeccao grave ou pacientes que foram a obito durante a internacao hospitalar. Conclusoes Entre os pacientes internados com SCA que nao receberam estatinas previamente, a terapia precoce com estatina associou-se independentemente com menor incidencia de hiperglicemia durante a internacao. (Arq Bras Cardiol. 2021; 116(2):285-294)
1 citations
TL;DR: In this article, the authors retrospectively analyzed 1,632 patients who were working prior to hospitalization for acute coronary syndrome (ACS) in a quaternary hospital and were followed-up for up to 17 years.