Pesquisa | SciELO

Abstract Background Strategies aimed at improving the diagnosis and treatment of cardiovascular diseases (CVD) are of utmost importance. Clinical decision support systems (CDSS) are guided by updated guidelines and may be capable of benefiting screening and early diagnosis initiatives in remote regions. Objective To develop a CDSS for screening hypertension and diabetes mellitus (DM), as well as to assess its feasibility and usability in the context of a primary care setting in a resource-constrained region. Methods This research focused on the strategy of screening hypertension and DM based on CDSS. A software was developed and implemented in 10 municipalities in the Northeast of the state of Minas Gerais, Brazil, from April 2017 to October 2018. Patients of 30 to 69 years of age were attended by primary care practitioners using the software. A Likert-scale questionnaire with 15 questions to assess usability (System Usability Scale) and satisfaction was applied to the professionals at the end of study. Groups were compared by applying the chi-squared test for categorical variables. Statistical significance was considered as p < 0.05. Results In the field study, 13,775 individuals were assessed; 185 patients were diagnosed with hypertension; 35 were diagnosed with DM, and 5 were diagnosed with both diseases. For the usability and satisfaction assessment, 258 healthcare professionals participated. Fifty-one percent considered their prior knowledge for the use of technologies to be good; 53.7% reported a desire to use the application frequently, and 78.4% would recommend the platform. Conclusion The implementation of a CDSS developed to assist in the screening of hypertension and DM was feasible in the context of a primary care setting in a resource-constrained region, with good user satisfaction. CVD (CVD importance (CDSS regions , (DM) resourceconstrained resource constrained region 1 Gerais Brazil 201 2018 3 6 Likertscale Likert scale System Scale study chisquared chi squared variables 005 0 05 0.05 13775 13 775 13,77 assessed 18 assessment 25 participated Fiftyone Fifty one 537 53 7 53.7 frequently 784 78 4 78.4 platform (DM 20 00 0.0 1377 77 13,7 2 53. 78. 0. 137 13,

https://doi.org/10.36660/ijcs.20230085

[SciELO Preprints] - Cardiovascular Statistics – Brazil 2023
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Oliveira, Gláucia Maria Moraes de Brant, Luisa Campos Caldeira Polanczyk, Carisi Anne Malta, Deborah Carvalho Biolo, Andreia Nascimento, Bruno Ramos Souza, Maria de Fatima Marinho de Lorenzo, Andrea Rocha De Fagundes Júnior, Antonio Aurélio de Paiva Schaan, Beatriz D. Silva, Christina Grüne de Souza e Castilho, Fábio Morato de Cesena, Fernando Henpin Yue Soares, Gabriel Porto Xavier Junior, Gesner Francisco Barreto-Filho, Jose Augusto Soares Passaglia, Luiz Guilherme Pinto-Filho, Marcelo Martins Machline-Carrion, M. Julia Bittencourt, Marcio Sommer Pontes Neto, Octavio M. Villela, Paolo Blanco Teixeira, Renato Azeredo Stein, Ricardo Sampaio, Roney Orismar Gaziano, Thomaz A. Perel, Pablo Roth, Gregory A. Ribeiro, Antonio Luiz Pinho

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Data de publicação: 2023-12-14

Resumo: En Pt

The publication Cardiovascular Statistics – Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil.  The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke.  Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG). 

A publicação Estatística Cardiovascular – Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil.  Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG). 

https://doi.org/10.1590/SciELOPreprints.7707

Evaluation of the properties of WHODAS-12 measurements in individuals with Chagas disease in Brazil WHODAS12 WHODAS 12 WHODAS-1 WHODAS1 1 WHODAS-
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Tavares, Patrícia Aparecida

; Oliveira, Cláudia Di Lorenzo

; Ferreira, Ariela Mota

; Baldoni, Nayara Ragi

; Quintino, Nayara Dornela

; Haikal, Desiree Sant’Ana

; Bierrenbach, Ana Luiza

; Ribeiro, Antonio Luiz Pinho

; Sabino, Ester Cerdeira

; Cardoso, Clareci Silva

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e30

Resumo: En | Texto: En | PDF: En

ABSTRACT Numerous tests employed to predict cardiac and functional status are expensive and not widely accessible for a considerable number of patients, particularly those diagnosed with Chagas disease (CD) residing in remote and endemic regions. To date, there is no knowledge of studies that have validated instruments that address functionality in an expanded way, including the biopsychosocial factors in patients with CD. This study aims to evaluate the psychometric properties of the World Health Organization Disability Assessment Schedule (WHODAS 2.0), in its 12-item shortened version (WHODAS-12) when applied to patients with CD. This is a cross-sectional study of a prospective cohort that follows individuals with CD (SaMi-Trop). Data collection took place between October 2019 and March 2020. In the interviews, sociodemographic information, life habits, clinical information, and indicators of disability measured by WHODAS-12 were collected. Descriptive analysis, internal consistency and construct validity of the instrument were performed. A total of 628 patients with CD were interviewed, most were women (69.5%), their mean age was of 57 years, and most declared an average self-perception of health (43.4%). The 12 items of WHODAS-12 were distributed into three factors, which together account for 61% of the variance. The Kaiser–Meyer–Olkin (KMO) index was 0.90, indicating adequacy of the sample for factor analysis. The internal consistency of the global scale showed alpha = 0.87. The percentage of incapacity was 16.05%, indicating mild incapacity for the evaluated patients. WHODAS-12 is a valid and reliable measure to assess the disability of the Brazilian population with CD. (CD regions date way WHODAS 2.0, 20 2.0 , 2 0 2.0) 12item item WHODAS12 (WHODAS-12 crosssectional cross sectional SaMiTrop. SaMiTrop SaMi Trop . (SaMi-Trop) 201 2020 interviews information habits WHODAS-1 collected analysis performed 62 interviewed 69.5%, 695 69.5% 69 5 (69.5%) years selfperception self perception 43.4%. 434 43.4% 43 4 (43.4%) 1 61 variance KaiserMeyerOlkin Kaiser Meyer Olkin KMO (KMO 090 90 0.90 087 87 0.87 1605 16 05 16.05% 2. WHODAS1 (WHODAS-1 (SaMi-Trop 202 WHODAS- 6 69.5 (69.5% 43.4 (43.4% 09 9 0.9 08 8 0.8 160 16.05 (WHODAS- 69. (69.5 43. (43.4 0. 16.0 (69. (43. 16. (69 (43 (6 (4 (

https://doi.org/10.1590/s1678-9946202365030

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio

; Rassi Jr, Anis

; Oliveira, Gláucia Maria Moraes

; Correia, Luís Claudio Lemos

; Ramos Júnior, Alberto Novaes

; Luquetti, Alejandro Ostermayer

; Hasslocher-Moreno, Alejandro Marcel

; Sousa, Andréa Silvestre de

; Paola, Angelo Amato Vincenzo de

; Sousa, Antônio Carlos Sobral

; Ribeiro, Antonio Luiz Pinho

; Correia Filho, Dalmo

; Souza, Dilma do Socorro Moraes de

; Cunha-Neto, Edecio

; Ramires, Felix Jose Alvarez

; Bacal, Fernando

; Nunes, Maria do Carmo Pereira

; Martinelli Filho, Martino

; Scanavacca, Maurício Ibrahim

; Saraiva, Roberto Magalhães

; Oliveira Júnior, Wilson Alves de

; Lorga-Filho, Adalberto Menezes

; Guimarães, Adriana de Jesus Benevides de Almeida

; Braga, Adriana Lopes Latado

; Oliveira, Adriana Sarmento de

; Sarabanda, Alvaro Valentim Lima

; Pinto, Ana Yecê das Neves

; Carmo, Andre Assis Lopes do

; Schmidt, Andre

; Costa, Andréa Rodrigues da

; Ianni, Barbara Maria

; Markman Filho, Brivaldo

; Rochitte, Carlos Eduardo

; Macêdo, Carolina Thé

; Mady, Charles

; Chevillard, Christophe

; Virgens, Cláudio Marcelo Bittencourt das

; Castro, Cleudson Nery de

; Britto, Constança Felicia De Paoli de Carvalho

; Pisani, Cristiano

; Rassi, Daniela do Carmo

; Sobral Filho, Dário Celestino

; Almeida, Dirceu Rodrigues de

; Bocchi, Edimar Alcides

; Mesquita, Evandro Tinoco

; Mendes, Fernanda de Souza Nogueira Sardinha

; Gondim, Francisca Tatiana Pereira

; Silva, Gilberto Marcelo Sperandio da

; Peixoto, Giselle de Lima

; Lima, Gustavo Glotz de

; Veloso, Henrique Horta

; Moreira, Henrique Turin

; Lopes, Hugo Bellotti

; Pinto, Ibraim Masciarelli Francisco

; Ferreira, João Marcos Bemfica Barbosa

; Nunes, João Paulo Silva

; Barreto-Filho, José Augusto Soares

; Saraiva, José Francisco Kerr

; Lannes-Vieira, Joseli

; Oliveira, Joselina Luzia Menezes

; Armaganijan, Luciana Vidal

; Martins, Luiz Cláudio

; Sangenis, Luiz Henrique Conde

; Barbosa, Marco Paulo Tomaz

; Almeida-Santos, Marcos Antonio

; Simões, Marcos Vinicius

; Yasuda, Maria Aparecida Shikanai

; Moreira, Maria da Consolação Vieira

; Higuchi, Maria de Lourdes

; Monteiro, Maria Rita de Cassia Costa

; Mediano, Mauro Felippe Felix

; Lima, Mayara Maia

; Oliveira, Maykon Tavares de

; Romano, Minna Moreira Dias

; Araujo, Nadjar Nitz Silva Lociks de

; Medeiros, Paulo de Tarso Jorge

; Alves, Renato Vieira

; Teixeira, Ricardo Alkmim

; Pedrosa, Roberto Coury

; Aras Junior, Roque

; Torres, Rosalia Morais

; Povoa, Rui Manoel dos Santos

; Rassi, Sergio Gabriel

; Alves, Silvia Marinho Martins

; Tavares, Suelene Brito do Nascimento

; Palmeira, Swamy Lima

; Silva Júnior, Telêmaco Luiz da

; Rodrigues, Thiago da Rocha

; Madrini Junior, Vagner

; Brant, Veruska Maia da Costa

; Dutra, Walderez Ornelas

; Dias, João Carlos Pinto

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 Nº 6 elocation e20230269

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.36660/abc.20230269

Estatísticas Cardiovasculares do Programa Boas Práticas em Cardiologia – Dados de um Hospital Público Terciário Brasileiro
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Passaglia, Luiz Guilherme

; Cerqueira, Marina Lírio Resende

; Pires, Mariana Martins

; Chagas, Lucas Vieira

; Cunha, Carolina Teixeira

; Rodrigues, Erika Nunes de Oliveira

; Diniz, Flávia Mariana Mendes

; Ferreira, Darkiane Fernandes

; Nogueira, Monique Rocha

; Braga, Gisia Teodoro

; Taniguchi, Fábio P.

; Ribeiro, Antonio Luiz Pinho

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 Nº 2 elocation e20220247

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Background The Good Practices in Cardiology Program is an initiative created by the Brazilian Society of Cardiology (SBC) to improve the quality of care of cardiovascular disease patients in Brazilian public hospitals. Objectives To characterize patients admitted to a tertiary public hospital with diagnosis of acute coronary syndrome (ACS) or heart failure (HF) and to evaluate performance indicators in both ACS and HF arms, with a pre-established target of 85% adherence to the SBC recommendations. Methods This was a descriptive cross-sectional study through data collection of patients hospitalized between May 2016 and September 2019. Results A total of 1,036 patients were included, 273 in the HF arm and 763 in the ACS arm. Mean age was 59.8 ± 12.0 years in the ACS and 57.0 ± 14.1 years in the HF, with a predominance of male patients in both groups. More than half of patients had some primary education and more than 90% reported a monthly income of less than five minimum wages. In ACS, the diagnosis of ACS with ST segment elevation was predominant (66.3%), and 2.9% of patients died. In HF, the most common etiology was Chagas disease (25.8%), and 17.9% died. Analysis of the performance indicators revealed an adherence rate higher than 85% to nine of the 12 indicators. Conclusion Quality programs are essential for improvement of quality of care. Performance indicators pointed to a good adherence to the SBC guidelines, mainly in the ACS arm. (SBC hospitals (ACS (HF arms preestablished pre established 85 recommendations crosssectional cross sectional 201 2019 1036 1 036 1,03 included 27 76 598 59 8 59. 120 0 12. 570 57 57. 141 14 14. groups 90 wages 66.3%, 663 66.3% , 66 3 (66.3%) 29 2 9 2.9 died 25.8%, 258 25.8% 25 (25.8%) 179 17 17.9 guidelines 20 103 03 1,0 7 5 66.3 6 (66.3% 2. 25.8 (25.8% 17. 10 1, 66. (66.3 25. (25.8 (66. (25. (66 (25 (6 (2 (

Resumo Fundamento O Programa Boas Práticas em Cardiologia é uma iniciativa da Sociedade Brasileira de Cardiologia (SBC) destinada à melhoria do cuidado cardiovascular nos hospitais públicos brasileiros. Objetivos Descrever características dos pacientes internados com Síndrome Coronariana Aguda (SCA) e Insuficiência Cardíaca (IC) e avaliar os indicadores de desempenho alcançados nos braços (SCA e IC) em um hospital público terciário, com uma meta pré-estabelecida de 85% de aderência às recomendações da SBC. Métodos Estudo do tipo transversal descritivo realizado por meio da coleta de dados de pacientes que estiveram internados entre maio de 2016 e setembro de 2019. Resultados Foram incluídos 1036 pacientes, 273 pacientes no braço IC e 763 no braço SCA. A média de idade foi de 59,8 ± 12,0 anos na SCA e 57,0 ± 14,1 anos na IC, com predomínio do sexo masculino em ambos os grupos. Mais da metade dos pacientes não tinham ensino fundamental completo e mais de 90% declararam renda mensal inferior a cinco salários-mínimos. Na SCA, predominou o diagnóstico de SCA com supradesnivelamento do segmento ST (66,3%) e 2,9% dos pacientes foram a óbito. Na IC, a etiologia mais comum foi a Doença de Chagas (25,8%) e 17,9% dos pacientes foram a óbito. Na avaliação dos indicadores de desempenho, nove dos 12 indicadores tiveram taxas de aderência acima de 85%. Conclusão Programas de qualidade são essenciais à melhoria do cuidado e os indicadores de desempenho do hospital apontam para uma boa adesão às diretrizes assistenciais da SBC, particularmente no braço da SCA. SBC (SBC brasileiros (IC terciário préestabelecida pré estabelecida 85 201 2019 103 27 76 598 59 8 59, 120 0 12, 570 57 57, 141 14 1 14, grupos 90 saláriosmínimos. saláriosmínimos salários mínimos. mínimos salários-mínimos 66,3% 663 66 3 (66,3% 29 2 9 2,9 óbito 25,8% 258 25 (25,8% 179 17 17,9 20 10 7 5 66,3 6 (66,3 2, 25,8 (25,8 17, 66, (66, 25, (25, (66 (25 (6 (2 (

https://doi.org/10.36660/abc.20220247

Health Literacy, Patient Knowledge and Adherence to Oral Anticoagulation in Primary Care Literacy
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Marcolino, Milena Soriano

; Sales, Thaís Lorenna Souza

; Oliveira, João Antônio de

; Rios, Danyelle Romana Alves

; Pedroso, Thaís Marques

; Sá, Laura Caetano de

; Martins, Maria Auxiliadora

; Ribeiro, Antonio Luiz Pinho

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220158

Resumo: En | Texto: En | PDF: En

Abstract Background Warfarin is the only oral anticoagulant available in the Brazilian public health system. Health knowledge and treatment are essential to achieving the desirable therapeutic effect. However, data on these aspects among primary care patients are still lacking. Objective To assess health literacy, patient knowledge, and adherence to oral anticoagulation with warfarin, as well as the medication regimen complexity in primary health units in the municipality of Divinópolis, Minas Gerais, Brazil. Methods This cross-sectional study included patients using warfarin from primary care settings. Sociodemographic and clinical data were collected from medical records. Short Assessment of Health Literacy for Portuguese-Speaking Adults (SAHLPA-18), Oral Anticoagulation Knowledge (OAK), adaptation of the Measure of Adherence to Treatment (MAT-adapted) to oral anticoagulation, and Medication Regimen Complexity Index (MRCI) were applied, and the time in therapeutic range (TTR) was calculated. Patients were stratified in two groups (TTR < 60% and TTR ≥ 60%) and compared using Fisher's exact test at a significance level of p < 0.050. Results Analysis included 162 patients (64.8 ± 12.7 years old, 55.6% women). Nonvalvular atrial fibrillation (26.5%) and venous thromboembolism (24.1%) were the main indications for warfarin, and 67.9%, 88.3%, and 16.7% of the patients had inadequate health literacy, insufficient knowledge regarding anticoagulant therapy, and non-adherence to warfarin therapy, respectively. There was no significant association of these parameters in relation to TTR. MRCI showed high pharmacotherapy complexity between the drug prescriptions. Conclusion This study showed alarming insufficient knowledge about warfarin therapy and low health literacy in primary care patients. system effect However lacking Divinópolis Gerais Brazil crosssectional cross sectional settings records PortugueseSpeaking Portuguese Speaking SAHLPA18, SAHLPA18 SAHLPA 18 , (SAHLPA-18) OAK, OAK (OAK) MATadapted MAT adapted (MAT-adapted (MRCI applied calculated 60 Fishers Fisher s 0050 0 050 0.050 16 64.8 648 64 8 (64. 127 12 7 12. old 556 55 6 55.6 women. women . women) 26.5% 265 26 5 (26.5% 24.1% 241 24 1 (24.1% 679 67 9 67.9% 883 88 3 88.3% 167 16.7 nonadherence non respectively prescriptions SAHLPA1 (SAHLPA-18 (OAK 005 05 0.05 64. (64 55. 26.5 2 (26.5 24.1 (24.1 67.9 88.3 16. (SAHLPA-1 00 0.0 (6 26. (26. 24. (24. 67. 88. (SAHLPA- 0. ( (26 (24 (SAHLPA (2

https://doi.org/10.36660/ijcs.20220158

Chagas disease and perceived quality of life: a cross-sectional study life crosssectional cross sectional
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Baldoni, Nayara Ragi

; Quintino, Nayara Dornela

; Oliveira, Claudia Di Lorenzo

; Silva, José Luiz Padilha da

; Ferreira, Ariela Mota

; Ribeiro, Antonio Luiz Pinho

; Sabino, Ester Cerdeira

; Cardoso, Clareci Silva

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0206-2023

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Chagas disease (ChD) is a neglected tropical disease that is caused by the protozoan parasite Trypanosoma cruzi and can negatively impact quality of life (QoL). This study aimed to assess and compare QoL between individuals with and without ChD. Methods: This cross-sectional study was performed within a concurrent cohort study (REDS). The participants were derived from two blood donation centers: São Paulo capital and Montes Claros, Minas Gerais, Brazil. Participants with ChD were identified in blood donations by serological diagnosis between 2008 and 2010, and those without ChD were donors with negative serology identified during the same period. QoL was assessed using the World Health Organization Quality of Life-BREF questionnaire. Logistic regression was used to compare sociodemographic and clinical characteristics between the groups, and mean, standard deviation, and beta regression were used to compare QoL. Results: In total, 611 individuals participated in the study (328 with ChD and 283 without ChD). Participants with ChD had lower QoL in the physical (p=0.02) and psychological (p<0.01) domains than did individuals without CD. Conclusions: Individuals with ChD had worse QoL perceptions. These results provide a comprehensive understanding of the impact of ChD on individuals' QoL, while also highlighting potential opportunities for improving the care and treatment of those affected. Background (ChD . (QoL) Methods crosssectional cross sectional REDS. REDS (REDS) centers Claros Gerais Brazil 200 2010 period LifeBREF Life BREF questionnaire groups mean deviation Results total 61 328 (32 28 ChD) p=0.02 p002 p 0 02 (p=0.02 p<0.01 p001 01 (p<0.01 CD Conclusions perceptions affected (QoL (REDS 20 201 6 32 (3 2 p=0.0 p00 (p=0.0 p<0.0 (p<0.0 3 ( p=0. p0 (p=0. p<0. (p<0. p=0 (p=0 p<0 (p<0 p= (p= p< (p< (p

https://doi.org/10.1590/0037-8682-0206-2023

Diretriz da Sociedade Brasileira de Cardiologia sobre a Análise e Emissão de Laudos Eletrocardiográficos – 2022
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Samesima, Nelson

; God, Epotamenides Good

; Kruse, Jose Claudio Lupi

; Leal, Marcelo Garcia

; Pinho, Claudio

; França, Francisco Faustino de A. C.

; Pimenta, João

; Cardoso, Acácio Fernandes

; Paixão, Adail

; Fonseca, Alfredo

; Pérez-Riera, Andrés R.

; Ribeiro, Antonio Luiz Pinho

; Madaloso, Bruna Affonso

; Luna Filho, Bráulio

; Oliveira, Carlos Alberto Rodrigues de

; Grupi, César José

; Moreira, Dalmo Antonio Ribeiro

; Kaiser, Elisabeth

; Paixão, Gabriela Miana de Mattos

; Feitosa Filho, Gilson

; Pereira Filho, Horacio Gomes

; Grindler, José

; Aziz, José Luiz

; Molina, Marcos Sleiman

; Facin, Mirella

; Tobias, Nancy M. M. de Oliveira

; Oliveira, Patricia Alves de

; Sanches, Paulo César R.

; Teixeira, Ricardo Alkmin

; Atanes, Severiano Melo

; Pastore, Carlos Alberto

Arquivos Brasileiros de Cardiologia

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Out 2022, Volume 119 Nº 4 Páginas 638 - 680

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20220623

10.

Carga de Doenças Cardiovasculares Atribuível aos Fatores de Risco nos Países de Língua Portuguesa: Dados do Estudo “Global Burden of Disease 2019”
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Nascimento, Bruno Ramos

; Brant, Luisa Campos Caldeira

; Naback, André Dias Nassar

; Veloso, Guilherme Augusto

; Polanczyk, Carisi Anne

; Ribeiro, Antonio Luiz Pinho

; Malta, Deborah Carvalho

; Ferreira, Albano Vicente Lopes

; Oliveira, Gláucia Maria Moraes de

Arquivos Brasileiros de Cardiologia

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Jun 2022, Volume 118 Nº 6 Páginas 1028 - 1048

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: O impacto dos fatores de risco (FR) sobre a morbimortalidade por doença cardiovascular (DCV) na maioria dos países de língua portuguesa (PLP) é pouco conhecido. Objetivo: Analisar a morbimortalidade por DCV atribuível aos FR e sua variação nos PLP de 1990 a 2019, a partir de estimativas do estudo Global Burden of Disease (GBD) 2019. Métodos: Avaliamos as mudanças nos FR ocorridas no período, as taxas de mortalidade e os anos de vida perdidos por incapacidade (DALYs), padronizados por idade, entre 1990 e 2019. Realizou-se a correlação entre a variação percentual das taxas de mortalidade e o índice sociodemográfico (SDI) de cada PLP pelo método de Spearman. O valor p<0,05 foi considerado estatisticamente significativo. Resultados: A pressão arterial sistólica (PAS) elevada foi o principal fator de risco para mortalidade e DALY por DCV para todos os PLP. A mortalidade por DCV mostrou uma tendência de redução em 2019, maior em Portugal (-66,6%, IC95% -71,0 - -61,2) e no Brasil (-49,8%, IC95% -52,5 - -47,1). Observou-se tendência à correlação inversa entre SDI e a variação percentual da mortalidade, que foi significativa para os riscos dietéticos (r=-0,70, p=0,036), colesterol LDL elevado (r=-0,77, p=0,015) e PAS elevada (r=-0,74, p=0,023). Conclusões: Além da PAS, os FR dietéticos e metabólicos justificaram uma maior variação da carga de DCV, correlacionada com o SDI nos PLP, sugerindo a necessidade de adoção de políticas de saúde adaptadas à realidade de cada país, visando a redução de seu impacto sobre a população.

Abstract Background: The impact of risk factors (RF) on morbidity and mortality from cardiovascular disease (CVD) for most Portuguese-speaking countries (PSC) is little known. Objectives: We aimed to analyze the morbidity and mortality from CVD attributable to RF and its variation, from 1990 to 2019, in PSC, based on estimates from the Global Burden of Disease (GBD) 2019 study. Methods: We evaluated changes in cardiovascular RF, mortality rates and age-standardized disability-adjusted life years (DALYs) between 1990 and 2019. The correlation between percentage changes in mortality rates and the sociodemographic index (SDI) of each PSC was evaluated by the Spearman method. A p-value <0.05 was considered statistically significant. Results: Elevated systolic blood pressure (SBP) was the main RF for mortality and DALYs for CVD for all PSC. Mortality from CVD showed a downward trend in 2019, more accentuated in Portugal (-66.6%, 95%CI -71.0 - -61.2) and in Brazil (-49.8%, 95%CI -52.5 - -47.1). There was a trend towards an inverse correlation between SDI and the percent change in mortality, which was significant for dietary risks (r=-0.70, p=0.036), high LDL cholesterol (r=-0.77, p=0.015) and high SBP (r=-0.74, p=0.023). Conclusions: In addition to SBP, dietary and metabolic RF justified a greater variation in the burden of CVD correlated with SDI in the PSC, suggesting the need to adopt health policies adapted to the reality of each country, aiming to reduce their impact on population.

https://doi.org/10.36660/abc.20210680

11.

Testes Ergométricos em Pacientes com Anemia Falciforme: Segurança, Viabilidade e Possíveis Implicações no Prognóstico
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Araújo, Christiano Gonçalves de

; Resende, Maria Betânia Solis

; Tupinambás, Julia Teixeira

; Dias, Rebeca Coeli Teodoro Maciel

; Barros, Flávio Coelho

; Vasconcelos, Maria Carmen Melo

; Januário, José Nelio

; Ribeiro, Antonio Luiz Pinho

; Nunes, Maria Carmo P.

Arquivos Brasileiros de Cardiologia

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Mar 2022, Volume 118 Nº 3 Páginas 565 - 575

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento Pacientes com anemia falciforme (AF) têm risco aumentado de complicações cardiovasculares. O teste ergométrico é usado como marcador de prognóstico em uma série de doenças cardiovasculares. Entretanto, há uma escassez de evidências sobre exercícios em pacientes com AF, especialmente em relação à sua segurança, viabilidade e possível função prognóstica. Objetivos Usamos o teste em esteira máximo para determinar a segurança e a viabilidade do teste ergométrico em pacientes com AF. Além disso, os fatores associados à duração do exercício, bem como o impacto das alterações causadas pelo exercício em resultados clínicos, também foram avaliados. Métodos 113 pacientes com AF que passaram pelo teste ergométrico e por uma avaliação cardiovascular abrangente incluindo um ecocardiograma e os níveis do peptídeo natriurético do tipo B (BNP). O desfecho de longo prazo foi uma combinação de eventos incluindo morte, crises álgicas graves, síndrome torácica aguda ou internações hospitalares por outras complicações associadas â doença falciforme. A análise de regressão de Cox foi realizada para identificar as variáveis associadas ao resultado. Um p valor <0,05 foi considerado estatisticamente significativo. Resultados A média de idade foi de 36 ± 12 anos (intervalo, 18-65 anos), e 62 pacientes eram do sexo feminino (52%). A presença de alterações isquêmicas ao esforço e resposta pressórica anormal ao exercício foram detectadas em 17% e 9 % da´população estudada respectivamente. Dois pacientes apresentaram crise álgica com necessidade de internação hospitalar no período de 48 horas da realização do exame. Fatores associados à duração do exercício foram idade, sexo, velocidade máxima de regurgitação tricúspide (RT), e relação E/e’, após a padronização quanto aos marcadores da gravidade da doença. Durante o período médio de acompanhamento de 10,1 meses (variando de 1,2 a 26), 27 pacientes (23%) apresentaram desfechos clínicos adversos. Preditores independentes de eventos adversos foram a concentração de hemoglobina, velocidade do fluxo transmitral tardio (onda A), e a resposta da PA ao exercício. Conclusões A realização de testes ergométricos em pacientes com AF, clinicamente estáveis, é viável. A duração do exercício estava associada à função diastólica e a pressão arterial pulmonar. A resposta anormal da PA foi um preditor independente de eventos adversos.

Abstract Background Patients with sickle cell disease (SCD) are at increased risk for cardiovascular complications. Exercise testing is used as a prognostic marker in a variety of cardiovascular diseases. However, there is a lack of evidence on exercise in SCD patients, particularly regarding its safety, feasibility, and possible prognostic role. Objectives We used the maximal treadmill test to determine safety and feasibility of the exercise testing in SCD patients. Additionally, the factors associated with exercise duration, as well as the impact of exercise-induced changes on clinical outcome, were also assessed. Methods One-hundred thirteen patients with SCD, who underwent exercise testing, were prospectively enrolled. A comprehensive cardiovascular evaluation, including echocardiography and B-type natriuretic peptide (BNP) levels, were obtained. The long-term outcome was a composite endpoint of death, severe acute painful episodes, acute chest syndrome, or hospitalization for other SCD-related complications. Cox regression analysis was performed to identify the variables associated with the outcome. A p-value<0.05 was considered to be statistically significant. Results The mean age was 36 ± 12 years (range, 18-65 years), and 62 patients were women (52%). Ischemic electrocardiogram and abnormal blood pressure (BP) response to exercise were detected in 17% and 9%, respectively. Two patients experienced pain crises within 48 hours that required hospitalization. Factors associated with exercise duration were age, sex, tricuspid regurgitation (TR) maximal velocity, and E/e’ ratio, after adjustment for markers of disease severity. During the mean follow-up of 10.1 months (ranging from 1.2 to 26), the endpoint was reached in 27 patients (23%). Independent predictors of adverse events were hemoglobin concentration, late transmitral flow velocity (A wave), and BP response to exercise. Conclusions Exercise testing in SCD patients who were clinically stable is feasible. Exercise duration was associated with diastolic function and pulmonary artery pressure. Abnormal BP response was an independent predictor of adverse events.

https://doi.org/10.36660/abc.20200437

12.

Estatística Cardiovascular – Brasil 2021
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Oliveira, Gláucia Maria Moraes de

; Brant, Luisa Campos Caldeira

; Polanczyk, Carisi Anne

; Malta, Deborah Carvalho

; Biolo, Andreia

; Nascimento, Bruno Ramos

; Souza, Maria de Fatima Marinho de

; Lorenzo, Andrea Rocha De

; Fagundes Júnior, Antonio Aurélio de Paiva

; Schaan, Beatriz D.

; Castilho, Fábio Morato de

; Cesena, Fernando Henpin Yue

; Soares, Gabriel Porto

; Xavier Junior, Gesner Francisco

; Barreto Filho, Jose Augusto Soares

; Passaglia, Luiz Guilherme

; Pinto Filho, Marcelo Martins

; Machline-Carrion, M. Julia

; Bittencourt, Marcio Sommer

; Pontes Neto, Octavio M.

; Villela, Paolo Blanco

; Teixeira, Renato Azeredo

; Sampaio, Roney Orismar

; Gaziano, Thomaz A.

; Perel, Pablo

; Roth, Gregory A.

; Ribeiro, Antonio Luiz Pinho

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Jan 2022, Volume 118 Nº 1 Páginas 115 - 373

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20211012

13.

Physical activity to prevent stroke mortality in Brazil (1990-2019)
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Silva, Diego Augusto Santos

; Ribeiro, Antonio Luiz Pinho

; Marinho, Fatima

; Naghavi, Mohsen

; Malta, Deborah Carvalho

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Supl. 1 elocation e0252-2021

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: This study aimed to estimate the burden of stroke mortality due to low levels of physical activity (PA) in Brazil from 1990 to 2019. METHODS: Data from the 2019 Global Burden of Disease (GBD) study for Brazil and Brazilian states were used. We used the number of deaths, age-standardized mortality rates, summary exposure value, and fraction of population risk attributable to low levels of PA. To standardize all estimates, data from the population aged 25 years or older were considered. RESULTS: The risk of exposure to low PA, SEV values, for the Brazilian male population was 11.8% (95%UI: 6.7; 19.9) and for the Brazilian female population was 13.2% (95%UI: 8.6; 19.2) in 2019. For males, it was estimated that there were, respectively, 2,025 (95%UI: 271; 4,839) and 3,595 (95%UI: 658; 7,302) deaths in 1990 and 2019 due to stroke attributable to low PA. For females, there were 2,518 (95%UI: 498; 5,006) and 4,735 (95%UI: 1,286; 8,495) deaths in 1990 and 2019 due to stroke attributable to low PA, respectively. From 1990 to 2019, reductions of 44.0% for males (95%UI: −0.54; -0.05) and 52.0% for females (95%UI: −0.60; -0.30) in age-standardized mortality rates due to stroke attributed to low PA were observed. Approximately 6.1% (for males) and 7.3% (for females) of deaths in 2019 due to stroke could be avoided if the Brazilian population were physically active. CONCLUSIONS: These findings support the promotion of PA in all Brazilian states for preventing early mortality due to stroke.

https://doi.org/10.1590/0037-8682-0252-2021

14.

Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019
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Leal, Lisiane Freitas

; Malta, Deborah Carvalho

; Souza, Maria de Fatima Marinho

; Vasconcelos, Ana Maria Nogales

; Teixeira, Renato Azeredo

; Veloso, Guilherme Augusto

; Lansky, Sônia

; Ribeiro, Antonio Luiz Pinho

; França, Giovanny Vinícius Araújo de

; Naghavi, Mohsen

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Supl. 1 elocation e0279-2021

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries. The objective of this study was to describe the problem of maternal death in Brazil, using estimates from the Global Burden of Disease Study (GBD). METHODS This study used data from the GBD 2019 to show the numbers of deaths and the Maternal Mortality Ratio (MMR) - number of deaths/100,000 live births - in Brazil and its 27 Federated Units (FU), for ages 10 to 54 years, from 1990 to 2019. The annual variation of the MMR was estimated in 1990, 2010, and 2019. The MMR were shown for specific causes as well as for five-year age groups. The estimates were presented with 95% uncertainty intervals (UI). RESULTS The number of maternal deaths, as well as the MMR showed a 49% reduction from 1990 to 2019. This reduction occurred heterogeneously throughout the country, and the profile of the MMR for specific causes changed between 1990 and 2019: from hypertensive gestation diseases, to indirect maternal deaths, followed by hypertensive gestation diseases. In the extreme age groups, the MMR is higher, with mortality increasing exponentially in direct proportion with age. CONCLUSIONS Maternal deaths in Brazil have decreased substantially since 1990; however, the numbers still fall short of what was established by the World Health Organization (WHO). Indirect causes are the greatest problem in more than 60% of the FU, especially for hypertensive pregnancy diseases.

https://doi.org/10.1590/0037-8682-0279-2021

15.

Road traffic injuries and deaths and the achievement of UN Sustainable Development Goals in Brazil: results from the Global Burden of Disease Study, 1990 to 2019
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Malta, Deborah Carvalho

; Morais Neto, Otaliba Libânio de

; Cardoso, Laís Santos de Magalhães

; Veloso, Guilherme Augusto

; Andrade, Fabiana Martins Dias de

; Vasconcelos, Ana Maria Nogales

; Lima, Cheila Marina de

; Ribeiro, Antonio Luiz Pinho

; Naghavi, Mohsen

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Supl. 1 elocation e0261-2021

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Brazil ranks 5th in the number of deaths due to road injuries. This study aimed to analyze mortality and disabilities resulting from road injuries in Brazil, and to assess the Sustainable Development Goals (SDG) target of reducing deaths due to road injuries by 50% by 2030. METHODS: This descriptive and exploratory study used the estimates from the Global Burden of Disease 2019: indicators of mortality, premature deaths, and disabilities according to sex, age group, and type of transport for 1990, 2015, and 2019. Time trends in mortality rates from 1990 to 2019 were assessed, and a projection for 2030 was calculated, applying a linear regression model. RESULTS: Deaths due to road injuries were 44,236 in 1990, and 44,529 in 2019, representing a 43% reduction in mortality rates. The highest rates were in the North, Northeast, and Midwest regions of Brazil, in males and young adults. A 77% reduction was observed in mortality rates for pedestrians and an increase of 53% for motorcyclists and of 54% for cyclists during the period. In terms of motorcycle road injuries, the mortality rate for men increased from 7.3/100,000 (1990) to 11.7/100,000 inhabitants (2019). The rates of premature deaths and disabilities were also higher for men when compared to women. Amputations, fractures, spinal cord injuries, and head trauma were the main types of road injuries. The projections for 2030 show that Brazil might not reach the SDG target. CONCLUSIONS: Despite the decline in mortality rates, the 2030 Agenda’s target might not be achieved.

https://doi.org/10.1590/0037-8682-0261-2021

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