Does C-reactive Protein Add Prognostic Value to GRACE Score in Acute Coronary Syndromes?

Fundamento: O valor prognóstico incremental da dosagem plasmática de Proteína C-reativa (PCR) em relação ao Escore GRACE não está estabelecido em pacientes com síndromes coronarianas agudas sem supradesnivelamento do segmento ST (SCA). Objetivo: Testar a hipótese de que a medida de PCR na admissão incrementa o valor prognóstico do escore GRACE em pacientes com SCA. Métodos: Foram estudados 290 indivíduos, internados consecutivamente por SCA, os quais tiveram material plasmático colhido na admissão para dosagem de PCR por método de alta sensibilidade (nefelometria). Desfechos cardiovasculares durante hospitalização foram definidos pela combinação de óbito, infarto não fatal ou angina refratária não fatal. Resultados: A incidência de eventos cardiovasculares durante hospitalização foi 15% (18 óbitos, 11 infartos, 13 anginas), tendo a PCR apresentado estatística-C de 0,60 (95% IC = 0,51 - 0,70; p = 0,034) na predição desses desfechos. Após ajuste para o Escore GRACE, PCR elevada (definida pelo melhor ponto de corte) apresentou tendência a associação com eventos hospitalares (OR = 1,89; 95% IC = 0,92 - 3,88; p = 0,08). No entanto, a adição da variável PCR elevada no modelo GRACE não promoveu incremento significativo na estatística-C, a qual variou de 0,705 para 0,718 (p = 0,46). Da mesma forma, não houve reclassificação de risco significativa com a adição da PCR no modelo preditor (reclassificação líquida = 5,7%; p = 0,15). Conclusão Embora PCR possua associação com desfechos hospitalares, esse marcador inflamatório não incrementa o valor prognóstico do Escore GRACE

Evaluation of Galectin-3 as a Novel Biomarker for Chagas Cardiomyopathy

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-11-23T12:50:45Z No. of bitstreams: 1 Rabelo MMN Evaluation of galectin-3....pdf: 140623 bytes, checksum: 3f19bd9f18869f4e4c812b28c9829fdf (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-11-23T13:01:55Z (GMT) No. of bitstreams: 1 Rabelo MMN Evaluation of galectin-3....pdf: 140623 bytes, checksum: 3f19bd9f18869f4e4c812b28c9829fdf (MD5)Made available in DSpace on 2017-11-23T13:01:55Z (GMT). No. of bitstreams: 1 Rabelo MMN Evaluation of galectin-3....pdf: 140623 bytes, checksum: 3f19bd9f18869f4e4c812b28c9829fdf (MD5) Previous issue date: 2017FAPESBHospital São Rafael. Department of Cardiology. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilHospital São Rafael. Department of Cardiology. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Center for Biotechnology and Cell Therapy. Salvador, BA, BrasilHospital São Rafael. Department of Cardiology. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Center for Biotechnology and Cell Therapy. Salvador, BA, BrasilHospital São Rafael. Department of Cardiology. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Center for Biotechnology and Cell Therapy. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Center for Biotechnology and Cell Therapy. Salvador, BA, BrasilHospital São Rafael. Clinical Diagnostics Laboratory. Salvador, BA, BrasilHospital São Rafael. Clinical Diagnostics Laboratory. Salvador, BA, BrasilCenter for Biotechnology and Cell Therapy. Salvador, BA, BrasilHospital São Rafael. Department of Cardiology. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Center for Biotechnology and Cell Therapy. Salvador, BA, BrasilChagas cardiomyopathy has worse long-term outcomes than other cardiomyopathies. A biomarker strategy to refer subjects for noninvasive cardiac imaging may help in the early identification of cardiac damage in subjects with Chagas disease. Galectin-3 (Gal-3) is a mediator of cardiac fibrosis shown to be upregulated in animal models of decompensated heart failure. Here we assessed the correlation of Gal-3 with myocardial fibrosis in patients with Chagas disease. Methods: This study comprised 61 subjects with Chagas disease. All subjects underwent clinical assessments, Doppler echocardiography and magnetic resonance imaging. Plasmatic Gal-3 was determined by ELISA. Results: Delayed enhancement (DE) was identified in 37 of 61 subjects (64%). The total amount of myocardial fibrosis was 9.4% [interquartile interval (IQI): 2.4–18.4]. No differences were observed in Gal-3 concentration according to the presence or absence of myocardial fibrosis, with a median Gal-3 concentration of 11.7 ng/ml (IQI: 9.4–15) in subjects with DE versus 12.9 ng/ml (IQI: 9.2–14) in subjects without DE (p = 0.18). No correlation was found between myocardial fibrosis and Gal- 3 concentration (r = 0.098; p = 0.47). Conclusions: There is no correlation between the degree of myocardial fibrosis and the concentration of Gal-3 in subjects with Chagas diseas

Circulating miRNAs as Potential Biomarkers Associated with Cardiac Remodeling and Fibrosis in Chagas Disease Cardiomyopathy

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2019-09-27T16:01:25Z No. of bitstreams: 1 Nonaka Vasques K.C Circulating.pdf: 2693091 bytes, checksum: ede286cd2f7ad2cf644ed62421a5a459 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2019-09-27T16:22:08Z (GMT) No. of bitstreams: 1 Nonaka Vasques K.C Circulating.pdf: 2693091 bytes, checksum: ede286cd2f7ad2cf644ed62421a5a459 (MD5)Made available in DSpace on 2019-09-27T16:22:09Z (GMT). No. of bitstreams: 1 Nonaka Vasques K.C Circulating.pdf: 2693091 bytes, checksum: ede286cd2f7ad2cf644ed62421a5a459 (MD5) Previous issue date: 2019-01-20Bahia State Foundation for Research (FAPESB) and Institutos Nacionais de Ciência e Tecnologia (INCT; 465656/2014-5). Milena B. P. Soares is a recipient of CNPq fellowship.Hospital São Rafael. Centro de Biotecnologia e Terapia Celular. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / São Rafael Hospital. Department of Cardiology. Salvador, BA, Brasil.Hospital São Rafael. Centro de Biotecnologia e Terapia Celular. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.Hospital São Rafael. Centro de Biotecnologia e Terapia Celular. Salvador, BA, Brasil.Hospital São Rafael. Centro de Biotecnologia e Terapia Celular. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.Hospital São Rafael. Centro de Biotecnologia e Terapia Celular. Salvador, BA, Brasil.Hospital São Rafael. Centro de Biotecnologia e Terapia Celular. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.Messejana Hospital. Fortaleza, CE, Brasil.Messejana Hospital. Fortaleza, CE, Brasil.São Rafael Hospital. Department of Cardiology. Salvador, BA, Brasil.University of Southern Denmark. Institute of Regional Health Research. Vejle Hospital. Department of Clinical Genetics. Vejle, Denmark.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / National Institute of Science and Technology for Regenerative Medicine. Rio de Janeiro, RJ, Brazil.Salvador, BA, Brasil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / National Institute of Science and Technology for Regenerative Medicine. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / National Institute of Science and Technology for Regenerative Medicine. Rio de Janeiro, RJ, Brazil.Chagas disease (CD) affects approximately 6-7 million people worldwide, from which 30% develop chronic Chagas cardiomyopathy (CCC), usually after being asymptomatic for years. Currently available diagnostic methods are capable of adequately identifying infected patients, but do not provide information regarding the individual risk of developing the most severe form of the disease. The identification of biomarkers that predict the progression from asymptomatic or indeterminate form to CCC, may guide early implementation of pharmacological therapy. Here, six circulating microRNAs (miR-19a-3p, miR-21-5p, miR-29b-3p, miR-30a-5p, miR-199b-5p and miR-208a-3p) were evaluated and compared among patients with CCC (n = 28), CD indeterminate form (n = 10) and healthy controls (n = 10). MiR-19a-3p, miR-21-5p, and miR-29b-3p were differentially expressed in CCC patients when compared to indeterminate form, showing a positive correlation with cardiac dysfunction, functional class, and fibrosis, and a negative correlation with ejection fraction and left ventricular strain. Cardiac tissue analysis confirmed increased expression of microRNAs in CCC patients. In vitro studies using human cells indicated the involvement of these microRNAs in the processes of cardiac hypertrophy and fibrosis. Our study suggests that miRNAs are involved in the process of cardiac fibrosis and remodeling presented in CD and indicate a group of miRNAs as potential biomarkers of disease progression in CCC