Dr. Antônio Carlos Sobral Sousa
TRABALHOS PUBLICADOS: roduziu vários artigos em periódicos especializados (inclusive no exterior), capítulos de livro, trabalhos em eventos médicos, aulas em congressos, simpósios e seminários, orientação de trabalhos científicos, participação em bancas examinadoras, orientação de trabalhos científicos.
THE 2008 WORLD CONGRESS OF CARDIOLOGY ABSTRACTS, BUENOS AIRES, ARGENTINA, MAY 18-21, 2008: ORAL PRESENTATIONS
CIRCULATION – JOURNAL OF THE AMERICAN HEART ASSOCIATION
Prognostic value of exercise echocardiography in diabetic patients.
TS Aragão, JLM Oliveira, FD Anjos-Andrade, EO Alves, AC Nascimento-Júnior, TJS Góes, A D’Oliveira-Junior, JAS Barreto-Filho, ACS Sousa. Department of Internal Medicine, Cardiology Division, Federal University of Sergipe, Aracaju, Sergipe, Brazil. Laboratory of Echocardiography of the São Lucas Hospital, Aracaju, Sergipe, Brazil. Department of Internal Medicine, School of Medicine, Federal University of the Bahia, Salvador, Bahia, Brazil.Coronary artery disease (CAD) is the leading cause of death in diabetic patients. Although exercise echocardiography is estabilished as a useful method for diagnosis and stratification of risk for CAD in general population, there are few studies about its value as a independent and additional prognostic tool in diabetic population. It has been demonstrated that exercise echocardiography allows early deteccion and stratification of CAD in these patients, and, consequently, better selection of therapeutic interventions and reduction of complications by cardiac events. This study evaluated the utility of exercise echocardiography for predicting cardiac events in diabetic patients. Two hundred and twelve patients, with average age of sixty years old, submitted to exercise echocardiography between 2001 and 2006 in ECOLAB-São Lucas Hospital and Federal University of Sergipe, Sergipe-Brasil, were studied in a medium follow-up of 41 months. Follow-up was obtained by scripted telephone or personal interviews, by contacting the patients’ primary physician and reviewing medical records and death certificates. The end points considered were cardiac events defined as nonfatal myocardium infarction, myocardium revascularization procedures and cardiac death. Sudden unexpected death without another explanation was included as cardiac death. Survival free of end points was estimated by the Kaplan-Meier method. Clinical data and occurrence of cardiac events were compared between patients in two groups: G1= patients with exercise echocardiography positive for myocardium ischemia (109 patients) and G2= patients with normal tests (103 patients). It was demonstrated that G1 had a higher rate of obesity and treatment with insulin, beta-blocker and nitrate (p<0.05). G1 presented higher frequency of cardiac events (81.6% vs 18.4%), p<0.05 – RR 5.45 IC 95% [2.27 – 13.04], mainly myocardium revascularization procedures (88.5% vs 11.5%), p=0.0001. In analysis of survival free of end points, the events rate was shorter in patients with exercise echocardiography negative for myocardium ischemia in 02 months (1% vs 5.5%), 10 months (2% vs 16%) and 28 months (17.4% vs 26.9%). Exercise echocardiography is a useful method for definition of survival free of cardiac events in diabetic patients with suspected or known coronary artery disease, providing more information to clinical and echocardiography variables at rest, allowing to be used for prognostic evaluation and risk stratification of this population.