Julio Cesar Vieira Braga

Publications (3)9.28 Total impact

• Article: Is Chagas cardiomyopathy an independent risk factor for patients with heart failure?

  Julio Cesar Vieira Braga, Francisco Reis, Roque Aras, Nei Dantas, Almir Bitencourt, Flavia S Neves, Adriana L Latado
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  ABSTRACT: Some studies showed increased mortality in chagasic patients but most of these studies did not perform statistical adjustments to socioeconomic variables. The main objective of this study was to investigate if there is an independent association between Chagas etiology and mortality in patients with heart failure and moderate to severe left ventricle systolic dysfunction. Stratified analysis by the variables associated to chagasic etiology and multivariate analysis through logistic regression were performed to evaluate the relationship between Chagas cardiomyopathy and one-year mortality. Among 417 patients initially evaluated, 191 had the inclusion criteria. The mortality was higher in patients with Chagas cardiomyopathy than in the patients with other etiologies (log rank test; p=0.036). At one-year follow-up, the mortality in chagasic patients was 21.6% versus 10.6% in the remaining (relative risk=2.03; 95% CI=0.98-4.2; p=0.05). At logistic regression, educational level was identified as a confounder variable of the association between Chagas cardiomyopathy and one-year mortality. This association was no more statistically significant after adjustment for educational level (odds ratio=1.67; 95% CI=0.63-4.41). In this study, Chagas cardiomyopathy was a marker of worse prognosis, but was not independently associated to increased one-year mortality in outpatients with heart failure and moderate to severe systolic dysfunction.
  International journal of cardiology 06/2008; 126(2):276-8. · 7.08 Impact Factor
• Article: Influence of gender on the prognostic value of troponin I after elective percutaneous coronary interventions.

  Julio Cesar Vieira Braga, Almir Galvão Vieira Bitencourt, Marianna Deway Andrade, Roque Aras, José Péricles Esteves
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  ABSTRACT: To evaluate the association between troponin I concentrations (TnI) in patients submitted to elective percutaneous coronary interventions (PCI) and adverse coronary events (ACE) during a six month follow-up period. One hundred and eleven patients who had been submitted to an elective PCI were consecutively selected during a one year timeframe. The patients had stable angina (SA), unstable angina (UA) or silent ischemia (SI) and were asymptomatic for at least 72 hours before the procedure. TnI concentrations were measured between 8 and 24 hours after the PCI. Each patient was contacted by telephone six months later and interviewed regarding ACE which were defined as death, myocardial infarction, new revascularization and recurrent ischemia. Twenty-four patients showed elevated concentrations of TnI (21.6%) after the PCI regardless of clinical characteristics or procedure complications. Those who presented elevated TnI concentrations had higher event rates: 66.7 vs. 42.5% (RR=1.57; CI 95%=1.08-2.28). This risk seems to be higher in the subgroups of females and patients with a previous diagnosis of unstable angina. Multivariate analysis confirmed that gender was the only effect modifying co-variable associated with ACE risk, which is higher for females with elevated TnI concentrations (OR=7.22; CI 95%=1.4 -36.9) and unaltered for males (OR=1.26; CI 95%=0.35-4.55). Elevated TnI concentrations were a common occurrence after PCI and is a factor related to the development of ACE in the mid term. However, when adjusted for other variables, this effect is only maintained in female patients.
  Arquivos brasileiros de cardiologia 10/2006; 87(3):288-93. · 1.32 Impact Factor
• Article: [Clinical and therapeutics aspects of heart failure due to Chagas disease].

  Julio Cesar Vieira Braga, Francisco Reis, Roque Aras, Nei Dantas Costa, Claudilson Bastos, Renata Silva, Alana Soares, Ademir Moura Júnior, Silvana Asfora, Adriana Lopes Latado
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  ABSTRACT: Describe the clinical and therapeutic characteristics of patients with heart failure (HF) secondary to chronic chagasic cardiomyopathy and evaluate if these characteristics are different from those found in other etiologies. A prospective analysis of the patients treated between August 2003 and June 2004 at a HF referral outpatient clinic was conducted. Three hundred and fifty six patients diagnosed with HF were included in the study. Chagasic cardiomyopathy was the most common etiology (48% of the cases). Other etiologies included hypertensive cardiomyopathy in 19% of the patients, idiopathic dilated in 11% and ischemic in 9%. Patients with HF secondary to chagasic cardiomyopathy were more frequently from non-white ethnic groups (88 vs. 75%; p = 0.002), had a family history of Chagas disease (57 vs. 21%; p = 0.001), had the disease for a longer length of time (71 vs. 56 months; p = 0.034), had lower levels of education (4.4 +/- 4.1 vs. 5.7 +/- 4.2 years of study; p = 0.004), had a lower heart rate (69 +/- 12 vs. 73 +/- 13; p = 0.03) and a lower systolic blood pressure (121 +/- 25 vs. 129 +/- 28 mmHg; p = 0.006). There was also a higher incidence of the use of amiodarone (22 vs. 13%; p = 0.036) and artificial pacemakers (15 vs. 1%; p = 0.001). There was a lower usage of beta-blockers (39 vs. 59%; p = 0.001). In this sample of HF outpatients, in a state with a high prevalence of Chagas disease, chagasic cardiomyopathy was the most common etiology and they presented some unique clinical and therapeutic characteristics in comparison to other heart failure patients.
  Arquivos Brasileiros de Cardiologia 05/2006; 86(4):297-302. · 0.88 Impact Factor