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Start Over Author "Daniel Augusto Message dos Santos" Topic coronary artery disease
2 results on '"Daniel Augusto Message dos Santos"'

1. Mortality in Women with Coronary Artery Disease in Paraná State, Brazil: A Bayesian Spatiotemporal Analysis

Author

Marcelo Puzzi, Miyoko Massago, Júlia Loverde Gabella, Samile Bonfim de Oliveira, Daniel Augusto Message dos Santos, Fernanda Shizue Nishida Carignano, Sandra Marisa Pelloso, Lincoln Luis Silva, Oscar Kenji Nihei, Maria Dalva de Barros Carvalho, Amanda de Carvalho Dutra, and Luciano de Andrade

Subjects
coronary artery disease, health disparities, women’s health, epidemiology, spatiotemporal analysis, Diseases of the circulatory (Cardiovascular) system, RC666-701, Public aspects of medicine, RA1-1270
Abstract

Background: Mortality resulting from coronary artery disease (CAD) among women is a complex issue influenced by many factors that encompass not only biological distinctions but also sociocultural, economic, and healthcare-related components. Understanding these factors is crucial to enhance healthcare provisions. Therefore, this study seeks to identify the social and clinical variables related to the risk of mortality caused by CAD in women aged 50 to 79 years old in Paraná state, Brazil, between 2010 and 2019. Methods: This is an ecological study based on secondary data sourced from E-Gestor, IPARDES, and DATASUS. We developed a model that integrates both raw and standardized coronary artery disease (CAD) mortality rates, along with sociodemographic and healthcare service variables. We employed Bayesian spatiotemporal analysis with Markov Chain Monte Carlo simulations to assess the relative risk of CAD mortality, focusing specifically on women across the state of Paraná. Results: A total of 14,603 deaths from CAD occurred between 2010 and 2019. Overall, temporal analysis indicates that the risk of CAD mortality decreased by around 22.6% between 2010 (RR of 1.06) and 2019 (RR of 0.82). This decline was most prominent after 2014. The exercise stress testing rate, accessibility of cardiology centers, and IPARDES municipal performance index contributed to the reduction of CAD mortality by approximately 4%, 8%, and 34%, respectively. However, locally, regions in the Central-West, Central-South, Central-East, and Southern regions of the Central-North parts of the state exhibited risks higher-than-expected. Conclusion: In the last decade, CAD-related deaths among women in Paraná state decreased. This was influenced by more exercise stress testing, better access to cardiology centers, improved municipal performance index. Yet, elevated risks of deaths persist in certain regions due to medical disparities and varying municipal development. Therefore, prioritizing strategies to enhance women’s access to cardiovascular healthcare in less developed regions is crucial.

Published
2024
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2. Prevalence of Ischemia on Myocardial Perfusion Scintigraphy of Pre- and Postmenopausal Women

Author

Leonardo Machado Alexandre, Paola Emanuela Poggio Smanio, Wendy Yasdin Sierraalta Navarro, Priscila Feitosa Cestari, and Daniel Augusto Message dos Santos

Subjects
Technetium Tc 99m Sestamibi, medicine.medical_specialty, Myocardial Ischemia/radionuclide imaging, Multivariate analysis, Ischemia, Myocardial Ischemia, Coronary Artery Disease, Coronary artery disease, symbols.namesake, Internal medicine, Diabetes mellitus, medicine, Diabetes Mellitus, Prevalence, Humans, Women, cardiovascular diseases, Obesity, Radionuclide Imaging, Fisher's exact test, Dyslipidemias, Retrospective Studies, business.industry, Retrospective cohort study, Original Articles, Middle Aged, medicine.disease, Surgery, Menopause, Postmenopause, Radiography, Premenopause, Risk factors, Posmenopause, Hypertension, symbols, Cardiology, Exercise Test, Female, Radiopharmaceuticals, Cardiology and Cardiovascular Medicine, business
Abstract

BACKGROUND: In postmenopausal women, the presence of risk factors for coronary artery disease (CAD) increases. However, the difference in prevalence of ischemia between pre- and postmenopausal women with multiple risk factors for CAD has not been well established. OBJECTIVES: To compare the prevalence of ischemia on Tc99m-sestamibi myocardial perfusion scintigraphy (MPS) in pre- and postmenopausal women, and to evaluate whether menopause can be considered an independent risk predictor of ischemia in women with multiple risk factors for CAD. METHODS: This study retrospectively assessed 500 MPS of pre- and postmenopausal women with multiple risk factors for CAD. Statistical analysis was performed by using Fisher exact test and univariate and multivariate analysis, a p value < 0.05 being considered significant. RESULTS: Postmenopausal women represented 55.9% of the sample; 83.3% were hypertensive; 28.9%, diabetic; 32.1%, smokers; 25%, obese; 61.2% had high cholesterol levels; and 34.3% had known CAD. Postmenopausal women were more often hypertensive, diabetic and dyslipidemic, and had lower functional capacity on exercise testing (p = < 0.005). The presence of ischemia on MPS did not significantly differ between the pre- and postmenopausal groups (p = 0.395). The only variable associated with ischemia on MPS was known CAD (p = 0.004). CONCLUSION: The results suggest that, in women with multiple risk factors for CAD, menopause was not an independent predictor of ischemia on MPS. Those data support the idea that the investigation of ischemia via MPS in women with multiple risk factors for CAD should begin prior to menopause.

Published
2013

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