Browsing by Autor "Jaime Gomez"

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DESCRIPTION OF THE METABOLIC SYNDROME AND ITS INDIVIDUALIZED RISK IN A LATIN AMERICAN COHORT OF GERIATRIC PATIENTS WITH HYPOTHYROIDISM
(2023) Luis Dulcey; Juan Sebastián Theran León; Jaime Gomez; Rafael Guillermo Parales Strauch; Raimondo Caltagirone; Edgar Blanco; María Paula Ciliberti Artavia; Juan Camilo Martínez; Valentina Cabrera Peña; Maria Amaya
Abstract Introduction It is still discussed whether hypothyroidism as an independent risk factor for cardiovascular events. Our objective was to evaluate the association between hypothyroidism and the risks of cardiovascular events and mortality through 3 stratification systems. Methods A retrospective study was carried out by reviewing medical records in the period of January 2015 - December 2017 in a South American hospital. Patients had fasting total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and plasma glucose were included. Quantitative variables are presented as mean ± standard deviation or median (interquartile range) according to their distribution, and qualitative variables as percentages. Student’s test was performed to assess the differences between two variables. all statistical analyzes of the database results were performed with (SPSS for Windows, v.20.1; Chicago, IL). Results The present study has demonstrated metabolic syndrome criteria present in patients diagnosed with hypothyroidism in a high proportion. The male gender was 32% compared to the female 68%. The Framingham equation classified a higher percentage of women patients with hypothyroidism as low cardiovascular risk compared to the PROCAM and SCORE equations. Item was found that there was a greater cardiovascular risk in those patients with still uncontrolled hypothyroidism profile, showing a statistical correlation of this alteration for the 3 stratification systems used. Conclusions Hypothyroidism is a risk factor for cardiovascular disease. Uncontrolled hypothyroidism in the present study is associated with greater adverse outcomes in the medium and long term, the present study warns about the need to better characterize this patient cohorts.
Diastolic function and its relationship with the ATP-III criteria for metabolic syndrome in a Latin American cohort
(2023) María Gómez; Diego Acevedo; Silvia Fernanda Castillo Goyeneche; Anderson Felipe Arias; Luis Dulcey; Jaime Gomez; Carlos Hernandez; Juan Sebastián Theran León; Raimondo Caltagirone; Edgar Blanco
Abstract INTRODUCTION In South America, heart failure poses a substantial concern due to its widespread occurrence and insufficient data accuracy. Metabolic syndrome, a risk factor for heart disease and diabetes, is the focal point of the study, which seeks to examine its correlation with left ventricular diastolic function (LVDF) and indications of heart failure in adults within a South American hospital. MATERIALS AND METHODS A cross-sectional study with 2380 adults aged 65-79 in a South American hospital reveals connections between metabolic syndrome (MetS) and heart health. Using ATP-III criteria, MetS was identified, and cardiac function was assessed by echocardiography. Significant associations between MetS and various cardiac indicators were found. RESULTS Metabolic Syndrome (MetS) affected 33.1% of the sample, showing health differences and cardiac alterations, including ejection fraction changes. Associations with diastolic dysfunction criteria and complex relationships between natriuretic peptides and ventricular filling pressure were observed. CONCLUSIONS Metabolic syndrome links to significant changes in diastolic function and left ventricular structure, but not with alterations in the left atrium. Nevertheless, individuals with Metabolic Syndrome are more prone to receiving a diagnosis of chronic heart failure. Further extensive studies in diverse populations are advised.
EXPRESSION OF VARIABILITY OF THE CYP2C19*2 GENE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION FROM A SOUTH AMERICAN HOSPITAL AND ITS FUTURE RELEVANCE IN THE INTERACTION BETWEEN GENETICS AND CARDIOLOGY
(2023) Luis Dulcey; Juan Sebastián Theran León; Jaime Gomez; Rafael Guillermo Parales Strauch; Raimondo Caltagirone; Edgar Blanco; María Paula Ciliberti Artavia; Juan Camilo Martínez; Valentina Cabrera Peña; Maria Amaya
Abstract Introduction Some Polymorphisms of the CYP2C19 gene are associated with a decrease in the activity of the enzyme they encode, being the case of CYP2C19*2 in causing a lower generation of active metabolite of clopidogrel and therefore a low or null antiplatelet action depending on the genotype present. Antiplatelet therapy, mainly clopidogrel, is considered essential treatment in the management of acute coronary syndromes (ACS). Target The frequency of the CYPC19*2 polymorphism, identified as relevant in resistance to clopidogrel, is unknown in the population of this part of South America. Methods A descriptive, observational and cross-sectional study was designed to determine the frequency of the CYP2C19*2 allele in patients with ACS admitted to a South American hospital during the period between 2015-2016, being the first study to determine polymorphism in our population. fifty-nine adults patients diagnosed with ACS were included, 48 male (81.3%) and 11 female (18.7%), aged between 54 and 86 years. The genotype for the CYP2C19 gene was determined through the PCRRFLP (Restriction Fragments Length Polymorphism) technique from DNA extracted desde peripheral blood . Results The allelic frequency of the CYP2C19*2 polymorphism was 28.5%. Three subgroups of metabolizers were characterized : extensive (*1/*1) 40 (67.8%), intermediate (*1/*2) 17 (28.9%) and poor (*2/*2) 2 (3.3%). Conclusions This high number of carriers of the CYP2C19*2 polymorphism in the context of ACS is relevant due to its association with a lower responsiveness to clopidogrel and the possible involvement in the choice of antiplatelet therapy, for which characterization studies are required most appropriate to identify the best therapeutic strategies in our populations through pharmacogenomics.
Lipid-lowering therapy for patients with arterial hypertension and concomitant chronic obstructive pulmonary disease in a south American cohort
(2023) Diego Lobo; Santiago Bermudez; Luis Dulcey; Jaime Gomez; Carlos Hernandez; Juan Sebastián Theran León; Raimondo Caltagirone; Maria Amaya; María Gómez; Diego Acevedo
ABSTRACT Introduction to assess the lipid-lowering effect, the effect on endothelial function, oxidative stress of Rosuvastatin at a dose of 40 mg in patients with dyslipidemia, arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) initially, over time after 4 weeks and 12 months of treatment. Material and methods The prospective study included 33 patients (mean age 60 [54;61] years) with hypertension, COPD and dyslipidemia. The laboratory examination consisted of determining the lipid spectrum and the level of lipid peroxidation products (LPO). To assess the tolerability of the prescribed therapy, creatinine, bilirubin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were studied. To assess endothelial function, an endothelium-dependent vasodilation test (EDVD) was performed. Rosuvastatin at a dose of 40 mg was prescribed as lipid-lowering therapy. Initially, after 12 months, an ultrasound duplex scanning of the carotid arteries was performed to assess the presence of atherosclerotic plaques (AP) in the lumen of the vessel. The study was approved by the Local Ethics Committee of the Andes University in Merida, Venezuela (protocol No. 10 of December 25, 2017). Results after 4 weeks of treatment with Rosuvastatin at a dose of 40 mg, there was a significant decrease in total cholesterol levels by 26%, low-density lipoproteins (LDL) by 33%, triglycerides (TG) by 19%, while high-density lipoproteins (HDL) increased by 18%. Improvements in endothelial dysfunction (ED) and lipid peroxidation were observed during treatment with Rosuvastatin. Treatment with Rosuvastatin at a dose of 40 mg did not cause adverse reactions in patients. Conclusion correction of lipid metabolism disorders in patients with hypertension and COPD by prescribing Rosuvastatin at a dose of 40 mg can quickly reduce total cholesterol, LDL and TG, positively affecting endothelial function and lipid peroxidation processes. Therapy with Rosuvastatin at a starting dose of 40 mg in patients with dyslipidemia, hypertension and COPD is safe. After 12 months of regular use of Rosuvastatin at a dose of 40 mg, regression of AB was observed.
Longevity and frailty and their associated factors in the prognosis of coronary heart disease in a Latin American cohort
(2023) Luis Dulcey; Diego Acevedo; Silvia Fernanda Castillo Goyeneche; Anderson Felipe Arias; María Gómez; Jaime Gomez; Carlos Hernandez; Juan Sebastián Theran León; Raimondo Caltagirone; Edgar Blanco
Introduction to study the characteristics of the anamnestic history, the clinical course, as well as the nature of medical care for elderly patients with acute myocardial infarction (MI) and evaluate their impact on the prognosis of the disease. Material and methods the study included patients aged 60 years or older, survivors of acute myocardial infarction and registered in the database of the Hospital Universitario de los Andes in Merida, Venezuela (n=410). During the 2013-2018 study, a five-year prospective observation of patients with an assessment of their vital status was conducted. For the statistical processing of the data obtained, the Statistica V10.0 application package (StatSoft Inc.) was used. Results the analysis showed that 90% of the patients had a history of comorbid pathology. The presence of an atypical manifestation of myocardial infarction lengthened the prehospital stage of medical care for patients who were late in seeking medical attention (120 [49; 311.5] minutes), as well as the longest time until the first medical contact (26.5 [20; 40] minutes (p = 0.005)). One-fifth of patients were treated for acute MI in complementary hospitals, where the level of in-hospital mortality among elderly patients reached 65.7%, three times higher than the same figure in specialized cardiology departments (19, 7%, p< 0.001). Conclusion The main factors influencing long-term post-infarction in elderly patients were isolated systolic arterial hypertension, diabetes mellitus, renal dysfunction, previous myocardial infarction and acute stroke.
Pilot study of the FoxP3+ T lymphocyte count and its relationship with the Gensini score in patients with coronary heart disease and type 2 diabetes mellitus from a South American cohort
(2023) María Gómez; Diego Acevedo; Silvia Fernanda Castillo Goyeneche; Anderson Felipe Arias; Luis Dulcey; Jaime Gomez; Carlos Hernandez; Juan Sebastián Theran León; Raimondo Caltagirone; Edgar Blanco
Abstract INTRODUCTION One of the pathogenic links between type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) is low-intensity chronic inflammation, which is limited by FoxP3+ regulatory T cells. MATERIALS AND METHODS A comparative, observational, single-center, single-stage study was carried out. The severity of atherosclerosis was assessed by calculating the Gensini score based on selective coronary angiography. The absolute and relative content of CD4+CD25 high FoxP3+ and CD4+CD25 low FoxP3+ T cells in the blood was evaluated by flow cytometry. RESULTS 57 patients with chronic ischemic heart disease were examined. Patients with a combination of CHF and T2DM are characterized by an increase in the relative and absolute content of FoxP3+CD25 lymphocytes in the peripheral blood and an increase in the intranuclear content of FoxP3 in them, which is more pronounced in patients with disease moderate. atherosclerosis (Gensini score 17 to 45 points). CONCLUSIONS This was the first Latin American study that managed to show the relationship between an increase in the content of low FoxP3+CD25 lymphocytes in the peripheral blood with atherosclerosis in patients with a combination of coronary artery disease and DM2.