Evidence-based Brazilian cardiovascular medicine

Pêgo-Fernandes, Paulo Manuel; Bibas, Benoit Jacques

doi:10.1590/S0066-782X2011001300001

EDITORIAL

Disciplina de Cirurgia Torácica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brasil

Mailing Address

Keywords: Meta-analysis; cardiology; Brazil; evidence - based medicine.

Evidence-based medicine has become increasingly important in national and international Cardiology. The São Paulo Medical Journal aims to publish articles from all medical fields, focusing on evidence-based Medicine. Original articles, systematic reviews, case reports and Cochrane's articles of interest are published.

During the period 2009-2011, 20 articles were published on cardiovascular medicine ^1-20. Of these, five were systematic reviews and well performed meta-analysis, addressing cardiac resynchronization in patients with heart failure ¹, drug treatment of hypertensive urgencies ³, valve diseases ¹², Marfan syndrome ¹³ and statins for aortic stenosis ¹⁶.

We also emphasize Cochrane's articles of interest, which covered topics such as drug intervention in obese children ², first-line drugs for the treatment of hypertension ⁶, anticoagulation management ¹⁰, oxygen therapy for acute myocardial infarction ¹⁴ and transmyocardial laser revascularization versus medical treatment for refractory angina ²⁰.

Among the original articles published, the one by Canti et al.⁴is noteworthy, which evaluated 40 women with preeclampsia (study group) and 14 pregnant women with normal blood pressure (control group).

These women had been followed ten years before and had undergone clinical and laboratory assessment. Patients that had had preeclampsia ten years before or longer had higher diastolic blood pressure, body mass index (BMI) and larger waist circumference, when compared to the control group. Zambon et al. ⁸ selected 222 men and divided them into two groups: men with erectile dysfunction (n = 111) and men without erectile dysfunction (n = 111). Patients were stratified according to the International Index of Erectile Function (Erectile Function domain, IIEF-EF domain).

C-reactive protein levels and Framingham risk score were analyzed, and the two groups were compared. C-reactive protein levels were significantly higher in men with erectile dysfunction (Pp = 0.04). Patients with erectile dysfunction also had a high Framingham risk score (Pp = 0.0015), suggesting that men with erectile dysfunction have a higher cardiovascular risk.

Mishra et al. ¹¹ evaluated the prevalence of common thrombophilia markers and risk factors in patients with primary venous thrombosis. The popliteal vein was the most often affected site, and a total of 44 samples (56%) showed abnormal results. The most frequent findings were increase in fibrinogen and APC-R (17.9% each), and low protein S levels (16.6%). Matos et al. ¹⁵ studied the correlation of anthropometric indicators to identify insulin sensitivity and resistance. They analyzed 61 individuals with normal fasting glucose and 43 overweight women, determining: BMI, waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR), conicity index, as well as HOMA-IS and HOMA-IR. The most promising indicators of insulin sensitivity in subjects with normal fasting glucose levels were BMI, WHtR and WC. Among overweight women, the WHtR showed a higher correlation with insulin resistance.

Fodor et al. ¹⁹ evaluated the association between osteoporosis and atherosclerosis in postmenopausal women. The aim of this study was to determine the association between the thickness of the intima and media layers of common carotid arteries, the atherosclerotic plaques and bone density. The results showed that in women with osteoporosis, there is an association between the media and intima layer thickness of the carotid arteries and atherosclerosis. The mean intima thickness (Pp <0.001), hypertension (Pp = 0.005) and osteoporotic vertebral fractures (Pp = 0.048) correlated with atherosclerotic plaque development.

The São Paulo Medical Journal, in the person of its editors, editorial board members and reviewers, has been working continuously to develop and improve the journal. It is a great pleasure to share our work with the Brazilian Archives of Cardiology, and together contribute to the development of the Brazilian Cardiovascular Medicine.

References

1. Lemos Júnior HP, Atallah AN. Cardiac resynchronization therapy in patients with heart failure: systematic review. São Paulo Med J. 2009;127(1):40-5.
2. Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, et al. Interventions for treating obesity in children. São Paulo Med J. 2009;127(5):321.
3. Souza LM, Riera R, Saconato H, Demathé A, Atallah AN. Oral drugs for hypertensive urgencies: systematic review and meta-analysis. São Paulo Med J. 2009;127(6):366-72.
4. Canti IC, Komlós M, Martins-Costa SH, Ramos JG, Capp E, Corleta HE. Risk factors for cardiovascular disease ten years after preeclampsia. São Paulo Med J. 2010;128(1):10-3.
5. Diaz-Olmos R, Nogueira AC, Penalva DQ, Lotufo PA, Benseñor IM. Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace. São Paulo Med J. 2010;128(1):18-23.
6. Wright JM, Musini VM. First-line drugs for hypertension. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD CD001841.
7. Macedo CR, Silva DL, Puga ME. Methodological adequacy of articles published in two open-access Brazilian cardiology periodicals. São Paulo Med J. 2010;128(2):85-9.
8. Zambon JP, Mendonça RR, Wroclawski ML, Karam Junior A, Santos RD, Carvalho JA, et al. Cardiovascular and metabolic syndrome risk among men with and without erectile dysfunction: case-control study. São Paulo Med J. 2010;128(3):137-40.
9. Abe IM, Goulart AC, Santos Júnior WR, Lotufo PA, Benseñor IM. Validation of a stroke symptom questionnaire for epidemiological surveys. São Paulo Med J. 2010;128(4):225-31.
10. Garcia-Alamino JM, Ward AM, Alonso-Coello P, Perera R, Bankhead C, Fitzmaurice D, et al. Self-monitoring and self-management of oral anticoagulation. Cochrane Database Syst Rev. 2010; 14(4):CD 003839.
11. Mishra MN, Bedi VS. Prevalence of common thrombophilia markers and risk factors in Indian patients with primary venous thrombosis. São Paulo Med J. 2010;128(5):263-7.
12. Yuan SM, Jing H. The bicuspid aortic valve and related disorders. São Paulo Med J. 2010;128(5):296-301.
13. Yuan SM, Jing H. Marfan's syndrome: an overview. São Paulo Med J. 2010;128(6):360-6.
14. Cabello JB, Burls A, Emparanza JI, Bayliss S, QuinnT. Oxygen therapy for acute myocardial infarction. Cochrane Database Syst Rev. 2010; Jun 16(6):CD007160.
15. Matos LN, Giorelli G de V, Dias CB. Correlation of anthropometric indicators for identifying insulin sensitivity and resistance. São Paulo Med J. 2011;129(1):30-5.
16. Thiago L, Tsuj SR, Atallah AN, Puga ME, de Góis AF. Statins for progression of aortic valve stenosis and the best evidence for making decisions in health care. São Paulo Med J. 2011;129(1):41-5.
17. de Lima VJ, de Andrade CR, Ruschi GE, Sass N. Serum lipid levels in pregnancies complicated by preeclampsia. São Paulo Med J. 2011;129(2):73-6.
18. Pêgo-Fernandes PM, Monteiro R. Surgical treatment of heart failure: a hot topic. São Paulo Med J. 2011;129(3):127-9.
19. Fodor D, Bondor C, Albu A, Muntean L, Simon SP, Poanta L, et al. Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study. São Paulo Med J. 2011;129(3):139-45.
20. Briones E, Lacalle JR, Marin I. Transmyocardial laser revascularization versus medical therapy for refractory angina. Cochrane Database Syst Rev. 2009 Jan 21(1):CD 003712.

Evidence-based Brazilian cardiovascular medicine

Paulo Manuel Pêgo-Fernandes; Benoit Jacques Bibas

Publication Dates

Publication in this collection
30 Nov 2011
Date of issue
Oct 2011

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Lemos Júnior HP, Atallah AN. Cardiac resynchronization therapy in patients with heart failure: systematic review. São Paulo Med J. 2009;127(1):40-5.

[2] 2. Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, et al. Interventions for treating obesity in children. São Paulo Med J. 2009;127(5):321.

[3] 3. Souza LM, Riera R, Saconato H, Demathé A, Atallah AN. Oral drugs for hypertensive urgencies: systematic review and meta-analysis. São Paulo Med J. 2009;127(6):366-72.

[4] 4. Canti IC, Komlós M, Martins-Costa SH, Ramos JG, Capp E, Corleta HE. Risk factors for cardiovascular disease ten years after preeclampsia. São Paulo Med J. 2010;128(1):10-3.

[5] 5. Diaz-Olmos R, Nogueira AC, Penalva DQ, Lotufo PA, Benseñor IM. Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace. São Paulo Med J. 2010;128(1):18-23.

[6] 6. Wright JM, Musini VM. First-line drugs for hypertension. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD CD001841.

[7] 7. Macedo CR, Silva DL, Puga ME. Methodological adequacy of articles published in two open-access Brazilian cardiology periodicals. São Paulo Med J. 2010;128(2):85-9.

[8] 8. Zambon JP, Mendonça RR, Wroclawski ML, Karam Junior A, Santos RD, Carvalho JA, et al. Cardiovascular and metabolic syndrome risk among men with and without erectile dysfunction: case-control study. São Paulo Med J. 2010;128(3):137-40.

[9] 9. Abe IM, Goulart AC, Santos Júnior WR, Lotufo PA, Benseñor IM. Validation of a stroke symptom questionnaire for epidemiological surveys. São Paulo Med J. 2010;128(4):225-31.

[10] 10. Garcia-Alamino JM, Ward AM, Alonso-Coello P, Perera R, Bankhead C, Fitzmaurice D, et al. Self-monitoring and self-management of oral anticoagulation. Cochrane Database Syst Rev. 2010; 14(4):CD 003839.

[11] 11. Mishra MN, Bedi VS. Prevalence of common thrombophilia markers and risk factors in Indian patients with primary venous thrombosis. São Paulo Med J. 2010;128(5):263-7.

[12] 12. Yuan SM, Jing H. The bicuspid aortic valve and related disorders. São Paulo Med J. 2010;128(5):296-301.

[13] 13. Yuan SM, Jing H. Marfan's syndrome: an overview. São Paulo Med J. 2010;128(6):360-6.

[14] 14. Cabello JB, Burls A, Emparanza JI, Bayliss S, QuinnT. Oxygen therapy for acute myocardial infarction. Cochrane Database Syst Rev. 2010; Jun 16(6):CD007160.

[15] 15. Matos LN, Giorelli G de V, Dias CB. Correlation of anthropometric indicators for identifying insulin sensitivity and resistance. São Paulo Med J. 2011;129(1):30-5.

[16] 16. Thiago L, Tsuj SR, Atallah AN, Puga ME, de Góis AF. Statins for progression of aortic valve stenosis and the best evidence for making decisions in health care. São Paulo Med J. 2011;129(1):41-5.

[17] 17. de Lima VJ, de Andrade CR, Ruschi GE, Sass N. Serum lipid levels in pregnancies complicated by preeclampsia. São Paulo Med J. 2011;129(2):73-6.

[18] 18. Pêgo-Fernandes PM, Monteiro R. Surgical treatment of heart failure: a hot topic. São Paulo Med J. 2011;129(3):127-9.

[19] 19. Fodor D, Bondor C, Albu A, Muntean L, Simon SP, Poanta L, et al. Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study. São Paulo Med J. 2011;129(3):139-45.

[20] 20. Briones E, Lacalle JR, Marin I. Transmyocardial laser revascularization versus medical therapy for refractory angina. Cochrane Database Syst Rev. 2009 Jan 21(1):CD 003712.