Primum non nocere

Hipócrates, ao redor do ano 430 aC, propôs aos médicos, no parágrafo 12 do primeiro livro da sua obra Epidemia:
"Pratique duas coisas ao lidar com as doenças; auxilie ou não prejudique o paciente" - ou seja, primum non nocere - primeiro de tudo, não provoque nenhum dano.

quinta-feira, 15 de maio de 2008

Biomarcadores melhoram a predição de morte cardiovascular em homens idosos

Zethelius B. et AL. Use of Multiple Biomarkers to Improve the Prediction of Death from Cardiovascular Causes. NEJM. May 15, 2008;358(20):2107-2116.

A incorporação de 4 biomarcadores (troponina, peptídeo natriurético cerebral, cistatina C e proteína C reativa) aos fatores usuais de avaliação de risco cardiovascular significativamente aumenta a previsibilidade de morte por causas cardiovasculares


Incorporating four biomarkers along with the usual factors in assessing cardiovascular risk significantly increases the predictability of death from cardiovascular causes, the New England Journal of Medicine reports.

Researchers used customary risk factors, plus four biomarkers, to evaluate a cohort of some 1100 men with a mean age of 71 years. The biomarkers chosen reflect damage to or malfunction of various systems — namely, myocardium (troponin), left ventricle (brain natriuretic peptide), kidney (cystatin C), and inflammation (C-reactive protein).

After 10 years' follow-up, the inclusion of biomarkers significantly increased the predictability of death from cardiovascular disease, both in the entire cohort and in those without cardiovascular disease at baseline. Those with elevations in any two biomarkers had a 3-fold increase in risk, and elevations in all four presaged a 16-fold increase.

Editorialists say the results need validation in younger cohorts that include both men and women who don't have cardiovascular disease.

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