Assistência cirúrgico-odontológica a pacientes com história de infarto do miocárdio

The execution of a appropriate odontological surgical treatment for patients with Myocardial Infarction has been based in established protocols for important works in world wide literature during the sixty’s and seventy’s decade, established with a minimum of six months before the noncardiac surgery. The recent advancements in the medical assessment of surgical risk based on the individual analysis of each case with availability of new therapeutic tools in reference to medical or dental treatment, allowing for new procedures that can be used in the execution of safer odontological surgery for each patients. This review of the literature shows the actual tendencies of the treatment of patients with Myocardial Infarction concerning specific care before, during and after surgery based on laboratory evaluation and drug therapy as well as the possibility of surgical treatment before six months post-infarction.

Medicamentos inadequados para idosos na estratégia da saúde da família

The ageing process can change the pharmacodynamics and pharmacokinetics parameters. Therefore, some medications are considered potentially inappropriate (PIM) for the elderly people, since they can increase the likelihood of occurrence of adverse drug events. The objectives are to estimate the frequency of use of PIM in the elderly people, with potentially hazardous drug interactions (PHDI) and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. A cross-sectional study was performed in a Health Family Strategy (region of Araraquara, SP), between January and February/2012. The medical records of patients aged ≥60 years, that use at least one drug, were consulted for identification of PIM, according to the Beers criteria. The MPI identified were classified considering the Anatomical Therapeutic Chemical Classification System (ATC) and the essentiality of the drug (safety, effectiveness, quality and cost parameters) The inclusion criteria were met by 358 elderly, being that 93 of them (26%) had taken at least one PIM. Of the 114 different drugs prescribed for elderly, ten were classified as PIM, of which four of them act on the central nervous system, four on cardiovascular system and two on the digestive tract. Seven MPI are essential medicines, belonging to national list of essential drugs (RENAME-2010). Fourteen drug interactions were identified, of which two are PHDI (fluoxetine/amitriptyline and digoxin/hydrochlorothiazide).After the PI, there was no change in medical prescriptions of patients with PIM use or with DI. Medical prescriptions of elderly attended in the Health Family Strategy show pharmacotherapeutic safety problems, of which may be responsible for health hazardous for this age group. Although the intervention carried out by letter had been ineffective for the adherence of doctors in prescribing safe alternatives, wide dissemination of the lists that contain PIM and PHDI is need, as well as the inclusion of safer equivalents in RENAME, in order to contribute for rational use of drugs.

Resultados da atenção farmacêutica no Brasil: uma revisão

The practice of pharmaceutical care (PC) is recent in Brazil and little is known about its impact on the health system or patients. The aim of this review was thus to identify the clinical, humanistic and economic outcomes achieved by the practice of PC in Brazil. In order to assess those outcomes, data published in studies from 1997 to 2011 were collected from Lilacs and MEDLINE databases, using the technique of content analysis. Original studies on PC that included pharmacotherapeutic follow-up were considered eligible for this descriptive review. A total of 306 articles were identified through the chosen descriptors. Of those, ten studies were eligible for this review and only two did not report significant results. The others reported increased adherence to pharmacotherapy, resolution of pharmacotherapeutic issues and control of clinical parameters of diseases (such as maintenance or reduction of blood pressure, reduction in HIV viral load and increase in lymphocyte count), promoting improvements in the general state of health and behavioral changes. However, economic impact was not assessed in any article analyzed, nor was a direct measurement of life quality performed. Although there are few studies on the outcomes of pharmaceutical care services in Brazil, it is demonstrated in this review that positive results were obtained when the pharmacist acted as a provider of optimized pharmacotherapy. This may be considered a result of the actions that followed the Brazilian Pharmaceutical Care Consensus of 2002, such as the restructuring of the curricular basis of pharmacy courses. From this point on, Brazilian researchers and pharmacists should think of a strategy to expand the offer of pharmaceutical care beyond academia and reach people in general who need this type of health care.

A importância da atenção farmacêutica após a verificação da qualidade microbiológica de medicamentos contendo paracetamol encontrados em algumas residências de Américo Brasiliense - SP

It is known that a high microbial count can compromise the stability of medicines, thus reducing their therapeutic efficacy. This work tried to demonstrate that the microbial contamination can be directly related to the inadequate handling of the medicines stored in homes, making it possible to draw strategies to reduce the possible risks of medical therapy offering correct information and advising. The objective of this work was to evaluate the quality of the medicines containing paracetamol found in the residences of Américo Brasiliense-SP, using the microbial analysis of non-sterile method described in the Brazilian Pharmacopoeia (1988). The medicine samples (30 samples) were obtained directly from the interviewed local residents, who had received new medicine bottles of the same product. An analysis of viable microorganisms (bacteria and fungus) was carried out to identify pathogens found in the collected samples. Although 90% of the analyzed samples have shown some microbial contamination, the results indicated the absence of pathogenic microorganisms, and the total count of viable microorganisms was below the maximum value for non-sterile (104 UFC/g or mL). It was also verified that the local residents stored the medicines in appropriate places, according to the orientations received when they bought the medicines in pharmacies and drugstores, showing the importance of information for the correct use and conservation of pharmaceuticals.

Revisão sistemática do perfil de risco e profilaxia de tromboembolismo venoso no Brasil e no mundo

Pós-graduação em Bases Gerais da Cirurgia - FMB

Idosos e embalagens alimentares: avaliação do design ergonómico de informação

The packaging often presents faults that difficult the communication between product and consumer. The aim of this research is to study the interaction between a group of elderly people with five food packagings, that being illinterpreted, can bring them health problems. The results of this study evidence the importance of ergonomics in graphic design for food packaging.

Autocuidado na percepção de pessoas com hanseníase sob a ótica da complexidade

Objective: This study aimed to understand how patients with Hansen's Disease perceive self-care from the complexity perspective. Methods: Qualitative, descriptive and exploratory study based on the Collective Subject Discourse. Results: Sample composed of 15 subjects, most of whom were married males (66.6%) with a mean age of 52.3 years and were classified in the polarized forms of the disease. The following themes emerged from the DCS synthesis: having Hansen's Disease, drug therapy, self-care and lifestyle. The study provided visibility to the vertical model, which is largely hegemonic in the tradition of public health care policies, showing concern about only treating the disease, disregarding the complex relationships involved. Conclusion: Acknowledging these limitations and setting strategies to change them in favor of the dialogue among interprofessional team members are challenges to further develop self-care practices and to empower patients in relation to treatment and disease.

Nível de atividade física, estado nutricional e níveis de BACE 1 e BACE 2 em idosos neurologicamente saudáveis e com doença de Alzheimer

Pós-graduação em Ciências da Motricidade - IBRC

Melhorando os resultados do transplante renal. Medidas comportamentais na redução da não adesão: estudo prospectivo controlado

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Melhorando os resultados do transplante renal. Medidas comportamentais na redução da não adesão: estudo prospectivo controlado

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Resistance to octreotide LAR in acromegalic patients with high SSTR2 expression: analysis of AIP expression

We present here the clinical and molecular data of two patients with acromegaly treated with octreotide LAR after non-curative surgery, and who presented different responses to therapy. Somatostatin receptor type 2 and 5 (SSTR2 and SSTR5), and aryl hydrocarbon receptor-interacting protein (AIP) expression levels were analyzed by qPCR. In both cases, high SSTR2 and low SSTR5 expression levels were detected; however, only one of the patients achieved disease control after octreotide LAR therapy. When we analyzed AIP expression levels of both cases, the patient whose disease was controlled after therapy exhibited AIP expression levels that were two times higher than the patient whose disease was still active. These two cases illustrate that, although the currently available somatostatin analogs bind preferentially to SSTR2, some patients are not responsive to therapy despite high expression of this receptor. This difference could be explained by differences in post-receptor signaling pathways, including the recently described involvement of AIP. Arq Bras Endocrinol Metab. 2012;56(8):501-6

Transtorno afetivo bipolar: perfil farmacoterapêutico e adesão ao medicamento

This cross-sectional and descriptive study aimed to verify the adherence of patients with Bipolar Affective Disorder (BAD) to medication and to identify possible causes of adherence and non-adherence to medication according to the pharmacotherapeutic profile. The study was carried out in a mental health service in a city in the interior of the state of Sao Paulo. Participants included 101 patients with BAD. Structured interviews and the Morisky-Green test were used for data collection, and the Statistical Package for Social Science was employed for data analysis. Most subjects (63%) did not adhere to medication. Although there were no significant differences between the adherent and non-adherent groups for the researched variables, the use of polypharmacotherapy and complex treatment regimens was observed in treatment for BAD. In practice, implementing strategies to improve the adherence of patients to medication treatment remains a challenge.

Summary of the II Brazilian Guideline Update on Acute Heart Failure 2009/2011

In the past two years we observed several changes in the diagnostic and therapeutic approach of patients with acute heart failure (acute HF), which led us to the need of performing a summary update of the II Brazilian Guidelines on Acute Heart Failure 2009. In the diagnostic evaluation, the diagnostic flowchart was simplified and the role of clinical assessment and echocardiography was enhanced. In the clinical-hemodynamic evaluation on admission, the hemodynamic echocardiography gained prominence as an aid to define this condition in patients with acute HF in the emergency room. In the prognostic evaluation, the role of biomarkers was better established and the criteria and prognostic value of the cardiorenal syndrome was better defined. The therapeutic approach flowcharts were revised, and are now simpler and more objective. Among the advances in drug therapy, the safety and importance of the maintenance or introduction of beta-blockers in the admission treatment are highlighted. Anticoagulation, according to new evidence, gained a wider range of indications. The presentation hemodynamic models of acute pulmonary edema were well established, with their different therapeutic approaches, as well as new levels of indication and evidence. In the surgical treatment of acute HF, CABG, the approach to mechanical lesions and heart transplantation were reviewed and updated. This update strengthens the II Brazilian Guidelines on Acute Heart Failure to keep it updated and refreshed. All clinical cardiologists who deal with patients with acute HF will find, in the guidelines and its summary, important tools to help them with the clinical practice for better diagnosis and treatment of their patients.

Lo intermedio como lugar : lo intersticial, lo fronterizo y lo impreciso en la arquitectura contemporánea

1. Nuestra investigación se centra en el estudio de los “ámbitos o espacios intermedios” en momentos de la arquitectura contemporánea, en un período de transición entre finales de los años 80 y nuestros días. Pretendemos analizar cómo se presenta el ámbito intermedio en el objeto o lugar arquitectónico y su función o relación con el entorno cercano, desde el proyecto hasta su repercusión en la experiencia vivida. 2. El concepto de intermedio entendido como ámbito o espacio intersticial, fronterizo y ambivalente (o multivalente), atraviesa en la presente investigación el campo de la etimología, de la ciencia, del pensamiento y del arte, para detenerse en la arquitectura actual, llevándose a cabo una indagación concreta en el proceso de concepción, en la propuesta formal, espacial y funcional, así como en la percepción y demás experiencias o vivencias en el lugar arquitectónico. 3. En primer lugar nos proponemos estudiar y explorar el concepto de “intermedio” en sus características, funciones y ubicaciones dentro de la cultura contemporánea, detectando sus antecedentes culturales más importantes, para a continuación aplicarlo reflexivamente a obras significativas de arquitectura. La investigación se enfoca en la modalidad figural (imprecisa) de lo intermedio (en alusión al “figural” deleuziano), cuyas metáforas base son lo translúcido, la penumbra y la espuma, vinculadas al actual paradigma cultural de la complejidad (C. Jencks). A continuación se analizan las relaciones o implicaciones de dicha modalidad figural en obras de arquitectos como Eisenman, Holl, Tschumi, Ito, Fujimoto, Van Berkel y Bos, y Siza, comprobando su valor operativo y poniendo de manifiesto su sentido e importancia en la actualidad y en la disciplina. El estudio tiene como trasfondo el concepto de in-between de la obra de Eisenman, y utiliza conceptos de la filosofía del límite de Trías como algunos de sus principales fundamentos. 4. En cada una de las obras de arquitectura presentadas esta modalidad imprecisa se traduce en un ámbito o espacio intermedio figural específico. Son obras en las que real y virtual, matricial y objetual, arquitectura y territorio, existente y nuevo, colectivo e individual, social e íntimo, interior y exterior, y demás usos y funciones se entrelazan o funden. Son arquitecturas cuya geometría ya no se encuentra tan determinada por aspectos bi o tridimensionales del dibujo o de la construcción. A través de la manipulación de estas geometrías más o menos complejas, dinámicas e intersticiales, estas obras reflejan (o intuyen) las premisas del actual Zeitgeist: un cambio de esquemas de objetos a relaciones basado en un pensamiento más holístico, transdisciplinar, sistémico o complejo (E. Morin), y una nueva conciencia colectiva sobre la realidad que anuncia la crisis de la percepción, el cambio de paradigma y nuevos valores (F. Capra). Emerge otra forma de sentir y percibir el mundo, los lugares y los espacios, que poco a poco está cambiando el modo de pensar y dibujar la arquitectura, y consecuentemente de interaccionar con ella. 5. El sentido del espacio intermedio figural, emerge en las cada vez más complejas cualidades morfológico-espaciales y funcionales de una parte importante de la arquitectura actual. Arquitectura, geometría y tecnología informática están más entrelazadas que nunca, y de un modo más libre, para así poder indagar en nuevas formas de pensar y crear lugares en que los “espacios intermedios” que investigamos son un testimonio. El espacio arquitectónico se vuelve afectivo e interactivo, un lugar intermedio figural, formalizado por espacialidades intersticiales que parecen aludir a lo líquido, donde la forma es más matriz que configuración, el espacio más espacialidad que compartimiento, la función más versátil y multivalente que específica o autónoma, y la perplejidad, la imaginación y la evocación se entrecruzan y vuelven patentes. 6. La arquitectura de los lugares intermedios valora no solamente el “plano”, la “configuración” y la “transparencia”, sino sobre todo el “espacio” y la “relación” en sus interrelaciones con los usuarios y demás contextos. De la identidad a la relacionalidad, de la representación a la presentación, es una arquitectura que propone “otros espacios” que más que espacios son topografías y espacialidades intersticiales, de tensión, transición, transformación, relación, intercambio e interacción. Son lugares intermedios reales y virtuales, que se sirven tanto de la morfología como de la topología para conquistar nuevas espacialidades, pretendiendo salir de la estricta operación de “forming”/”morphing”/formación/”conformación” para explorar la de “spacing”/espaciamiento. Son lugares que se basan en conceptos como la zona de indiscernibilidad de Deleuze, la imagen- flujo de Buci-Glucksmann, la suspensión-entre de Sloterdijk, o el espacio no-objetivo al que se refiere José Gil, plasmándose en la arquitectura contemporánea como tropos de lo intersticial. 7. Son los lugares intermedios de la arquitectura actual, de espacialidad háptica, más “afectiva”, generativa e interactiva, donde ese ámbito intermedio transforma y es transformado, “afecta”, “con-mueve” (nos hace mover/accionar) y evoca otros lugares, otras posibilidades de espacio habitable u ocupable. Emerge lo intermedio como lugar, algo que anuncia y exhibe, de manera paradigmática y manifiesta, el monumento de Eisenman en Berlín. ABSTRACT 1. Our research focuses on the study of “in-between spaces or environments” at particular times in contemporary architecture, in a transition period from the end of the 1980’s through to today. We aim to analyse how in-between environments are presented in the architectural object or place and their function or their relationship with the nearby surroundings, from the project through to the experience had. 2. In this research, the in-between concept, understood as an interstitial, border and ambivalent (or multi-purpose) environment or space, is assessed from the viewpoint of etymology, science, thought and art, to conclude in current architecture, with specific exploration of the conception process, of the formal, spatial and functional proposal, together with the perception and other experiences in the architectural place. 3. Firstly, we aim to study and explore the “in-between” concept as regards its features, functions and locations within contemporary culture, revealing its most important cultural background, to then apply it reflexively to important works of architecture. The research focuses on the figural (imprecise) mode of in-between (in allusion to Deleuze’s “figural” approach) whose base metaphors are the translucent, semi-darkness and foam, linked to the current cultural paradigm of complexity (C. Jenks). We then go on to assess the relationships or implications of said figural mode in architectural works by Eisenman, Holl, Tschumi, Ito, Fujimoto, Van Berkel and Bos, and Siza, verifying their operational worth and revealing their meaning and importance today and in this discipline. The backdrop of the study is the in-between concept of Eisenman’s work and it also uses concepts from the philosophy of the limit of Trías as its main underpinnings. 4. In each of the architectural works presented, this imprecise mode is translated into a specific in-between environment or space. They are works in which real and virtual, matricial and objectual, architecture and territory, existing and new, collective and individual, social and intimate, interior and exterior and other uses and functions all intertwine or blend together. They are architectures the geometry of which is not so much determined by bi- or tri-dimensional aspects of the drawing or construction. Through the manipulation of these more or less complex, dynamic and interstitial geometries, these works reflect (or insinuate) the premises of the current Zeitgeist: A change in the scheme of objects to relationships towards a more holistic, transdisciplinary, systemic or complex thought (E. Morin), and a new collective conscience about the reality which announces the crisis of perception, the change in paradigm and new values (F. Capra). Another way of feeling and perceiving the world, places and spaces, which little by little is changing the way of thinking and drawing architecture and hence of interacting with it. 5. The meaning of figural in-between space emerges in the increasingly complex, morphological-spatial and functional qualities of a large part of architecture today. Architecture, geometry and computer technology are more than ever intertwined in a freer way to inquire into other ways of thinking and making places, where the “in-between” spaces we research are a testimony. Architectural space becomes affective and interactive, a figural in-between place, formed by interstitial spatiality which seems to allude to something liquid, where shape is more matrix than configuration, space more spatiality than compartment, its function more versatile and multi-purpose than specific or autonomous, and perplexity, imagination and evocation criss-cross each other, becoming obvious. 6. The architecture of in-between places values not only “flat”, “configuration” and “transparency”, but above all “space” and the “relationship” in its interrelations with users and other contexts. From identity to relationality, from representation to presentation, it is an architecture that proposes “other spaces”, which more than spaces are topographies and interstitial spatialities, of tension, transition, transformation, relation, exchange and interaction. They are real and virtual in-between places, that take in both morphology and topology to conquer new spatialities, aiming to depart from the strict “forming”/”morphing” operation in order to explore “spacing”. They are places that derive both from Deleuze’s indiscernibility zone concept, from Buci-Glucksmann´s image-flow concept, from Sloterdijk’s suspension-between, and from the non-objective space referred to by José Gil, and they are embodied in contemporary architecture as tropes of the interstitial. 7. They are the in-between places in architecture today, of haptic spatiality, more “affective”, generative and interactive, where that in-between environment transforms and is transformed, “affects”, “moves” (it makes us move/act) and evokes other places, other possibilities of habitable or occupiable space. The in-between emerges as a place, which paradigmatically and declaredly, Eisenman´s monument in Berlin announces and exhibits. RESUMO 1. A investigação centra-se no estudo dos “âmbitos ou espaços intermédios” em momentos da arquitectura contemporânea, no período de transição entre os finais dos anos 80 e os nossos dias. Pretende-se analisar como se apresenta o âmbito intermédio no objecto ou lugar arquitectónico e sua função ou relação com o meio envolvente, desde o projecto até à sua repercussão na experiencia vivenciada. 2. O conceito de intermédio entendido como âmbito ou espaço intersticial, fronteiriço e ambivalente (ou multivalente), atravessa na presente investigação o campo da etimologia, da ciência, do pensamento e da arte, para deter-se na arquitectura actual, realizando-se uma indagação concreta no processo de concepção, na proposta formal, espacial e funcional, assim como na percepção e demais experiencias ou vivencias no lugar arquitectónico. 3. Em primeiro lugar, explora-se o conceito de “intermédio” nas suas características, funções e concretizações na cultura contemporânea, detectando os seus antecedentes culturais mais importantes, para em seguida aplicá-lo reflexivamente a obras significativas de arquitectura. A investigação centra-se na modalidade figural (imprecisa) do intermédio (alusão ao figural deleuziano) cujas metáforas base são o translúcido, a penumbra e a espuma, relacionadas com o actual paradigma da complexidade (C. Jencks). Em seguida analisam-se as relações ou implicações da referida modalidade figural em obras de arquitectos como Eisenman, Holl, Tschumi, Ito, Fujimoto, Van Berkel e Bos, e Siza, como modo de comprovar o seu valor operativo e revelar o seu sentido e importância na actualidade e na disciplina. O estudo tem como referencia o conceito de in-between da obra de Eisenman, e utiliza conceitos da filosofia do limite de Trias como alguns dos seus principais fundamentos. 4. Em cada uma das obras de arquitectura apresentadas esta modalidade imprecisa traduz-se num âmbito ou espaço intermédia figural especifico. São obras nas quais real e virtual, matricial e objectual, arquitectura e território, existente e novo, colectivo e individual, social e intimo, interior e exterior, e outros usos e funções se entrelaçam ou fundem. São arquitecturas cuja geometria já não está tão determinada por aspectos bi ou tridimensionais do desenho ou da construção. Através do uso destas geometrias mais ou menos complexas, dinâmicas e intersticiais, estas obras reflectem (ou intuem) as premissas do actual zeitgeist: uma mudança de esquemas de objectos a relações para um pensamento mais holístico, transdisciplinar, sistémico ou complexo (E. Morin) e uma nova consciência colectiva sobre a realidade, que anuncia a crise da percepção, a mudança de paradigma e novos valores (F. Capra). Emerge uma outra forma de sentir e perceber o mundo, os lugares e os espaços, que gradualmente vai alterando o modo de pensar e desenhar a arquitectura, e consequentemente de interagir com ela. 5. O sentido do espaço intermédio figural, emerge nas cada vez mais complexas qualidades morfológico-espaciais e funcionais de uma parte importante da arquitectura actual. Cada vez mais, arquitectura, geometria e tecnologia informática, relacionam-se de um modo mais livre para indagar outras formas de pensar e fazer lugares, onde os espaços intermédios que investigamos são um testemunho. O espaço arquitectónico torna-se afectivo e interactivo, um lugar intermédio figural, formalizado por espacialidades intersticiais que parecem aludir ao estado liquido, onde a forma é mais matriz que configuração, o espaço mais espacialidade que compartimento, a função mais versátil e multivalente que especifica ou autónoma, e a perplexidade, a imaginação e a evocação entrecruzam-se e tornam-se patentes. 6. A arquitectura dos lugares intermédios valoriza não só o “plano”, a “configuração” e a “transparência”, mas sobretudo o” espaço” e a ”relação” nas suas inter-relações com os utentes e restante contextos. Da identidade à relacionalidade, da representação à apresentação, é uma arquitectura que propõe “outros espaços”, que além de espaços são topografias e espacialidades intersticiais, de tensão, transição, transformação, relação, intercambio e interacção. São lugares intermédios reais e virtuais que utilizam tanto a morfologia como a topologia para conquistar novas espacialidades, pretendendo ultrapassar a estrita operação de “forming”/“morphing”/formação para explorar a de “spacing”/espaçamento. São lugares que se apoiam tanto no conceito de zona de indescernibilidade de Deleuze, como na de imagem-fluxo de Buci-Glucksmann como no de suspensão–entre de Sloterdijk ou de espaço-não objectivo que refere José Gil, e se plasmam na arquitectura contemporânea como tropos do intersticial. 7. São os lugares intermédios da arquitectura actual, de espacialidade háptica, mais “afectiva”, generativa e interactiva, onde esse âmbito intermédio transforma e é transformado, “afecta”, ”co-move “(nos faz mover/agir) e evoca outros lugares, outras possibilidades de espaço habitável ou ocupável. Emerge o intermédio como lugar que, paradigmática e manifestamente, o monumento de Eisenmann em Berlim, anuncia e exibe.

Análise transcriptômica de miRNAs em pacientes sob dupla terapia de antiagregação

A terapia antiagregante é comumente indicada na prevenção e tratamento de doenças cardiovasculares. A dupla antiagregação com clopidrogrel e ácido acetilsalicílico (AAS) tem sido frequentemente adotada em pacientes com Doença Arterial Coronariana (DAC), mas apresenta ineficácia em uma parcela significativa da população com genótipo de respondedores. Essa falha terapêutica nos leva a questionar se outros mecanismos moleculares podem estar influenciando na resposta a esses fármacos. Recentes estudos sugerem que pequenas sequências de RNA não codificantes denominadas microRNAs (miRNAs) podem estar fortemente relacionadas com resposta ao tratamento fármaco-terapêutico, controlando as proteínas envolvidas na farmacocinética e farmacodinâmica. Entretanto, os principais miRNAs que atuam na dinâmica da resposta medicamentosa ainda não foram bem definidos. O objetivo deste estudo foi avaliar o perfil de miRNAs no sangue total periférico, procurando melhor esclarecer os mecanismos envolvidos na resposta aos antiagregantes plaquetários AAS e clopidogrel. Para isso, selecionou-se pacientes com DAC, os quais apresentavam diferentes respostas à dupla terapia de antiagregação determinadas pelo teste de agregação plaquetária. Baseados nos fenótipos, os perfis de expressão de miRNAs foram comparados entre os valores da taxa de agregação categorizados em tercis (T) de resposta. O grupo T1 foi constituído de pacientes respondedores, o T2 de respondedores intermediários e o T3 de não respondedores. Os perfis de miRNAs foram obtidos após sequenciamento de última geração e os dados obtidos foram analisados pelo pacote Deseq2. Os resultados mostraram 18 miRNAs diferentemente expressos entre os dois tercis extremos. Dentre esses miRNAs, 10 deles apresentaram importantes alvos relacionados com vias de ativação e agregação plaquetária quando analisados pelo software Ingenuity®. Dos 10 miRNAs, 4 deles, os quais apresentaram-se menos expressos no sequenciamento, demonstraram os mesmos perfis de expressão quando analisados pela reação em cadeia pela polimerase quantitativa (qPCR): hsa-miR-423-3p, hsa-miR-744-5p, hsa-miR- 30a-5p e hsa-let-7g-5p. A partir das análises de predição de alvos, pôde-se observar que os quatro miRNAs, quando menos expressos simultaneamente, predizem ativação da agregação plaquetária. Além disso, os miRNAs hsa-miR- 423-5p, hsa-miR-744-5p e hsa-let-7g-5p mostraram correlação com o perfil lipídico dos pacientes que, por sua vez, apresentou influência nos valores de agregação compreendidos no T3 de resposta a ambos os medicamentos. Sendo assim, conclui-se que maiores taxas de agregação plaquetária podem estar indiretamente relacionadas com os padrões de expressão de hsa-miR- 423-3p, hsa-miR-744-5p e hsa-let-7g-5p. Sugere-se que a avaliação do perfil de expressão destes 3 miRNAs no sangue periférico de pacientes com DAC possa predizer resposta terapêutica inadequada ao AAS e ao clopidogrel