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Predictors of cardiovascular events during hospitalization after non-cardiac surgery
Session:
Posters 3 - Écran 01 - Cardiologia Clínica/Miscelânia
Speaker:
Ana Catarina Gomes
Congress:
CPC 2018
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.4 Non-cardiac Surgery/Pre-surgical Assessment
Session Type:
Posters
FP Number:
---
Authors:
Ana Catarina Gomes; Ana I. Marques; Ana Rita F. Pereira; Sofia Alegria; Rita Carvalheira Santos; Daniel Sebaiti; Dra. Inês Cruz; Paula Fazendas; Isabel João; Helder Pereira
Abstract
<p><strong>Introduction:</strong> Pre-operative assessment of patients before non-cardiac surgery is a common request in clinical practice. Patients (pts) who undergo non-cardiac surgery are at increased risk of cardiac morbidity and mortality, both intra-operatively and in the recovery period.</p> <p><strong>Purpose:</strong> To analyze predictors of cardiovascular (CV) events and new-onset AF or fast AF during hospitalization, after non-cardiac surgery.</p> <p><strong>Methods:</strong> Retrospective study including pts submitted to transthoracic or dobutamine echocardiography before non-cardiac surgery between 2012-2016. The medical history, echocardiographic parameters, medication and CV events during hospital stay were registered.</p> <p><strong>Results:</strong> We included 123 pts: 69 (56%) males, mean age of 69±13 years. 90 (73%) pts with arterial hypertension, 37 (30%) with diabetes or dyslipidemia, 22 (18%) pts with known coronary artery disease and 16% with atrial fibrillation. 28 (33%) pts were pre-operatively assessed by a Cardiologist.Transthoracic echocardiography was performed in 112 pts (90%) and dobutamine echocardiography in 12 pts: 108 (88%) pts had a normal left ventricular ejection fraction (LVEF), with mean LVEF of 59±10%; 19 pts (15%) had left ventricle wall motion abnormalities; 10 pts (9%) had right ventricular systolic dysfunction; 10 pts (9%) had at least moderate valvular heart disease (mainly aortic stenosis). In 100 (81%) pts an elective surgery and in 4 (3%) pts an urgent surgery were performed. 19 (15%) pts were submitted to a high cardiovascular risk surgery, 79 (64%) pts to an intermediate cardiovascular risk surgery and 25 (20%) pts to a low cardiovascular risk surgery. Pts were mainly submitted to abdominal and vascular surgery.</p> <p>The mean time of hospital stay was 11±10 days, with 10 (8%) pts having complications: 4 pts died (1 of them due to CV disease), 5 pts had an episode of fast AF, 2 pts had new onset-AF, 2 had an ischemic stroke and 1 had an episode of ventricular fibrillation.</p> <p>Pts with previous AF (30 vs 4%, p=0.001) and those submitted to a high-risk surgery (26% vs 5%, p=0.008) had significantly more CV events. Pts with valvular heart disease (33 vs 7%, p=0.075) or arterial hypertension (11 vs 0%, p=0.06) tended to have more events during hospital stay.</p> <p>Previous chronic renal disease (29% vs 3%, p=0.038), high-risk surgery (16% vs 3%, p=0.047) and a lower TAPSE value (17 vs 21 mm, p=0.034) were associated with new-onset AF or fast AF during hospital stay.</p> <p><strong>Conclusion:</strong> In our study, 8% of pts submitted to echocardiography before non-cardiac surgery had cardiovascular events during hospital stay, being atrial fibrillation and a high-risk surgery associated with increased incidence. Previous chronic renal disease, high-risk surgery and lower TAPSE values were associated with new-onset AF or fast AF, during hospital stay.</p> <p> </p> <p> </p>
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