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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
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14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
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19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
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Lp(a) levels are associated with atherosclerotic plaque instability and with MACE following acute myocardial infarction
Session:
CO4 - Prevenção / Reabilitação
Speaker:
Joel Monteiro
Congress:
CPC 2019
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.2 Risk Factors and Prevention – Cardiovascular Risk Assessment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Joel Ponte Monteiro; Maria Isabel Mendonça; Andreia Pereira; Joao Adriano Sousa; Flávio Mendonça; Micaela Rodrigues Neto; Ana Célia Sousa; Eva Henriques; Sónia Freitas; Mariana Rodrigues; Ilídio Ornelas; A. Drumond de Freitas; Roberto Palma dos Reis
Abstract
<p>Previous work has shown that LPA gene variant increases its expression as well as plasma levels of Lp(a). Elevated levels of this lipoprotein have been associated with earlier events in patients after acute myocardial infarction (AMI).</p> <p><strong>Objective:</strong> Investigate in our population whether high plasma levels of Lp (a) are associated with the onset of cardiovascular events (MACE) and whether event-free time is lower than in those with low Lp (a) levels.</p> <p><strong>Methods:</strong> This study included 1181 patients with history of AMI from the GENEMACOR population. Traditional risk factors (TRF) such as smoking, dyslipidemia, diabetes, family history, hypertension, body mass index, alcohol consumption, physical inactivity and others considered new risk factors were studied (creatinine clearance, pulse wave velocity, homocysteine, fibrinogen, Lp (a), APO B, and PCR (as)). Bivariate analysis was used, followed by multivariate Cox regression, adjusted for all potential confounding factors, calculating the risk of CAD. Finally, a Kaplan Meier analysis was performed to estimate event-free time in coronary patients with high and low plasma levels of Lp (a) (≥30 mg / dl and <30mg / dl, respectively).</p> <p><strong>Results:</strong> Patients with high Lp (a) levels had a HR of MACE of 1.33 (95%CI: 1.06-1.65; p=0.012) after Cox regression. At the end of the mean follow-up of 4.5 ± 3.6 years, 62.7% of patients with Lp (a) <30 had MACE versus 77.8% of patients with Lp (a) ≥30.</p> <p><strong>Conclusion:</strong> In our population, higher Lp (a) levels in patients with a history of AMI increases the risk of MACE and reduces event-free time. We can hypothesize that the increase of Lp (a) plasma levels influences the destabilization of the atherosclerotic plaque increasing its vulnerability. A better understanding of the genetic regulation of Lp (a) may lead to new pharmacological targets in the prevention of events in patients with an AMI.</p>
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