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CPC 2019
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
G. Aortic Disease, Peripheral Vascular Disease, Stroke
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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)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
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
37. Miscellanea
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Abstract
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Lipoprotein as a cardiovascular risk factor when cholesterol LDL is controlled
Session:
CO4 - Prevenção / Reabilitação
Speaker:
M. Raquel Santos
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:
M. Raquel Santos; Andreia Pereira; Adriano Sousa; Flávio Mendonça; Micaela Rodrigues Neto; Joel Monteiro; Ana Célia Sousa; Mariana Rodrigues; Sónia Freitas; Ilídio Ornelas; A. Drumond de Freitas; Roberto Palma dos Reis; Isabel Mendonça
Abstract
<p><strong><u>Introduction</u></strong>: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, despite optimized therapy. According to several studies, the plasma level of LDL cholesterol (LDL-C) is strongly associated with atherosclerosis, and its reduction with statins has led to a decrease in the incidence of CAD. However, some studies show that the residual cardiovascular risk of some individuals remains high even with controlled LDL-C levels, so other factors, including lipoprotein a (Lpa), appear to be responsible for this phenomenon. Despite recognition of the role of Lpa as an independent risk factor for CV events, the medical knowledge is still limited and Lpa is rarely appreciated.</p> <p><strong><u>Objective: </u></strong>To evaluate Lpa as a risk factor for increased risk of major adverse cardiovascular events (MACE) when LDL-C <100mg/dl in CAD patients.</p> <p><strong><u>Materials and methods:</u></strong> Study analyses of 1607 subjects selected from GENEMACOR study population, with at least one >75% coronary stenosis by angiography (median age 53.3±8 and 78.9% men): 689 had LDL-C <100mg/dl (median age 54.1±7.7 and 76.4% men). X<sup>2</sup> and T student tests were used to analyze the demographic, laboratorial, angiographic and anthropometric characteristics of the population according to Lpa level. LDL-C was determined at least a month after angiography under maximum statin therapy. Lpa was determined by immunoturbidimetry, and a level superior to 30mg/dl was considered high. Adverse cardiovascular events (MACE) was adjudicated by cox regression analysis, with a mean follow-up of 4.5 ± 3.6 years.</p> <p><strong><u>Results:</u></strong> In our population Lpa >30mg/dl was associated with increased risk of MACE (OR 1.572, 95% CI: 1.1-2.2, p 0.015). Patients with more adverse events were more sedentary (p=0.007), diabetic (p=0.063), had inferior levels of HDL-C (P=0.001), superior levels of ApoB (p=0.018) and of Homocysteine (p=0.05). 32.1% patients with Lpa >30mg/dl vs 23.1% patients with Lpa <30mg/dl had MACE (p=0.015) had more MACE, by cox analyses.</p> <p><strong><u>Conclusions:</u></strong> In our population in patients under statin therapy with controlled LDL (<100mg/dl) higher Lpa levels were associated with adverse prognosis and higher occurrence of MACE. To date, there are no drugs available for the reduction of Lpa, so new drugs towards Lpa levels may indeed improve prognosis even on patients under statins.</p>
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