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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
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
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L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
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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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Antithrombotic treatment in patients with new-onset Atrial Fibrillation after acute coronary syndrome
Session:
Posters 2 - Écran 1 - Doença Coronária
Speaker:
Ana Marques
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.4 Acute Coronary Syndromes – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Ana I. Marques; Sofia Alegria; Ana Rita F. Pereira; Alexandra Briosa; Daniel Sebaiti; Cristina Dantas Martins; Inês Rangel; Rita Calé; Isabel João; Helder Pereira; Em nome dos investigadores do Registo Nacional de Síndromes Coronárias Agudas
Abstract
<p>Introduction: ESC guidelines recommend an oral anticoagulant (OAC) after an Acute Coronary Syndrome (ACS) in Atrial Fibrillation (AF) patients (pts) at risk of stroke. </p> <p>Aims: To analyse the proportion of anticoagulated pts with new-onset AF during hospital stay due to ACS. To analyse predictors of OAC therapy prescription at discharge. </p> <p>Methods: A multicentre, retrospective study was performed during 10/2010-3/1/2018 period. Were excluded pts with previous AF, AF in the electrocardiogram (EKG) at admission or pts without information regarding OAC at discharge. Univariate analysis and posteriorly multivariate analysis were performed to identify predictors of OAC prescription at discharge.</p> <p>Results: Of 17.834 pts selected, were included 617 pts that fulfil our criteria (65% male, mean age 73±12 years). At discharge, 161 (26.1%) pts were anticoagulated: 55% with a vitamin K antagonist, 45% with a direct oral anticoagulant.</p> <p>Age between 65-74 years, previous pacemaker (PCM)/implantable cardioverter defibrillator implantation, non-ST segment elevation myocardial infarction (STEMI) or anterior STEMI occurrence, PCM rhythm in the EKG at admission, higher haemoglobin and lower left ventricular ejection fraction levels were positively associated with OAC prescription at discharge. </p> <p>Pts with ≥75 years, kidney disease, STEMI, particularly inferior STEMI, those submitted to coronary angioplasty or blood transfusion during hospital stay and those that evolved with cardiorespiratory arrest were significantly less anticoagulated at discharged. </p> <p>After multivariate analysis, the predictors of OAC prescription at discharge were non-STEMI (OR 1.6, CI 1,04-2.4, p=0.03) occurrence and PCM rhythm in the EKG at admission (OR 11, CI 1.2-99.4, p=0.04).</p> <p>Age ≥75 years (OR 0.6, CI 0.4-0.9, p=0.02), kidney disease (OR 0.4, CI 0.2-0.8, p=0.02), coronary angioplasty (OR 0.6, CI 0.4-0.95, p=0.03) or cardiorespiratory arrest during hospitalization (OR 0.3, CI 0.13-0.86, p=0.02) were factors that decreased the odd of OAC prescription at discharge. </p> <p>Conclusion: In our cohort, the proportion of pts with ACS and new-onset AF during hospitalization that were anticoagulated at discharge was 26.1%, being the predictors of OAC prescription non-STEMI occurrence and PCM rhythm in the EKG at admission. Age ≥75 years, kidney disease, coronary angioplasty performance or cardiorespiratory arrest during hospital stay were factors that decreased the odd of OAC prescription at discharge.</p>
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