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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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A. Basics
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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
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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
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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MINOCA and CMR: are there any gender-specific features?
Session:
Posters 2 - Écran 8 - Doença Coronária
Speaker:
Daniel Seabra De Carvalho
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Posters
FP Number:
---
Authors:
Daniel Seabra De Carvalho; Ana Leal Neto; Inês Pereira Oliveira; Aurora Andrade; João A. G. Azevedo; Paula Pinto
Abstract
<p><strong>Introduction: </strong>Etiologies of acute coronary syndromes (ACS) in women expand beyond the traditional paradigm of obstructive epicardial atherosclerotic disease. Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a syndrome with different causes, characterised by clinical evidence of myocardial infarction with normal or near-normal coronary arteries on angiography. The key principle in the management of MINOCA is to clarify the underlying etiology to achieve patient-specific treatments.</p> <p><strong>Purpose: </strong>Characterize a cohort of patients (pts) admitted with MINOCA who underwent cardiac magnetic ressonance (CMR) and identify clinical, analytical, electrical (ECG) and imaging differences between genders.</p> <p><strong>Methods: </strong>Unicentric, retrospective analysis of pts who underwent CMR after a diagnose of MINOCA, between 1/2013 and 9/2018. Divided in two groups: female (G1) and male gender (G2). Clinical, analytical, ECG, imagiological features and cardiovascular (CV) events (CVE) – ACS, heart failure (HF), stroke and peripheral embolism – were analysed.</p> <p><strong>Results: </strong>Included 124 pts with a mean age of 52.3±14.8 years (G1: 51 pts; 41%). G1 mean age was higher (56.9vs49.1±14.8years, p=0.003). No statistic differences were found on atrial fibrillation (AF) (17.6vs9.6%, p=0.188) nor CV risk factors prevalence, except for hypertension (49vs30%, p=0.033) and tabagism (16vs43%, p=0.002). No differences on cardiac or inflammatory biomarkers. G1 presented less frequently with ST elevation (19.6vs39.7%, p=0.018) but had longer QTc (424.4vs402.1±37.8ms, p=0.001). No differences were found on left ventricle ejection fraction (LVEF) assessed by echocardiogram, although CMR showed higher LVEF (61vs56±9.6%, p=0.023) in G1. Regarding discharge prescription, G1 had more prescription of single antiplatelet therapy (66.7vs47.9%, p=0.039), beta-blocker (82vs63%, p=0.02) and ACE inhibitor (82vs62%, p=0.013). G1 performed CMR later than G2 (2.9vs1.3 months, p=0.05). Concerning final diagnosis, myocarditis was more frequent in G2 (12vs43%, p<0.001) and G1 had more takotsubo syndrome (22vs0%, p<0.001). No differences were found in CVE or mortality.</p> <p><strong>Conclusion: </strong>In our cohort, women were younger and had more hypertension. G1 usually presented with nonspecific ECG changes with less ST elevation at admission. Women tend to preform CMR later than man, which may justify the asymmetries in prescription at hospital discharge. There were no significant differences concerning CVE during follow-up.</p>
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