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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
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
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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Will my patient with Acute coronary syndrome end up in surgery?
Session:
Posters 2 - Écran 9 - Doença Coronária
Speaker:
Raquel Menezes Fernandes
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:
Raquel Menezes Fernandes; Teresa Faria Da Mota; João De Sousa Bispo; Pedro Oliveira De Azevedo; João Pedro Moura Guedes; Daniela Carvalho; Dina Bento; Nuno Marques; Walter Santos; Jorge Mimoso; Ilidio Paulos De Jesus
Abstract
<p><strong>Introduction:</strong> In acute coronary syndrome (ACS), about 10% of patients are eligible for coronary artery bypass grafting (CABG). This study pretends to identify a predictive score of CABG in patients with ACS.</p> <p><strong>Methods:</strong> We performed a retrospective, descriptive and correlational study encompassing patients admitted with ACS in a Cardiology service from 1<sup>st </sup>October 2010 to 1<sup>st</sup> October 2018. Demographic factors, risk factors, antecedents and clinical characteristics were analyzed. The correlation between the categorical variables was performed by the Chi-square test, while the T-Student test was applied to the continuous variables, with a significance level of 95%. Independent predictors of CABG were identified through a binary logistic regression analysis, considering p=0,05. Then, a discriminatory function was applied using the Wilks lambda test to determine the discriminant score of the analized groups. Statistical anaylis was conducted using SPSS 24.0.</p> <p><strong>Results:</strong> During this period, 4458 patients were admitted with ACS and 313 (7,0%) had indication for CABG. This subgroup had a mean age of 66 ± 11 years and 78,3% were males. Regarding the diagnosis at admission, 87,2% presented with ACS without ST-segment elevation (NSTEACS) and 12,8% with ST-segment elevation acute myocardial infarction (STEMI). NSTEACS (p<0,001), presence of ST-depression (p<0,001), creatinine <1,5mg/dL (p=0,007), BNP>100 pg/ml (p=0,007), history of angina pectoris (p=0,001) and absence of history of percutaneous coronary intervention (PCI) (p=0,002) were independent predictors of CABG. A predictive score of CABG in patients with ACS was determined with the formula: -2,120-1,075x(NSTEACS) + 0,648x(angina pectoris) + 1,133x(ST-depression) + 0,433x(BNP>100) – 0,926X(history of ICP) – 0,893x(creatinine>1,5). A cutoff of 0,5 was obtained with 74% sensitivity and 67% specificity.</p> <p><strong>Conclusion:</strong> In this population of patients admitted with ACS, 7% were referred for CABG. We determined a predictive score of CABG including NSTEACS, ST-depression, BNP>100 pg/ml, creatinine <1.5mg/dL, history of angina pectoris and no history of PCI, with a good discriminative power. By considering clinical variables, this score can be used at an early stage of the patient’s admission, but requires validation to allow its application in clinical practice.</p>
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