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Curso de Atualização em Medicina Cardiovascular 2019
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A. Basics
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C. Arrhythmias and Device Therapy
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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
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15. Valvular Heart Disease
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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
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
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34. Public Health and Health Economics
35. Research Methodology
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CHA2DS2-VASC score as a mortality predictor in sinus rhythm heart failure patients
Session:
Posters 3 - Écran 10 - Insuficiência Cardíaca
Speaker:
Hélder Santos
Congress:
CPC 2019
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Helder Santos; Inês Grácio De Almeida; Hugo Miranda; Catarina Santos De Sousa; Lurdes Almeida; Joana Chan Chin; Samuel Almeida; Luís Santos; João Tavares
Abstract
<p><strong>Introduction:</strong> CHA<sub>2</sub>DS<sub>2</sub>-VASC score is a validated and established tool to stratify the stroke risk in atrial fibrillation patients. However, CHA<sub>2</sub>DS<sub>2</sub>-VASC score has not been validated in heart failure (HF) patients as well as its capability to predict mortality in sinus rhythm patients.</p> <p><strong>Objective:</strong> Validation of the CHA<sub>2</sub>DS<sub>2</sub>-VASC score as a predictive tool of mortality in patients admitted with acute heart failure in a peripheral centre.</p> <p><strong>Methods</strong>: Single-centre retrospective study, engaging patients hospitalized for acute heart failure between 1/01/2010-31/12/2017. All patients’ clinical data were extracted at admission and the follow up occurred in our centre. CHA<sub>2</sub>DS<sub>2</sub>-VASC score was assessed at admission. Patients were divided in two samples, according to their rhythm at admission (sinus rhythm - SR or other (included atrial fibrillation/flutter, pacing) - Ot). To evaluate the survival rates between SR and Ot, Kaplan-Meier method was used (log-rank test). Chi-square, T-student and ANOVA tests were used to compare categorical and continuous variables. SR patients were then categorized in 4 groups (1-only heart failure; 2-3; 4-5; ≥6), according to CHA<sub>2</sub>DS<sub>2</sub>-VASC score risk and survival rates were established with a Kaplan-Meier test.</p> <p><strong>Results</strong>: 298 patients were included, 72.1% were male, mean age 67.48 ± 12.34 years with 33.79 ± 28.52 months of follow up. SR (181 patients) and Ot (117 patients) were similar regarding age, gender, cardiovascular risk factors, mean CHA<sub>2</sub>DS<sub>2</sub>-VASC score and survival rates. Interestingly, the presence of vascular disease (defined as a previous acute coronary syndrome) was significantly different between SR and Ot, (54.7% vs 35.9%, respectively), <em>p</em>=0.002. As expected, the categorization of SR patients in 4 groups, revealed that the CHA<sub>2</sub>DS<sub>2</sub>-VASC score’s variables had significant differences between the groups (namely in mean age, gender, arterial hypertension, diabetes, vascular disease and previous stroke). Mortality rates significantly increase with the CHA<sub>2</sub>DS<sub>2</sub>-VASC score (42.9, 43.5, 59.7, 85.7%), with a Kaplan-Meier test of <em>p</em><0.001 – figure 1.</p> <p><strong>Conclusions:</strong> CHA<sub>2</sub>DS<sub>2</sub>-VASC score, largely implemented in atrial fibrillation patients assessment, proved to be a predictor of mortality in heart failure patients admitted in HF, even in SR.</p> <p> </p> <p>Note:</p> <p>Figure 1: Sinus rhythmic patients represented according with CHA<sub>2</sub>DS<sub>2</sub>-VASC score</p>
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