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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
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
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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
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In-hospital outcomes of acute coronary syndrome in patients with a previous history of a coronary artery bypass grafting surgery (CABG) compared with non-CABG patients: a nation-wide study
Session:
Posters 3 - Écran 2 - Doença Coronária
Speaker:
Joana Ribeiro
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Joana M. Ribeiro; Rogerio Teixeira; Luís Puga; João Lopes; José Pedro Sousa; Alexandrina Siserman; Diana Decampos; Carolina Saleiro; Lino Gonçalves; Em nome dos investigadores do Registo Nacional de Síndromes Coronárias Agudas; Carolina Lourenço
Abstract
<p><strong>AIMS</strong>: 1) To assess the in-hospital outcomes of ACS patients with previous history CABG <em>versus</em> non-CABG ACS patients. 2) Within the previous CABG ACS patients, to compare the in-hospital outcomes of patients submitted to percutaneous coronary intervention (PCI) of the bypass grafts <em>versus</em> the ones with PCI of the native coronary tree (NCT)</p> <p><strong>METHODS</strong>: 1) From the Portuguese Registry of Acute Coronary Syndromes (PRACS, N=17 834), a propensity score (PS) matching was elaborated. The matching was performed in a 1:3 fashion (1 CABG patient per 3 non-CABG), with correction for the following variables: age, gender, type of ACS, hypertension, <em>diabetes mellitus</em>, dyslipidaemia, smoking, stable angina, ACS, PCI, valvular heart disease (VHD), heart failure, cerebrovascular disease and peripheral artery disease (PAD), Killip-Kimbal class and impaired kidney function at admission, invasive coronariography and PCI during hospital stay. After the PS matching, 3024 remained in the analysis: 756 in the CABG group (group A) and 2268 in the non-CABG group (group B). The primary outcome was in-hospital mortality.</p> <p>2) Within the population of the PRACS we selected all patients with ACS and previous CABG who underwent either bypass or NTC PCI during hospital stay. This subanalysis included 342 patients, of whom 110 underwent bypass PCI and 232 NCT PCI. We compared both groups for the main basal characteristics and for in-hospital mortality.</p> <p><strong>RESULTS</strong>: 1) The final sample for the main analysis consisted of 3024 patients with a mean age of 71±11 years (80% male). Median hospital stay was of 6 days (3-7) and was similar between groups. Groups A and B were balanced for all main clinical characteristics, except for history of stable angina (62 <em>vs</em> 58%, <em>P</em>=0.03), previous PCI (34 <em>vs</em> 41%, <em>P</em><0.01), VHD (11 <em>vs</em> 8%, <em>P</em>=0.03) and PAD (20% <em>vs</em> 14%, <em>P</em><0.01). In-hospital mortality was similar between groups (3.7 <em>vs</em> 3.4%, <em>P</em>=0.69).</p> <p>2) A total of 342 patients were included in the sub-analysis. Mean age was of 70±10 years and 84% of patients were male. Patients who underwent bypass circulation PCI were older (73±9 <em>vs</em> 69±10 years, <em>P</em><0.01) and had more PAD (22 <em>vs</em> 14%, <em>P</em>=0.05). There were no significant differences regarding in-hospital mortality (0,9 <em>vs</em> 1,3, <em>P</em>=1,0).</p> <p><strong>CONCLUSION</strong>: According to our propensity-matching, a previous history of CABG does not influence the short term outcome after an ACS. In patients with previous CABG, bypass circulation <em>versus</em> NCT PCI had no influence in in-hospital mortality.</p>
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