Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
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
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
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
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
The ratio between admission and chronic glycaemia is a predictor of worse outcomes in ACS patients.
Session:
Posters 3 - Écran 2 - Doença Coronária
Speaker:
José P. Guimarães
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:
José P. Guimarães; FM Gonçalves; S Borges; M Moz; J Trigo; PS Mateus; JI Moreira
Abstract
<p><strong>Background:</strong><br /> Hyperglycemia in acute coronary syndrome (ACS) patients (pts) is associated with worse in-hospital outcomes. In diabetic (DM) pts it does not necessarily indicate the presence of acute hyperglycemia and the prognostic impact isn’t clear, emphasizing the importance of quantifying the relative acute glucose (gc) rise instead. The ratio between acute and chronic Gc levels (A/C ratio) could provide a better prognostic value.</p> <p><strong>Objective:</strong><br /> We investigated the association between the A/C ratio and in-hospital and long term prognosis in ACS pts.</p> <p><strong>Methods:</strong><br /> Retrospective study of pts with ACS periodically included in our center registry between October/2012 and November/2017 with HbA1c information. Gc and HbA1c levels were measured at hospital admission. To calculate the A/C ratio the published formula <em>28.7×HbA1c-46.7 </em>to estimate chronic Gc was used. The primary endpoints were a composite of in-hospital death and maximum Killip class (KK)>=III and a composite of infarction, stroke, heart failure and cardiovascular death (MACCE) in the follow-up.</p> <p><strong>Results:</strong><br /> We included 404 pts (68±13 years; 72.8% males; 43.6% STEMI). The median A/C ratio was 1.07 (IQR 0.92-1.32). Pts in the highest tertile of the A/C ratio were older (68±12, 65±14, 70±12; p=.003), more likely to have STEMI (STEMI: 31%, 45%, 55%; p<.001); higher GRACE risk score (134±32, 139±38, 158±42; p<.001); higher KK (>=II: 11%, 24%, 33%; p<.001) and have a lower ejection fraction (EF) (53±10%, 50±10%, 48±12%; p=.003), than pts in the lower tertiles.</p> <p>During hospitalization 9 (2.2%) pts died and 48 (11.9%) had the primary endpoint. The incidence of the in-hospital primary endpoint increased with A/C ratio tertiles (4.4%, 8.2%, 23.0%; p for trend <.001), for which it showed a good predictive capability (AUC=0.72, 95%CI: 0.67-0.76). Using the Youden index the cut-off value of 1.31 for the A/C ratio was decided.</p> <p>After a median follow-up of 34 months (IQR 19-51), 50 (13%) pts died (6.8% from CV causes) and 84 (21.9%) had MACCE. After adjusting for admission diagnosis, DM, GRACE and EF, an A/C ratio=1.31 was an independent predictor for the risk of death (HR 2.79, 95%CI: 1.17-6.65; p=.021) and MACCE (HR 1.79, 95%CI: 1.09-2.93; p=.020).</p> <p><strong>Conclusion:</strong><br /> In ACS pts, the A/C glycemic ratio increased with the severity of the index event, showed a good predictive ability and was a predictor of death and MACCE during the follow-up. It is readily available and provides valuable risk stratification and prognostic information.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site