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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
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L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
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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
37. Miscellanea
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Coronary revascularization in elderly patients with acute myocardial infarction without ST-segment elevation
Session:
Posters 3 - Écran 5 - Doença CV em populações especiais
Speaker:
Fernando Gonçalves
Congress:
CPC 2019
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.5 Cardiovascular Disease in the Elderly
Session Type:
Posters
FP Number:
---
Authors:
Fernando Fonseca Gonçalves; José P. Guimarães; Sara Borges; José João Monteiro; Pedro Sousa Mateus; Ilidio Moreira
Abstract
<p><u>Introduction:</u> Acute coronary syndrome in elderly patients may present a real clinical challenge because of the high number of co-morbidities these patients may have. The aim of this study was to evaluate a population of patients ≥85 years old with non-ST-segment elevation myocardial infarction (NSTEMI) and to compare the short and long term prognosis according to the type of revascularization performed.</p> <p><u>Methods:</u> This was a retrospective study of patients with NSTEMI periodically included in a national multicenter registry between October/2010 and October/2018, aged ≥85 years, who underwent coronary angiography (CC) and had at least one stenosis ≥50%. Patients with unfavorable coronary anatomy and patients undergoing cardiac surgery were excluded. Two groups were designated: percutaneous coronary intervention (PCI) and optimized medical treatment (OMT) without PCI. All the results presented are statistically significant (p<0,05).</p> <p><u>Results:</u> A total of 324 patients were identified, of whom 73,1% underwent PCI and 26,9% OMT. The OMT group had more past history of diabetes mellitus (43,7% vs. 29,6%), cerebrovascular disease (20% vs. 9,4%) and dementia (6% vs. 0,9%).</p> <p>The PCI group had more frequently a loading dose of 600mg of clopidogrel (20,4% vs. 4,8%) and used more the femoral artery as vascular access (35,5% vs. 19,3%). The presence of single vessel lesions was more common in this group (29,2% vs. 18,8%), whereas 3 vessel disease was more common in the OMT group (48,8% vs. 33,2%). Left ventricular ejection fraction was similar in both groups.</p> <p>During hospitalization, there were more major bleeding events (4,2% vs. 0%) and death (4,2% vs. 0%) in the PCI group. There were no differences in re-infarction, cardiogenic shock or stroke.</p> <p>At discharge, clopidogrel prescription was higher in the PCI group (85,2% vs. 74,1%), and there were no significant differences in the prescription of other antithrombotic therapy.</p> <p>During the one-year follow-up there were no significant differences in terms of new coronary revascularization or mortality.</p> <p><u>Conclusions:</u> Very old patients with NSTEMI submitted to OMT had more comorbidities and more 3 vessel disease, factors that could have influenced the therapeutic decision. Patients undergoing PCI had more single vessel lesions, but had more in-hospital major bleeding events and mortality, with no difference in a 1 year follow-up.</p>
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