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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
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01. History of Cardiology
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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34. Public Health and Health Economics
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Prognostic impact of occluded culprit in non-ST segment elevation myocardial infarction
Session:
Posters 4 - Écran 2 - Doença Coronária
Speaker:
Carla Marques Pires
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:
Carla Marques Pires; Paulo Medeiros; Cátia Costa Oliveira; Isabel Durães Campos; Rui Files Flores; João Costa; Carlos Galvão Braga; Nuno Antunes; Jorge Marques
Abstract
<p><strong>INTRODUCTION</strong>: The long-term prognostic impact of coronary occlusion in non-ST-segment elevation myocardial infarction (NSTEMI) is still being investigated.</p> <p> </p> <p><strong>AIM</strong>: To evaluate in patients (pts) with NSTEMI the impact of occluded culprit arteries on the primary endpoint, a composite of all-cause mortality, recurrent nonfatal myocardial infarction and unplanned revascularization during a 24 months follow-up.</p> <p> </p> <p><strong>METHODS</strong>: We analysed retrospectively 488 NSTEMI pts admitted without cardiogenic shock in our coronary care unit, from January 2015 to December 2016.</p> <p>They were divided in two groups: group 1- NSTEMI pts with coronary occlusion (n=112, 22,95%); group 2-NSTEMI pts without coronary occlusion (n=376, 77,05%). The follow-up was completed in 99% of pts. To compare the primary endpoint between the two groups we first elaborated a Kaplan Meier curve to show the event free-survival curve during the 24 months and then a multivariate Cox regression analysis adjusted to confounding factors.</p> <p> </p> <p><strong>RESULTS</strong>: During follow-up the prevalence of all-cause mortality, recurrent nonfatal myocardial infarction and unplanned revascularization was not statistically different among the two groups (9,8% vs 12%, p-0,532). The Kaplan Meier event-free survival curves, non-adjusted to confounding factors, were also not statistically different (Tarone-Ware test: p-value 0,620).</p> <p>In addition, the multivariate Cox regression analysis adjusted to confounding factors (age, gender, multiple cardiovascular risk factors, previous myocardial infarction, previous percutaneous coronary intervention and coronary artery bypass grafting, time from hospital arrival to angiography and successful intervention) did not demonstrate a significant statistical impact of occluded culprit arteries on the primary endpoint (HR adjusted=1,247; p-value-0,523).</p> <p> </p> <p><strong>CONCLUSION</strong>: In the NSTEMI population studied, the presence of a totally occluded culprit lesion was not associated with worst long term-clinical outcomes during a 24-months follow-up.</p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p>
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