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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
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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
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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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C-reactive protein elevation at the time of presentation in MINOCA
Session:
Posters 4 - Écran 3 - Doença Coronária
Speaker:
Ana Neto
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Posters
FP Number:
---
Authors:
Ana Leal Neto; Daniel Seabra De Carvalho; Inês Pereira Oliveira; Aurora Andrade; João A. G. Azevedo; Paula Pinto
Abstract
<p><strong>Background: </strong>C-reactive protein (CRP) is a nonspecific marker of inflammation. CRP levels reflect the severity of myocardial damage and are associated with worse outcomes. Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is characterised by clinical evidence of MI with normal or near-normal coronary arteries on angiography. It is not known whether inflammation plays a role in the time-course of MINOCA.</p> <p><strong>Purpose: </strong>To appraise the association of CRP with clinical features and prognosis in a MINOCA cohort who underwent cardiac magnetic ressonance (CMR).</p> <p><strong>Methods: </strong>Unicentric, retrospective analysis of pts who underwent CMR after a diagnose of MINOCA, between 1/2013 and 9/2018. Clinical, analytical, electrical (ECG), imagiological features and cardiovascular (CV) events (CVE) – acute coronary syndrome, heart failure, stroke and peripheral embolism – were analysed and associated with peak CRP levels.</p> <p><strong>Results: </strong>Included 124 pts with a mean age of 52.3±14.8 years (male predominance, 59%). Mean CRP level (mCRP) was 41.1 mg/L and the median CRP level was 17.5 (7.5-475) mg/L. There were no differences in age, gender, atrial fibrillation and CV risk factors prevalence, except for diabetes (mCRP 79vs35mg/L, p=0.004). A positive correlation between mCRP and BNP level (p=0.019) was found, but not with peak troponin I. Pts who presented with ECG changes had higher mCRP (p=0.005). A negative correlation was found with left ventricle ejection fraction (LVEF) (p=0.003) assessed by echocardiogram (but not in CMR). Regarding discharge prescription, pts with higher CRP were less prone to be prescribed with antiplatelet therapy. Concerning CMR parameters, there was a positive correlation between the number of segments with late gadolinium enhancement and CRP (p=0.045), with no differences on its distribution pattern. Regarding final diagnosis, myocarditis had higher mCRP (p=0.048) and normal CMR had lower mCRP (p=0.009). However, there was no difference in the coronary artery disease diagnosis. No differences were found in CVE or mortality.</p> <p><strong>Conclusion: </strong>In our MINOCA cohort, mCRP associated with ECG changes at admission. There was a positive relation with BNP and LVEF measured by echocardiogram. Pts with higher CRP were less prescribed with antiplatelet therapy. Pts with myocarditis tend to have higher mCRP contrary to normal CMR. Interestingly, pts with the final diagnosis of MI had no relevant asymmetries in mCRP. There were no differences in CVE or mortality.</p>
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