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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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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
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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
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Non-cardiac complications in patients with acute coronary syndrome in a heart intensive care unit: Epidemiology, prognosis and predictors
Session:
Posters 5 - Écran 2 - Doença Coronária
Speaker:
Bruno Piçarra
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
14. Acute Cardiac Care
Subtheme:
14.6 Acute Cardiac Care – Other
Session Type:
Posters
FP Number:
---
Authors:
Bruno Cordeiro Piçarra; Antonio; Ana Rita Santos; Mafalda Carrington; Diana Coutinho; Ana Bernardo; Diogo Brás; José Eduardo Aguiar
Abstract
<p>~~Introduction: The presence of non-cardiac complications in patients hospitalized with acute coronary syndrome (ACS) can be an important challenge in the treatment and prognosis of these patients. Currently, information is lacking on its prevalence and prognostic impact in these patients.<br /> Objective: To determine the prevalence of non-cardiac complications, their impact on prognosis and to identify possible predictors in patients hospitalized with ACS in a Intensive Cardiac Care Unit (ICCU).<br /> Methods: Prospective study, which included all patients consecutively admitted in an ICCU in a 3 years period. We considered 2 groups: Group 1 - patients who developed non-cardiac complications and Group 2 - patients who did not develop non-cardiac complications. The non-cardiac complications evaluated were: infectious (urinary, respiratory or sepsis), hemorrhagic (not related with invasive procedures), renal (acute kidney injury) and neurological disorders (transient ischemic attacks or stroke). We collected demographic data, patient provenience (emergency department (ED), cardiology or medicine ward, general intensive care units (ICU), outpatient clinic or other hospitals), duration of hospitalization and destination of the patient (ambulatory, cardiology ward or death).</p> <p>RESULTS: Of a total of 851 patients admitted to the ICCU with a diagnosis of ACS, 122 patients (14.3%) developed non-cardiac complications during hospitalization. Their prevalence was: infectious complications - 69.7%, renal - 22.1%, hemorrhagic - 17.2% and neurological - 8.1%. These patients were older (73,4 ± 11,0 vs 66,7 ± 13,5 years, p=0,001) and more females (38,6% vs 28,4%, p=0,031). In both groups, the majority of patients were admitted to the ED (Group 1: 69,7% vs 62,6%, p = ns), with no significant differences in patient provenience. Group 1 patients had a higher prevalence of undetermined acute myocardial infarction (8.3% vs 3.1%, p = 0.012), lower unstable angina (2,5% vs 10,2%; p=0,01) with no differences regarding AMI with and without ST elevation. Patients with non-cardiac complications had longer hospitalizations (5,4 ± 3,7 vs 2,9 ± 1,6 days), higher mortality (6,5% vs 2,6%, p=0,04) and more transfers to a general intensive care unit (2,4% vs 0,0%, p=0,001).<br /> Conclusions: In patients with ACS, non-cardiac complications are frequent and presented in 14.3% of patients, with infectious complications being the one of the most prevalent. Its incidence appears to be higher in older patients, female and undetermined acute myocardial infarction. The presence of non-cardiac complications is associated with an increase in days of ICCU stay and mortality.</p>
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