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Curso de Atualização em Medicina Cardiovascular 2019
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01. History of Cardiology
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
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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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Relation of bilirubin and coronary artery disease severity in non ST elevation myocardial infarction
Session:
Posters 5 - Écran 9 - Doença Coronária
Speaker:
João Gameiro
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.1 Acute Coronary Syndromes – Pathophysiology and Mechanisms
Session Type:
Posters
FP Number:
---
Authors:
João Gameiro; Simone Costa; Liliana Reis; Diana Decampos; Carolina Saleiro; José Sousa; Joana M. Ribeiro; Luís Puga; Marta Madeira; Joana Delgado Silva; Lino Gonçalves
Abstract
<p><strong>Background</strong></p> <p>Oxidation is an important process in atherosclerosis. More recent evidence suggests that bilirubin is a potent physiological antioxidant that may provide important protection against atherosclerosis and inflammation. In previous studies, bilirubin levels were associated with the severity of coronary disease in patients with ST elevation myocardial infarction (STEMI), as well as short-term outcomes but not long-term outcomes.</p> <p>The association between bilirubin and non-STEMI (NSTEMI) is unknown.</p> <p><strong>Aim</strong></p> <p>The aim of this study is to access the relation between bilirubin levels and severity of atherosclerosis, using the SYNTAX score (SYscore), in patients with NSTEMI, and to determine if bilirubin at admission is an independent predictor of all-cause mortality in this population.</p> <p><strong>Methods</strong></p> <p>We included 446 patients (P) with NSTEMI who were admitted to the coronary intensive care unit (CICU), in one cardiology department from January 2010 to December 2016. Blood samples for laboratory analysis were drawn on admission to the CICU and the SYscore was calculated in the cath lab.</p> <p>The study population was divided into tertiles according to the SYscore, and high syntax group (n= 147) – G1 - was defined as a value in the third tertile (> 15), and low syntax group (n= 299) - G2 - as a value in the lower 2 tertiles (< 15). </p> <p><strong>Results</strong></p> <p>In our sample, the mean age was 69 ± 12 years old, with 72,4% male P. There was no difference in the sex distribution (p= 0,425), prevalence of hypertension (p= 0,084), dyslipidemia (p= 0,499) or smoking (p= 0,145) between G1 and G2. In G1 there were more diabetic patients (G1 44,9% vs G2 33,4%, p= 0,019) and chronic renal failure patients (G1 31,3% vs G2 17,1%, p= 0,001).</p> <p>There was no difference in the levels of bilirubin in the 2 groups (G1 10,7 mmol/l vs G2 11,5 mmol/l, p= 0,214) and there was only a very weak negative correlation between bilirubin levels and SYscore results (Spearman correlation, rs = -0,034). No differences were seen in all-cause mortality rates (p= 0,678), heart failure admission rates (p= 0,567) or in-hospital mortality rates (p= 0,765) between the high and low bilirubin groups.</p> <p><strong>Conclusion</strong></p> <p> In opposition with STEMI patients, low bilirubin levels on admission are not significantly correlated with high syntax score in patients with NSTEMI. No differences were found in all-cause mortality, in-hospital mortality or heart failure admission between high and low bilirubin groups.</p>
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