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A. Basics
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C. Arrhythmias and Device Therapy
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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
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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
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Abstract
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Virtue lies in the middle? Outcomes of mid-range ejection fraction after acute coronary syndrome
Session:
Painel 2- Insuficiencia cardiaca 4
Speaker:
Diana De Campos
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Diana Decampos; Carolina Saleiro; Rogerio Teixeira; Ana Rita M. Gomes; João Lopes; Joana M. Ribeiro; Luís Puga; José Pedro Sousa; Ana Botelho; Lino Gonçalves
Abstract
<p>Background: Prognosis of ischemic heart failure with mid-range ejection fraction (left ventricular ejection fraction, LVEF, 40 to 49%) is unknown. We aimed to assess the long-term outcomes of patients with mid-range LVEF after percutaneous coronary intervention (PCI) compared with reduced LVEF and normal LVEF.</p> <p>Methods: We retrospectively assessed patients admitted to our coronary unit with an acute coronary syndrome (ACS) and available information on LVEF. Patients were classified into three groups: normal (LVEF≥50%), mid-range (40–49%) and reduced (<40%). Long-term risk of all-cause mortality adjusted for prognostic clinical variables (sex, age, type of ACS, diabetes, chronic kidney disease, heart failure history, Killip-Kimbal class, potassium and LDL levels) was assessed. Kaplan-Meier survival curves and log-rank tests were used to compare the unadjusted survival curves of the three groups.</p> <p>Results: Of 1544 patients, 928 patients had information on LVEF and were submitted to PCI (66.27±13.23yo, 73.6% male, median follow-up of 63 months). Mid-range LVEF represented 27.7% of all population. Mid-range and normal LVEF patients were younger. Mid-range LVEF’s mean levels of LDL cholesterol and HbA1c were intermediate between reduced and normal LVEF. Mid-range LVEF patients had the same higher tendency to have previous history of atrial fibrillation as patients with reduced LVEF; but previous history of coronary artery disease was more similar to those with normal LVEF. Previous history of heart failure had a significant inverse relationship with LVEF. Medication use (ACEIs/ARBs, beta-blocker and aspirin) was not different. Unadjusted risk of death of mid-range patients was lower when compared to reduced LVEF (HR=0.70 95%CI 0.54-0.92, <em>P</em>=0.011). Adjusted risk of death of mid-range LVEF was similar to reduced LVEF (HR=1.2, 95%CI 0.79-1.82) but rose when compared to normal LVEF (HR=0.57 95%CI 0.42-0.79, <em>P</em>=0.001). Kaplan-Meier curves show that the risk of all-cause mortality was significantly different among the three groups. </p> <p>Conclusion: Patients with mid-range LVEF after an ACS resembled those with reduced LVEF in terms of survival. Patients with mid-range LVEF present a 43% increased risk of long-term all-cause death compared to those with normal LVEF.</p>
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