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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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07. Syncope and Bradycardia
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Stress Echocardiography in multivessel coronary artery disease – 12 months follow up
Session:
Painel 3 - Imagiologia Cardiovascular 5
Speaker:
Pedro Custodio
Congress:
CPC 2020
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Posters
FP Number:
---
Authors:
Pedro Custódio; Alexandra Briosa; Paula Fazendas; Isabel João; Marco Quadrado; Angela Pereira Manuel; Helder Pereira
Abstract
<p>Introduction:<br /> Stress echocardiography(SE) is currently a first line exam for the diagnosis of chronic coronary syndromes, as well as for risk stratification of future coronary events. Recently, Cibele Larrosa Garzillo, at al(2019), concluded in their study that regardless of the therapeutic strategy applied, the presence of documented myocardial ischemia in stress testing did not appear to be associated with an increased occurrence of major adverse cardiovascular events(MACE) or changes in ventricular function in patients with multivessel coronary artery disease (MVCAD) during a long-term follow-up.</p> <p> Currently, in our center, SE is abundantly used to stratify patients with chronic coronary disease according to risk of future events and to assess the need of coronary angiography(CA) and eventual percutaneous coronary intervention(PCI) when feasible.</p> <p><br /> Objective:<br /> To assess the association of a positive SE with MACE, in patients with documented MVCAD, for a period of 12 months.</p> <p>Methods:<br /> A retrospective unicentric study was performed. Patients who underwent a SE between 2016 and June 2018 were analyzed. Patients who had a coronary angiogram(CA) less than 12 months before the SE were included.<br /> Patients with MVCAD were then selected for further analysis. MVCAD was defined as stenosis in 2 or more epicardial coronary arteries. MACE was defined as: overall mortality, new acute myocardial infarction or additional percutaneous coronary intervention(PCI). The 1-year MACE outcome was compared between patients with either positive or negative SE.</p> <p>Results:<br /> Of the 215 patients enrolled, 145 had MVCAD. Age 63 +-10 years, males 80,7% When the groups were compared according to MACE events, no association was found in overall mortality or new myocardial infarction. However, there was a strong association between positive SE and additional PCI (p= 0,001).</p> <p>Conclusion:<br /> Patients with MVCAD and a positive SE were more likely to undergo PCI in the following 12 months after the exam. This is statistical significant after adjusting for chronic kidney injury, dyslipidemia, antiplatelet therapy, hypertension or smoking. The one year prognosis of these patients after PCI is similar to patients with previous MVCAD and negative SE.</p>
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