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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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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
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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
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13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
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
37. Miscellanea
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CLEAR FILTERS
De novo atrial fibrillation in Acute Coronary Syndromes
Session:
Painel 4 - Arritmologia 5
Speaker:
Hélder Santos
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.2 Atrial Fibrillation - Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Helder Santos; Hugo Miranda; Inês Grácio De Almeida; Mariana Da Silva Santos; Catarina Sá; Joana Chan Chin; Samuel Almeida; Catarina Santos De Sousa; Lurdes Almeida; João Tavares; Em nome dos investigadores do Registo Nacional de Síndromes Coronárias Agudas
Abstract
<p><strong>Background: </strong>Acute coronary syndromes (ACS) and atrial fibrillation (AF) are common and in some cases the first episode of AF can occur in the context of an ACS. A stressful event as an ACS can be the trigger for AF, however, not all patients presented AF, being important identified the patients with more risk.</p> <p><strong>Objective:</strong> Evaluate predictors of <em>de novo</em> AF in ACS.</p> <p><strong>Methods:</strong> Multicenter retrospective study including ACS between 1/10/2010-4/09/2019. Patients were divided in two groups: A – patients without AF, and B – patients that presented <em>de novo</em> AF. Were excluded patients without a previous cardiovascular history or clinical data. Logistic regression was performed to assess predictors of <em>de novo</em> AF in ACS.</p> <p><strong>Results:</strong> 25727 patients had ACS, 24660 in group A (95.9%) and 1067 in group B (4.1%). Both groups were similar regarding smoker status. Group A had more dyslipidemia (61.8 vs 56.3%, <em>p</em><0.001), chest pain at admission (92.9 vs 81.9%, <em>p</em><0.001) and hemoglobin (Hb)>12g/dL (83.4 vs 73.3%, <em>p</em><0.001). Group B was elderly (66±14 vs 75±12, <em>p</em><0.006), female (27.3 vs 35.8%, <em>p</em><0.001), was admitted directly to the cat lab (10.4 vs 18.8%, <em>p</em><0.001), had arterial hypertension (70.4 vs 75.6%, <em>p</em><0.001), diabetes mellitus (31.4 vs 34.6%, <em>p</em>=0.029), valvulopathy (3.7 vs 5.7%, <em>p</em><0.001), previous heart failure (5.7 vs 11.5%, <em>p</em><0.001), stroke (7.0 vs 11.3%, <em>p</em><0.001), peripheral artery disease (5.4 vs 8.1%, <em>p</em><0.001), ST-segment elevation myocardial infarction (41.9 vs 53.4%, <em>p</em><0.001), Killip-Kimball (KK) classification > I (14.3 vs 35.6%,<em> p</em><0.001), admission glycemia (33.6 vs 40.4%, <em>p</em><0.001), mutivessel disease (51.5 vs 56.0%, <em>p</em><0.001), hybrid revascularization (2.1 vs 2.1%, <em>p</em><0.001) and left ventricular ejection fraction (LVEF) <50% (38.2 vs 59.4%, <em>p</em><0.001). Logistic regression revealed that age >75 years old (<em>odds ratio</em> (OR) 2.07, <em>p</em><0.001, confidence interval (CI) 1.74-2.47), stroke history (OR 1.40, <em>p</em>=0.019, CI 1.06-1.85), KK>1 (OR 2.10, <em>p</em><0.001, CI 1.72-.56), Hb<12g/dL (OR 1.29, <em>p</em>=0.018, CI 1.04-1.59), admission glycemia (OR 1.84, <em>p</em><0.001, CI 1.52-2.22) and LVEF<50% (OR 1.91, <em>p</em><0.001, CI 1.60-2.27) as predictors of <em>de novo</em> AF in ACS.</p> <p><strong>Conclusions</strong>: Using real life data, older age, LVEF<50% and KK class at presentation were the most relevant factors predicting <em>de novo</em> AF in ACS.</p>
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