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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
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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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15. Valvular Heart Disease
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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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CLEAR FILTERS
Initially elevated troponin I in rapid atrial fibrillation should lead to coronary angiography
Session:
Painel 7 -Doença Coronária 2
Speaker:
Ana Fátima Esteves
Congress:
CPC 2020
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
14. Acute Cardiac Care
Subtheme:
14.2 Acute Cardiac Care – Prehospital and Emergency Department Care
Session Type:
Posters
FP Number:
---
Authors:
Ana Fátima Esteves; Rita Marinheiro; Leonor Parreira; Marta Ferreira Fonseca; José Maria Farinha; Antonio Pinheiro Cumena Candjondjo; Joana Silva Ferreira; Dinis Valbom Mesquita; Pedro Campos Amador; Nuno J. Fonseca; Filipe Seixo; Ricardo Santos; Cátia Costa; Rui Caria
Abstract
<p><em>Background</em>: In patients admitted to the emergency department (ED) with rapid atrial fibrillation (AF), the decision to undergo coronary angiography is usually due to elevated cardiac biomarkers. However, a study evaluating the rentability of this approach has never been done.</p> <p><em>Purpose</em>: Evaluate the predictors of a positive coronary angiography performed in patients with rapid AF and elevated cardiac biomarkers.</p> <p><em>Methods</em>: We retrospectively studied patients admitted to the ED between January 2016 and December 2018 with rapid AF who have undergone coronary angiography. We analysed symptoms, risk factors, initial value, peak value and curve of troponin I (TnI) and ST-T segment abnormalities. We evaluated the presence of significant coronary artery stenosis with the need of revascularization at coronary angiography and we used logistic regression to assess the predictors of a positive result.</p> <p><em>Results</em>: From 2265 patients admitted to the ED with rapid AF, 46 patients, 60.9% (28) male, median age 73 (IQR 14.75) years, were submitted to coronary angiography. Significant coronary artery stenosis was present in 24 (52.2%) patients. Regarding cardiovascular risk factors, 39 (85.6%) patients had hypertension, 15 (32.6%) had type 2 diabetes mellitus, 36 (78.3%) had dyslipidaemia, 25 (54.3%) were obese or overweight and 12 (26.1%) had a previous history of CAD. Twenty-eight (60.9%) patients presented with chest pain and 27 (58.7%) had ST-T segment abnormalities. Of note, in 17 (37.0%) cases high-sensitivity TnI was measured.</p> <p>In univariate analysis, ST-T segment abnormalities, the presence of typical TnI curve and an elevated initial TnI predicted the presence of significant CAD in coronary angiography (Table).</p> <p>In multivariate analysis, an initial TnI value above the upper reference limit (URL) was the only independent predictor of significant CAD in coronary angiography.</p> <p><em>Conclusion</em>: In this group of patients with rapid AF an initial elevated TnI was the only independent predictor of the presence of significant CAD. Therefore, maybe it would be advisable to perform coronary angiography in these patients.</p>
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