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Impact Of Pro-Thrombotic, Antioxidant Plasma Status On Prognosis After Acute Coronary Syndrome (ACS)
Session:
Painel 7 - Doença Coronária 8
Speaker:
Daniel Sebaiti
Congress:
CPC 2020
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Daniel Sebaiti; Paula Fazendas; Filipa Ferreira; Alexandra Briosa; Ana Rita F. Pereira; Ana Marques; Sofia Alegria; Helder Pereira
Abstract
<p>Free radicals have an important role in tissue lesions pathogenesis, including in atherosclerotic plaque formation and thrombus formation, which may have a central role in developing acute coronary syndrome in young. In a previous study, the group of patients that had ACS in young age, presented a significantly lower total value of antioxidant plasma status compared with the control group and reference values. Aims: Analysis of long-term influence of pro-thrombotic, atherogenic and total antioxidant states factors in patients that had an acute coronary syndrome in young age.</p> <p>Methods: The study population included 23 patients admitted for acute coronary syndrome between January 1995 and June 1998. The male/female ratio was 87%/13% and mean age was 35 years. None of the patients had diabetes or diagnosis of familial hypercholesterolemia. Blood samples were collected 16,5 (+/- 10,7) months after ACS. Laboratory tests: plasma antioxidant status (PAS) (colorimetric method measured in Trolox equivalent), Lipoprotein (a), Apolipoprotein A and Apoliproprotein B (Nephelometry technique), Apolipoprotein E (immune-electro-diffusion method), factors VII e VIII activity. None of the patients were lost on follow-up. </p> <p>Results: Mean Follow-up period 13,7 years; 3 deaths. Fifteen patients presented major cardiovascular events: heart failure 4 patients; new ACS 11 patients; 6 patients underwent percutaneous coronary intervention for stable coronary artery disease. PAS: 1,21(0,1) mmol/L, Apo B 1,28 (0,37) g/L, Apo E 45,6(17,3) mg/L, Homocistein 10,9(2,87)µmol/L, Lip (a) 0,24 (0,81) g/L, Apo A 1,14 (0,22) g/L, VII 114(109) %, VIII 50(42) %, vWF 99(40) %. Patients that had major cardiovascular events had significantly higher levels of Lip (a) e vWF (Mann-Whitney Test p <0,05). The ROC analysis of this parameters presented an AUC of 0.84 and 0.79 respectively, with a cut-off for Lp (a) of 0,195 (73% sensitivity, 75 % specificity) and vWF 90% (73% sensitivity, 75 % specificity). </p> <p>Conclusion: Total plasma antioxidant status was lower in the ACS patients compared with the control group. Occurrence of MACE wasn’t associated with a lower level of antioxidant activity. Higher values of pro-thrombotic and atherogenic factors such as Lip (a) e vWF were associated with a worst prognosis after the first ACS.</p>
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