Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
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
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
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
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
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
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
PREDICTORS OF ADVERSE PROGNOSIS AT FOLLOW-UP IN NSTEMI WITH RBBB
Session:
Painel 8 - Doença Coronária 9
Speaker:
Mariana Saraiva
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:
Mariana Saraiva; Ana Rita Moura; Nuno Craveiro; Maria João Matos Vieira; Kevin Domingues; Maria Da Luz Pitta; Vitor Paulo Martins; Em nome dos investigadores do Registo Nacional de Síndromes Coronárias Agudas
Abstract
<p>Introduction: Recent myocardial infarction (MI) recommendations underline the adverse prognosis associated with right bundle branch block (RBBB). However, it is uncertain if RBBB itself or the clinical severity inherent to these patients (pts) encloses a worse outcome at follow-up (FU).</p> <p>Aim: to characterize a population with non-ST segment elevation MI (NSTEMI) and RBBB and find predictors of worse outcome at FU.</p> <p>Methods: retrospective analysis of pts included in a multicentric registry of Acute Coronary Syndromes, discharged after NSTEMI, comparing pts with RBBB (group A) and pts without RBBB (group B), regarding clinical and demographic variables, diagnostic and therapeutic approaches. Primary endpoint was all-cause death or hospital admissions due to cardiovascular causes (HACV) during FU (1 year).</p> <p>Results: we included 4663 pts, 359 in group A and 4304 in group B. Pts in group A were more likely to be male (Odds ratio - OR - 1.65, p<0.001) and >75 years old (OR 2.73, p<0.001). Also, they were more prone to have cardiovascular (CV) risk factors (hypertension - OR 1.71, p<0.001, diabetes – OR 1,31, p=0.017), history of coronary artery disease (stable angina OR 1.29, p=0.024, previous MI OR 1.28, p=0.038 and surgical revascularization OR 1.88, p<0.001), stroke (OR 1.6, p=0.004), chronic kidney disease (OR 2.03, p<0.001) and dementia (OR 2.33, p=0.003). There were no differences between time from onset of symptoms and first medical contact or hospital admission. Upon admission, pts from group A presented more frequently with hypotension (p=0.017), Killip class≥II (p<0.001) and atrial fibrillation (p<0.001). The use of non-invasive (p=0.002) and invasive ventilation (p=0.025) and temporary pacing (p=0.001) was significantly more frequent in group A.</p> <p>Pts with RBBB were less likely to undergo coronary angiography (OR 0.67, p=0.001). However, among those who did, three-vessel disease (OR 1.5, p=0.005) and the decision of no revascularization (OR 1.42, p=0.031) were both more prevalent. Moreover, left ventricular systolic dysfunction was more common in group A (OR 1.53, p<0.001).</p> <p>At FU, rates of all-cause death, all-cause hospital readmissions and HACV were 7.93%, 22.89% and 15.56%, respectively. Death (p=0.001) and hospital readmissions (p=0.003) were more common in pts in group A, which were also more likely to reach the endpoint (hazard ratio 1.27, p=0.044). In a multivariate regression analysis, including variables such as gender, age, CV risk factors, previous evidence of CV disease, clinical, echocardiographic and coronary anatomy data, RBBB was not an independent predictor of the primary endpoint (p=0.219).</p> <p>Conclusion: while pts with NSTEMI and RBBB had worse in-hospital evolution and a poorer prognosis at FU, this is probably related with their greater clinical complexity (older age, comorbidities and complex coronary anatomy) and not the presentation with RBBB itself.</p>
Our mission: To reduce the burden of cardiovascular disease
Visit our site