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
FAST-RVD score, a better predictor of in-hospital mortality in acute pulmonary embolism?
Session:
Painel 9 - Doença Valvular 9
Speaker:
João Miguel Santos
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
João Miguel Santos; Inês Pires; Luísa Gonçalves; Joana Laranjeira Correia; Hugo Da Silva Antunes; Inês Almeida; Emanuel Correia; José Costa Cabral
Abstract
<p><strong>Introduction</strong></p> <p>Pulmonary embolism (PE) is a life-threatening disorder associated with significant in-hospital mortality (IHM). Different scores for mortality prediction have been validated in these patients. We aimed to evaluate if the addition of right ventricle dilation/dysfunction signs (RVD) obtained from imaging methods to the recently validated FAST score would refine its ability to predict IHM and long-term death.</p> <p> </p> <p><strong>Methods </strong></p> <p>Retrospective analysis of 127 patients admitted for acute PE. Patients with shock or hemodynamic instability at admission were excluded. FAST (variables: syncope, troponin I and heart rate, range 0-5 points), PESI and BOVA scores were calculated for each patient. We evaluated signs of RVD from echocardiographic (defined as TAPSE<16, Tricuspid S’<9.5 or dilation of right ventricle as assessed by 2D measures) and pulmonary CT angiography exams (ratio right/left ventricle diameter >1.0). To the initial FAST score, we added this variable, attributing 2 points to patients with evidence of RVD, and 0 points otherwise. The new score – FAST-RVD – was calculated (range 0-7). ROC curve analysis was performed to evaluate the predictive value of different scores for IHM. Kaplan-Meier analysis was used to assess 8-year follow-up mortality (8YM) and combined endpoint of 8-year rehospitalization or death (8YHD).</p> <p> </p> <p><strong>Results</strong></p> <p>Mean age was 62±18y; 60% were female; 14.7% had previous history of venous thromboembolism; 48.7% had no precipitating factor identified; 15% had sigs of RVD on imaging evaluation. 36% had low-risk PE, 54% intermediate-low risk PE and 10% intermediate-high risk PE, as defined by European Society of Cardiology guidelines.</p> <p>Mean PESI score was 94±39, mean BOVA 3.6±2, mean FAST 2.5±1.6, mean FAST-RVD 2.9±1.8. IHM was 2.4%.</p> <p>8YM and 8YHD rates were 26% and 55.1%, respectively.</p> <p>ROC curve analysis revealed that FAST-RVD score had the best predictive performance for IHM (AUC: 0.909, p=0.048), followed by FAST score (0.606, p=NS). Other scores had poor predictive performance for this outcome.</p> <p>When stratified by high (≥3) and low-risk (<3) FAST-RVD score, we observed no in-hospital mortality in low risk patients, while high-risk patients had ≈4% IHM risk.</p> <p>Kaplan Meier analysis by risk subgroup revealed higher 8YM in patients with high-risk FAST-RVD (31.1% vs 25%, χ<sup>2</sup>= 0.386, p= 0.534) that did not reach statistical significance. Analysis of 8YHD rate did not reveal significant differences between groups (60.8% vs 50%, χ<sup>2</sup>= 0.814, p= 0.367). High-risk stratification with other scores (PESI>105, FAST>3 or BOVA>4) also did not reveal significant effect on 8YM or 8YHD risk (p=NS).</p> <p> </p> <p><strong>Conclusion</strong></p> <p>Evaluation of signs of RVD and their addition to the previously validated FAST score allows better IHM risk prediction in patients hospitalized for PE. This new score might be a better tool for IHM prediction in these patients, particularly by defining a low-risk subgroup with very low IHM risk.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site