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
High-risk Acute Pulmonary Embolism in a Portuguese centre: are we doing enough?
Session:
Prémio Jovem Investigador
Speaker:
Mariana Martinho
Congress:
CPC 2021
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Prémios
FP Number:
---
Authors:
Mariana Martinho; Rita Calé; Sofia Alegria; Filipa Ferreira; Maria José Loureiro; Tiago Judas; Melanie Ferreira; Ana Oliveira Gomes; Francisca Delerue; Hélder Pereira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Introduction:</span></strong><span style="font-size:12.0pt"> For high-risk acute Pulmonary Embolism patients (HR-PE pts), reperfusion treatment is imperative to improve mortality. Although systemic thrombolysis (ST) is generally an appropriate first-line therapy, several population-based studies report its underuse. Data on epidemiology, management and outcomes of HR-PE in Portugal is scarce.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Purpose: </span></strong><span style="font-size:12.0pt">Estimate the reperfusion rate in HR-PE pts, the reasons for non-reperfusion (NR) and how it influences outcomes.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Methods:</span></strong><span style="font-size:12.0pt"> Retrospective single-centre registry of consecutive HR-PE pts between 2008-2018, defined by the 2019 ESC guidelines criteria. Independent predictors for NR were assessed by multivariate logistic regression. The cumulative incidence of PE-related mortality at 30 days was calculated according to the Kaplan-Meier method and differences stratified by reperfusion were assessed using the log-rank test.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Results:</span></strong><span style="font-size:12.0pt"> Of a total of 1955 pts admitted with acute PE, 74 (3.8%) had HD instability at admission (mean age 68</span><span style="font-size:12.0pt">±</span><span style="font-size:12.0pt">15 years). The majority of pts (68.5%) came from the emergency department while the remaining 31.5% were already hospitalized for other reasons. The total reperfusion rate was 50% - 35pts were submitted to systemic thrombolysis, 1pt to first-line percutaneous embolectomy and 1pt to rescue endovascular treatment. Age was an independent predictor of NR (63</span><span style="font-size:12.0pt">±17 </span><span style="font-size:12.0pt">vs 73</span><span style="font-size:12.0pt">±12, p=0.02) with >75 years representing 15 times the risk of non-treatment (OR 15.5, 95%CI 3.23-74.25, p<0.001). Absolute contraindication for thrombolysis was </span><span style="font-size:12.0pt">present in 29.7% (22pts), with recent major surgery (13pts) and recent cerebral event (8pts) as the most common reasons. The presence of an absolute contraindication for systemic thrombolysis was also an independent predictor of NR (66.7% vs 13.6%; OR 13.3, 95%CI 2.51-70.65, p=0.002). Being hospitalized was associated with the presence of absolute contraindications for thrombolysis (68.2% vs 14.0%, p<0.001) and was also an independent predictor of NR (38% vs 77.3%; OR 8.49, 95%CI 1.56-46.11, p=0.013). PE-related death at 30 days was 28.4% (21pts), which was significantly lower in the reperfusion group (17.1% vs 38.9%, p=0.042). At a mean follow-up of 2.5</span><span style="font-size:12.0pt">±3.3 years, survival rate was 33.8% (figure 1).</span> </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Conclusions:</span></strong><span style="font-size:12.0pt"> Low reperfusion rate due to contraindications for thrombolysis was associated with high PE-related mortality. This data suggests that it is necessary to implement interventional alternative strategies, at a national level, to improve outcomes.</span></span></span></p>
Video
Our mission: To reduce the burden of cardiovascular disease
Visit our site