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Curso de Atualização em Medicina Cardiovascular 2019
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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
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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
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
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CLEAR FILTERS
We Need to Treat Our Women Better
Session:
Posters - D. Heart Failure
Speaker:
Eric Monteiro
Congress:
CPC 2021
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Eric Alberto Monteiro; José Pedro Barbosa; Joana Guimarães; Diogo Fernandes; Gonçalo Costa; Ana Rita m. Gomes; Carolina Saleiro; Diana Campos; José Pedro Sousa; João Lopes; Luís Puga; Rogério Teixeira; Carolina Lourenço; Marta Madeira; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Background: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">In heart failure (HF) with reduced ejection fraction (HFrEF), neuro-hormonal antagonists (NHA) are recommended for every patient (unless contraindicated) to reduce the risk of HF hospitalization and improve survival. Despite extracting similar benefits, there is a strong concern that women are less frequently treated according to these guidelines. The aim of this study was to compare the prescription of NHA between men and women with acute coronary syndrome (ACS) and HFrEF.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Retrospective analysis of 168 consecutively admitted patients for ACS, in a single coronary intensive care unit, in whom a left ventricular ejection fraction (LVEF) <40% was present at discharge. Patients were divided into two groups according to sex. Age and relevant comorbidities were assessed using the Mann-Whitney U or χ² test (according to variable type) to ensure comparability between groups. Prescription of beta-blockers (BB), angiotensin-converting enzyme inhibitors (ACEI)/ angiotensin II receptor blockers (ARB) and mineralocorticoid receptor antagonists (MRA) at discharge was evaluated using the χ² test.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">In the studied sample, 75% were male (M). Baseline comparison between groups is presented in table 1. While there were no significant differences in the prescription of BB and MRA at discharge in M vs F (89.7% vs 84.2% p=0.388 and 44.0% vs 37.8% p=0.511, respectively), prescription of ACEI/ARB at discharge was significantly more frequent in M (93.1% vs 76.3%; p=0.013). Since age between groups was significantly different, binary logistic regression was used to determine whether age might have been a confounding factor in the association between gender and ACEI/ARB prescription. In multivariate logistic regression, significance for age was borderline (OR 0.95; 95% CI 0.89–1.00; p=0.051), while sex remained significantly associated with the likelihood of having ACEI/ARB prescribed at discharge (OR 3.09; 95% CI 1.06–9.04; p=0.04). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusions:</strong> </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Our study seems to confirm that women are less likely to receive guideline-directed medical therapy for HFrEF, more specifically ACEI/ARB at discharge. More effort is needed to sensitise physicians to prescribe these lifesaving drugs in the female population. Additional studies to assess the prognostic impact of this asymmetry could help in achieving this goal.</span></span></p>
Slides
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