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
Is major bleeding related to the timing of intervention in NSTE-ACS?
Session:
Posters - E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Speaker:
Inês Grácio Almeida
Congress:
CPC 2021
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:
Inês Grácio De Almeida; Hélder Santos; Mariana Santos; Hugo Miranda; Joana Chin; Catarina sá; Samuel Almeida; Catarina Sousa; Lurdes Almeida; Registo Nacional de Síndromes Coronárias Agudas
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> The use of potent antithrombotic drugs reduced ischaemic risk in patients with NSTE-ACS but is invariably associated with an increased bleeding risk, negatively affecting prognosis and survival. Previous trials showed that in patients with NSTE-ACS with no pre-treatment (PT) both early and delayed strategies had similar safety regarding bleeding events.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objective:</strong> To evaluate the prognostic value of an early strategy (ES; <24h) versus a delayed strategy (DS; >24h) in NSTE-ACS without PT regarding major bleeding.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Material and methods: </span></strong><span style="color:black">Retrospective analysis of patients´ data admitted with NSTE-ACS at multicentric national registry between 2015-19. Compared demographic and clinical characteristics of patients with an ES versus DS. A multivariate logistic regression was performed to evaluate predictor factors of major bleeding during hospitalization. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results: </strong>691 patients were included, mean age 64±11 years, 77.4% male. 59.2% performed coronary angiography as an ES and the others 40.8% as a DS. There was a trend to worse in-hospital outcomes in the DS regarding heart failure, shock, ventricular arrhythmias, cardiac arrest and death, although not statistically significant. The only statistically significant endpoint was major bleeding (1.8 vs 0.2%, p=0.044), observed in a higher percentage in DS group. 0.9% of overall population presented major bleeding. These patients were older (73±16 vs 64±11, p=0.079). There were no significant differences regarding cardiovascular risk factors or other comorbidities. At admission, 25.9% patients were under aspirin and 10.9% one P2Y12 inhibitor. P proposed to a DS presented higher levels of creatinine and lower levels of hemoglobin. Pending coronary angiography, 98.4% were medicated with aspirin, 64.8% with ticagrelor, 44% clopidogrel, and 0.4% prasugrel, with no difference. There were also no differences regarding the anticoagulation strategy in both groups. Coronary angiography was performed in all patients of both groups. The preferred vascular access was the transradial in both groups (92.9% in overall population); however a higher proportion in the major bleeding group was used the transfemoral access (33.3 vs 6.8%, p=0.061). On coronary angiography, 6.2% had normal coronary arteries, 49.2% 1-vessel disease and 45.1% multivessel disease. Revascularization was performed in 88.2%: PCI in 86.2%, CABG in 1.7% and both in 0.3%, with no significant differences. Predictor factors for major bleeding were age ≥75 years (p=0.032) and previous bleeding (p=0.013). Timing of coronary angiography (<24 versus >24h) was not a predictor factor (p=0.99). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion: </strong>Our results are in accordance with published data: only age ≥75 years and previous bleeding were potent predictors of major bleeding, while the timing of coronary angiography did not show to predict major bleeding in the absence of P2Y12 antagonist pre-treatment.</span></span></p>
Our mission: To reduce the burden of cardiovascular disease
Visit our site