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Long-term prognosis in patients with atrioventricular block in acute coronary syndrome
Session:
Posters (Sessão 3 - Écran 3) - Arrítmias 4 - Vários
Speaker:
Hélder Santos
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.2 Arrhythmias, General – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Helder Santos; Sofia b. Paula; Mariana Santos; Inês Almeida; Samuel Almeida; Lurdes Almeida
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"><span style="font-family:"Times New Roman",serif">Background: </span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">The presence of atrioventricular block (AVB) in the setting of an acute</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> coronary syndrome (ACS) can be just an in-hospital complication, without any implication in the long-term prognosis of these patients.</span></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"><span style="font-family:"Times New Roman",serif">Objective:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> Evaluate the long-term impact and prognosis of AVB in ACS patients.</span></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"><span style="font-family:"Times New Roman",serif">Methods:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> This is a multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-3/05/2020. Patients were divided into two groups: A – patients without AVB, and B – patients that presented AVB. Were excluded patients without a previous cardiovascular history or clinical data regarding AVB occurrence. Logistic regression was performed to assess predictors of long-term mortality in patients that had AVB during the ACS.</span></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"><span style="font-family:"Times New Roman",serif">Results:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> From 32157 patients, 23834 was included, 23178 in group A (97.4%) and 656 in group B (2.6%). Both groups were similar regarding initial symptons until first medical contact, smoker status, arterial hypertension, diabetes mellitus, peripheral artery disease and chronic kidney disease. Group A had higher body mass index (27.4±4.4 vs 26.9±4.6, <em>p</em>=0.005), dislipidaemia (59.6 vs 51.4%, <em>p</em><0.001), coronary artery disease (18.9 vs 13.0, <em>p</em><0.001), heart rate (78±19 vs 65±25, <em>p</em><0.001), systolic blood pressure (139±29 vs 119±32, <em>p</em><0.001) and left ventricular ejection fraction (LVEF) >50% (60.1 vs 51.7%, <em>p</em><0.001). On the other hand, group B was elderly (66±13 vs 71±13, <em>p</em><0.001), female (27.4 vs 32.4%, <em>p</em><0.001), previous stroke (6.9 vs 10.9%, <em>p</em><0.001), neoplasia (4.9 vs 6.8%, <em>p</em>=0.031), ST-segment elevation myocardial infarction (46.2 vs 75.4%, <em>p</em><0.001), syncope as major symptom (1.3 vs 10.0%, p<0.001), Killip-Kimball class > I (15.4 vs 31.6%, <em>p</em><0.001), multivessel diasease (52.1 vs 61.4%, <em>p</em><0.001) and major adverse cardiac events (<em>p</em><0.001). However, just 8755 had a follow-up at one-year, 8127 in the group A and 628 in the group B. AVB during the ACS was not a predictor of moratlity at one year follow-up (<em>p</em>=0.122). Nonetheless, logistic regression revealed that age >75 years old (<em>odds ratio</em> (OR) 2.44, <em>p</em><0.001, confidence interval (CI) 1.87-3.18), chronic kidney disease (OR 1.86, <em>p</em>=0.002, CI 1.25-2.78), neoplasia (OR 1.80, <em>p</em>=0.010, CI 1.15-2.81), STEMI (OR 1.58, <em>p</em>=0.002, CI 1.18-2.11), heart rate at admission >100 (OR 1.53, <em>p</em>=0.009, CI 1.11-2.09), Killip-Kimball class > I (OR 1.50, <em>p</em>=0.009, CI 1.11-2.04), right bundle branch block at admision (OR 1.70, <em>p</em>=0.004, CI 1.18-2.46), multivessel disease (OR 1.43, <em>p</em>=0.009, CI 1.09-1.87), left ventricular ejection fration <50% (OR 1.86, <em>p</em><0.001, CI 1.40-2.49) and cardiogenic shock during the hospitalization for ACS (OR 1.96, <em>p</em>=0.012, CI 1.16-3.33) were predictors of mortality in patients that presented AVB during the ACS. </span></span></span></span></p> <p><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Conclusions</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: AVB during the ACS was not a predictor of long-term mortality.</span></span></p>
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