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Delay between symptoms onset and seeking medical care – does initial rhythm plays a role?
Session:
Posters (Sessão 3 - Écran 6) - Doença Coronária e Cuidados Intensivos 4 - Vários
Speaker:
Sofia B. Paula
Congress:
CPC 2022
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:
Pósters Electrónicos
FP Number:
---
Authors:
Sofia b. Paula; Mariana Santos; Hélder 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">Acute coronary syndromes (ACS) and atrial fibrillation (AF) are frequent causes of admissions in a Cardiology Department. </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 if the presence of AF or other rhythms had an influence between the onset of symptoms and seeking medical care. </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"> Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-8/01/2019. Patients (P) were divided into three groups (G): GA – P in sinus rhythm; GB – P in AF and GC - other rhythms. P without a previous cardiovascular history or clinical data were excluded. Chi-square test, T-student test and Mann-Whitney U test were used to compare categorical and continuous variables.</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"> 15927 P were included, 14637 in GA (91.9%), 1049 in GB (6.6%) and 241 in GC (1.5%). Both G were similar regarding dyslipidemia, time between the onset of symptoms and first medical contact, symptoms and admission and between the first medical contact and admission, multivessel disease and culprit lesion in ST-segment elevation myocardial infarction</span></span><span style="background-color:white"><span style="font-family:"Arial",sans-serif"><span style="color:#545454"> (</span></span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">STEMI). GA exhibited higher rates of STEMI (42.6 vs 33.6 vs 50.6%, p<0.001), systolic blood pressure (sBP) (140±29 vs 135±30 vs 122±34, p<0.001), smoking (31.0 vs 8.7 vs 20.2%, p<0.001) and p</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">ercutaneous coronary intervention (PCI) (67.8 vs 50.4 vs 67.6%, p<0.001). GC had more P with previous history of neoplasia (4.3 vs 6.4 vs 9.2%, p<0.001) and Killip-Kimball classification > I (12.7 vs 30.5 vs 32.0%, p<0.001).</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> GB was older (65±13 vs 75±10 vs 73±13, <em>p</em><0.001), more frequently admitted at the emergency room (53.8 vs 62.6 vs 61.3%, p<0.001), higher rates of arterial hypertension (67.1 vs 83.2 vs 79.2%, p<0.001), diabetes mellitus (30.4 vs 36.0 vs 36.9%, p<0.001), stroke (6.7 vs 14.9 vs 11.7%, p<0.001), peripheral artery disease (4.8 vs 8.9 vs 4.6%, p<0.001), chronic kidney disease (4.7 vs 10.5 vs 10.4%, p<0.001), dementia (1.5 vs 4.2 vs 3.1%, p<0.001), heart rate (77±18 vs 91±29 vs 68±30, p<0.001) and left ventricular ejection fraction <50% (35.3 vs 51.1 vs 43.1%, p<0.001). Regarding <em>de novo </em>heart failure (13.0 vs 29.7 vs 26.6%, p<0.001), sustained ventricular tachycardia (1.5 vs 3.1 vs 3.7%, p<0.001), cardiac arrest (2.8 vs 4.9 vs 7.1%, p<0.001), stroke (0.6 vs 1.7 vs 0.4%, p<0.001) and death (2.7 vs 9.0 vs 10.4%, p<0.001) all were higher in GB and GC.</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">Conclusions</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: Rhythm at admission did not influence the timing between symptoms onset and seek of medical care but it was associated with worse prognosis and complications.</span></span></span></span></p> <p> </p>
Slides
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