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32. Cardiovascular Nursing
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Follow-up of sustained ventricular tachycardia in Acute Coronary Syndromes
Session:
Posters (Sessão 6 - Écran 2) - Arrítmias 6 - Arrítmias Ventriculares 2
Speaker:
Hélder Santos
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.2 Ventricular Arrhythmias and SCD - Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Helder Santos; Mariana Santos; Sofia b. Paula; 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">Sustained ventricular tachycardia (VT) is a dangerous but frequent situation associated with the onset of Acute Coronary Syndrome (ACS). It is related to the worst short-term prognosis, however, the long-term prognosis of VT in the ACS is not clarified. </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 VT in ACS is a predictor of long-term mortality.</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 1/10/2010-4/09/2019. Patients were divided in two groups: A – patients without VT, and B – patients that presented VT on the hospitalization. VT was defined as a register or more of the VT with at least 30 seconds. Logistic regression was performed to assess predictors of mortality at one year of follow-up. </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"> 25725 patients were included, yet just 9686 had a 1-year follow-up, with 9543 in group A (98.5%) and 143 in group B (1.5%). Both groups were similar regarding gender, age, cardiovascular risk factors, previous ACS therapy, cholesterol, creatinine and hemoglobin at admission, multivessel disease and revascularization rates. Group A had higher time since the onset of symptoms until the medical assistance (371±163 vs 278±115, <em>p</em>=0.003), chest pain (91.8 vs 72.7%, <em>p</em><0.001), HbA1c (6.7±1.8 vs 5.3±0.5, <em>p</em>=0.008), radial access (81.7 vs 55.8%, <em>p</em><0.001) and left ventricular ejection fraction (LVEF)>50% (68.6 vs 36.7%, <em>p</em><0.001). On the other hand, group B exhibited higher rates of direct cardiac unit admission (22.6 vs 37.6%, <em>p</em>=0.022), previous heart failure (6.2 vs 12.0%, <em>p</em>=0.005), STEMI (40.2 vs 65.7%, <em>p</em><0.001), admission heart rate (77±19 vs 84±33, <em>p</em>=0.025), admission systolic blood pressure (SBP) (141±29 vs 127±34, <em>p</em><0.001), Killip-Kimball classification > I (KK>I) (13.5 vs 32.9%,<em> p</em><0.001), atrial fibrillation at admission (AF) (7.1 vs 14.1%,<em> p</em>=0.001), admission glycemia (155±79 vs 176±87, <em>p</em>=0.002), BNP (360±589 vs 598±612, <em>p</em><0.001), hybrid revascularization strategy (0.7 vs 3.3%, <em>p</em>=0.011), in-hospital time (5±4 vs 10±7, <em>p</em><0.001) and major adverse cardiac events (all <em>p</em><0.001). Mortality rates significantly increase at one year of follow-up, with a Kaplan-Meier test of <em>p</em><0.001 (figure 1), however readmission for all causes (<em>p</em>=0.873) and cardiovascular readmission (<em>p</em>=0.792) at one year were similar between the groups. Logistic regression revealed that VT was not a predictor of mortality at one-year follow-up (<em>p</em>=0.117). Also logistic regression revealed that age >75 years (<em>odds ratio</em> (OR) 2.53, <em>p<</em>0.001, confidence interval (CI) 2.04-3.14), SBP (OR 1.85, <em>p</em>=0.004, CI 1.21-2.81), KK>I (OR 1.51, <em>p</em><0.001, CI 1.21-1.89), AF (OR 1.32, <em>p</em>=0.0033, CI 1.02-1.70), LVEF<40% (OR 1.89, <em>p</em><0.003, CI 1.51-2.34) and mechanical complication (OR 7.79, <em>p</em><0.001, CI 2.84-21.37) were predictors of mortality at one-year follow-up in ACS patients.</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">: VT during the admission for ACS was not a predictor of mortality at one-year follow-up.</span></span></p>
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