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32. Cardiovascular Nursing
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Acute ST segment elevation myocardial infarction leaves no-one behind: a young population analysis
Session:
Posters (Sessão 4 - Écran 8) - Síndromes coronárias agudas em populações especiais
Speaker:
Joao Santos Fonseca
Congress:
CPC 2023
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Joao Santos Fonseca; Joana Brito; Beatriz Valente Silva; Pedro Alves da Silva; Ana Beatriz Garcia; Ana Margarida Martins; Catarina Simões de Oliveira; Catarina Gregório; Miguel Azaredo Raposo; Ana Abrantes; Daniel Inácio Cazeiro; Marta Vilela; Diogo Rosa Ferreira; Pedro Pinto Cardoso; Fausto J. Pinto
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Introduction: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Acute ST segment elevation myocardial infarction (STEMI) remains a leading cause of premature mortality and morbidity, even in younger patients (pts), with an important loss of quality adjusted life years. Recent studies have tried to identify specific characteristics of young pts with STEMI to help stratify risk factors and optimize prevention measures. </span></span></span></p> <p> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Purpose:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"> To characterize and evaluate outcomes in a population of young pts with STEMI. </span></span></span></p> <p> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Methods:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"> Retrospective, single-center study of consecutive pts, with age below 50 years, who were admitted with STEMI and underwent percutaneous coronary intervention (PCI), between 2017 and 2021. Demographics, clinical characteristics, and clinical outcomes, including major cardiovascular events (MACE) and mortality, were analyzed. Multivariable cox proportional hazard model was performed to identify predictors of long-term prognosis. </span></span></span></p> <p> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Results: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">We included</span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong> </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">257 pts, 82,5% were men, with a mean age of 44.4 ± 4.9 years. Smoking was identified in 73% of pts, which represents a 7 fold increase when compared with general Portuguese population´s smoking habits, followed by dyslipidemia, present in 63% of pts, with a mean cLDL of 120 ± 41mg/dL, excess of weight, with 39,6% of pts having a BMI ≥ 25, hypertension (35% of pts) and diabetes (15% of pts). Most pts presented with a Killip class 1, with only 4 presenting with Killip 4. The majority of pts had one vessel disease and were submitted to angioplasty with stent implantation, being anterior descendent coronary artery (CA) and right CA identified as culprit lesions in 58% and 28% of pts, respectively. During a mean follow-up (FUP) of 2.9 ± 1.4 years, 16 pts died, 12 of which within the first 30 days, 27 developed heart failure, 18 suffered a reinfarction and 7 were admitted with stroke. In our analysis, ejection fraction (EF) at presentation (mean 48.9 ±11%) was the only variable associated with MACE and mortality during FUP (p<0.001). </span></span></span></p> <p><br /> <span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Conclusion:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"> Despite having an apparent less severe presentation, STEMI in young pts is associated with high risk mortality and MACE. Close follow-up and risk factor management have a major role, particularly in this population. </span></span></span></p>
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