SPC365

Clinical and long-term prognostic trends in ST-segment elevation myocardial infarction: a multicentre national registry analysis

Session: Posters (Sessão 6 - Écran 7) - Enfarte miocárdio elevação ST
Speaker: Carolina Miguel Gonçalves

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: Carolina Miguel Gonçalves; Margarida Cabral; Mariana Carvalho; Sara Fernandes; Fátima Saraiva; João Morais; Em Nome Dos Investigadores do Registo de Síndromes Coronárias Agudas da Sociedade Portuguesa de Cardiologia

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Background</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Although significant advances in patient care, ST-segment elevation myocardial infarction (STEMI) remains a major health problem.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Aim</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">To describe clinical and prognostic characteristics of Portuguese STEMI patients.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Material and methods</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Retrospective multicentre analysis of STEMI patients&nbsp;included in the Portuguese Registry on Acute Coronary Syndromes (ProACS) between October 2010 and October 2022. Baseline characteristics, clinical findings, treatment and mortality were analyzed. Multivariate analysis was performed to assess predictors of mortality.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results </strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">The authors studied 14470 patients with a mean age of 64 &plusmn; 14 years, of which 74% were male. A high frequency cardiovascular risk factors was observed, namely high blood pressure (63%), dyslipidemia (54%), smoking (35%) and diabetes (25%). Previous myocardial infarction was present in 11%. The most common symptom was chest pain (94%),&nbsp;Killip class 1 the most frequent presentation and left ventricular ejection fraction was preserved in 52%. Multivessel disease was found in 44% although left anterior descending artery was the most frequent culprit artery - in about 44% of cases. Around 64% of patients were submitted to reperfusion therapy, mostly coronary angioplasty (95%) and roughly 98% were successful. Regarding in-hospital complications: shock (36%), congestive heart failure (17%) and death (5%) were reported. Thirty-day and one-year mortality occurred in 6% and 8%, respectively. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">After multivariate analysis, older age (HR=4.06; CI 95% [2.556-6.448<span style="color:black">]; p&lt;0.001), left ventricular ejection fraction under 30% </span>(HR=2.038; CI 95% [1.284-3.234<span style="color:black">]; p=0.003) and Killip class over 1 </span>(HR=1.578; CI 95% [1.104-2.256<span style="color:black">]; p=0.012) remai</span>ned&nbsp;independent risk factors for one-year mortality.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusions</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Cardiovascular risk factors were highly prevalent in our population. Although multivessel disease was common, the most frequent culprit artery was the left anterior descending artery with successful treatment. Several clinical characteristics were independent risk factors for one-year mortality.</span></span></span></p>