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Shangai Score as an outcome predictor for Brugada Syndrome patients
Session:
Sessão de Posters 28 - Morte súbita cardíaca
Speaker:
Ana Beatriz Garcia
Congress:
CPC 2024
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.4 Ventricular Arrhythmias and SCD - Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Ana Beatriz Garcia; Ana Margarida Martins; Catarina Simões de Oliveira; Ana Abrantes; Catarina Gregório; Miguel Azaredo Raposo; Joana Brito; Afonso Ferreira; Gustavo Lima da Silva; Nuno Cortez Dias; Fausto J. Pinto; João de Sousa
Abstract
<p style="text-align:justify"><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">Introduction: </span></span></span><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">Brugada syndrome (BS) is a rare but potentially life-threatening heart rhythm condition. Shangai Brugada Scoring System for (BS) diagnosis considers electrocardiographic (ECG) recordings, genetic results, clinical characteristics, and family history. Diagnosis of probable and/or definite BS, possible or nondiagnostic were assigned scores of ≥ 3.5, 2 to 3, and <2 points, respectively.</span></span></span></p> <p style="text-align:justify"><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">Purpose: </span></span></span><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">This study was designed to evaluate the value of Shangai Score (SS) in Brugada patient’s prognosis. </span></span></span></p> <p style="text-align:justify"><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">Methods: </span></span></span><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">A prospective analysis of Brugada patients followed in a tertiary hospital was conducted. We examine each item of SS at initial evaluation and calculate the point score. The association of the SS with outcomes was assessed using Kaplan-Meier survival analysis with risk estimation through univariate Cox regression analysis. The primary outcome was a composite of arrhythmic death, aborted cardiac arrest and appropriately triggered implantable cardioverter-defibrillator (ICD) shock.</span></span></span></p> <p style="text-align:justify"><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">Results:</span></span></span><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">We enrolled 163 patients in our analysis (68% male, mean age 53 ± 13.6 years) with a mean follow-up (FUP) time of 7 years. All patients exhibited type 1 ECG patterns, which occurred spontaneously in 38% of patients. Thirteen percent of the patients were symptomatic: 10% had aborted cardiac arrest or documented ventricular tachycardia/fibrillation (VT/VF) and 3% had suspected arrhythmic syncope. An ICD was implanted in 25% of patients due to history of VF, arrhythmic syncope or judgement of being at high risk. Main categories of SS are summarized in figure 1a. </span></span></span><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">During the follow-up, potentially fatal cardiac events and deaths occurred in 10 patients (1 aborted cardiac arrest, 1 arrhythmic death, and 8 appropriately triggered ICD shocks). The enrolled patients were categorized based on the SS score into two groups: those with a possible or nondiagnostic result (48%) and those with a probable or definite result (≥ 3.5) (52%). Patients presenting with an SS score ≥ 3.5 had a significantly higher arrhythmogenic event rate during the follow-up compared to others, as indicated by the Kaplan-Meier curve (p=0,044) with an Hazard Ratio 44,9 (95% CI, 0.03-77141; p=0.028) (Figure 1b).</span></span></span></p> <p style="text-align:justify"><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">Conclusion: </span></span></span><span style="font-family:Calibri"><span style="font-size:11,0000pt"><span style="font-family:'Calibri Light'">Our analysis found out that SS can be a potential tool to risk stratification in BS patients, being a valuable tool in clinical decision-making. </span></span></span></p>
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