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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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01. History of Cardiology
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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34. Public Health and Health Economics
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CLEAR FILTERS
Pulmonary infarction in acute pulmonary embolism: a sign of poor prognosis?
Session:
Posters 2 - Écran 10 - Circulação / Embolia Pulmonar
Speaker:
João Miguel Santos
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
João Miguel Santos; Inês Pires; Luísa Gonçalves; Hugo Da Silva Antunes; Júlio Gil; Luís Abreu; Emanuel Correia; Inês Almeida; José Costa Cabral
Abstract
<p><strong>Introduction</strong></p> <p>Pulmonary infarction (PI) is a common complication in patients with pulmonary embolism (PE), and its impact on prognosis is still uncertain. The main purpose of this study was to evaluate the association between the presence of PI and clinical characteristics and prognosis in patients with PE.</p> <p> </p> <p><strong>Methods</strong></p> <p>A retrospective analysis of 209 patients admitted to a Cardiology ward due to PE was performed. Patients without data on PI were excluded (n=143). The Mann-Whitney U or T-test were used to compare means of selected variables: leukocytes, neutrophils, C-reactive protein (CRP), troponin I, BNP, heart rate (HR), oxygen pressure in arterial blood gas analysis (pO2), right ventricle diameter (RVD), pulmonary artery diameter (PAD), days of hospitalization (DH) and PESI score. The Chi-square test (χ2) was used to evaluate the association between fever, chest pain, hemoptysis, tachypnea or syncope at presentation and PI, as well as the association with in-hospital mortality. Mortality at 2 years of follow-up was evaluated with a Kaplan-Meier survival analysis. A multivariable logistic regression (MRlog) model was used to assess the predictive value of the significant variables for the presence of PI.</p> <p> </p> <p><strong>Results</strong></p> <p>Mean patient age was 63 (±18) years and 60% were female. PI was present in 25%. There was no significant association between PI and neutrophil count, troponin I, BNP, HR, RVD, PAD, DH and PESI score. Higher leukocyte count (p=0.02) and CRP value (p<0.001) revealed significant association with PI. There was a trend towards association between higher pO2 and PI (p=0.052). χ2 test revealed a significant association with hemoptysis (p=0.001) and chest pain (p=0.014). There was no difference between patients in terms of fever, tachypnea or syncope. There was no significant association between the presence of PI and the risk of in-hospital mortality. The logrank test in Kaplan-Meier survival curves did not reveal a significant difference in mortality after 2 years of follow-up (p=0.17). In MRlog model, only CRP (p=0.001), hemoptysis (p=0.015) and chest pain (p=0.049) retained statistically significant association with PI.</p> <p> </p> <p><strong>Conclusion</strong></p> <p>PI might be related with a more pronounced inflammatory process, associated with greater rise in CRP levels. Patients with PI appear to present more often with hemoptysis and chest pain than patients without PI. There is no apparent association between PI and in-hospital mortality or mortality at 2 years of follow-up.</p>
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