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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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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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Lipid area of controversy: Is seric Lipoprotein (a) a cardiovascular risk factor in Portuguese population?
Session:
Posters 3 - Écran 2 - Doença Coronária
Speaker:
M. Raquel Santos
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
M. Raquel Santos; Andreia Pereira; Joao Adriano Sousa; Flávio Mendonça; Joel Monteiro; Micaela Rodrigues Neto; Ana Célia Sousa; Sónia Freitas; Eva Henriques; Ilídio Ornelas; A. Drumond de Freitas; Isabel Mendonça; Roberto Palma dos Reis
Abstract
<p><strong><u>Introduction:</u></strong> Coronary artery disease (CAD) remains a leading cause of morbidity and mortality despite implementation of lifestyle measures and the existence of drugs to reduce classical risk factors. It is necessary to identify other causal risk factors and potential therapeutic targets, and Lipoprotein a (Lpa) seems a likely candidate. Despite the recognition of the Lpa as an independent risk factor for cardiovascular events, the medical knowledge about it is still limited. Lpa determination involves challenging laboratory techniques, limiting its universal implementation.</p> <p><strong><u>Objective:</u></strong> To evaluate if the level of Lpa can be considered a risk marker for CAD in Portuguese population.</p> <p><strong><u>Materials and methods:</u></strong> Case control study of 3050 subjects: 1619 patients with at least one >75% coronary stenosis by angiography (median age 53.3±8 and 78.9% men) and 1431 controls adjusted by age and gender (median age 52.8±7.8 and 89.3% men) selected from GENEMACOR study population. Lipoprotein a was determined by immunoturbidimetry. The distribution normality study was done by Kolmogorov-smirnov test in case-control mode and using non-parametric tests to evaluate the distribution and spearman correlations were determined. The independent predictor value of Lpa from other risk factors and family history of CAD was evaluated by multivariate regression.</p> <p><strong><u>Results:</u></strong> The Lpa didn´t show a normal distribution curve either in cases or in controls (p<0.0001). Median of Lpa was superior in patients (18.9mg/dl, 6-234mg/dl) in comparison with controls (13.6mg/dl, 0.5-241mg/dl), p<0.001. Although increasing level of Lpa was observed with LDL increase, a low degree correlation was found with LDL (0.098, p<0.0001) both in patients and in controls. In multivariate logistic regression the Lpa was an independent predictor of coronary disease (OR 1.01, p<0.0001). Smoking habits (OR 3.09), dyslipidemia (OR 2.8), hypertension (OR 2.2) and familiar history (OR 2.1) were also independent predictors.</p> <p><strong><u>Conclusions</u>: </strong>In our population there were higher levels of Lpa in relation to controls, matched by gender and age. Lpa was an independent marker for CAD. Knowledge about the interaction between Lpa and other risk factors may allow the identification of patients at increased risk of CAD in order to implement adequate preventive strategies.</p>
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