Login
Search
Search
0 Dates
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
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
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Identifying Predictors of Misclassification in Occlusion Myocardial Infarction
Session:
SESSÃO DE POSTERS 08 - DOENÇAS CARDIOVASCULARES - PROGNÓSTICO NO SCA
Speaker:
Andre Lobo
Congress:
CPC 2025
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.3 Acute Coronary Syndromes – Diagnostic Methods
Session Type:
Cartazes
FP Number:
---
Authors:
André Lobo; Francisca Nunes; Francisco Sousa; Fábio Nunes; Marta Catarina Almeida; Marta Leite; Inês Neves; Inês Rodrigues; António Gonçalves; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">Introduction</span></strong><span style="font-family:"Calibri",sans-serif">: Occlusion Myocardial Infarction (OMI) is an evolving concept in Acute Coronary Syndromes (ACS) that challenges the traditional STEMI paradigm. It emphasizes detecting acute coronary occlusion through subtle ECG findings to better identify patients requiring urgent revascularization. This study evaluates the characteristics of patients classified as NSTEMI despite presenting with acute OMI, focusing on cases where a paradigm shift may hold greater clinical significance.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">Methods</span></strong><span style="font-family:"Calibri",sans-serif">: We retrospectively analyzed 336 ACS patients admitted over one year. Patients initially classified as STEMI or NSTEMI/UA were reclassified as OMI or non-OMI ACS based on OMI definition: TIMI flow ≤2 and/or significantly elevated troponin (Troponin T >1000 ng/L or Troponin I >5000 ng/L) with regional wall motion abnormalities. Patients were grouped as STEMI, NSTEMI-OMI, or NSTEMI-non-OMI. Baseline characteristics, including demographics, comorbidities, and ECG findings (rhythm abnormalities, bundle branch block [BBB], pacemaker rhythm, and left ventricular hypertrophy), were compared across groups.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">Results</span></strong><span style="font-family:"Calibri",sans-serif">: Among 336 ACS patients, including 196 STEMI and 134 NSTEMI/UA cases. Of those, 52 were reclassified as NSTEMI-OMI. NSTEMI-OMI patients were more likely to present with BBB or pacemaker rhythm (23.1% vs. 6.1%; p < 0.001) and a history of coronary disease (30.8% vs. 11.2%; p = 0.002) compared to STEMI patients. No other significant differences in demographics, comorbidities, or ECG characteristics were found. Similarly, no significant differences were observed between NSTEMI-OMI and NSTEMI-non-OMI patients.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">Discussion</span></strong><span style="font-family:"Calibri",sans-serif">: Prior ECG changes, such as BBB or pacemaker rhythm, and a history of coronary disease may obscure coronary occlusion using STEMI criteria, likely due to baseline ECG abnormalities. Even modified criteria may miss these cases. Transitioning to the OMI paradigm could improve early recognition and management by identifying occlusions irrespective of STEMI criteria. This study highlights a subgroup where this shift may be particularly important. Advanced tools like AI-driven ECG analysis could enhance detection, bridge diagnostic gaps, and support timely revascularization. However, the OMI paradigm still faces challenges, including a lack of standardization in ECG interpretation and validation in randomized studies.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">Conclusion</span></strong><span style="font-family:"Calibri",sans-serif">: Adopting the OMI paradigm could improve the detection and management of coronary occlusion in patients with challenging ECGs, such as BBB, pacemaker rhythm, or prior coronary disease. Further standardization and validation are needed to ensure broader clinical applicability.</span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site