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Predicting major adverse cardiovascular events after unstable angina: is it possible?
Session:
SESSÃO DE POSTERS 08 - DOENÇAS CARDIOVASCULARES - PROGNÓSTICO NO SCA
Speaker:
Mariana Rodrigues Simões
Congress:
CPC 2025
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:
Cartazes
FP Number:
---
Authors:
Mariana Rodrigues Simões; Bernardo Resende; Mafalda Griné; João Gameiro; Luís Paiva; Maria João Ferreira; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-family:"Arial",sans-serif">Introduction: </span></strong><span style="font-family:"Arial",sans-serif">Acute coronary syndromes (ACS), such as unstable angina (UA), represent a significant burden of morbidity and may severely impact quality of life. Over their lifetime, many patients experience recurrent cardiovascular events, for example, additional episodes of ACS or development of heart failure. </span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><strong><span style="font-family:"Arial",sans-serif"><span style="color:black">Methods and purpose:</span></span></strong><span style="font-family:"Arial",sans-serif"><span style="color:black"> We performed a single-centre retrospective study reviewing patients with the diagnosis of unstable angina (UA) between January 2013 - June 2021. Our purpose was to identifying predictors of major adverse cardiac events (MACE). MACE was defined as a composite of nonfatal myocardial infarction (MI), hospitalization for heart failure (hHF), and repeated coronary angiography because of recurring UA (rUA) during follow-up. A revision of informatized clinical files was performed and SPSS software was used for statistical analysis. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><strong><span style="font-family:"Arial",sans-serif">Results: </span></strong><span style="font-family:Arial,sans-serif">A total of 742 patients were included. Sixty-eight percent of patients were men. The mean age was 65.75±11.18 years. All patients underwent coronary angiography and the median high sensitivity troponin levels at admission were 0.012 (0.011-0.034) ng/ml. The follow-up time was 46.1±25.7 months. Patients were divided in MACE and non-MACE groups. MACE happened to 125 patients (17%). MACE group had higher percentage of diabetes <em>mellitus </em>(DM) (47% versus (<em>vs</em>) 33%, p=0.002), arterial hypertension (90%<em> vs</em> 83%, p=0.03) and hyperlipidaemia (91% <em>vs</em> 83%, p=0.02). There was not any association between gender (p=0.118), age (p=0.23) or past/current history of smoking (p=0.140) and MACE. Regarding, echocardiographic alterations, patients in MACE group presented lower median left ventricular ejection fraction (LVEF) (55 (IQR15)<em> vs </em>60 (IQR5), p<0.001) and a higher percentage of patients with wall motion alterations (45% <em>vs </em>29%, p<0.001). Significant coronary artery disease (CAD) was also more common in MACE group: 73% <em>vs</em> 50%, p<0.001. When performing multivariate analysis, and adjusting to confounders, presence of significant CAD (</span><span style="font-family:Symbol">B</span><span style="font-family:Arial,sans-serif">=0.864; OR=2.37 (CI 1.53-3.67), p<0.001), DM (</span><span style="font-family:Symbol">B</span><span style="font-family:Arial,sans-serif">=0.472; OR=1.60 (CI 1.06-2.41), p=0.024) and LVEF (</span><span style="font-family:Symbol">B</span><span style="font-family:Arial,sans-serif">=-0.042; OR=0.96 (CI 0.94-0.98), p<0.001) were independent predictors of MACE.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-family:"Arial",sans-serif">Conclusion:</span></strong><span style="font-family:"Arial",sans-serif"> In our contemporary cohort of unstable angina, presence of significant CAD, diabetes <em>mellitus</em>, and lower values of LVEF were predictors of composite of nonfatal myocardial infarction, hospitalization for heart failure and repeated coronary angiography because of recurring UA, after index event. </span></span></span></p>
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