SPC365

Predictors of significant coronary artery disease in a contemporary cohort of unstable angina patients

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; Rafaela Fernandes; Gonçalo Terleira Batista; Luís Paiva; Lino Gonçalves

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Arial&quot;,sans-serif">Introduction: </span></strong><span style="font-family:&quot;Arial&quot;,sans-serif">The diagnosis of unstable angina (UA) can be challenging due to its diverse clinical presentations, as well as its varying association with significant coronary artery disease and the need for myocardial revascularization.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="background-color:white"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">Methods and purpose:</span></span></strong><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black"> We performed a single-centre, retrospective observational study reviewing patients with the diagnosis of UA </span></span><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">between January 2013 - June 2021. The cohort was divided in two group: patients with significant coronary artery disease (CAD<sup>+</sup>) and those without (CAD<sup>-</sup>), detected by coronary angiography. </span></span><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">A revision of informatized clinical files was performed and SPSS software was used statistical analysis. </span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Arial&quot;,sans-serif">Results: </span></strong><span style="font-family:&quot;Arial&quot;,sans-serif">A total of 742 patients were included. </span><span style="font-family:&quot;Arial&quot;,sans-serif">Sixty-eight percent of patients were men. The mean age was 65.75&plusmn;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&plusmn;25.7 months. Significant CAD was present in 396 patients (53%). Patients in CAD<sup>+</sup> group were more frequently men (n=293 versus (<em>vs</em>) 215, p=0.001) and were older (66.8&plusmn;10.7 <em>vs</em> 64.5&plusmn;11.6, p=0.004). They also presented more risk factors such as arterial hypertension (n=344<em> vs</em> 278, p=0.016), diabetes <em>mellitus </em>(156 <em>vs </em>104, p=0.008) and hyperlipidemia (n=355 <em>vs</em> 271, p&lt;0.001), but current or past smoking history was not associated to CAD (n=135<em> vs </em>108, p=0.405). In the electrocardiogram (ECG), patients in the CAD<sup>+</sup> group more commonly exhibited ST segment deviation (n=62 vs. 33, p=0.013). Related to echocardiographic findings, CAD<sup>+</sup> group showed lower left ventricular ejection fraction (LVEF) (54.43&plusmn;8.38 <em>vs</em> 56.48&plusmn;7.89%, p=0.001) and more frequently wall motion abnormalities (WMA) (n=150 <em>vs </em>73, p&lt;0.001).&nbsp;&nbsp;</span></span></span><span style="font-size:12pt"><span style="font-family:Arial,sans-serif">When performing multivariate analysis, and adjusting to confounders, age (</span><span style="font-family:Symbol">B</span><span style="font-family:Arial,sans-serif">=0.02, OR=1.02 (CI 1.005-1.035), p=0.007), male gender (</span><span style="font-family:Symbol">B</span><span style="font-family:Arial,sans-serif">=0.504, OR=1.66 (CI 1.178-2.326), p=0.004), hyperlipidemia (</span><span style="font-family:Symbol">B</span><span style="font-family:Arial,sans-serif">=0.747, OR=2.111 (CI 1.356-3.286), p=0.001), WMA (</span><span style="font-family:Symbol">B</span><span style="font-family:Arial,sans-serif">=0.726, OR=2.07 (CI 1.468-2.91), p&lt;0.001) and ST-segment deviation (</span><span style="font-family:Symbol">B</span><span style="font-family:Arial,sans-serif">=0.633, OR=1.88 (CI 1.174-3.02), p=0.009) were independent predictors of CAD.</span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Arial&quot;,sans-serif">Conclusion: </span></strong><span style="font-family:&quot;Arial&quot;,sans-serif">In a contemporary UA cohort,<strong> </strong>age, male gender, hyperlipidaemia, WMA on echocardiography and ST-segment deviation on ECG were independent predictors of significant CAD. </span></span></span></p>