Publication
Are there differences on prognosis among patients with previous ischemic heart disease versus cerebrovascular disease admitted with acute coronary syndrome?
| dc.contributor.author | Abreu, G | |
| dc.contributor.author | Arantes, C | |
| dc.contributor.author | Martins, J | |
| dc.contributor.author | Quina-Rodrigues, C | |
| dc.contributor.author | Vieira, C | |
| dc.contributor.author | Álvares-Pereira, M | |
| dc.contributor.author | Azevedo, P | |
| dc.contributor.author | Marques, J | |
| dc.date.accessioned | 2015-11-19T22:37:50Z | |
| dc.date.available | 2015-11-19T22:37:50Z | |
| dc.date.issued | 2015 | |
| dc.description.abstract | Background: It is known that patients with previous vascular disease (PVD) have a poorer outcome than those without these previous conditions, and prognosis worsens as the number of affected vascular beds increases. Aim: To evaluate if there are differences in in-hospital and 6-month mortality among patients admitted with acute coronary syndromes with previous ischemic heart disease (IHD) versus cerebrovascular disease (CVD). Methods: We analysed 4871 patients (pts) admitted consecutively in our coronary care unit with a diagnosis of acute coronary syndrome and included in a prospective registry, from January 2002 to October 2013. Patients were divided in 3 groups: group 1 - pts without PVD (n=3718, 76.3%); group 2 – pts with previous IHD (n=825, 16.9%); group 3 - pts with previous CVD (n=257, 5.3%). We excluded pts with previous IHD plus CVD (n=71, 1.5%). For each group we compared clinical features and adverse events. Primary endpoint was the occurrence of death at 6 months; follow-up was completed in 98% of patients. Results: Pts in group 3 were older (63±13 vs 67±12 vs 71±11;p<0.001), had higher proportion of women (25% vs 21.9% vs 32.3%;p<0.001) and hypertension (58% vs 73.1% vs 83.7%;p<0.001). Group 2 had more often body mass index >25kg/m2 (47.1% vs 52.5% vs 50.8%; p=0.016), dyslipidaemia (46% vs 69.3% vs 52.1%;p<0.001) and diabetes (23.5% vs 38.8% vs 36.6%;p<0.001). Group 1 had more frequently history of smoking (29.5% vs 19.0% vs 12.8%;p<0.001) and absence of conventional risk factors (8.7% vs 4.0% vs 3.9%;p<0.001). On admission, those with previous CVD presented more often Killip >1 (19.6 % vs 29.6% vs 34.2%;p<0.001), anaemia (19.8% vs 28.6% vs 33.9%;p<0.001) and renal insufficiency (eGFR <60 ml/min) (19.2% vs 31% vs 40.9%;p<0,001). Group 2 presented more severe coronary artery disease (11.7% vs 22.2% vs 16.7%;p<0.001) and higher prevalence of left ventricular dysfunction (56.2% vs 61.8% vs 58.4%;p=0.03). ST-segment myocardial infarction was more prevalent in Group 1 (54.5% vs 25.6% vs 51%;p<0.001), while myocardial infarction without ST-elevation was more frequent in group 2 (41.2% vs 65% vs 45.5%;p<0.001). In-hospital (4.5% vs 4.7% vs 7.0%;p<0.001) and 6-month mortality (8.7% vs 10.6% vs 16.5%;p<0.001) were higher in patients with previous CVD. In multivariate analysis and after adjusting for different baseline characteristics, pts with previous CVD had higher risk of 6-month mortality compared to those without PVD [OR 1.67, 95% CI (1.06-2.63),p=0.026]. Conclusion: Previous CVD remained as a strong predictor of 6-month mortality in patients admitted with acute coronary syndrome. | pt_PT |
| dc.identifier.citation | ESC Congress 2015. London, UK, 29 August - 02 September. 2015 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.23/956 | |
| dc.language.iso | eng | pt_PT |
| dc.subject | Síndrome Coronária Aguda | pt_PT |
| dc.subject | Doenças Cerebrovasculares | pt_PT |
| dc.title | Are there differences on prognosis among patients with previous ischemic heart disease versus cerebrovascular disease admitted with acute coronary syndrome? | pt_PT |
| dc.type | conference object | |
| dspace.entity.type | Publication | |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | conferenceObject | pt_PT |