Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/2956 |
Resumo: | OBJECTIVE:: To compare patients without previously diagnosed cardiovascular risk factors) and patients with one or more risk factors admitted with acute coronary syndrome. METHODS:: This was a retrospective analysis of patients admitted with first episode of acute coronary syndrome without previous heart disease, who were included in a national acute coronary syndrome registry. The patients were divided according to the number of risk factors, as follows: 0 risk factor (G0), 1 or 2 risk factors (G1 - 2) and 3 or more risk factors (G ≥ 3). Comparative analysis was performed between the three groups, and independent predictors of cardiac arrest and death were studied. RESULTS:: A total of 5,518 patients were studied, of which 72.2% were male and the mean age was 64 ± 14 years. G0 had a greater incidence of ST-segment elevation myocardial infarction, with the left anterior descending artery being the most frequently involved vessel, and a lower prevalence of multivessel disease. Even though G0 had a lower Killip class (96% in Killip I; p < 0.001) and higher ejection fraction (G0 56 ± 10% versus G1 - 2 and G ≥ 3 53 ± 12%; p = 0.024) on admission, there was a significant higher incidence of cardiac arrest. Multivariate analysis identified the absence of risk factors as an independent predictor of cardiac arrest (OR 2.78; p = 0.019). Hospital mortality was slightly higher in G0, although this difference was not significant. By Cox regression analysis, the number of risk factors was found not to be associated with mortality. Predictors of death at 1 year follow up included age (OR 1.05; p < 0.001), ST-segment elevation myocardial infarction (OR 1.94; p = 0.003) and ejection fraction < 50% (OR 2.34; p < 0.001). CONCLUSION:: Even though the group without risk factors was composed of younger patients with fewer comorbidities, better left ventricular function and less extensive coronary disease, the absence of risk factors was an independent predictor of cardiac arrest. |
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Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome PatientsParadoxo dos Fatores de Risco na Ocorrência de Parada Cardiorrespiratória em Pacientes com Síndrome Coronária AgudaAcute Coronary SyndromeAdultAge FactorsAgedFemaleFollow-Up StudiesHeart ArrestHospital MortalityHumansIncidenceMaleMiddle AgedMultivariate AnalysisProportional Hazards ModelsRetrospective StudiesRisk FactorsST Elevation Myocardial InfarctionVentricular Function, LeftHSM CAROBJECTIVE:: To compare patients without previously diagnosed cardiovascular risk factors) and patients with one or more risk factors admitted with acute coronary syndrome. METHODS:: This was a retrospective analysis of patients admitted with first episode of acute coronary syndrome without previous heart disease, who were included in a national acute coronary syndrome registry. The patients were divided according to the number of risk factors, as follows: 0 risk factor (G0), 1 or 2 risk factors (G1 - 2) and 3 or more risk factors (G ≥ 3). Comparative analysis was performed between the three groups, and independent predictors of cardiac arrest and death were studied. RESULTS:: A total of 5,518 patients were studied, of which 72.2% were male and the mean age was 64 ± 14 years. G0 had a greater incidence of ST-segment elevation myocardial infarction, with the left anterior descending artery being the most frequently involved vessel, and a lower prevalence of multivessel disease. Even though G0 had a lower Killip class (96% in Killip I; p < 0.001) and higher ejection fraction (G0 56 ± 10% versus G1 - 2 and G ≥ 3 53 ± 12%; p = 0.024) on admission, there was a significant higher incidence of cardiac arrest. Multivariate analysis identified the absence of risk factors as an independent predictor of cardiac arrest (OR 2.78; p = 0.019). Hospital mortality was slightly higher in G0, although this difference was not significant. By Cox regression analysis, the number of risk factors was found not to be associated with mortality. Predictors of death at 1 year follow up included age (OR 1.05; p < 0.001), ST-segment elevation myocardial infarction (OR 1.94; p = 0.003) and ejection fraction < 50% (OR 2.34; p < 0.001). CONCLUSION:: Even though the group without risk factors was composed of younger patients with fewer comorbidities, better left ventricular function and less extensive coronary disease, the absence of risk factors was an independent predictor of cardiac arrest.Associação de Medicina Intensiva BrasileiraRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEAguiar Rosa, STimóteo, ATNogueira, MBelo, ACruz Ferreira, R2018-03-15T15:52:43Z20162016-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/2956engRev Bras Ter Intensiva. 2016 Oct-Dec;28(4):405-41210.5935/0103-507X.20160065info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:40:30Zoai:repositorio.chlc.min-saude.pt:10400.17/2956Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:16.570308Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients Paradoxo dos Fatores de Risco na Ocorrência de Parada Cardiorrespiratória em Pacientes com Síndrome Coronária Aguda |
title |
Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients |
spellingShingle |
Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients Aguiar Rosa, S Acute Coronary Syndrome Adult Age Factors Aged Female Follow-Up Studies Heart Arrest Hospital Mortality Humans Incidence Male Middle Aged Multivariate Analysis Proportional Hazards Models Retrospective Studies Risk Factors ST Elevation Myocardial Infarction Ventricular Function, Left HSM CAR |
title_short |
Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients |
title_full |
Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients |
title_fullStr |
Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients |
title_full_unstemmed |
Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients |
title_sort |
Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients |
author |
Aguiar Rosa, S |
author_facet |
Aguiar Rosa, S Timóteo, AT Nogueira, M Belo, A Cruz Ferreira, R |
author_role |
author |
author2 |
Timóteo, AT Nogueira, M Belo, A Cruz Ferreira, R |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Aguiar Rosa, S Timóteo, AT Nogueira, M Belo, A Cruz Ferreira, R |
dc.subject.por.fl_str_mv |
Acute Coronary Syndrome Adult Age Factors Aged Female Follow-Up Studies Heart Arrest Hospital Mortality Humans Incidence Male Middle Aged Multivariate Analysis Proportional Hazards Models Retrospective Studies Risk Factors ST Elevation Myocardial Infarction Ventricular Function, Left HSM CAR |
topic |
Acute Coronary Syndrome Adult Age Factors Aged Female Follow-Up Studies Heart Arrest Hospital Mortality Humans Incidence Male Middle Aged Multivariate Analysis Proportional Hazards Models Retrospective Studies Risk Factors ST Elevation Myocardial Infarction Ventricular Function, Left HSM CAR |
description |
OBJECTIVE:: To compare patients without previously diagnosed cardiovascular risk factors) and patients with one or more risk factors admitted with acute coronary syndrome. METHODS:: This was a retrospective analysis of patients admitted with first episode of acute coronary syndrome without previous heart disease, who were included in a national acute coronary syndrome registry. The patients were divided according to the number of risk factors, as follows: 0 risk factor (G0), 1 or 2 risk factors (G1 - 2) and 3 or more risk factors (G ≥ 3). Comparative analysis was performed between the three groups, and independent predictors of cardiac arrest and death were studied. RESULTS:: A total of 5,518 patients were studied, of which 72.2% were male and the mean age was 64 ± 14 years. G0 had a greater incidence of ST-segment elevation myocardial infarction, with the left anterior descending artery being the most frequently involved vessel, and a lower prevalence of multivessel disease. Even though G0 had a lower Killip class (96% in Killip I; p < 0.001) and higher ejection fraction (G0 56 ± 10% versus G1 - 2 and G ≥ 3 53 ± 12%; p = 0.024) on admission, there was a significant higher incidence of cardiac arrest. Multivariate analysis identified the absence of risk factors as an independent predictor of cardiac arrest (OR 2.78; p = 0.019). Hospital mortality was slightly higher in G0, although this difference was not significant. By Cox regression analysis, the number of risk factors was found not to be associated with mortality. Predictors of death at 1 year follow up included age (OR 1.05; p < 0.001), ST-segment elevation myocardial infarction (OR 1.94; p = 0.003) and ejection fraction < 50% (OR 2.34; p < 0.001). CONCLUSION:: Even though the group without risk factors was composed of younger patients with fewer comorbidities, better left ventricular function and less extensive coronary disease, the absence of risk factors was an independent predictor of cardiac arrest. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016 2016-01-01T00:00:00Z 2018-03-15T15:52:43Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/2956 |
url |
http://hdl.handle.net/10400.17/2956 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Rev Bras Ter Intensiva. 2016 Oct-Dec;28(4):405-412 10.5935/0103-507X.20160065 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Associação de Medicina Intensiva Brasileira |
publisher.none.fl_str_mv |
Associação de Medicina Intensiva Brasileira |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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