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Risk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patients

2016Journal article Open access
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dc.contributor.authorAguiar Rosa, S
dc.contributor.authorTimóteo, AT
dc.contributor.authorNogueira, M
dc.contributor.authorBelo, A
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2018-03-15T15:52:43Z
dc.date.available2018-03-15T15:52:43Z
dc.date.issued2016
dc.description.abstractOBJECTIVE:: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Bras Ter Intensiva. 2016 Oct-Dec;28(4):405-412pt_PT
dc.identifier.doi10.5935/0103-507X.20160065pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2956
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAssociação de Medicina Intensiva Brasileirapt_PT
dc.subjectAcute Coronary Syndromept_PT
dc.subjectAdultpt_PT
dc.subjectAge Factorspt_PT
dc.subjectAgedpt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHeart Arrestpt_PT
dc.subjectHospital Mortalitypt_PT
dc.subjectHumanspt_PT
dc.subjectIncidencept_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectMultivariate Analysispt_PT
dc.subjectProportional Hazards Modelspt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRisk Factorspt_PT
dc.subjectST Elevation Myocardial Infarctionpt_PT
dc.subjectVentricular Function, Leftpt_PT
dc.subjectHSM CARpt_PT
dc.titleRisk Factor Paradox in the Occurrence of Cardiac Arrest in Acute Coronary Syndrome Patientspt_PT
dc.title.alternativeParadoxo dos Fatores de Risco na Ocorrência de Parada Cardiorrespiratória em Pacientes com Síndrome Coronária Agudapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage412pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage405pt_PT
oaire.citation.titleRevista Brasileira de Terapia Intensivapt_PT
oaire.citation.volume28pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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