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Avalia??o da rela??o do ?ndice tornozelo-braquial com a gravidade da doen?a arterial coron?riaPetracco, Andrea Mabilde 31 March 2017 (has links)
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Previous issue date: 2017-03-31 / Introduction: Peripheral Artery Disease (PAD) is associated with cardiovascular events and can be diagnosed and estimated through the Ankle-Brachial Index (ABI). It is well established that ABI is an aggravating factor in the stratification of cardiovascular risk, but its contribution to defining the severity of coronary artery disease is not well established.
Objective: The study compared the value of ABI with the severity of coronary atherosclerotic disease by the Syntax (ES) Score in patients with Acute Coronary Syndrome (ACS).
Methods: A prospective study with the ABI measurement of all patients hospitalized with ACS at the S?o Lucas Hospital of PUCRS, consecutively, from May to September 2016, and the comparison of their value with ES of these patients and the respective forms of presentation of ACS.
Results: We studied101 patients, mean age 62.6 ? 12 years, 58 (57.4%) males, 74 (82.2%) hypertensive, 33 (45.8%) diabetics and 46 (45.5%) presented acute myocardial infarction with ST segment depression (STEMI) . The frequency of PAD was 3 times higher than that described in the general population. The severity of PAD was not related to the anatomical severity of the coronary disease. We found a significant association of patients with intermediate ES with non-ST elevation myocardial infarction (STEMI) and low ES with unstable angina (UA) (P = 0.015), who remained even after adjusting for age, smoking, family history of CAD and prior CAD. OR (95% CI-1.02-1.25).
Conclusions: Our results demonstrate that patients with ABI lower than 0.9 were not associated with a greater complexity of coronary atherosclerotic disease, as determined by ES in patients with ACS. Patients with NSTEMI were more associated with intermediate ES. / Introdu??o: A Doen?a Arterial Perif?rica (DAP) est? associada a eventos cardiovasculares podendo ser diagnosticada e estimada atrav?s do ?ndice Tornozelo-Braquial (ITB). Est? bem estabelecido que o ITB ? fator agravante na estratifica??o de risco cardiovascular, mas sua contribui??o para definir a gravidade do acometimento arterial coronariano n?o est? bem estabelecida.
Objetivo: O estudo comparou o valor do ITB com a gravidade da doen?a ateroscler?tica coronariana pelo Escore de Syntax (ES) em pacientes com S?ndrome Coronariana Aguda (SCA).
M?todos: Estudo prospectivo com a medida do ITB de todos pacientes internados com SCA no Hospital S?o Lucas da PUCRS, consecutivamente, de maio a setembro de 2016, e a compara??o de seu valor com o ES destes pacientes e as respectivas formas de apresenta??o da SCA.
Resultados: Estudamos 101 pacientes, com m?dia de idade de 62,6?12,0 anos, 58 (57,4% ) masculinos, 74 (82,2% ) hipertensos, 33 (45,8%) diab?ticos e 46 (45,5% ) apresentaram infarto agudo do mioc?rdio com infradesn?vel do segmento ST (IAMCSST). A gravidade da DAP n?o teve rela??o com a gravidade anat?mica da doen?a coronariana. Encontramos uma associa??o significativa dos pacientes com ES intermedi?rio com o infarto agudo do mioc?rdio sem supradesnivel do segmento ST (IAMSSST) e de ES baixo com angina inst?vel (AI) OR (IC95%): 1,11 (1,03-1,20) (P=0,004), que se manteve ap?s an?lise multivariada, ajustada para idade, tabagismo, hist?ria familiar de doen?a arterial coron?ria (DAC) e DAC pr?via OR (IC95%): 1,13 (1,02-1,25) (P=0,019).
Conclus?es: A an?lise dos nossos resultados, demonstram que pacientes com ITB menor que 0,9 n?o apresentaram associa??o com maior complexidade de doen?a ateroscler?tica coronariana determinados pelo ES em pacientes com SCA. Os pacientes com IAMSSST estiveram mais associados com ES intermedi?rio.
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Perfil lip?dico de pacientes com s?ndrome coronariana aguda sem supradesnivelamento de STBervian, Juliana 29 March 2012 (has links)
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438376.pdf: 401653 bytes, checksum: 71b508ee48ad226494584a2a12902901 (MD5)
Previous issue date: 2012-03-29 / Objective: Analyze the lipid profile of patients with SCASSST/Unstable Angina and IAM with no ST-segment elevation (IAMSSST), including the determination of non- HDL-C. Methods: Observational Transversal. Study analyzed data of 1080 admitted patients with Acute Coronary Syndrome (IA/IAMSSST at the cardiovascular Intensive care unit at PUCRS-S?o Lucas Hospital between the period of September/1999 and October/2010. Analysis of the lipid profile were realized in the first 24h of the admission. Results: Among the 1080 patients, 51,9% male, 32,9% diabetics, 84,1% presented systemic arterial hypertension,26,1 smokers. In the analyzed sample it was observed that 53,4% of the patients had been using hypolipidemic treatment. At the lipid profile it was observed that 44,8% of patients presented abnormal levels of Triglycerides, 66,6% (men) and 73,3 (women) HDL-C out of goals; 30,2% of patients presented total cholesterol >200mg/dL, and 24,4% had LDL-C >130mg/dl and 51,7% LDL-C >100mg/dL. Among the 1080 patients 182 had triglycerides >200mg/dL associated to LDL-C > 130mg/dL of which, 58 patients (31,9%) presented non-HDL-C >160mg/dL. Conclusion: The results of our study demonstrate that the majority of patients with SCA (AI/IAMSSST) had low HDL-C and about half of them presented LDL-C <100mg/dL. The non-HDL-C had been elevated in one third of the patients, associated to elevated triglycerides levels / Introdu??o: A dislipidemia ? um dos principais fatores de risco para a doen?a arterial coronariana, por?m cerca de um ter?o dos pacientes com infarto agudo do mioc?rdio est?o com n?veis de colesterol total e LDL-C normais. H? poucos dados do perfil lip?dico e do n?o-HDL-colesterol (n?o-HDL-C), em pacientes com s?ndrome coronariana aguda sem supradesnivelamento de ST (SCASSST). Objetivo: Analisar o perfil lip?dico de pacientes com SCASSST/Angina Inst?vel e IAM sem supradesnivelamento de ST (IAMSSST), incluindo-se a determina??o do n?o-HDL-C. M?todos: Estudo observacional transversal analisou 1080 pacientes internados com S?ndrome Coronariana Aguda (AI/IAMSSST) na Unidade de Terapia Intensiva Cardiovascular do Hospital S?o Lucas-PUCRS, entre setembro/1999 a outubro/2010. Foram realizadas an?lises do perfil lip?dico nas primeiras 24h da admiss?o. Resultados: Entre os 1080 pacientes, 51,9% do sexo masculino, 32,9% diab?ticos, 84,1% apresentavam hipertens?o arterial sist?mica e 26,1% tabagistas. Na amostra analisada, observou-se que 53,4% dos pacientes faziam o uso de tratamento hipolipemiante. Na an?lise do perfil lip?dico observou-se: 44,8% apresentaram n?veis de triglicer?deos anormais; 66,6% (homens) e 73,3% (mulheres) HDL-C fora das metas; 30,2% dos pacientes apresentavam colesterol total >200mg/dL, sendo que 24,4% tinham LDL-C >130mg/dL e 51,7% LDL-C >100mg/dL. Entre os 1080 pacientes, 182 tinham triglicer?deos >200mg/dL associado a LDL-C > 130mg/dL; destes, 58 pacientes (31,9%) apresentavam n?o-HDL-C >160mg/dL. Conclus?o: Os resultados do nosso estudo demonstram que a maioria dos pacientes com SCA (AI/IAMSSST) tinham HDL-C baixo e cerca de metade apresentavam LDL-C <100mg/dL. O n?o-HDL-C esteve elevado em um ter?o dos pacientes associado a n?veis elevados de triglicer?deos.
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