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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.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7387 |
| Date | 31 March 2017 |
| Creators | Petracco, Andrea Mabilde |
| Contributors | Bodanese, Luiz Carlos |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 600, 600, 600, -224747486637135387, -969369452308786627 |
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