Incidência de eventos coronarianos pós Síndrome Coronariana Aguda

Abstract

Cardiovascular diseases are the leading cause of death in Brazil. Objective: To evaluate the prevalence at 6 months of cardiovascular events after acute coronary syndrome (ACS) in patients enrolled in the Foundation State Public Hospital of Gaspar Vianna in Belém (PA), Brazil . To analyze the clinical and epidemiological characteristics, diagnostic and therapeutic procedures and in-hospital mortality at 30 days and 6 months of inpatients. Methods: This is a prospective cohort study, observational study in which 154 patients were followed with SCA of a public hospital in Bethlehem, Pa. Data collected: socioeconomic, medical history, cardiovascular risk factors, and previous medication on admission exams , procedures and clinical outcomes during hospitalization, at 30 days and 6 months after discharge. Results: Unstable angina was diagnosed in 13.6% and acute myocardial infarction (AMI) in 86.4%. The mean age was 60.83 ± 11.39, which occupied 71.4% aged 55 and over 65 and male, 79.87%. Most prevalent risk factors: hypertension (64.94%), smoking (68.83%), stress and depression (53.9%), family history of CAD (49.4%), abdominal obesity (48.05% ), dyslipidemia (44.16%), sedentary with 67 (43.51%), diabetes in 56 (36.36%). 23.38% had previous myocardial infarction. Coronary angiography was performed in 77.27% and 59.74% indicated myocardial revascularization with angioplasty. The hospital mortality was 1.3% at 30 days (3.9%) at 6 months (6.8%). Overall mortality of 11.7%. There was no significant difference in mortality in acute myocardial infarction and unstable angina. The outcome reinfarction occurred in 3.9% of the population and the variables that were statistically significant after multiple logistic regression were diabetes (p = 0.0183 [OR: 65.0228]) and abdominal obesity (p = 0.0233 [OR : 0.0011]). To the death, only the use of acetylsalicylic acid had statistically significant. However we emphasize the gender variable with a p in the bivariate analysis (p = 0.013). Conclusion: The prevalence of cardiovascular events, although not statistically significant, there was a high percentage of deaths in 6 months after ACS, death was significant for males. We found a high prevalence of modifiable risk factors, predominantly among men, especially hypertension, smoking, stress and depression, abdominal obesity, dyslipidemia, physical inactivity and diabetes. Reinfarction for the event, we found values with statistical significance for inactivity, abdominal obesity, diabetes, congestive heart failure, the use of aspirin in the last month, previous myocardial infarction, angioplasty abnormal electrocardiograms and post-event. After logistic regression, only diabetes (p = 0.0183 [OR: 65.0228]) and abdominal obesity (p = 0.0233 [OR: 0.0011]) were significant. Of the variables associated with the outcome of death were significant gender, hypertension, previous stroke, age, coronary angiography, use within 6 months of the following medications: beta-blockers, aspirin, clopidogrel and statin. In multiple logistic regression, only acetylsalicylic acid remained as a predictor of mortality after the study period. However we emphasize the gender variable with a p in the bivariate analysis (p = 0.013), as only men showed these outcomes. As 83.33% of deaths had hypertension.