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Abstract(s)
Introdução: As doenças cardíacas e os acidentes vasculares cerebrais (AVCs) constituem
uns dos principais problemas de saúde pública e as principais causas de morbimortalidade
no mundo. Este estudo visou investigar a incidência e potenciais fatores que podem atuar
como preditores de AVC isquémico em doentes com enfarte agudo do miocárdio (EAM),
ambicionando auxiliar na identificação de pacientes de elevado risco que possam
beneficiar de um follow-up e redução de fatores de risco mais intensivos, atuando mais
eficazmente na prevenção destes eventos cardioembólicos.
Materiais e Métodos: Foi realizado um estudo observacional retrospetivo com base na
informação clínica de doentes diagnosticados concomitantemente com EAM e posterior
AVC isquémico, tendo como grupo controlo doentes diagnosticados com EAM sem
posterior AVC isquémico, em diversos serviços do Centro Hospitalar Universitário Cova da
Beira (CHUCB), entre janeiro de 2010 e dezembro de 2016. O grupo de estudo incluiu 16
doentes e o grupo controlo 780, tendo sido analisada uma amostragem aleatória de 10%
deste último. Os fatores analisados incluíram idade, sexo, hipertensão arterial,
dislipidemia, diabetes mellitus, tabagismo, acidente isquémico transitório (AIT) ou AVC
prévios, trombos intraventriculares, qualificação do EAM, procedimento de
revascularização no EAM e terapêutica antitrombótica no pós-alta do EAM.
Resultados: Dos 796 doentes com EAM, 16 (2%) desenvolveram posteriormente um
AVC isquémico, tendo sido o intervalo mais curto entre os dois eventos de 48 dias e o mais
longo de ˜4 anos. Os preditores significativos de AVC pós-EAM incluíram idade avançada
e AIT ou AVC prévios (p-valor<0.05). A toma de antiagregantes plaquetários foi
considerada um fator protetor significativo da ocorrência de AVC (p-valor<0.05).
Conclusões: Embora haja uma baixa incidência de AVC pós-EAM, este está associado a
aumento da morbimortalidade e, além disso, o risco da sua ocorrência parece persistir por
um longo período de tempo. A reperfusão precoce da lesão coronária, juntamente com a
prevenção secundária com terapêutica antitrombótica apropriada, podem constituir
importantes elos para a redução destes eventos cardioembólicos.
Introduction: Heart diseases and strokes are one of the main public health problems and the main causes of morbidity and mortality in the world. This study aimed to investigate the incidence and potential factors that may act as predictors of ischaemic stroke (IS) in patients with acute myocardial infarction (AMI), aiming to assist in the identification of high-risk patients who may benefit from more intensive follow-up and reduction of risk factors, acting more effectively in the prevention and consequent reduction of these cardioembolic events. Materials and Methods: A retrospective observational study was conducted based on the clinical information of patients diagnosed concomitantly with AMI and subsequent IS, with a control group of patients diagnosed with AMI without subsequent IS, in several services of the Centro Hospitalar Universitário Cova da Beira (CHUCB), between January 2010 and December 2016. The study group included 16 patients and control group 780, and a random sampling of 10% of the last one was analysed. The factors analysed included age, gender, hypertension, dyslipidemia, diabetes mellitus, smoking, previous transient ischaemic accident (TIA) or stroke, intraventricular thrombi, qualification of AMI, revascularization procedure in AMI and antithrombotic therapy in post-discharge of AMI. Results: Of the 796 patients with AMI, 16 (2%) later developed an IS, with the shortest interval between the two events of 48 days and the longest of ˜4 years. Significant predictors of post-AMI stroke included advanced age and previous TIA or stroke (pvalue<0.05). Antiplatelet therapy was considered a significant protective factor of stroke (p-value<0.05). Conclusions: Although there is a low incidence of post-AMI stroke, it is associated with increased morbidity and mortality and, in addition, the risk of its occurrence seems to persist for a long period. Early reperfusion of coronary lesion, along with secondary prevention with appropriate antithrombotic therapy, may constitute important links for the reduction of these cardioembolic events.
Introduction: Heart diseases and strokes are one of the main public health problems and the main causes of morbidity and mortality in the world. This study aimed to investigate the incidence and potential factors that may act as predictors of ischaemic stroke (IS) in patients with acute myocardial infarction (AMI), aiming to assist in the identification of high-risk patients who may benefit from more intensive follow-up and reduction of risk factors, acting more effectively in the prevention and consequent reduction of these cardioembolic events. Materials and Methods: A retrospective observational study was conducted based on the clinical information of patients diagnosed concomitantly with AMI and subsequent IS, with a control group of patients diagnosed with AMI without subsequent IS, in several services of the Centro Hospitalar Universitário Cova da Beira (CHUCB), between January 2010 and December 2016. The study group included 16 patients and control group 780, and a random sampling of 10% of the last one was analysed. The factors analysed included age, gender, hypertension, dyslipidemia, diabetes mellitus, smoking, previous transient ischaemic accident (TIA) or stroke, intraventricular thrombi, qualification of AMI, revascularization procedure in AMI and antithrombotic therapy in post-discharge of AMI. Results: Of the 796 patients with AMI, 16 (2%) later developed an IS, with the shortest interval between the two events of 48 days and the longest of ˜4 years. Significant predictors of post-AMI stroke included advanced age and previous TIA or stroke (pvalue<0.05). Antiplatelet therapy was considered a significant protective factor of stroke (p-value<0.05). Conclusions: Although there is a low incidence of post-AMI stroke, it is associated with increased morbidity and mortality and, in addition, the risk of its occurrence seems to persist for a long period. Early reperfusion of coronary lesion, along with secondary prevention with appropriate antithrombotic therapy, may constitute important links for the reduction of these cardioembolic events.
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Keywords
Preditores Acidente Vascular Cerebral Isquémico Enfarte Agudo do Miocárdio Incidência Prevenção