Navegando por Palavras-chave "Infarto Agudo Do Miocárdio Com Elevação Do Segmento ST"

Agora exibindo 1 - 1 de 1
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Impacto da apneia obstrutiva do sono grave na estratégia fármaco-invasiva de pacientes com infarto agudo do miocárdio com elevação do segmento ST
    (Universidade Federal de São Paulo (UNIFESP), 2019-05-30) Maroja, Fabrizio Urbinati [UNIFESP]; Luiz, Fatima Dumas Cintra [UNIFESP]; Poyares, Dalva; http://lattes.cnpq.br/4176832922554657; http://lattes.cnpq.br/8836659601497424; http://lattes.cnpq.br/8809443058533394; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To evaluate the impact of severe OSA in the patients underwent on pharmacoinvasive treatment strategy with STEMI. Methods: We enrolled consecutive STEMI patients without previous vascular disease and heart failure. Those with a Killip classification III or IV, receiving vasoactive drugs, pregnant or with a previous OSA were not included. The cardiovascular risk factors of the sample were evaluated and the Epworth Sleepiness Scale was applied. All patients underwent either on pharmacoinvasive strategy or primary-percutaneous coronary intervention (PCI) depending on the distance and estimated time from their homes to PCI center. Their SYNTAX scores (SS) were calculated before any interventional procedure. Full bedside polysomnography was performed in the first 72 hours of admission and then all the patients were divided in two groups: controls (AIH <30 events/h) and severe OSA (AIH ≥ 30 events/h). Results: A sample comprised 116 patients, 87 male gender (75%), 19 with severe OSA (16.4%) and 97 controls (83.6%). The severe OSA patients were older (p= 0.015); had higher neck (p=0.007) and abdominal (P=0.001) circumferences (p=0.001); higher BMI (p<0.001); and had lower smoking percentage (p=0.015). They also had lower reperfusion rates post-fibrinolysis (20.0% vs 65.4%; p=0.001); higher SS (20.2 ± 11.2 vs 14.6 ± 10.6; p=0.037); lower left ventricle ejection fraction (45.3 ± 7.7% vs 50.6 ± 9.5%; p=0.023); and higher incidence of atrial arrhythmias (21.1% vs 4.1%; p=0.021). STEMI patients with severe OSA had more than three times risk of at least one adverse outcome. Regression analysis showed that both severe OSA (p=0.032) and hypertension (p=0.010) were independent predictors of higher SS. Conclusion: Severe OSA was associated with lower reperfusion rate post-fibrinolysis; higher SS and incidence of atrial arrhythmias post-STEMI.