Funding Acknowledgements Type of funding sources: None. Introduction Coronary embolism (CE) is a rare cause of acute coronary syndrome with current evidence from small case series. In our previous work (n=36), atrial fibrillation was the main risk factor and STEMI the most frequent presentation. Objetives In this analysis we compare severity characteristics, management and in-hospital prognosis between an embolic cohort versus a non-embolic one among patients with left anterior descending artery as culprit vessel. Methods Observational, retrospective descriptive study of patients admitted in our unit from July 2011 to march 2021 for ACS. The diagnosis of CE was established according to the National Cerebral Cardiovascular Center Criteria. Data were obtained from the ARIAM Andalucia Registry. Results 646 Patients were analysed (19 embolic vs 627 non-embolic). There were no differences in ejection fraction (EF) (43±9% vs 44±10%, p>0.05) or Killip-Kimbal (KK) stage at admission moment (stage I more frequent in both groups) or use of inotropes or vasoactive drugs. Embolic cohort had more in-hospital complications: worse KK stage (p=0.001; KKII 23.5% vs 15.3%; KKIII 23.5% vs 5.9%), more thrombocytopenia (5.3% vs 0.8%, p=0.046) and higher hsTnT levels (p=0.000). There was more use of non-invasive mechanical ventilation in embolic group (21.1% vs 4.9%, p=0.002). Without differences in incidence of cardiac arrest, mechanical complications, bradycardia, hemorrhage or in-hospital dead. Conservative management was more frequent in the embolic group. Percutaneous coronary intervention was the most frequent strategy in both cohorts (14.3% vs 3%; 85.6% vs 92.3%; p<0.05). At discharge, there were not significant differences in antithrombotic or anticoagulant therapy. Conclusions In our series the embolic group had worse KK stage and more need of non-invasive mechanical ventilation. They had no significant differences in EF, other mayor complications nor in-hospital mortality.
Funding Acknowledgements Type of funding sources: None. Introduction Coronary embolism (CE) is a rare cause of acute coronary syndrome with current evidence from small case series. In our previous work (n=36), atrial fibrillation was the main risk factor and STEMI the most frequent presentation. Objetives In this analysis we compare baseline characteristics from an embolic versus a non-embolic cohort both with left anterior descending artery as culprit vessel. Methods Observational, retrospective descriptive study of patients admitted in our unit from July 2011 to march 2021 for acute coronary syndrome and diagnosed with CE (National Cerebral Cardiovascular Center Criteria). Comparative cohort data were analysed from ARIAM Andalucia Registry. Results 646 patients were analysed (19 embolic vs 627 non-embolic). 73.7% were women in the embolic group, 27% in the non-embolic one (p<0.05). Mean age 75±12 in the embolic cases versus 62±13 in non-embolic ones (p<0.05). 9.3% of patients had history of ischemic events and there was more previous heart failure in the embolic cohort (21.1% vs 3.0%, p<0.05%). Smoking was more frequent in the non-embolic group (43.5% vs 5.3%, p<0.05), insulin-dependent diabetes mellitus was more prevalent in the embolic cohort (21.1% vs 6.1%, p<0.05). There were no differences in other cardiovascular risk factors. AF and anticoagulation therapy were more frequent in the embolic cohort (31.6% vs 6.2%, p<0.05; 31.6% vs 5%, p<0.05). Time to first medical attention was not significantly shorter in the embolic group (95±80min vs 503±3278min, p>0.05). De novo AF was more frequent in the embolic group (31.6% vs 0.8%, p=0.02). GRACE and CRUSADE scores values were higher in embolic patients (162±31 vs 145±40, p=0.042; 45±10 vs 23±23, p=0.001). Conclusions CE is an infrequent entity. Our data suggest that in STEMI, elder women patients, with atrial fibrillation, insulin-dependent diabetes mellitus and not smoking, and with short delay to first medical attention, should rise the suspiction of this fenomenon.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.