Prospective Validation of the Dante Pazzanese Risk Score in Non-ST-Segment Elevation Acute Coronary Syndrome

Santos, Elizabete Silva dos; Minuzzo, Luiz; Souza, Roberta de Castro; Timerman, Ari

doi:10.5935/abc.20130163

Cited by 6 publications

(8 citation statements)

References 22 publications

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“…The sociodemographic profile of the sample was similar to other studies, revealing mainly an average age above 60 years old, a slight predominance of males and the presence of cardiovascular risk factors classically reported in the literature (4,(12)(13)(14) . Lower income favors diseases and complicates the recognition of the signs and symptoms of acute myocardial infarction (12) .…”

Section: Discussionsupporting

confidence: 82%

Chest pain during admission in a reference cardiac emergency unit

Gomes¹,

Queiroga²,

Araujo³

et al. 2014

Rev Rene

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This study aimed to verify the presence of chest pain in a reference emergency cardiac unit of Recife, PE, Brazil. This is a cross-sectional, descriptive-exploratory study, with a quantitative approach. Between December 2012 and February 2013, data from 39 patients admitted to the unit with chest pain were collected. For comparison between the averages, the Mann-Whitney test was used and the Pearson correlation was used to verify the association between numerical variables and pain scores and time between symptoms' onset and attendance (delta t). The main presentations were retrosternal chest pain isolated (51.3%) and combined with radiation (33.3%). The average scores reported for pain was 5.15±1.63 and the delta t of the sample was 14.95±8:48h. The delay to arrive at the reference unit harms the diagnosis and the possibility of initiating reperfusion therapy in pre-hospital care should be considered. Descriptors: Emergency Medical Services; Chest pain; Cardiology; Nursing. Objetivou-se verificar a apresentação da dor torácica em uma unidade de referência em emergência cardiológica do Recife, PE, Brasil. Trata-se de um estudo de corte transversal, descritivo-exploratório, de abordagem quantitativa. Foram coletados entre dezembro de 2012 e fevereiro de 2013, dados de 39 pacientes admitidos na unidade com dor torácica. Para a comparação entre as médias foi utilizado o teste de Mann-Whitney e a correlação de Pearson foi utilizada para verificar a associação entre variáveis numéricas com os escores de dor e tempo entre início dos sintomas e atendimento (delta t). As principais apresentações foram a dor retroesternal isolada (51,3%) e combinada à irradiações (33,3%). O escore médio referido para dor foi de 5,15±1,63 e o delta t da amostra foi de 14,95±8,48h. A demora até a unidade de referência prejudica o diagnóstico e deve-se considerar a hipótese de a terapia de reperfusão iniciar no atendimento pré-hospitalar. Descritores: Serviços Médicos de Emergência; Dor no peito; Cardiologia; Enfermagem. El objetivo fue verificar la presentación del dolor torácico en servicio de urgencia de referencia cardíaca de Recife, PE, Brasil. Estudio de corte transversal, descriptivo, exploratorio, cuantitativo. Fueron recogidos entre diciembre de 2012 y febrero de 2013 los datos de 39 pacientes ingresados en la unidad de dolor torácico. Para comparación entre las medias, fue utilizado test de Mann-Whitney y correlación de Pearson para verificar asociación entre variables numéricas con puntuaciones de dolor y tiempo entre el inicio de los síntomas y atendimiento (delta t). Las principales presentaciones fueron dolor retro esternal solo (51,3%) y combinada con la irradiación (33,3%). La puntuación promedia para dolor retro esternal solo fue de 5,15 ± 1,63 y el delta T de la muestra fue de 14,95 ± 8,48 h. El retraso de la unidad de referencia perjudica el diagnóstico y debe considerarse la posibilidad de iniciar la terapia de reperfusión en la atención prehospitalaria. Descriptores: Servicios Médicos de Urgencia; Dolor en el pecho; Card...

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Section: Discussionsupporting

confidence: 82%

Chest pain during admission in a reference cardiac emergency unit

Gomes¹,

Queiroga²,

Araujo³

et al. 2014

Rev Rene

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“…This is consistent with the findings of others. In our country, the previously cited study by Santos et al 14 found that a diabetes diagnosis was significantly associated to all-cause mortality or re-infarction in 30 days. AlFaleh et al 28 analyzed 6,362 patients from the Gulf Registry of Acute Coronary Events-2 (Gulf RACE-2), and found that a history of diabetes or new-onset hyperglycemia at admission was associated with higher in-hospital, 30 day, and one-year mortality rates.…”

Section: Discussionmentioning

confidence: 56%

“…In Brazil, the Acute Coronary Care Evaluation of Practice Registry (ACCEPT study), a multicenter post-ACS Brazilian study with 2,485 patients, found a 30-day mortality rate of 1.8%, 3.0%, and 3.4% in individuals with UA, NSTEMI, and STEMI, respectively 13 . A study of 1,027 patients with NSTEMI from a single cardiology referral center in the city of São Paulo 14 found that 5.3% of the participants died or had a new infarction within 30 days.…”

Section: Discussionmentioning

confidence: 99%

“…In this scenario, long-term information about survival after an ACS event is of growing interest. Most long-term post-ACS studies focus on patients treated in cardiology referral centers or facilities with specialized cardiology divisions 9 - 14 . However, a large number of ACS patients seek treatment in community, non-specialized hospitals 15 - 17 .…”

Section: Introductionmentioning

confidence: 99%

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One-year Mortality after an Acute Coronary Event and its Clinical Predictors: The ERICO Study

Santos

Goulart

Brandão

et al. 2015

Arquivos Brasileiros De Cardiologia

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BackgroundInformation about post-acute coronary syndrome (ACS) survival have been mostly short-term findings or based on specialized, cardiology referral centers.ObjectivesTo describe one-year case-fatality rates in the Strategy of Registry of Acute Coronary Syndrome (ERICO) cohort, and to study baseline characteristics as predictors.MethodsWe analyzed data from 964 ERICO participants enrolled from February 2009 to December 2012. We assessed vital status by telephone contact and official death certificate searches. The cause of death was determined according to the official death certificates. We used log-rank tests to compare the probabilities of survival across subgroups. We built crude and adjusted (for age, sex and ACS subtype) Cox regression models to study if the ACS subtype or baseline characteristics were independent predictors of all-cause or cardiovascular mortality.ResultsWe identified 110 deaths in the cohort (case-fatality rate, 12.0%). Age [Hazard ratio (HR) = 2.04 per 10 year increase; 95% confidence interval (95%CI) = 1.75–2.38], non-ST elevation myocardial infarction (HR = 3.82 ; 95%CI = 2.21–6.60) or ST elevation myocardial infarction (HR = 2.59; 95%CI = 1.38–4.89) diagnoses, and diabetes (HR = 1.78; 95%CI = 1.20‑2.63) were significant risk factors for all-cause mortality in the adjusted models. We found similar results for cardiovascular mortality. A previous coronary artery disease diagnosis was also an independent predictor of all-cause mortality (HR = 1.61; 95%CI = 1.04–2.50), but not for cardiovascular mortality.ConclusionWe found an overall one-year mortality rate of 12.0% in a sample of post-ACS patients in a community, non-specialized hospital in São Paulo, Brazil. Age, ACS subtype, and diabetes were independent predictors of poor one‑year survival for overall and cardiovascular-related causes.

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“…18 derivation studies [7,11,20,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] with 56,560 UA/ NSTEMI patients and 18 validation cohorts [18,20,22,24,28,30,[32][33][34][35][36][46][47][48][49][50][51][52] with 56,673 patients were included. As in ACS studies, validation cohorts included more NSTEMI patients than derivation ones (Table 2), with rates of PTCA ranging from 26 to 48%.…”

Section: Ua/nstemimentioning

confidence: 99%