Portal de Periódicos da CAPES

An unexpected risk predictor in acute coronary syndromes

2013; Oxford University Press; Volume: 34; Issue: suppl 1 Linguagem: Inglês

10.1093/eurheartj/eht310.p4902

1522-9645

Helga Martins, F Soares, Nádia Moreira, Rafael Ferreira, Jorge Ferreira, Rui Baptista, Francisco Gonçalves, Sílvia Monteiro, Pedro Monteiro, Mariano Pêgo,

Atrial Fibrillation Management and Outcomes

Introduction: Despite all the diagnostic and therapeutic development, the Acute Coronary Syndromes (ACS) remain an important factor of morbidity and mortality. New anticoagulants and antiplatelet agents have been studied to reduce the residual risk, with varying success. However, it remains uncertain the prognostic value of INR on admission, particularly if it is within the normal range. Population and methods: We studied 1569 patients admitted since May 2004 and December 2010 in a coronary care unit, with the admission INR between 0.85 and 1.34 (normal values in this hospital). They were divided into three groups according to tertiles of INR (group 1≤1.05, 0.85 Results: Patients in group 1 were younger (65±13 vs 66±13 vs 70±13 years, p <0.001) but there were no gender differences. The CVRF had similar prevalence between groups. The STEMI was less frequent in group 1 (33 vs. 38 vs. 41%, p=0.02). The ejection fraction of the left ventricle was higher in group 1 (53±10 vs 52±10 vs 49±11%, p<0.001). There were no differences in serum creatinine or hemoglobin between groups. There was a mortality of 13.9%, 18.5% and 19.1% in groups 1,2 and 3, respectively (log rank 0.003) - graph 1. In multivariate analysis, higher INR at admission was an independent predictor of mortality after discharge. Graph 1 Graph 1 Conclusion: In ACS patients with an INR considered normal and not undergoing oral anticoagulation, the values at upper limit of normal are associated with a worse prognosis. More studies are needed in this field.