Naslov
Profil godišnjeg rizika za ishemijski moždani udar/krvarenje određen CHA2DS2-VASc/HAS-BLED zbrojem te cirkulirajuće razine hstroponina I i NT-proBNP-a kod prijema akutno dekompenziranih bolesnika sa zatajivanjem srca i fibrilacijom atrija
(The annual risk profile for ischemic stroke/bleeding determined by CHA2DS2-VASc/HAS- BLED score and circulating levels of hs- troponin I and NT-proBNP at admission of patients with acutely decompensated heart failure and atrial fibrillation)

Autori
Borovac, Josip Anđelo ; Božić, Joško ; Sušilović Grabovac, Zora ; Bradarić, Anteo ; Matetić, Andrija ; Novak, Katarina ; Glavaš, Duška

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, prošireni sažetak, znanstveni

Izvornik
Cardiologia Croatica / Miličić, Davor - Zagreb : Cardiologia Croatica, Medicinska Naklada, 2018, 348-349

Skup
12. kongres Hrvatskoga kardiološkog društva ; 7. kongres Hrvatske udruge kardioloških medicinskih sestara = 12th Congress of the Croatian Cardiac Society ; 7th Congress of the Croatian Association of Cardiology Nurses

Mjesto i datum
Zagreb, Hrvatska, 29.11.2018. - 02.12.2018

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
fibrilacija atrija ; zatajivanje srca ; ishemijski moždani udar ; krvarenje ; hs-Troponin-I ; NT-proBNP
(atrial fibrillation ; heart failure ; ischemic stroke ; bleeding ; hs-Troponin-I ; NT-proBNP)

Sažetak
Introduction: Atrial fibrillation (AF) is the most common arrhythmia associated with heart failure (HF). Previous studies have shown the correlation of cardiac markers such as NT- proBNP and high-sensitivity Troponin I (hsTnI) with increased risk for thromboembolic and adverse cardiovascular events in patients with AF. Goals of this study were to evaluate the risk for ischemic stroke (IS) and significant bleeding, to examine clinical and laboratory characteristics, and to determine potential associations of NT-proBNP and hsTnI with aforementioned risks in patients with acute decompensated HF (ADHF) and AF. Patients and Methods: This study included a total of 47 patients with ADHF and AF, diagnosed according to the current criteria of the European Society of Cardiology (ESC), which were hospitalized in University Hospital Centre Split during 2018 (Table 1). Patients with acute coronary syndrome and/or infectious disease were excluded. Results: Mean annual risk for IS without therapy was 8.74% while bleeding risk was 0.60% (p<0.001). After risk adjustment for individual antithrombotic therapy, mean risks for IS and bleeding were 3.46% and 3.10%, respectively, without significant difference between these risks (p=0.430). Use of non- vitamin K oral anticoagulants was almost equated with warfarin use (47.5% vs. 52.5%). Mean levels of hsTnI and NT-proBNP on admission were 56.7 ng/mL and 6550 pg/mL, respectively. Levels of hsTnI above the upper reference limit adjusted by sex were found in 26 (55.3%) patients. Levels of NT- proBNP on admission were significantly higher (p=0.014) in patients with higher risk for IS, as well as levels of hsTnI but without statistical significance (p=0.388). hsTnI showed positive correlation with NT-proBNP (r=0.545, p=0.010) and C- reactive protein (r=0.559, p<0.001), while NT- proBNP exhibited positive correlation with mean annual risk for IS (r=0.587, p=0.002) (Figure 1). Conclusion: The antithrombotic management reduced the risk for IS by nearly threefold, with acceptable bleeding risk. Levels of hsTnI were increased in a large number of patients suggesting that myocardial injury is common during the hospitalization event of ADHF with AF. Levels of NT-proBNP on admission, in the presented population, may aid in annual risk stratification for IS and thromboembolic event.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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