• Med Clin Barcelona · Apr 2014

    Multicenter Study Observational Study

    [Influence of the combination of antiplatelet agents on the occurrence of early left ventricular insufficiency in patients with acute coronary syndromes without persistent ST-segment elevation].

    • Rafael Blancas Gómez-Casero, Manuel Quintana Díaz, Miriam Chana García, Carmen Martín Parra, Blanca López Matamala, Belén Estébanez Montiel, Daniel Ballesteros Ortega, Oscar Martínez González, Dolores Vigil Escribano, Francisca Prieto Valderrey, Luis Marina Martínez, and Olmos Castro Gallego.
    • Servicio de Medicina Intensiva, Hospital Universitario del Tajo, Aranjuez, Madrid, España. Electronic address: rafael.blancas@salud.madrid.org.
    • Med Clin Barcelona. 2014 Apr 7; 142 (7): 293-8.

    Background And ObjectiveThe frequency of left ventricular failure (LVF) in the early stages of non-ST-segment elevation acute coronary syndrome (NSTE ACS) has not been described so far. The objective of this study is to describe for the first time the frequency of LVF in the early course of NSTE ACS and to assess its association with other interventions.Patients And MethodObservational prospective cohort multicenter study in intensive and coronary care units (ICCU). Patients with NSTE ACS admitted within 24h after onset were included. Main outcome was the occurrence of LVF. We evaluated the association between LVF and clinical and therapeutic variables.ResultsLVF occurred in 15.6% of patients. Coronary angiography (CA) during admission to the ICCU was a protective variable against the main outcome, performed before 72h (odds ratio [OR] 0.47; 95% confidence interval [95% CI] 0.25-0.89; P=.022) and later (OR 0,39; 95% CI 0,15-0,98; P=.044). The administration of beta-blockers was a protective variable against the occurrence of LVF (OR 0,54; 95% CI 0,32-0,87; P=.013). Patients receiving acetylsalicylic acid before admission to the ICCU had a higher risk of developing LVF (OR 1.74; 95% CI 1.06-2.86; P=.028). Age was also a factor of risk for LVF (OR 1.02; 95% CI 1.00-1.05; P=.032).ConclusionsCA and beta-blockers can decrease the occurrence of LVF. The association between previous administration of acetylsalicylic acid and age with the occurrence of LVF may reflect long-standing cardiovascular disease.Copyright © 2012 Elsevier España, S.L. All rights reserved.

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