Perfil clínico e suas associações com resultados angiográficos de pacientes submetidos à coronariografia em hospital público universitário

Abstract

Ischemic heart disease is one of the most common causes of death worldwide. There are few data in the literature about the association of clinical profile and coronary angiography results in our population. From August 2015 to April 2018, 1 844 patients submitted to coronary angiography at Hospital Universitário Pedro Ernesto (HUPE) were enrolled in this cross-sectional study. They were evaluated by their clinical variables, angiographic results and procedure complications. Results: mean age 62,1±10,3 years, mean body mass index (BMI) 27,4±5,0 kg/m² and 26,3% were obese. Most of the population were outpatients (71,0%). Patients referred by HUPE were 15,5% of population. Stable angina was the most common indication (62,9%). Only 19,7% underwent noninvasive testing (NT). Arterial hypertension (AH) was the most prevalent RF (88,2%), followed by dyslipidemia (DLP) with 60,2%. Only 4,2% of population did not have any RF. Transradial approach was used in 91,7% of patients. Most patients (65%) had obstructive CAD (intermediate and severe stenosis) and 58,2% when considered only severe stenosis CAD. Mild and severe left main coronary artery (LM) disease was found in 8,1% of patients and 4,7% when considered only severe stenosis. AH, DLP, diabetes mellitus (DM), family history (FH) of CAD, smoking, peripheral artery disease (PAD) and chronic kidney disease (CKD) were associated with CAD (p<0,05) and worse angiographic results. DM and DLP were associated (p<0,05) with LM disease. Obesity and NT were not associated with CAD. The quantity of RF, male sex, older age group and patients referred by HUPE were considered independent risk predictors for CAD after multivariable analysis. LM disease independent risk predictors were male sex, older age group, non-insulin-dependent DM (NIDM) and DLP. Death occurred in 3 (0,16%) patients and acute coronary occlusion in 4 (0,2%). In conclusion: classic risk factors were associated with the presence of CAD. Older age, male sex, quantity of RF, PAD and patients referred by HUPE were risk predictors for CAD; male sex, older age, NIDM and DLP were risk predictors for LM disease. The low rate of procedure complications demonstrates the safety of coronary angiography in a tertiary university hospital.