Associação e comparação das alterações eletrocardiográficas de alto risco com os achados de lesão coronariana e o desfecho clínico intra-hospitalar em pacientes com Síndrome Coronariana Aguda
DOI:
https://doi.org/10.24220/2318-0897v30e2021a4836Palavras-chave:
Cateterismo cardíaco. Eletrocardiograma. Síndrome coronariana aguda.Resumo
Objetivo
Associar e comparar as citadas alterações do eletrocardiograma com lesões angiocoronarianas obstrutivas e com desfecho clínico.
Métodos
Estudo retrospectivo, observacional e transversal, com análise de prontuários eletrônicos de 165 pacientes internados com síndrome coronariana aguda e submetidos à cineangiocoronariografia, no período de abril de 2016 a março de 2017.
Resultados
Os padrões de alto risco estiveram presentes em 22 pacientes (13,3%). Houve mais lesões estenóticas graves (>70%) de artéria descendente anterior nos casos de achados eletrocardiográficos sem supradesnivelamento de ST (42,5%), com supradesnivelamento de ST (56,5%) e de alto risco (63,6%) em relação aos casos sem alterações típicas (11,1%; p=0,0002). Não houve diferença estatisticamente significante entre os desfechos clínicos de óbito (p=0,83) ou tempo de internação (p=0,28) entre nenhum grupo de padrão eletrocardiográfico. A análise de subgrupo também não mostrou diferença estatisticamente significante entre o tratamento instituído (clínico, endovascular ou cirúrgico) entre os casos de síndrome coronariana aguda com supradesnivelamento de ST, sem supradesnivelamento de ST ou de achados de alto risco (p>0,999).
Conclusão
Os padrões de alto risco estiveram associados a lesões coronarianas graves e evolução para tratamento invasivo (endovascular ou cirúrgico) de forma semelhante aos casos de infarto agudo do miocárdio com ou sem supradesnivelamento de segmento ST. Entretanto, não foi possível observar diferenças nos desfechos clínicos (tempo de internação e óbito) em nenhum dos grupos analisados.
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