Associação da adesão ao tratamento médico intensivo na frequência de desfechos cardiovasculares em pacientes com dislipidemia
Associação da adesão ao tratamento médico intensivo na frequência de desfechos cardiovasculares em pacientes com dislipidemia
Data
2023
Autores
Silva, Guilherme Dias Renke Brandão e
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Objetivo: avaliar se a adesão ao tratamento médico intensivo alterou a frequência de eventos cardiovasculares em uma análise retrospectiva de 7 anos de acompanhamento. Métodos: estudo observacional e retrospectivo com seguimento prospectivo no qual 92 pacientes foram divididos em dois grupos de acordo com sua adesão: o grupo aderente, composto por 64 pacientes que realizaram acompanhamento médico intensivo de 2012 a 2018; e o grupo não aderente, composto por 28 pacientes que não seguiram acompanhamento médico intensivo até 2018. Os modelos de risco proporcional de Cox foram ajustados para estimar as razões de risco associadas a eventos cardiovasculares como desfechos primários. Resultados: observamos um total de 32 casos de infarto agudo do miocárdio na população estudada, com risco aumentado no grupo não aderente (53,57%) em comparação com o grupo aderente (26,56%) por tempo de seguimento (p<0,001). Constatamos que eventos prévios de infarto agudo do miocárdio e insuficiência cardíaca foram associados com progressão para abandono do tratamento (p< 0,05) e que dois medicamentos foram considerados fator de risco para abandono do tratamento, os diuréticos e os fibratos (p<0,05). Conclusão: uma redução de risco para eventos cardiovasculares, especialmente infarto agudo do miocárdio, foi observada nos pacientes aderentes ao tratamento médico intensivo.
Palavras chave: Dislipidemia; Comunicação Interdisciplinar; Doença cardiovascular; Infarto agudo do miocárdio
Objective: this study aimed to evaluate whether adherence to intensive medical treatment changed the prevalence of cardiovascular events in a retrospective 7-year follow-up analysis. Methods: this retrospective with prospective follow-up observational study involved 92 patients divided into two groups accordingly to their adherence: the adherent group who had medical appointments from 2012 to 2018 with 64 patients, and the non-adherent group composed of 28 patients who did not follow intensive medical follow-up until 2018. Cox proportional hazard ratios associated with cardiovascular outcomes as primary endpoints. Results: we observed a total of 32 cases of acute myocardial infarction in the studied population, with an increased risk in the non-adherent group (53.57%) compared to the adherent group (26.56%) by follow-up time (p<0.001). We found that previous events of acute myocardial infarction and heart failure were associated with progression to treatment dropout (p < 0.05) and that two drugs were considered risk factors for treatment dropout, the diuretics and the fibrates (p < 0.05). Conclusions: a reduced hazard of cardiovascular events, especially acute myocardial infarction, was observed in patients who adhered to intensive medical treatment. Keywords: Dyslipidemia; Multidisciplinary Care Team; Cardiovascular Disease; Myocardial Infarction.
Objective: this study aimed to evaluate whether adherence to intensive medical treatment changed the prevalence of cardiovascular events in a retrospective 7-year follow-up analysis. Methods: this retrospective with prospective follow-up observational study involved 92 patients divided into two groups accordingly to their adherence: the adherent group who had medical appointments from 2012 to 2018 with 64 patients, and the non-adherent group composed of 28 patients who did not follow intensive medical follow-up until 2018. Cox proportional hazard ratios associated with cardiovascular outcomes as primary endpoints. Results: we observed a total of 32 cases of acute myocardial infarction in the studied population, with an increased risk in the non-adherent group (53.57%) compared to the adherent group (26.56%) by follow-up time (p<0.001). We found that previous events of acute myocardial infarction and heart failure were associated with progression to treatment dropout (p < 0.05) and that two drugs were considered risk factors for treatment dropout, the diuretics and the fibrates (p < 0.05). Conclusions: a reduced hazard of cardiovascular events, especially acute myocardial infarction, was observed in patients who adhered to intensive medical treatment. Keywords: Dyslipidemia; Multidisciplinary Care Team; Cardiovascular Disease; Myocardial Infarction.
Description
Palavras-chave
Dislipidemia, Comunicação Interdisciplinar, Doença cardiovascular, Infarto agudo do miocárdio, Dyslipidemia, Multidisciplinary Care Team, Cardiovascular Disease, Myocardial Infarction
Citação
Silva GDRB. Associação da adesão ao tratamento médico intensivo na frequência de desfechos cardiovasculares em pacientes com dislipidemia. Dissertação [Mestrado Profissional em Ciências Cardiovasculares]. Instituto Nacional de Cardiologia; 2022.