High-Sensitivity Troponin I and Cardiovascular Events in Stable Coronary Artery Disease: Insights from a Longitudinal Outpatient Study.

Numerous studies have been published suggesting that troponin levels are related to adverse outcomes in chronic cardiac and non-cardiac conditions. Our study investigated whether troponin levels gathered from unselected blood samples taken during outpatient care are associated with adverse outcomes in a population with stable coronary artery disease. In a cohort of 949 patients with stable coronary artery disease, an average age of 67.5 ± 9.5 years, 69.5% male, 52.1% diabetics, 51.6% with previous myocardial infarction, and 57.9% with triple-vessel disease, 21.7% of patients encountered new events during an average period of monitoring of 2.07 ± 0.81 years. Troponin I/99th percentile categorized into tertiles emerged as an independent predictor of death and combined events risk (hazard ratio: 2.02 (1.13-3.60), p = 0.017; 2.30 (1.37-3.88, p = 0.002, respectively). A troponin ratio > 0.24 was able to identify 53.3% of patients at risk of death and heart failure hospitalization. In patients with stable coronary artery disease who are adherent to treatment, troponin levels are independently associated with death and heart failure hospitalization in a medium-term follow-up.

Analysis of Cardiovascular Disease Risk Factors in Women.

AIM: Study the cardiovascular risk factors in a feminine population vulnerable to cardiovascular events particularly to evaluate the principal factors or possible confounding variables. METHODS: This is a cross-sectional descriptive study. Were analysed all the female patients from the Cardiovascular Rehabilitation Institute of Sports Medicine of Caxias do Sul who had the complete information on cardiovascular disease history, comorbidities and habits and who knew the complete gynaecological history by a phone interview. RESULTS: A group of 91 patients were analysed. About the comorbidities and habits, 45.2% of these patients presented some tobacco load, 82.4% are hypertensive, 61.5% are dyslipidemic, 25.3% are diabetic and the BMI average was 29.27 (overweight). Between the patients who undergone a hysterectomy and had an episode of the acute coronary syndrome (10 patients), 70% had the event after the procedure. Between the post-menopause women with at least one episode of the acute coronary syndrome, 80.5% (33 patients) had the first event after the menopause. CONCLUSION: We found multiple lifetime risk factors that predisposed the women of the sample to have cardiovascular disease. Between the women with specific to women risk factors and without, the prevalence of cardiovascular disease was very similar. This information supports the idea that these are just confounding factors of CVD and the principals involved are the genetic factors and habits. For this reason, the focus of CVD prevention and treatment should be directed towards these aspects.

Treatment of the Aged Patients at a Large Cardiac Rehabilitation Center in the Southern Brazil and Some Aspects of Their Dropout from the Therapeutic Programs.

AIM: This paper aims to assess the dropout rate in different age groups through the example of the large cardiac rehabilitation centre affiliated with the Institute of Sports Medicine, University of Caxias do Sul. MATERIAL AND METHODS: A historic cohort study comprising the following groups: Non-Old < 65 (n = 141); Young-Old 65-74 (n = 128); and Middle-Old 75-84 years old (n = 57). The exercise program lasted 48 sessions and dropout was defined as attendance of 50% of sessions or less. Logistic binominal regression was performed to assess the risk of dropout. For all analyses, a two-tailed P value of < 0.05 was used. RESULTS: The total dropout rate was 38.6%. The Young-Old and Middle-Old groups showed lower dropouts compared to Non-Old patients (p = 0.01). Young-Old has 96% less risk for dropout compared to Non-Old group (adjusted odds ratios = 1.96 [1.16-3.29]). Furthermore, patients underwent the Coronary Artery Bypass Graft showed a lower rate of dropout (p = 0.001). The absence of CABG involved three times more risk of dropout (p = 0.001). CONCLUSION: The Non-Old and the Middle-Old patients showed higher dropout rates compared to Young-Old. To ensure the best possible rehabilitation and to improve patients´ participation in CR, these programs should be adjusted to the needs of patients in terms of their age.