Risultati per: Gestione dei pazienti con angina stabile

Iniziativa Special Cook per l’oncologia pediatrica

Coinvolti 12 centri pediatrici, coordinati da Regina Margherita

De Paoli(Acc), aspetti anche non sanitari hanno ruolo nella cura

De Paoli(Acc), aspetti anche non sanitari hanno ruolo nella cura

L’investimento è stato di 40 milioni di euro

Indagine Piepoli, per troppi è solo un comune mal di testa

Andos, ‘ ha effetti benefici sulla salute migliorando la qualità di vita’

Campagna Aiom su vaccinazioni, 80% malati non conosce i vantaggi

New England Journal of Medicine, Ahead of Print.

Circulation, Volume 148, Issue Suppl_1, Page A12552-A12552, November 6, 2023. Introduction:Managing unstable angina (UA) poses a significant challenge due to its subjective diagnosis and underrepresentation in pivotal clinical trials that have greatly influenced current practices. The aim of this study is to determine the key variables that impact the management of UA in a referral cardiology hospital.Hypothesis:In addition to prognostic scores, other factors such as the nature of chest pain may have a relevant role in the management of UA.Methods:This retrospective cohort study enrolled patients consecutive hospitalized with a diagnosis of UA from July 16, 2018 to February 28, 2020. The primary objective was to analyze the factors associated with the utilization of either an invasive or non-invasive strategy. The secondary objective sought to identify the factors associated with the presence of obstructive coronary artery disease (CAD) or ischemia, as determined by the results of complementary tests. Between-group comparisons were performed using multiple logistic regression analysis, with statistical significance set at a 5% level.Results:A total of 729 patients were included in the study, with a mean age of 62.9 years, with a male predominance (64.6%). Factors significantly associated with an invasive strategy were smoking (p = 0.001), type of chest pain (p < 0.001), angina "in crescendo" (p = 0.006), TIMI risk (p = 0.006), and HEART score (p = 0.011). In the multivariate analysis, current smokers (OR 2.23, CI 95% 1.13-4.8) and type A chest pain (OR 3.39, CI 95% 1.93-6.66) were independently associated with the invasive strategy. Regarding the presence of obstructive CAD or ischemia, male gender (p = 0.032), exertional chest pain (p = 0.037), Diamond-Forrester (p = 0.026) and TIMI risk (p = 0.001) showed significant associations. In the multivariate analysis, the type of chest pain (type B chest pain: OR 0.6, CI 95% 0.38-0.93, p = 0.026) and presence of previous CAD (OR 1.42, CI 95% 1.01-2.0, p = 0.048) were independently associated with obstructive CAD or ischemia.Conclusion:Chest pain type is not only instrumental in diagnosing UA but also critical in shaping the suitable treatment approach. Our study emphasizes the significance of integrating pain traits with guidelines-endorsed scoring systems for optimal management.