Relação do fragmento C-terminal de agrina e da fragilidade com a mortalidade intra-hospitalar de pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST

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2020-07-29

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Universidade Estadual Paulista (Unesp)

Resumo

Com o envelhecimento da população mundial, doenças crônicas, como as doenças coronarianas, vem se tornando mais comuns, assim como a Síndrome de Fragilidade. Esse diagnóstico é subestimado apesar dos escores cada vez mais simplificados para uso na prática clínica. Com o avanço da ciência biomolecular, o papel dos marcadores na fragilidade, como a proteína C terminal de agrina (CAF), ainda parecem incertos. A relação entre as doenças, sua mortalidade, e de possíveis marcadores podem ser de grande valia no manejo destes pacientes. Avaliar a associação entre o diagnóstico de Síndrome de Fragilidade e o CAF, além da mortalidade intra-hospitalar em pacientes com Infarto Agudo do Miocárdio com supradesnivelamento do segmento ST (IAMCSST).
Background: With the increase in age in the world population, chronic diseases such as coronary heart disease have become common, as well as the Frailty Syndrome. This diagnosis is underestimated despite the simplified scores for use in clinical practice. With the advancement of biomolecular science, the role of markers in fragility such as the C-terminal fragment of agrin (CAF), still seems uncertain. The relationship between diseases, their mortality, and possible markers can be of great value in the management of these patients. Objective: Evaluate the association between the diagnosis of Frailty Syndrome and CAF, in addition to in-hospital mortality and time of hospitalization in patients with ST-segment elevation acute myocardial infarction (STEMI). Methods: An observational and prospective cohort study was conducted, with analysis of clinical factors, application of diagnostic scores for Frailty Syndrome using the FRAIL and CFS scales, in addition to the serum CAF measurement and the follow-up of 112 patients during hospitalization, being statistical methods are applied to these relationships. Results: Patients diagnosed with frailty syndrome by the scales evaluated were related to hospital mortality. The FRAIL scale is an independent factor for mortality in the patients evaluated, while the CFS was related to the total length of stay, and time necessity of intensive care. The CAF dosage was not related to the diagnosis of frailty, but it correlated with the GRACE score positively, and with the CKMB peak in an inversely proportional way. Conclusion: The use of FRAIL and CFS scores can be used as a prognostic factor in patients with STEMI, being better evaluated by FRAIL. The CFS can be used to assess the length of stay in coronary care units. CAF had no diagnostic value for frailty, but the size of the infarction and the GRACE score were correlated.

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Infarto do miocárdio, Proteína C termina de agrina, Síndrome de fragilidade, Acute myocadiac infarction, C-terminal fragment of agrin, Frailty syndrome

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