Idade Avançada Reduz a Tipicidade da Apresentação Clínica em Pacientes Com Dor Torácica Aguda Relacionada a Doença Coronária Obstrutiva?
Pedro Henrique Correia Filgueiras, Antônio Maurício Cerqueira, Gabriela Oliveira Bagano, Vitor Calixto de Almeida Correia, Fernanda Oliveira de Andrade Lopes, Thiago Menezes Barbosa de Souza, Leticia Lara Fonseca, Lara Queiroz Kertzman, Yasmin Falcon Lacerda, Marcia Noya Rabelo, Luis Claudio Lemos Correia
2021
Arquivos Brasileiros de Cardiologia
According to traditional diagnosis thinking, very elderly individuals are more predisposed to develop atypical symptoms in acute coronary syndromes. To test the hypothesis that very elderly individuals are more predisposed to atypical chest pain manifestations due to obstructive coronary artery disease (CAD). The Registry of Thoracic Pain includes patients admitted with acute chest pain. Firstly, the typicality index of this clinical manifestation was constructed: the sum of 12 symptom
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... istics (8 typical and 4 atypical symptoms). In the subgroup of patients with coronary etiology, the typicality index was compared between octogenarian and non-octogenarian individuals. Statistical significance was defined by p<0.05. 958 patients were included in the registry, and 486 (51%) had a supposedly coronary etiology. In this group, 59 (12%) octogenarians (age 84±3.5, 50% men) were compared to 427 patients aged <80 (60±12 years, 71% men). The typicality index in octogenarians was 3.42±1.92, which is similar to that of non-octogenarians (3.44±1.74; p=0.92 in univariate analysis and p=0.80 after adjustment for sex by analysis of variance - ANOVA). There was also no statistically significant difference when the sample was divided into median age (62 years; 3.41±1.77 vs. 3.49 ± 1.77; p=0.61). There was no statistically significant linear association between age and typicality index (r=- 0.05; p=0.24). Logistic regression analysis for prediction of CAD in the general sample of 958 patients showed no interaction of typicality index with numeric age (p=0.94), octogenarians (p=0.22) or age above median (p=0.74). In patients with acute chest pain of coronary etiology, advanced age does not influence the typical clinical presentation.
doi:10.36660/abc.20190089
pmid:34133584
fatcat:geisosipcvgjjkjn2loc6rueji
