No abstract

The main issue in the prevention of myocardial infarction (MI) is to reduce risk factors. Periodontal disease is related to cardiovascular disease and both share risk factors. The purpose of this study is to investigate whether periodontitis can be considered a risk factor for MI and common risk factors in a case–control study and in a prospective follow-up study in patients with MI. The test group (MIG) was made up of 144 males who had MI in the previous 48 h. The control group (CG) was composed of 138 males without MI. Both groups were subdivided according to the presence or absence of stage III and IV of periodontitis. General data; Mediterranean diet and physical activity screening; periodontal data; and biochemical, microbiological and cardiological parameters were recorded. ANOVA, Mann–Whitney U and Kruskal–Wallis statistical tests and binary logistic regression analysis were applied. No differences in anthropometric variables were observed between the four groups. The average weekly exercise hours have a higher value in CG without periodontitis. The number of leukocytes was higher in MIG, the number of monocytes was higher in CG and the number of teeth was lower in MIG with periodontitis. Adherence to the Mediterranean diet was higher in CG. Porphyromonas gingivalis and Tannerella forsythia were higher in CG with periodontitis and in MIG with and without periodontitis. At follow-up, the left ventricular ejection fraction (LVEF) data were better in the non-periodontitis group: 15 patients had Mayor Cardiovascular Adverse Events (MACE), 13 of them had periodontitis and 2 did not show periodontitis. Periodontitis, exercise, diet and smoking are risk factors related to MI. MACE presented in the ‘MI follow-up’ shows periodontitis, weight, exercise hours and dyslipidemia as risk factors. LVEF follow-up values are preserved in patients without periodontitis. Our data suggest that periodontitis can be considered a risk factor for MI and MACE in the studied population.

No abstract

Funding Acknowledgements Type of funding sources: None. Introduction Acute coronary syndrome (ACS) is one of the most common health problems in the world, and the leading cause of death. The goals of this study are to determine ACS incidence and the seasonal distribution of ocurrence (Spring/Summer/Autumn/Winter) as well as clinical outcomes per season. Methods Retrospective and observational analysis of consecutive patients hospitalized for ST-elevation myocardial infarction (STEMI) in the Critical Coronary Care Unit (CCCU) of a tertiary center with Mediterranean climate from July 2011 to September 2022. We analyzed the influence of the seasons on the incidence and characteristics of ACS. Results We enrolled a total of 1668 patients: 431 in Winter, 382 in Spring, 405 in Summer and 450 in Autumn, with the baseline characteristics summarized in Table 1. There were no differences in baseline characteristics among the 4 seasons, except for the higher prevalence of obesity in Autumn. There was no statistically significant difference in the incidence of STEMI among seasons, although numerically the highest incidence was recorded in Autumn. The occurrence of ACS was not different according to age or sex. ACS complications were not statistically different among seasons with similar incidence of ventricular arrythmias (VT, VF), invasive mechanical ventilation support, need for inotrope/vasopressor support or development of de-novo atrial fibrillation. In-hospital mortality is less frequent in Autumn, but the differences did not reach statistical significance. Conclusions In this Mediterranean climate cohort, STEMI incidence was higher in Autumn, although no differences in clinical profile or outcomes were found among seasons.

Funding Acknowledgements Type of funding sources: None. Introduction Inotropic support is frequently needed after acute coronary syndromes(ACS) at coronary care units(CCU). Despite it has being long time since approval of levosimendan(LV) as inotropic support to cardiogenic shock, dobutamine(DB) still being the basis of this treatment. We think levosimendan is a secure and effective alternative. Purpose To analyse the use of levosimendan and dobutamine done in our ACS patients to determine if we have followed some clear criteria of selection, and try to draw a defined pattern for future use. Method Retrospective, analytic, observational study of all ACS admitted to our CCU between 08/2011- 02/2022. We confront patients treated with dobutamine versus levosimendan. X2, U-Mann Whitney and T-Student were used when necessary. Statistical significance: p-value<0.05. Result 2881patients were admitted with ACS, 6.49%of them(n: 187) needed ionotropic support. Out of these, 60.96%(n: 114) were supported with dobutamine, 28.88%(n: 54) with levosimedan and 10.16%(n: 19)received in some time both drugs, so were excluded from the analysis. Mean age: 68.43±11.48years old. 66.66%(n: 112) men. 54.76%(n: 92)with persistent ST-segment elevation. No difference was found between groups, neither in past medical history, including cardiovascular risk factors, history of arrhythmias(11.3% of patients), previous use of betablockers(30.4%), antiarrhythmic drugs(0.6%) or having pacemaker(1.2%). 114 patients(67.86%)needed norepinephrine(70.17%with DB and 62.96% LV, p:0.35); 29(17.26%) were supported with intra-aortic balloon pump(20.18% in DB group and 11.11% in LV group, p:0.134), without differences by drug. 62 patients(36.9%) presented atrial fibrillation(33.33% in DB and 44.44% in LV, p:0.166), 58(34.52%)ventricular arrhythmias[sustained ventricular tachycardia/ventricular fibrillation](33.33% in DB and 37.04% in LV, p:0.638). In-hospital mortality of these patients was 29.17%(n:49), 29.82% in DB and 27.77% in LV, p:0.785. In multivariate analysis adjusted by clinic and epidemiologic factors, only cardiogenic shock resulted an independent predictor of in-hospital death. Pattern of use we use DB in those patients with worst Killip-kimball(KK) state(73.54%in DB group with KK-IV vs53.70%in LV´s) and LV in those in intermediate states of instability(38.88%LV in KK-II/III vs 8.84%DB in KK-II/III),p<0.001. We chose DB in those who became unstable in CCU and LV in those who became unstable in hospitalization room, p:0.049. Finally, we noted a significant change in trend of use during the period of study, falling use of DB in favour of LV(p<0.001). Conclusion In our experience, dobutamine has been the most frequent ionotropic drug used in last 11 years after an acute coronary syndrome. Nevertheless, a substitution by levosimendan trend is evolving. We did not detect differences in complications or prognosis dependent on the inotropic drug used, but the use of dobutamine were predominant in those patients with more severe situation.