{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:32:39Z","timestamp":1772253159271,"version":"3.50.1"},"reference-count":14,"publisher":"Sociedade Brasileira de Cardiologia","issue":"3","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento: O manejo da angina inst\u00e1vel (AI) \u00e9 um desafio devido ao seu diagn\u00f3stico subjetivo e \u00e0 sua escassa representa\u00e7\u00e3o em ensaios cl\u00ednicos randomizados que determinem as pr\u00e1ticas atuais.  Objetivos O objetivo deste estudo \u00e9 identificar os principais fatores associados \u00e0 indica\u00e7\u00e3o de estratifica\u00e7\u00e3o invasiva ou n\u00e3o nessa popula\u00e7\u00e3o e avaliar os fatores associados \u00e0s altera\u00e7\u00f5es nos exames de estratifica\u00e7\u00e3o.  M\u00e9todos: Coorte retrospectiva de pacientes internados por AI, em um per\u00edodo de 20 meses consecutivos. Para avaliar os fatores associados \u00e0 estrat\u00e9gia de estratifica\u00e7\u00e3o, os pacientes foram divididos em estratifica\u00e7\u00e3o invasiva (cinecoronariografia) e n\u00e3o invasiva (demais m\u00e9todos). Para an\u00e1lise de fatores relacionados \u00e0s altera\u00e7\u00f5es nos exames de estratifica\u00e7\u00e3o, os pacientes foram divididos em grupos com ou sem doen\u00e7a arterial coronariana (DAC) obstrutiva ou isquemia, conforme resultados dos exames solicitados. Foram realizadas compara\u00e7\u00f5es entre grupos e an\u00e1lise de regress\u00e3o log\u00edstica m\u00faltipla, com signific\u00e2ncia estat\u00edstica definida em um n\u00edvel de 5%.  Resultados: 729 pacientes foram inclu\u00eddos, com mediana de idade de 63 anos e predom\u00ednio do sexo masculino (64,6%). Estiveram associados \u00e0 estratifica\u00e7\u00e3o invasiva: tabagismo (p = 0,001); tipo de dor tor\u00e1cica (p &lt; 0,001); dor \"em crescendo\" (p = 0,006); escore TIMI (p = 0,006); escore HEART (p = 0,011). Na an\u00e1lise multivariada, tabagistas (OR 2,23, IC 95% 1,13-4,8), ex-tabagistas (OR 2,19, IC 1,39-3,53) e dor tor\u00e1cica tipo A (OR 3,39, IC 95% 1,93-6,66) estiveram associados de forma independente. Estiveram associados \u00e0 DAC obstrutiva ou isquemia: tempo de interna\u00e7\u00e3o hospitalar (p &lt; 0,001); sexo masculino (p = 0,032); dor desencadeada por esfor\u00e7o (p = 0,037); Diamond-Forrester (p = 0,026); escore TIMI (p = 0,001). Na an\u00e1lise multivariada, apenas dor tor\u00e1cica (dor tor\u00e1cica tipo B: OR 0,6, IC 95% 0,38-0,93, p = 0,026) e DAC pr\u00e9via (OR 1,42, IC 95% 1,01-2,0, p = 0,048) estiveram associadas de maneira independente.  Conclus\u00f5es: O tipo de dor tor\u00e1cica desempenha um papel crucial n\u00e3o apenas no diagn\u00f3stico da AI, mas tamb\u00e9m na defini\u00e7\u00e3o do tratamento adequado. Nossos resultados destacam a import\u00e2ncia de incorporar caracter\u00edsticas da dor aos escores progn\u00f3sticos endossados pelas diretrizes, para otimiza\u00e7\u00e3o do manejo da AI.<\/jats:p>","DOI":"10.36660\/abc.20230049","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T12:04:10Z","timestamp":1716984250000},"source":"Crossref","is-referenced-by-count":2,"title":["Avalia\u00e7\u00e3o Cr\u00edtica do Manejo da Angina Inst\u00e1vel em Pronto-Socorro Terci\u00e1rio de Cardiologia"],"prefix":"10.36660","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3267-4969","authenticated-orcid":false,"given":"Mateus Arantes","family":"Prata","sequence":"first","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4823-9673","authenticated-orcid":false,"given":"Louis Nakayama","family":"Ohe","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4407-2906","authenticated-orcid":false,"given":"Kelvin Henrique","family":"Vilalva","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-9163","authenticated-orcid":false,"given":"Lucas Ferreira Marcondes","family":"Lemos","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7096-3193","authenticated-orcid":false,"given":"Paola Emanuela Poggio","family":"Smanio","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil; Fleury Group,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2024]]},"reference":[{"issue":"25","key":"ref1","first-page":"2982","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update from the GBD 2019 Study","volume":"76","author":"Roth GA","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"ref2","series-title":"DATASUS. 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