IJCS | Volume 31, Nº2, March / April 2018

138 Barros et al. Acute pulmonary edema. Coronary artery disease. Int J Cardiovasc Sci. 2018;31(2)133-142 Original Article Table 4 – Predictors of obstructive coronary artery disease (CAD) in acute pulmonary edema of unclear origin Predictors Obstructive CAD OR (IC95%) p value Yes (n = 89) No (n = 60) Age a 65.9 ± 9.1 64.7 ± 11.7 1.01 (0.98-1.05) 0.459 Male gender 31 (34.8) 23 (37.7) 0.88 (0.45-1.74) 0.719 Previous dyspnea 68 (76.4) 51 (83.6) 0.63 (0.28-1.46) 0.287 Ischemic pain 25 (28.1) 5 (8.2) 3.18 (0.83-12.3) 0.093 Diabetes 53 (59.5) 19 (31.1) 3.25 (1.64-6.47) 0.001 b Hypertension 77 (86.5) 45 (73.8) 2.28 (1.00-5.25) 0.053 Smoking 54 (60.7) 33 (54.1) 1.38 (0.71-2.70) 0.346 History of CAD 40 (44.9) 4 (6.6) 11.4 (3.81-34.2) 0.000† History of POAD 15 (16.8) 1 (1.6) 12.2 (1.56-94.7) 0.017† Previous Stroke 16 (18.0) 2 (3.3) 6.56 (1.44-29.7) 0.015† SBP on admission a 170.6 ± 37.7 175.6 ± 51.8 1.00 (0.99-1.01) 0.496 DBP on admission a 100.9 ± 24.0 99.4 ± 25.8 1.00 (0.99-1.02) 0.714 Ejection fraction a 44.1 ± 13.6 50.1 ± 15.6 0.97 (0.95-0.99) 0.018† Myocardium segmental deficit 46 (51.7) 7 (11.5) 8.33 (3.41-20.4) 0.000† Creatinine ≥ 1.2 mg% 32 (36.0) 12 (19.7) 2.12 (0.97-4.66) 0.060 ST depression, mm d 34 (38.2) 20 (32.8) 1.13 (0.50-2.55) 0.763 Dynamic ST depression mm d 27 (30.3) 16 (26.2) 1.17 (0.53-2.57) 0.699 ST elevation mm d 22 (24.7) 10 (31.2) 1.52 (0.40-1.79) 0.356 Q wave > 0.03" d 38 (42.7) 15 (24.6) 2.53 (1.11-5.77) 0.027† Negative T wave mm d 30 (33.7) 14 (23.0) 1.73 (0.75-3.94) 0.194 Dynamic T wave d 18 (20.2) 10 (16.4) 1.24 (0.50-3.07) 0.638 LBBB 17 (19.1) 12 (19.7) 0.89 (0.38-2.07) 0.788 LVH 34 (38.2) 24 (39.3) 0.84 (0.37-1.89) 0.672 Positive troponin ng/mL 48 (53.9) 29 (47.5) 1.29 (0.67-2.48) 0.442 Troponin (1 st day) ng/m 0.11 (0.056; 0.35) 0.054 (0.025; 0.13) 2.69 (1.30-5.58) ‡ 0.008† BNP 4.586 (1.862; 9.064) 2.223 (965; 4.960) 1.07 (1.01-1.15) // 0.047 a Mean ± standard deviation; b statistically significant association (p < 0.05); c median as reference; d in patients without left bundle branch block (101 patients); this elevation was not considered as acute myocardial infarction with ST elevation, but elevation of other etiologies, such as left ventricular hypertrophy and early repolarization; f increased chance of obstructive coronary disease at each increase of 1,000 BNP units. Results expressed as n (%), mean ± standard deviation and median - P25; P75. OR: odds ratio; 95% CI: 95% confidence interval; POAD: peripheral obstructive arterial disease; SBP: systemic blood pressure; DBP: diastolic blood pressure; LBBB: left bundle branch block; LVH: left ventricular hypertrophy; BNP: B-type natriuretic peptide. values were not able to differentiate between obstructive and non-obstructive CAD. The troponin elevation occurred, respectively, in 63% and 48% of the cases. This points to the following question: were more than half of the patients with APE going to have an acute myocardial infarction? Probably not, since the association between APE and acute myocardial infarction was more expected to be found during a