RESUMEN
BACKGROUND AND OBJECTIVES: The level of cardiac specific troponin (cTn) may be important in patients with acute coronary syndrome (ACS), but with normal electrocardiography (ECG). SUBJECTS AND METHODS: Three hundred and nineteen patients (61+/-11 years, M:F=212:107), with ACS and normal ECG, who underwent a diagnostic coronary angiogram (CAG), between July 2000 and June 2001, were analyzed according to their cTn level. The clinical characteristics, initial CAG findings and major adverse cardiac events (MACE), during a one-year clinical follow-up, were compared between positive and negative cTn groups. RESULTS: Of the enrolled patients, 191 had a negative cTn (group A, 61+/-10 years, M:F=131:60), and 128 a positive cTn (group B, 60+/-11 years, M:F=81:47), and 176 (55.2%) were shown to have significant coronary artery stenosis on CAG. There were no significant differences in risk factors between the two groups. The mean left ventricular ejection fraction was 64+/-9%, and was lower in group B than in group A (59+/-10% vs. 67+/-7%, p<0.05). cTn positivity was associated with the percentage of significant coronary artery stenosis present (88% vs. 32%, p<0.05), a smaller minimal luminal diameter (1.09+/-0.44 mm vs. 2.68+/-0.33 mm, p<0.05) and a larger diameter of stenosis (68+/-6% vs. 44+/-6%, p<0.05). A multi-vessel lesion was more common in group B than in group A (58.3% vs. 30.3%, p<0.05). During the one-year follow-up period, 36 patients developed MACE, resulting in 3 deaths, 7 acute myocardial infarctions and 34 patients with restenosis. MACE was observed in 9 patients of group A and in 27 of group B (4.7% vs. 21.1%, p<0.05). CONCLUSION: The troponin levels are valuable for the early diagnosis, and prediction of the long-term prognosis, in patients with ACS and a normal ECG.
Asunto(s)
Humanos , Síndrome Coronario Agudo , Angina Inestable , Constricción Patológica , Enfermedad Coronaria , Estenosis Coronaria , Diagnóstico Precoz , Electrocardiografía , Estudios de Seguimiento , Infarto del Miocardio , Fenobarbital , Pronóstico , Factores de Riesgo , Volumen Sistólico , TroponinaRESUMEN
BACKGROUND: The BiodivYsio stent is a balloon-expandable stent coated with phosphorylcholine designed to reduce the formation of thrombus and the risk of restenosis. METHODS: We prospectively studied 20 patients who underwent implantation of BiodivYsio stent (group I; 60.8+/-9.3 years, male 60.0%) and compared to 20 patients who underwent balloon angioplasty alone (group II; 60.3+/-7.9 years, male 45.0%) for small coronary arterial lesions (target arterial diameter was between 2.0 mm and 2.8 mm) between February 2001 and October 2001. Major adverse cardiac events such as acute myocardial infarction, target vessel revascularization and death were evaluated during hospital admission and at 6-months after percutaneous coronary intervention (PCI). RESULTS: During hospitalization, the incidence of acute myocardial infarction, target vessel revascularization and death was not different between the two groups. At follow-up coronary angiography 6 months after PCI, the incidence of restenosis was lower in group I than in group II (Group I; 3/20, 15.0% vs Group II; 9/20, 45.0%, p=0.032) and the incidence of target vessel revascularization (TLR) was lower in group I than in group II (Group I; 3/20, 15.0% vs Group II; 8/20, 40.0%, p=0.041). CONCLUSION: Coronary BiodivYsio stenting in small coronary artery leads to excellent short- and mid-term clinical outcomes.
Asunto(s)
Humanos , Masculino , Angioplastia de Balón , Angiografía Coronaria , Enfermedad de la Arteria Coronaria , Vasos Coronarios , Estudios de Seguimiento , Hospitalización , Incidencia , Infarto del Miocardio , Intervención Coronaria Percutánea , Fosforilcolina , Estudios Prospectivos , Stents , TrombosisRESUMEN
BACKGROUND: The BiodivYsio stent is a balloon-expandable stent coated with phosphorylcholine designed to reduce the formation of thrombus and the risk of restenosis. METHODS: We prospectively studied 20 patients who underwent implantation of BiodivYsio stent (group I; 60.8+/-9.3 years, male 60.0%) and compared to 20 patients who underwent balloon angioplasty alone (group II; 60.3+/-7.9 years, male 45.0%) for small coronary arterial lesions (target arterial diameter was between 2.0 mm and 2.8 mm) between February 2001 and October 2001. Major adverse cardiac events such as acute myocardial infarction, target vessel revascularization and death were evaluated during hospital admission and at 6-months after percutaneous coronary intervention (PCI). RESULTS: During hospitalization, the incidence of acute myocardial infarction, target vessel revascularization and death was not different between the two groups. At follow-up coronary angiography 6 months after PCI, the incidence of restenosis was lower in group I than in group II (Group I; 3/20, 15.0% vs Group II; 9/20, 45.0%, p=0.032) and the incidence of target vessel revascularization (TLR) was lower in group I than in group II (Group I; 3/20, 15.0% vs Group II; 8/20, 40.0%, p=0.041). CONCLUSION: Coronary BiodivYsio stenting in small coronary artery leads to excellent short- and mid-term clinical outcomes.