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1.
Arq. bras. cardiol ; 105(5): 466-471, Nov. 2015. tab
Article Dans Anglais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: lil-764999

Résumé

AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD), a clinical (non-invasive) evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77), age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26), diabetes (OR, 2.01; CI 95%, 1.40 - 2.90), dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07), typical angina (OR, 2.92; CI 95%, 1.77 - 4.83) and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27).Conclusions:In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.


ResumoFundamento:Diretrizes recomendam que na suspeita de doença arterial coronariana (DAC) estável, uma avaliação clínica (não-invasiva) deve ser realizada antes da realização da coronariografia.Objetivo:Avaliar a eficácia da seleção de pacientes à coronariografia invasiva na suspeita de DAC estável.Métodos:Prospectivamente, selecionamos pacientes sem diagnóstico prévio de DAC referenciados a um centro terciário de grande volume. Características demográficas, fatores de risco, sintomatologia e resultados de exames não-invasivos foram correlacionados com a presença de DAC obstrutiva. Estimamos a probabilidade de DAC com base nos dados clínicos disponíveis e no valor incremental diagnóstico dos exames não-invasivos.Resultados:Um total de 830 pacientes foi incluído, mediana de idade de 61 anos, 49,3% homens, 81% hipertensos e 35,5% de diabéticos. Exames não-invasivos foram realizados em 64,8% dos pacientes. Na coronariografia, 23,8% dos pacientes tinham DAC obstrutiva. Os preditores independentes para DAC obstrutiva foram: sexo masculino (odds ratio [OR], 3,95; intervalo de confiança [IC] de 95%, 2,70 – 5,77), idade (OR por incremento de 5 anos, 1,15; IC 95%, 1,06 – 1,26), diabetes (OR, 2,01; IC 95%, 1,40 – 2,90), dislipidemia (OR, 2,02; IC 95%, 1,32 – 3,07), angina típica (OR, 2,92; IC 95%, 1,77 – 4,83) e teste não-invasivo prévio (OR 1,54; IC 95% 1,05 – 2,27).Conclusão:Nesse estudo, menos de um quarto dos pacientes referenciados a um centro terciário para a realização de coronariografia por suspeita de DAC estável teve o diagnóstico confirmado. Uma melhor avaliação clínica e maior acesso a exames não-invasivos são necessários para aumentar a eficácia da seleção de pacientes para coronariografia invasiva.


Sujets)
Humains , Mâle , Femelle , Adulte d'âge moyen , Sujet âgé , Coronarographie/méthodes , Maladie des artères coronaires , Sélection de patients , Électrocardiographie , Méthodes épidémiologiques , Valeurs de référence
2.
Rio de Janeiro; Elsevier; 2010. ", "_f": "7", "_l": "78 p. (Nova série monográficas Dante Pazzanese Fundação Adib Jatene).
Monographie Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1073001

Sujets)
Cardiologie
3.
Rio de Janeiro; Elsevier; 2009. 557 p. (Nova Série Monografias Dante Pazzanese Fundação Adib Jatene).
Monographie Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1072986

Sujets)
Cardiologie
4.
São Paulo; RSpress; 2008. n.p (Nova Série Monografias Dante Pazzanese Fundação Adib Jatene 2008).
Monographie Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1073008

Sujets)
Cardiologie
5.
São Paulo; RS Press; 2008. 68 p. (Nova Série Monografias DANTE PAZZANESE Fundação Adib Jatene).
Monographie Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1078584
6.
Arq. bras. cardiol ; 86(03): 524-530, 9 de maio de 2006.
Article Dans Anglais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1059911

Résumé

Objective: To assess the performance of multidetector computed tomography in determining late clinical outcomes of patients undergoing sirolimus-eluting stent implantation.Methods: Thirty patients, successfully submitted to sirolimus-eluting stent implantation for more than six months, were


selected to participate in the study. All underwent invasive angiography and intravascular ultrasound following CT angiography


using iodinated contrast medium at a dose of 1.5 ml/kg.Results: Mean proximal reference diameter was 3.01 ± 0.31 mm by tomography and 3.14 ± 0.31 mm by angiography (p


= 0.04). When the left circumflex artery was excluded from the analysis, the difference between both examinations was


no longer significant (tomography = 3.01 ± 0.32 mm; angiography = 3.10 ± 0.30 mm, p = 0.65). Mean distal reference


diameter was 2.86 ± 0.30 mm by tomography and 2.92 ± 0.32 by angiography (p = 0.25). Mean in-stent minimal lumen


diameter was 2.85 ± 0.25 mm by tomography and 2.85 ± 0.29 mm by angiography (p = 0.27). Mean minimal in-stent crosssectional


area was 7.19 ± 1.47 mm2 by tomography and 6.90 ± 1.52 mm2 by intravascular ultrasound (p = 0.36), but there


was only a weak correlation between these measurements (r = 0.33).Conclusion: Computed tomography allows the qualitative assessment of sirolimus-eluting stents, accurate estimate of proximal


and distal reference diameters of the target vessel, and in-stent minimal lumen diameter. Its correlation with measurements


performed using intravascular ultrasound, however, is less strong.


Sujets)
Angiographie , Défaillance cardiaque , Tomographie , Échographie interventionnelle
7.
In. Ellis, Stephen G; Holmes Jr, David R. Strategic approaches in coronary intervention. Philadelphia, Lippincott Williams & Wilkins, 3; 2006. p.181-187, ilus.
Monographie Dans Anglais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069452
10.
Rio de Janeiro; Revinter; 2005. 226 p. ilus.
non conventionnel Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069436

Sujets)
Cardiologie
11.
Rio de Janeiro; Revinter; 2005. 184 p. ilus.
non conventionnel Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069439

Sujets)
Cardiologie
12.
In. Serruys, Patrick W; Gershilick, Anthony H. Handbook of drug-eluting stents. New York, Taylor & Francis, 2005. p.103-107, ilus, tab, graf.
Monographie Dans Anglais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069447

Résumé

Takind advantage of the knowledge accumulated over decades of unsuccessful attempts to prevent restenosis, novel devices for local drug-eluting stents, have been developed in the recent years. Sirolimus eluting Bx Velocity stents is certainly one of these novel technologies that may finnally represent the "magic bullet" we have been searching for in our war against the restenosis. The first clinical evaluation of this new technology was initiated in December 1999. This endeavor was conducted at Institute Dante Pazzanese of Cardiology in São Paulo, Braziland at Thoraxcenter, Rotterdam, The Netherlands. The unparalleled 1-year out-come of this first series of patients treated with sirulimus-eluting stents (SES) paved the way to launch a more challenging pilot study involving only patients with in-stent restenosis, which was started in 2000...


Sujets)
Humains , Resténose coronaire/thérapie , Endoprothèses/tendances , Lésions traumatiques du coeur/thérapie
14.
In. Sousa, Amanda GMR; Buitrón, Fausto; Hayashi, Ernesto Ban; Sousa, J Eduardo; Sousa, Amanda GMR, d. Instituto Dante Pazzanese de Cardiologia. BrasilBuitrón, Fausto, d, nstituto del Corazón. UruguaiHayashi, Ernesto Ban, d, nstituto Nacional de Cardiologia Ignacio Chávez. MéxicoSousa, J Eduardo, d. Instituto Dante Pazzanese de Cardiologia. Brasil. Intervenciones Cardiovasculares SOLACI. São Paulo, Atheneu, 2005. p.153-159, tab.
Monographie Dans Espagnol | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069499
15.
In. Sousa, Amanda GMR; Buitrón, Fausto; Hayashi, Ernesto Ban; Sousa, J Eduardo; Sousa, Amanda GMR, d. Instituto Dante Pazzanese de Cardiologia. BrasilBuitrón, Fausto, d, nstituto del Corazón. UruguaiHayashi, Ernesto Ban, d, nstituto Nacional de Cardiologia Ignacio Chávez. MéxicoSousa, J Eduardo, d. Instituto Dante Pazzanese de Cardiologia. Brasil. Intervenciones Cardiovasculares SOLACI. São Paulo, Atheneu, 2005. p.249-261, ilus, tab.
Monographie Dans Espagnol | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069502
16.
In. Sousa, Amanda GMR; Buitrón, Fausto; Hayashi, Ernesto Ban; Sousa, J Eduardo; Sousa, Amanda GMR, d. Instituto Dante Pazzanese de Cardiologia. BrasilBuitrón, Fausto, d, nstituto del Corazón. UruguaiHayashi, Ernesto Ban, d, nstituto Nacional de Cardiologia Ignacio Chávez. MéxicoSousa, J Eduardo, d. Instituto Dante Pazzanese de Cardiologia. Brasil. Intervenciones Cardiovasculares SOLACI. São Paulo, Atheneu, 2005. p.409-418, tab.
Monographie Dans Espagnol | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069504
17.
Rio de Janeiro - RJ; Revinter; 2005. 226 p. (Série Monografias Dante Pazzanese Volume I - 2005. Edição Especial do Jubileu de Ouro, 1).
Monographie Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1078437
18.
Rio de Janeiro; Revinter; 2004. 198 p. ilus.
non conventionnel Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069428

Sujets)
Cardiologie
19.
Rio de Janeiro; Revinter; 2004. 166 p. ilus.
non conventionnel Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069431
20.
Rio de Janeiro; Revinter; 2003. 113 p. ilus.
non conventionnel Dans Portugais | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1069418

Sujets)
Cardiologie
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