RESUMO
Background:Re-stenosis after percutaneous Coronary Angioplasty (PTCA) is related to clinical and angiographic features. Aim: To describe the clinical and angiographic characteristic of our patients with coronary cardiopathy subjected to PTCA and the predictor factors for re-stenosis. Material and methods: We gathered the clinical and angiographic characteristics of all patients who underwent a successful PTCA of a native coronary artery. All patients had a clinical assessment one year after the procedure. Patients were classified in Group 1, if they did not have angina or coronary events after the angioplasty or Group 2, if they had angina or a coronary event after the procedure. Only Group 2 patients were subjected to a coronary angiogram. Results: We collected 383 PTCA procedures. Follow up information was obtained in 92.2 percent. Three hundred forty two patients (89.3 percent) were assessed one year the procedure. Nine patients (2.3 percent) died of a cardiovascular cause. Ninety patients (26.3 percent) were classified in Group 2. In 65 patients, angiographic re-stenosis was demonstrated (19 percent). Re-stenosis occurred in 36 and 13 percent of patients with an without Diabetes Mellitus, respectively (p <0.01). The other clinical predictor variables were a history of myocardial infarction (p =0.007), obesity (p =0.041) and hypercholesterolemia (p =0.050). None of the angiographic characteristics predicted restenosis. Stents were protective factors against restenosis (15.6 percent in stented lesions vs 25.4 percent in nonstented; p =0.01). Conclusions: Re-stenosis after angioplasty occured in 19 percent of our patients with angina or coronary events. The clinical variables associated with a higher risk of re-stenosis were diabetes (the main risk factor), previous myocardial infarction, obesity and hypercholesterolemia. Angiographic variables were not associated with re-stenosis. The use of stents decreases the incidence of re-stenosis in all groups).
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Angioplastia Coronária com Balão , Estenose Coronária/terapia , Stents , Reestenose Coronária/prevenção & controle , Reestenose Coronária , Estenose Coronária , Seguimentos , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
Background:Coronary angioplasty was introduced in Chile in 1982, but only after the introduction of stents it became commonplace. However, the results of this procedure at the national level remain largely unknown. Aim: To assess the results and characteristics of coronary angioplasty and develop a national registry in Chile (RENAC). Patients and Methods: All centers performing angioplasty were invited to contribute prospectively with the clinical, angiographic, procedural characteristics and results of all consecutive coronary angioplasty procedures attempted between June 2001 and October 2002. Results: In 10 centers, 1768 lesions were treated in 1484 procedures (22.98 percent in women). Mean age was 60.8±11.3 years old. Diabetes was found in 21.8 percent, hypertension in 60.2 percent, dyslipidemia in 52.0 percent, active smoking in 40.0 percent, renal failure in 6.2 percent. Myocardial infarction was recent in 28.4 percent and acute in 19.7 percent. Forty eight percent of patients had unstable angina and 15.5 percent had stable angina. Fifty three percent of patients had single vessel disease and 71 percent, normal left ventricular eyection fraction. One vessel was treated in 90.6 percent of patients and 81.7 percent of lesions were treated with stents, 17.9 percent only with baloon and in 0.4 percent with atherectomy. Angiographic success was obtained in 95.2 percent. Clinical success was obtained in 92.2 percent, and 95.1 percent in patients without acute myocardial infarction. Overall inhospital death was 2.2 percent. In patients without myocardial infarction, the figure was 1.1 percent. Conclusions: Coronary angioplasty in Chile is performed mostly for the treatment of acute coronary syndromes. Stents are the most frequently used devices. The high success, low mortality and complications observed are comparable to North American registries (Rev Méd Chile 2004; 132: 913-22).
Assuntos
Adulto , Masculino , Humanos , Feminino , Idoso , Angioplastia Coronária com Balão , Doença das Coronárias/terapia , Sistema de Registros , Prática ProfissionalRESUMO
Para la evaluación preoperatoria del paciente cardiópata, es básico considerar detalladamente las condiciones clínicas del enfermo; sus antecedentes mórbidos y factores de riesgo asociados (predictores), así como el tipo de cirugía al cual será sometido