Resultados alejados de la angioplastía coronaria en Chile en elRegistro Nacional de Angioplastía Coronaria (RENAC) 2001-2002 / Long-term results of coronary angioplasty in Chile according to the National Registry of Angioplasty (RENAC)

Introducción: En el año 2004 publicamos los resultados intrahospitalarios del primer registro chileno de angioplastía coronaria (AC), RENAC. Sin embargo, la información nacional sobre los resultados alejados de la AC en Chile hasta la fecha ha sido escasa y parcelar. Objetivo: Evaluar los resultados alejados de la angioplastía coronaria en pacientes sin infarto agudo de miocardio (IAM) en el país. Pacientes y métodos: Seis de los 10 centros participantes en el RENAC entre junio de 2001 y octubre de 2002 efectúan seguimiento clínico alejado de sus pacientes. Resultados: De un total de 892 pacientes sin IAM sometidos a AC y dados de alta vivos, se obtuvo seguimiento clínico en 744 (83,3 por ciento) y en 772 (86,5 por ciento) sólo de su estado vital. La mayoría había presentado un síndrome coronario agudo y en el 88,7 por ciento fueron sometidos a angioplastía de un vaso. El 84,8 por ciento de las 936 lesiones fueron tratadas con stents. Se obtuvo éxito angiográfico en el 97,2 por ciento de las lesiones y clínico en un 97,6 por ciento de los pacientes. Al cabo de un seguimiento promedio de 21 meses, la mortalidad cardíaca fue de 0,9 por ciento y la total de 1,7 por ciento. Se efectuó una nueva revascularización del vaso tratado en el 5,5 por ciento de los pacientes. La sobrevida libre de eventos isquémicos mayores fue de 90,0 por ciento. Conclusiones: Los resultados extrahospitalarios de pacientes sin IAM y sometidos a AC en Chile muestran una baja mortalidad cardíaca, una baja frecuencia de revascularización del vaso tratado y una alta sobrevida libre de eventos isquémicos.

Background: In 2004 we published the in-hospital results of the first Chilean coronary angioplasty registry (RENAC). To date the long-term results of coronary angioplasty in Chile is scant. Aim: To assess the long-term results of coronary angioplasty in patients without acute myocardial infarction in Chile. Patients and Methods: Six out of 10 participating centers in RENAC between June 2001 and October 2002, providedclinical follow-up of their patients. Results: A total of 892 patients without acute myocardial infarction underwent angioplasty and were discharged alive. In 744 (83,3 percent) patients clinical follow-up was obtained and in 772 (86,5 percent) only vital status could be ascertained. Most patients underwent one vessel angioplasty (88,7 percent) for an acute coronary syndrome. Stent implantation was performed in 84,8 percent of the 936 treated coronary lesions. Angiographic success was obtained in 97,2 percent of lesions and clinical success in 97,6 percent of patients. After an average follow-up of 21 months, cardiac and all cause mortality were 0,9 and 1,7 percent. Target vessel revascularization was performed in 5,5 percent and survival free of cardiac ischemic events was 90,0 percent Conclusions: Long-term results of coronary angioplasty in patients without an acute myocardial infarction shows low rates of cardiac death, target vessel revascularization and a high survival free of cardiac ischemic events.

Práctica contemporánea de la angioplastia coronaria en Chile: informe final del Registro Nacional de Angioplastia Coronaria (RENAC) 2001-2002 / Final report of the Chilean National Coronary Angioplasty Registry (RENAC)

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).