Evolução clínica pós-stent coronário em pacientes submetidos a transplante de rim / Clinical outcome of renal transplant patients after coronary stenting
Rev. bras. cardiol. invasiva
;
14(4): 386-390, out.-dez. 2006. graf, tab
Article
in Portuguese
| LILACS
| ID: lil-441117
RESUMO
Objetivo:
Avaliar a evolução clínica de pacientes submetidos a transplante de rim, portadores de doença arterial coronariana, que foram tratados com implante de stent coronariano (ATC-ST).Método:
Entre julho de 1998 e novembro de 2004, foram realizados, no total, 3.334 transplantes de rim em nossa instituição (Hospital do Rim e Hipertensão - HRH). Desse total, 33 pacientes previamente submetidos a transplante de rim fizeram ATC-ST para tratamento de 62 estenoses graves em 54 artérias coronárias, nos quais foi realizada análise retrospectiva. O registro dos eventos clínicos foi feito por meio de análise do prontuário médico, consulta médica e ligações telefônicas.Resultados:
No seguimento clínico de 30 meses, após a ATC-ST, observouse que 64% dos pacientes permaneceram assintomáticos, 18% dos pacientes apresentaram quadro de angina estável, 6% apresentaram síndrome coronariana aguda sem supra de ST e 3% apresentaram síndrome coronariana aguda com supra de ST. Houve três (9%) mortes não cardíacas. Não houve pacientes com acidente vascular cerebral, insuficiência cardíaca congestiva ou morte cardíaca. Foi observado índice de reestenose de 9%, o qual é comparável aos estudos de stent farmacológico.Conclusão:
Concluímos que pacientes submetidos a transplante de rim, que desenvolveram doença arterial coronariana e que foram tratados com stent coronário, tiveram baixo porcentual de reestenose clínica, provavelmente relacionado ao regime de imunossupressão administrado para evitar a rejeição renal.ABSTRACT
Objective:
To assess the clinical outcome of renal transplant patients who developed coronary artery disease and were treated with coronary stenting (TCA-ST).Method:
A total of 3.334 renal transplants were performed in our service-Hospital do Rim e Hipertensão-HRH (Kidney and Hypertension Hospital) from July,1998 to November, 2004. During this period, 33 of the renal transplant patients underwent TCA-ST to treat 62 severe stenoses treated in 54 coronary arteries. A retrospective analysis was performed with renal transplant patients undergoing TCA-ST at HRH. The clinical events were registered using medical charts, medical visits and phone calls.Results:
During the 30 months clinical follow-up after TCA-ST, 64% of the patients remained asymptomatic, 18% presented stable angina, 6% presented acute coronary syndrome without ST-segment elevation (ACSWSTE) and 3% presented acute coronary syndrome with ST-segment elevation (ACSSTE). Three (9%) noncardiac deaths occurred. No strokes, CHF or cardiac deaths were observed. A restenosis rate of 9% was observed, which is comparable to those found in studies on drug-eluting stents.Conclusion:
In conclusion, renal transplant patients who developed coronary artery disease and were treated withcoronary stenting had a low rate of in-stent restenosis, probably related to the immunosuppressive regimen given to prevent kidney rejection.
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Index:
LILACS (Americas)
Main subject:
Stents
/
Kidney Transplantation
/
Coronary Disease
Type of study:
Etiology study
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
Portuguese
Journal:
Rev. bras. cardiol. invasiva
Journal subject:
Cardiology
/
General Surgery
Year:
2006
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade Federal de São Paulo/BR
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