Progressão da aterosclerose coronária avaliada pela coronariografia, em portadores de doença multiarterial submetidos a tratamento clínico, cirúrgico ou angioplastia / The progression of atherosclerotic coronary disease assessed by coronary arteriography in patients with multivessel coronary disease undergoing medicine: angioplasty, or surgery treatments

RESUMO

Comparou-se a progressão da aterosclerose nos enxertos e nas artérias coronárias nativas de pacientes submetidos de maneira randomizada, aos tratamentos clínico, cirúrgico ou angioplastia. Foram incluídos 611 pacientes portadores de doença coronariana multiarterial estável DAC e função ventricular preservada. Coronariografia foi realizada após 5 anos. Considerou-se progressão surgimento de estenose ou aumento de 20 por cento. Dos 392 pacientes re-estudados, 136 eram do grupo Cirúrgico, 146 do grupo Angioplastia, e 110 do grupo Clínico. Observou-se maior progressão DAC em território de DA em relação aos territórios CX e CD no grupo Angioplastia e, mais freqüentemente, nos pacientes com HAS p=0,048...

ABSTRACT

Progression of atherosclerosis in coronary artery disease (CAD) was evaluated in native coronary arteries and bypass grafts in patients undergoing surgery (CABG), angioplasty (PCI), or medical strategy (MT). Atherosclerotic lesion was assessed in 611 patients, and, after a 5-year of follow-up in 392 patients (64 per cent). Analysis of progression within the three groups showed a more significant progression of atherosclerosis in the left anterior descending (LAD) territories of the PCI group. Among the factors related to progression, there was a significant influence of hypertension (p=0.048). Higher incidence of occlusion was found in male patients (p=0.0078) and in patients with a new Myocardial Infarction. (p=0.0006). There was no statistical difference between coronary events and the development of progression in the sample studied. PCI group showed more progression, especially in the LAD territories, and occurred more frequently in hypertensive patients.