ABSTRACT
OBJECTIVE: To evaluate the impact of chronic kidney disease on the survival of patients - 80 years of age undergoing percutaneous coronary intervention (PCI) in the long term. METHODS: 273 subjects who underwent PCI between January 2010 and January 2016 were divided into four categories: (1) stable angina (SA) and creatinine clearance - 30 (n=24); (2) patients with SA and CrCl <30 (n=70); (3) patients with acute coronary syndrome (ACS) and CrCl - 30 (n=51); (4) patients with ACS and ICC <30 (n=128). Mortality curves were evaluated using the Kaplan-Meier method and differences between groups were compared by log-rank statistic. Multivariate analysis was performed using the Cox proportional hazards method. The 4 groups were compared and the survival between the groups was evaluated. RESULTS: Octogenarian patients with CrCl <30 with SA and ACS have lower long-term survival (p<0.0001). CONCLUSION: CKD has a worse long-term prognosis for patients undergoing PCI.
Subject(s)
Acute Coronary Syndrome/mortality , Percutaneous Coronary Intervention , Renal Insufficiency, Chronic/complications , Acute Coronary Syndrome/complications , Acute Coronary Syndrome/surgery , Aged, 80 and over , Brazil/epidemiology , Cause of Death/trends , Creatinine/metabolism , Female , Follow-Up Studies , Glomerular Filtration Rate , Humans , Male , Prognosis , Renal Insufficiency, Chronic/mortality , Renal Insufficiency, Chronic/physiopathology , Retrospective Studies , Risk Factors , Survival Rate/trends , Time FactorsABSTRACT
In this work are reported two cases of anomalous aortic origin of a coronary artery (AAOCA), with the left main coronary artery (LMCA) arising at the right sinus of Valsalva in a 77-year-old woman and in a 79-year-old man submitted to angiography after positive ischemic tests. The origin of the LMCA or the left descendant artery (LDA) from the right sinus of Valsalva has a prevalence of 0.2%, the origin of the circumflex artery (CXA) from the right sinus 0.5%, and the origin of the right coronary artery (RCA) from the left sinus of Valsalva has a prevalence of 0.3%. It is the subgroup of the coronary anomalies that has the greatest potential for clinical repercussions, especially the sudden cardiac death (SCD). We discuss the diagnostic methods and treatment options for this kind of coronary anomaly in symptomatic cases.
