ABSTRACT
BACKGROUND: Previous evidence suggests that acute treatment with statins reduce atherosclerotic complications, including periprocedural myocardial infarction, but currently, there are no large, adequately powered studies to define the effects of early, high-dose statins in patients with acute coronary syndrome (ACS) and planned invasive management. OBJECTIVES: The main goal of Statins Evaluation in Coronary procedUres and REvascularization (SECURE-PCI) Trial is to determine whether the early use of a loading dose of 80 mg of atorvastatin before an intended percutaneous coronary intervention followed by an additional dose of 80 mg 24 hours after the procedure will be able to reduce the rates of major cardiovascular events at 30 days in patients with an ACS. DESIGN: The SECURE-PCI study is a pragmatic, multicenter, double-blind, placebo-controlled randomized trial planned to enroll around 4,200 patients in 58 different sites in Brazil. The primary outcome is the rate of major cardiovascular events at 30 days defined as a composite of all-cause mortality, nonfatal acute myocardial infarction, nonfatal stroke, and coronary revascularization. SUMMARY: The SECURE PCI is a large randomized trial testing a strategy of early, high-dose statin in patients with ACS and will provide important information about the acute treatment of this patient population.
Subject(s)
Acute Coronary Syndrome/drug therapy , Acute Coronary Syndrome/surgery , Atorvastatin/therapeutic use , Percutaneous Coronary Intervention/methods , Acute Coronary Syndrome/diagnostic imaging , Acute Coronary Syndrome/mortality , Aged , Anticholesteremic Agents/therapeutic use , Brazil , Dose-Response Relationship, Drug , Double-Blind Method , Drug Administration Schedule , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Myocardial Revascularization/methods , Myocardial Revascularization/mortality , Percutaneous Coronary Intervention/mortality , Postoperative Care/methods , Preoperative Care/methods , Prognosis , Proportional Hazards Models , Risk Assessment , Survival Rate , Treatment OutcomeABSTRACT
The aim of this study was to evaluate the effect of different output powers of Er,Cr:YSGG laser and the association with tribochemical silica coating on the bond strength between zirconia ceramic and two resin cements. One hundred ninety-two zirconia ceramic bars (IPS e-max ZirCAD Ivoclar Vivadent-) were sectioned (6 × 6 × 4 mm), sintered, and randomly divided into 12 groups for each cement system according to the surface treatment (n = 8): C-without treatment (control); R-tribochemical coating + resin cement (control); 2L-laser (2.0 W) + resin cement; 2LR-laser (2.0 W) + tribochemical coating + resin cement; R2L-tribochemical coating + laser (2.0 W) + resin cement; 2.5L-laser (2.5 W) + resin cement; 2.5LR-laser (2.5 W) + tribochemical coating + resin cement; R2.5L-tribochemical coating + laser (2.5 W) + resin cement; 3L-laser (3.0 W) + resin cement; 3LR-laser (3.0 W) + tribochemical coating + resin cement, R3L-tribochemical coating + laser (3.0 W) + resin cement; and RPHO-tribochemical + resin cement + photoactivation (control). After the surface treatment, the respective primers were applied, and resin cements, Multilink N, Ivoclar Vivadent (M), and Panavia F 2.0, Kuraray Medical Inc. (P), were inserted into Tygon molds which were bonded to the zirconia bars. Each specimen received two cements bars. After 24 h of storage in a relative humidity (100%) at 37 °C, they were evaluated by the microshear test speed of 1 mm/min. The microshear values were analyzed by one-way ANOVA and Tukey's test (α = 0.05). ANOVA showed statistically significant differences among the evaluated groups. The highest bond strength was observed in RPHO, which statistically differed from all groups. The lowest bond strength was observed in M2.5L (Multilink N) and in P3LR (Panavia F 2.0). It can be concluded that the lowest power output tested was suitable and showed bond strength values similar to tribochemical silica deposition. The light curing is important to adhesion and the tribosilicatizated surface achieves similar microshear values to untreated surface in absence of light.