RESUMO
We present 6-month follow-up of 435 patients undergoing stent deployment. Forty-four patients were referred because of myocardial ischemia related to the stented artery. In six of these patients (14%), the stented vessel revealed a new proximal lesion separated from the stented portion, which warranted further intervention. It is felt that these new lesions are related to the stenting technique as a result of local trauma induced from the guiding catheter.
Assuntos
Cateterismo/efeitos adversos , Doença das Coronárias/etiologia , Doença das Coronárias/terapia , Vasos Coronários , Doença Iatrogênica , Stents/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia Coronária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , RecidivaRESUMO
We recently showed that culture-derived metacyclic trypomastigotes (CMT), but not epimastigotes (Epi), of the Miranda 88 strain of Trypanosoma cruzi evade lysis by the human alternative complement pathway because of inefficient binding of factor B to complement component C3b on the parasite surface. These results suggested that CMT and tissue-culture-derived trypomastigotes (TCT), which also activate the alternative pathway poorly, might produce a molecule capable of interfering with factor B binding to C3b. We now demonstrate that CMT and TCT lysates, as well as molecules spontaneously shed from CMT and TCT but not Epi, accelerate decay of 125I-labeled factor Bb from the alternative-pathway C3 convertase (C3bBb) assembled on zymosan or Epi and also accelerate decay of the classical-pathway C3 convertase (C4b2a) on sheep erythrocytes. Parasites metabolically labeled with [35S]methionine spontaneously shed a limited number of radioactive components ranging in molecular mass from 86 to 155 kDa for trypomastigotes and 25 to 80 kDa for Epi. Decay-accelerating activity within supernatants is inactivated by papain and is coeluted with 35S-containing polypeptides on FPLC anion-exchange chromatography, suggesting that the active constituents are protein molecules. Molecules with decay-accelerating activity may explain the developmentally regulated resistance to complement-mediated lysis in infective and vertebrate stages of the T. cruzi life cycle.