RESUMO
OBJECTIVE: To evaluate the immediate post procedure, thirty-days, and six-months clinical outcomes of sirolimus-eluting stents (SES) implantation in patients with single and multivessel coronary artery disease (CAD). METHODS: A case series of all consecutive patients undergoing percutaneous coronary interventions (PCI) with SES implantation at Shifa International Hospital, Islamabad, were evaluated at early post-procedure, 30-days and six-months clinical follow-up for the incidence of major adverse cardiac event (MACE). This included death, nonfatal myocardial infarction (MI) and repeat revascularization. RESULTS: Out of 206 consecutive patients, 324 had SES implanted. Cumulative MACE rate was 2.93% and 6% at 30-days and six-months follow-ups respectively. Five patients developed ST-segment elevation MI (STEMI). One patient developed non-STEMI. Emergency Coronary Artery Bypass Grafting (CABG) was done in two patients. Repeat (PCI) was carried in three (1.46%) patients for acute in-stent thrombosis. Diabetes Mellitus and multivessel stenting were found to be the independent predictors for acute in-stent thrombosis (P-value < 0.02 and 0.05 respectively). CONCLUSION: SES implantation in coronary artery disease can be safe and effective MACE at one and six months follow-ups.
Assuntos
Angioplastia Coronária com Balão , Doença da Artéria Coronariana/tratamento farmacológico , Stents Farmacológicos , Imunossupressores/uso terapêutico , Sirolimo/uso terapêutico , Doença da Artéria Coronariana/cirurgia , Doença da Artéria Coronariana/terapia , Reestenose Coronária/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Falha de Tratamento , Resultado do TratamentoRESUMO
'aVR' is usually not the preferred lead to diagnose myocardial infarction in clinical settings, it is rather a neglected lead in this context. We describe the case of a 44 year old male who presented with short duration chest pain and ST segment elevation in lead 'aVR'. His left heart catheterization showed left main stem equivalent disease and totally occluded right coronary artery. Patient underwent emergency coronary artery bypass-grafting with favorable outcome. This case highlights the significance of ST segment elevation in lead aVR during chest pain both in diagnosis and management of patients with acute coronary syndrome.
