Doença arterial coronária e diabetes: do tratamento farmacológico aos procedimentos de revascularização

Centemero, Marinella; Cherobin, Juliano Caetano; Conti, K.; Ohe, Louis Nakayama; Mallmann, Nicki; Abizaid, Alexandre; Farkouh, Michael E.; Fuster, Valentín

doi:10.1590/s2179-83972009000300018

Cited by 8 publications

(4 citation statements)

References 57 publications

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“…Estimates of the World Health Organization show that worldwide prevalence of this disease may have an increase of 114% during the next 20 years, leading to the emergence of 330 million new cases [ 1 ] . Brazil is following this global trend, and is included among the 10 countries with the highest absolute number of individuals with DM [ 2 ] . In this context, it is necessary to remember that one of the main causes of mortality related to DM is cardiovascular disease (CVD), especially coronary artery disease, accounting for 60% to 80% of deaths among adults.…”

Section: Introductionmentioning

confidence: 99%

Prognosis and Complications of Diabetic Patients Undergoing Isolated Coronary Artery Bypass Surgery

Santos¹,

Berto²,

Sousa³

et al. 2015

Brazilian Journal of Cardiovascular Surgery

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Objective:Compare the prognosis and complications of diabetic and non-diabetic patients undergoing isolated coronary artery bypass surgery at a hospital with a high surgical volume.Methods:Data of patients who underwent coronary artery bypass surgery from June 2009 to July 2010 were analyzed. We selected diabetic and non-diabetic patients and evaluated their postoperative and long-term prognosis based on clinical complications. To reduce the disparity within the sample, statistical analyses were performed using propensity scores.Results:We included 2,688 patients who underwent coronary artery bypass surgery; 36% of them had diabetes, their mean age was 62.1±9.49 years and 70% (1,884) of them were men. Patients with diabetes were older (63±9 years vs. 61±10 years; P<0.001), more often obese (BMI>25 kg/m2: 70.7% vs. 64.5%; P<0.001), dyslipidemic (50.4% vs. 41.1%; P<0.001), hypertensive (89.2% vs. 78.7%; P<0.001), and presented chronic renal failure (8.3% vs. 3.8%; P<0.001). They also presented higher rates of acute renal failure (5.6% vs. 2.7%, P<0.001), infection (11.4% vs. 7.2%, P<0.001) and mortality after one year (9.1% vs. 5.6%, P<0.001). Pneumonia was more common among patients with diabetes (7.7% vs. 4.0%, P<0.001). According to propensity scoring, 430 patients (215 diabetics and 215 non-diabetics) had a mean age of 61.3±8.97 years, and 21.2% (91 of 430) were women. However, diabetes was not an independent factor for poor prognosis.Conclusion:Patients with diabetes were at higher risk for postoperative complications and mortality after undergoing coronary artery bypass surgery. However, diabetes did not explain the poor prognosis of these patients after pairing this factor with the propensity score.

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Section: Introductionmentioning

confidence: 99%

Prognosis and Complications of Diabetic Patients Undergoing Isolated Coronary Artery Bypass Surgery

Santos¹,

Berto²,

Sousa³

et al. 2015

Brazilian Journal of Cardiovascular Surgery

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“…Sem o controle devido, a longo prazo pode acarretar em complicações, dentre as principais o déficit visual, insuficiência renal, amputações de membros, neuropatias e maior desenvolvimento de doenças cardiovasculares como infarto agudo do miocárdio (2)(3) . Ela é responsável por alterar várias funções celulares, principalmente endoteliais, musculares lisas e plaquetárias (4) , sendo que a disfunção do endotélio é o primeiro precursor fisiopatológico para o surgimento da aterosclerose, caracterizada por ocasionar processo inflamatório, trombose, rigidez arterial e redução do tônus e fluxo arterial (5)(6)(7) .…”

Section: Neuropatía Periférica Y Signos Clínicos De Síndrome Coronariunclassified

Neuropatia Periférica E Sinais Clínicos De Síndrome Coronariana Aguda Em Pacientes Com Diabetes Mellitus

et al. 2017

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RESUMO: Objetivou-se avaliar o nível de neuropatia periférica em pacientes diabéticos com síndrome coronariana aguda e sua associação com a intensidade dos sinais clínicos. Estudo prospectivo, transversal e quantitativo. Os dados foram coletados de novembro de 2015 a fevereiro de 2016 em um hospital na cidade de São Paulo. Foram analisados os sinais clínicos apresentados pelos pacientes com síndrome coronariana aguda portadores de diabetes mellitus e o nível de neuropatia periférica pela Escala de Sintomas Neuropáticos. Foram avaliados 50 pacientes, apresentaram dor precordial em aperto em 33 (66%) participantes, além da sudorese e dispneia. Sintomas neuropáticos foram identificados em 33 (66%) pacientes, não observada associação entre o nível de neuropatia e a intensidade dos sinais clínicos da síndrome coronariana aguda. A avaliação clínica realizada pelo enfermeiro em pacientes diabéticos com síndrome coronariana aguda deve ser feita de forma rigorosa, principalmente nos pacientes que podem apresentar sinais clínicos atípicos dependendo do grau de neuropatia periférica. DESCRITORES: Diabetes Mellitus; Síndrome coronariana aguda; Dor precordial; Neuropatias Diabéticas; Infarto.NEUROPATIA PERIFÉRICA E SINAIS CLÍNICOS DE SÍNDROME CORONARIANA AGUDA EM PACIENTES COM DIABETES MELLITUS PERIPHERAL NEUROPATY AND CLINICAL SIGNS OF ACUTE CORONARY SYNDROME IN PATIENTS WITH DIABETES MELLITUSABSTRACT: This study aimed to assess the severity of peripheral neuropathy in diabetic patients with acute coronary syndrome and its association with the severity of clinical signs. Prospective, cross-sectional and quantitative study. Data were collected from November 2015 to February 2016 in a hospital in the city of São Paulo. The clinical signs of diabetic patients with acute coronary syndrome were analyzed and the intensity of peripheral neuropathy was assessed using the Neuropathic Symptom Score (NSS). Fifty patients were assessed, and 33 (66%) participants had precordial catch syndrome, as well as sweating and dyspnea. Neuropathic symptoms were also identified in 33 (66%) patients, and there was no association between intensity of neuropathy and intensity of clinical signs of acute coronary syndrome. The clinical assessment of diabetic patients with acute coronary syndrome by nurses should be very careful, especially in patients with atypical clinical signs, depending onthe degree of peripheral neuropathy. DESCRIPTORS: Diabetes Mellitus; Acute coronary syndrome; Precordial pain; Diabetic neuropathies; Infarction. NEUROPATÍA PERIFÉRICA Y SIGNOS CLÍNICOS DE SÍNDROME CORONARIO AGUDO EN PACIENTES CON DIABETES MELLITUSRESUMEN: El objetivo fue evaluar el nivel de la neuropatía periférica en los pacientes diabéticos con síndrome coronario agudo y su asociación con la gravedad de los signos clínicos. Un estudio prospectivo, transversal y cuantitativo. Los datos fueron recolectados a partir de noviembre 2015 a febrero 2016 en un hospital de Sao Paulo. Se analizaron los signos clínicos observados en pacientes con síndrome coronario agudo...

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“…[1][2][3] The Firebird TM drug-eluting stent (Microport Co., Ltd. -Qinghai, China) has been approved for clinical use in China since 2005, and 350,000 units have been used worldwide. 4 This stent has a thin stainless steel strut platform with an ethylene vinyl acetate copolymer coating that releases sirolimus.…”

Section: Desempenho Do Stent Farmacológico Firebird™ Em Diabéticos Pomentioning

confidence: 99%

Desempenho do stent farmacológico firebird em diabéticos portadores de doença coronária multiarterial

Osterne¹,

Filho²,

Custódio³

et al. 2012

Rev. Bras. Cardiol. Invasiva

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Background: Preliminary data have shown that the Firebird TM and the Cypher ® stents have similar safety and efficacy profiles. However, to date, no study has evaluated percutaneous coronary intervention (PCI) with the Firebird TM stent in diabetic patients. Methods: The performance of the Firebird TM stent in diabetic patients with multivessel coronary artery disease (CAD) (n = 100) was compared with that of the Cypher ® stent using historical data from the ARTS-II study (n = 159). One-year major adverse cardiovascular events (MACE) were compared. Results: Most of the patients in the Firebird TM group were male (65%), with a mean age of 63.3 ± 10.4 years, and 5% were on insulin. Stable coronary syndrome was prevalent (60%), and 45% of patients had three-vessel CAD with preserved ventricular function (56.6 ± 13.7%). In patients with three-vessel CAD, 135 lesions were treated with three or more stents in 78% of cases and with two stents in the remainder. In patients with two-vessel CAD, 110 lesions were treated with two or more stents in 80% of the cases and with one stent in the remainder. The one-year incidence of MACE with the Firebird TM stent was 21%. Mortality occurred in 3% of the patients, myocardial infarction in 2%, and a new revascularisation procedure in 18%, predominantly a new PCI (14% of cases). Comparison with the Cypher ® group did not show differences for any of the evaluated endpoints. Conclusions: In the present study, the use of the Firebird TM stent showed similar results to those of the patients in the ARTS-II study, demonstrating its suitability for use in the complex scenario of diabetic patients with multivessel CAD.

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Doença arterial coronária e diabetes: do tratamento farmacológico aos procedimentos de revascularização

Cited by 8 publications

References 57 publications

Prognosis and Complications of Diabetic Patients Undergoing Isolated Coronary Artery Bypass Surgery

Prognosis and Complications of Diabetic Patients Undergoing Isolated Coronary Artery Bypass Surgery

Neuropatia Periférica E Sinais Clínicos De Síndrome Coronariana Aguda Em Pacientes Com Diabetes Mellitus

Desempenho do stent farmacológico firebird em diabéticos portadores de doença coronária multiarterial

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Doença arterial coronária e diabetes: do tratamento farmacológico aos procedimentos de revascularização

Cited by 8 publications

References 57 publications

Prognosis and Complications of Diabetic Patients Undergoing Isolated Coronary Artery Bypass Surgery

Prognosis and Complications of Diabetic Patients Undergoing Isolated Coronary Artery Bypass Surgery

Neuropatia Periférica E Sinais Clínicos De Síndrome Coronariana Aguda Em Pacientes Com Diabetes Mellitus

Desempenho do stent farmacológico firebird em diabéticos portadores de doença coronária multiarterial

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Product

Resources

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Desempenho do stent farmacológico firebird em diabéticos portadores de doença coronária multiarterial