Resultados clínicos de pacientes com reestenose intrastent não tratada com novo procedimento de revascularização

Gottschall, Carlos Antônio Mascia; Sarmento‐Leite, Rogério; Welter, D.; Quadros, Alexandre Schaan de

doi:10.1590/s2179-83972010000400011

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References 14 publications

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“…All seven (6.4%) patients who remained in clinical treatment after the diagnosis of ISR did not undergo a new revascularization procedure due to technical limitation. Our results corroborate the findings of Gottschall et al 38 , who described that patients with CISR not treated with a new revascularization procedure and who remained in long-term clinical treatment showed higher rates of MACE (death, AMI and CAGB), compared with patients who underwent a new revascularization procedure.…”

Section: Discussionsupporting

confidence: 91%

Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes

Marino

Nascimento

Rabelo

et al. 2014

Arquivos Brasileiros De Cardiologia

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BackgroundClinical in-stent restenosis (CISR) is the main limitation of coronary angioplasty with stent implantation.ObjectiveDescribe the clinical and angiographic characteristics of CISR and the outcomes over a minimum follow-up of 12 months after its diagnosis and treatment.MethodsWe analyzed in 110 consecutive patients with CISR the clinical presentation, angiographic characteristics, treatment and combined primary outcomes (cardiovascular death, nonfatal acute myocardial infarction [AMI]) and combined secondary (unstable angina with hospitalization, target vessel revascularization and target lesion revascularization) during a minimal follow-up of one year.ResultsMean age was 61 ± 11 years (68.2% males). Clinical presentations included acute coronary syndrome (ACS) in 62.7% and proliferative ISR in 34.5%. CISR was treated with implantation of drug-eluting stents (DES) in 36.4%, Bare Metal Stent (BMS) in 23.6%, myocardial revascularization surgery in 18.2%, balloon angioplasty in 15.5% and clinical treatment in 6.4%. During a median follow-up of 19.7 months, the primary outcome occurred in 18 patients, including 6 (5.5%) deaths and 13 (11.8%) AMI events. Twenty-four patients presented a secondary outcome. Predictors of the primary outcome were CISR with DES (HR = 4.36 [1.44–12.85]; p = 0.009) and clinical treatment for CISR (HR = 10.66 [2.53–44.87]; p = 0.001). Treatment of CISR with BMS (HR = 4.08 [1.75–9.48]; p = 0.001) and clinical therapy (HR = 6.29 [1.35–29.38]; p = 0.019) emerged as predictors of a secondary outcome.ConclusionPatients with CISR present in most cases with ACS and with a high frequency of adverse events during a medium-term follow-up.

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Section: Discussionsupporting

confidence: 91%