Impacto dos stents e do sirolimus por via oral na vasomotilidade coronariana dependente e independente do endotelio

Fernandes, Rósley Weber Alvarenga; Dantas, João Miguel Malta; Oliveira, Dinaldo Cavalcanti; Bezerra, Hiram G.; Brito, Fábio Sândoli de; Lima, Valter C.

doi:10.1590/s0066-782x2012005000022

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…The greater sympathetic activation during bare-metal stent implantation cannot be attributed to the anatomical characteristics of the stent or of the balloon, or even to the hemodynamic variables, because no statistical difference was observed. The endothelium-dependent vasomotor response, occurring hours after stent implantation 32 and mainly related to first-generation stents, was not assessed to explain that sympathetic response. Stent implantation triggers several biological responses, such as prosthesis-induced lesion, thrombus formation, inflammation and smooth-muscle cell proliferation, resulting in vasomotor dysfunction 13,33 .…”

Section: Discussionmentioning

confidence: 99%

Spectral Analysis Related to Bare-Metal and Drug-Eluting Coronary Stent Implantation

Silva¹,

Silva²,

Greco³

et al. 2014

Arquivos Brasileiros De Cardiologia

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BackgroundThe autonomic nervous system plays a central role in cardiovascular regulation; sympathetic activation occurs during myocardial ischemia. ObjectiveTo assess the spectral analysis of heart rate variability during stent implantation, comparing the types of stent. MethodsThis study assessed 61 patients (mean age, 64.0 years; 35 men) with ischemic heart disease and indication for stenting. Stent implantation was performed under Holter monitoring to record the spectral analysis of heart rate variability (Fourier transform), measuring the low-frequency (LF) and high-frequency (HF) components, and the LF/HF ratio before and during the procedure. ResultsBare-metal stent was implanted in 34 patients, while the others received drug-eluting stents. The right coronary artery was approached in 21 patients, the left anterior descending, in 28, and the circumflex, in 9. As compared with the pre-stenting period, all patients showed an increase in LF and HF during stent implantation (658 versus 185 ms2, p = 0.00; 322 versus 121, p = 0.00, respectively), with no change in LF/HF. During stent implantation, LF was 864 ms2 in patients with bare-metal stents, and 398 ms2 in those with drug-eluting stents (p = 0.00). The spectral analysis of heart rate variability showed no association with diabetes mellitus, family history, clinical presentation, beta-blockers, age, and vessel or its segment. ConclusionsStent implantation resulted in concomitant sympathetic and vagal activations. Diabetes mellitus, use of beta-blockers, and the vessel approached showed no influence on the spectral analysis of heart rate variability. Sympathetic activation was lower during the implantation of drug-eluting stents.

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Section: Discussionmentioning

confidence: 99%

Spectral Analysis Related to Bare-Metal and Drug-Eluting Coronary Stent Implantation

Silva¹,

Silva²,

Greco³

et al. 2014

Arquivos Brasileiros De Cardiologia

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Randomized Comparison Between bare-metal Stent Plus Colchicine Versus drug-eluting Stent Alone in Prevention of Clinical Adverse Events After Percutaneous Coronary Intervention

et al. 2020

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The use of colchicine is associated with a significant reduction of cardiac adverse events in patients with coronary artery disease. Past small randomized trials with oral immunosuppressive or anti-inflammatory therapies have demonstrated a reduction of adverse clinical events after bare metal stent implantation. The potential role of adjunctive colchicine after bare-metal stent implantation, compared with drug-eluting stent alone, is unknown. The primary end point of the study will be to compare cost–effectiveness at 1 year of follow-up of coronary intervention with bare-metal stent implantation plus 1 mg of colchicine during 3 months versus percutaneous coronary intervention with drug-eluting stent implantation alone. ClinicalTrials.gov identifier: NCT04382443

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Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Marzà-Florensa

Drotos

Gulayin

et al. 2022

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Background: Coronary heart disease (CHD) is the most common cause of death globally, and clinical guidelines recommend cardioprotective medications for patients with established CHD. Suboptimal use of these medications has been reported, but information from South America is scarce. Methods: We conducted a systematic review on prevalence of secondary prevention medication in South America. We pooled prevalence estimates, analysed time-trends and guideline compliance, and identified factors associated with medication use with meta-regression models. Results: 73 publications were included. Medication prevalence varied by class: beta-blockers 73.4%(95%CI 66.8%–79.1%), ACEI/ARBs 55.8%(95%CI 49.7%–61.8), antiplatelets 84.6%(95%CI 79.6%–88.5%), aspirin 85.1%(95%CI 79.7%–89.3%) and statins 78.9%(95%CI 71.2%–84.9%). The use of beta-blockers, ACEI/ARBs and statins increased since 1993. Ten publications reported low medication use and nine reported adequate use. Medication use was lower in community, public and rehabilitation settings compared to tertiary centres. Conclusion: Cardioprotective medication use has increased, but could be further improved particularly in community settings.

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Impacto dos stents e do sirolimus por via oral na vasomotilidade coronariana dependente e independente do endotelio

Abstract: Background: There is no consensus regarding the impact of stenting on long-term endothelial function. There have been reports of increased endothelial dysfunction with sirolimus-eluting stents as compared to bare metal stenting (BMS).

Cited by 3 publications

References 26 publications

Spectral Analysis Related to Bare-Metal and Drug-Eluting Coronary Stent Implantation

Spectral Analysis Related to Bare-Metal and Drug-Eluting Coronary Stent Implantation

Randomized Comparison Between bare-metal Stent Plus Colchicine Versus drug-eluting Stent Alone in Prevention of Clinical Adverse Events After Percutaneous Coronary Intervention

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

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