&lt;![CDATA[&lt;B&gt;Is the best option of treatment being offered to patients with multiple coronary artery diseases?&lt;/B&gt;]]&gt;

Almeida, Rui

doi:10.1590/s1678-97412006000200002

Cited by 1 publication

(1 citation statement)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering the worldwide evidence that indicates a reduced number of surgical revascularizations compared with a simultaneous and significant increase in the percutaneous approaches, with or without coronary stent implantation [ 16 ] , concepts such as cost-effectiveness and ischemia-free survival or re-intervention justify the real concern of the assistant cardiologist regarding the appropriate clinical monitoring of these patients. In this context, a recent review published by Andrade et al [ 17 ] demonstrated that the comparison between percutaneous and surgical revascularization approaches is controversial even when it is based only on the most robust randomized clinical trials and mainly when it includes studies conducted in different stages of the interventional cardiology (period of exclusive use of balloon catheters compared with the subsequent advent of conventional coronary stents and, more recently, drug-eluting stents) and studies using different surgical techniques, considering whether the myocardial revascularization is associated to the cardiopulmonary bypass.…”

Section: Introductionmentioning

confidence: 99%

Management of multivessel coronary disease after primary angioplasty: staged reintervention versus optimized clinical treatment and two-year follow-up

Paula¹,

Godoy²,

Santos³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

View full text Add to dashboard Cite

Objective In the clinical scenario of ST-segment elevation acute myocardial infarction, several patients with multivessel coronary atherosclerotic disease are discharged without a defined strategy to monitor the residual atherosclerotic lesions. The clinical endpoints evaluated were cardiovascular death, symptoms of angina pectoris, rehospitalization for a new acute coronary syndrome, and the necessity of reintervention during the two-year follow-up. MethodsThis observational, prospective, and historical study included multivessel coronary atherosclerotic disease patients who were admitted to a tertiary care university hospital with ST-segment elevation acute myocardial infarction and underwent primary percutaneous coronary intervention with stent implantation only at the culprit lesion site; these patients were monitored in the outpatient clinic according to two treatments: the Clinical Group - CG (optimized pharmacological therapy associated with counseling for a healthy diet and cardiac rehabilitation) or the Intervention Group - IG (new staged percutaneous coronary intervention or surgical coronary artery bypass graft surgery combined with the previously prescribed treatment). Results Of 143 patients consecutively admitted with ST-segment elevation acute myocardial infarction, 57 were eligible for the study (CG=44 and IG=13). Regarding the clinical endpoints, the cardiovascular death rate did not differ between the CG and IG. The symptom of angina pectoris and the rehospitalization rate for a new episode of acute coronary syndrome were accentuated in the CG (P=0.020 and P=0.049, respectively) mainly in individuals with evidence of ischemia evidenced by myocardial scintigraphy (P<0.001 and P=0.001, respectively) which culminated in an even greater need for reintervention (P=0.001) in this subgroup of patients. Conclusion The staged intervention was demonstrated to be safe and able to reduce angina pectoris and rehospitalization for a new episode of acute coronary syndrome. In addition, it decreases the likelihood of unplanned reinterventions of patients without ischemia evidenced by myocardial scintigraphy.

show abstract

Section: Introductionmentioning

confidence: 99%