Predictive factors of complications after coronary stent implantation

Abstract

Percutaneous coronary interventions are currently the main technique for myocardial revascularization, and stents have been used in more than 70% of these procedures, reducing restenosis and in-hospital mortality [1][2][3] . Based on the last studies on coated stents and the perspective that restenosis should be drastically reduced 4 , the occurrence or not of complications and the clinical success of the procedure should become the major limitation of this technique. Although many randomized clinical assays have suggested the almost nonexistence of complications, data illustrating the so-called "real world" of clinical practice are not so encouraging. In the recently published dynamic NHLBI registry, the incidence of acute myocardial infarction remained around 3%, of urgent surgery around 1.5%, of death around 2%, and overall success of the procedure around 92% 1 . However, few studies have analyzed the predictive factors of complications after percutaneous procedures using only stents [5][6][7][8][9][10][11][12] . Predictive models of complications based on angioplasty studies may overestimate events when applied to a series of patients treated only with stents 5 . Variations in the populations studied and in the criteria of the definition of success and complications reduce the external validity of the studies available 13,14 . Aiming at analyzing predictive factors of complications in patients undergoing stent implantation, we carried out a consecutive cohort study with 1,018 patients undergoing 1,070 stent implantations at a referral hospital for interventional cardiology. MethodsIn the period from April 1996 to December 2000, 1,092 coronary stents were implanted in 1,030 patients. The patients were prospectively included in an Access database, and clinical and angiographic characteristics were analyzed, as were aspects related to stent implantation and inhospital evolution. filamentary stent, multiple stents,); complexity of the lesion, thrombus,). Conclusion

Diabetes e implante de stents coronarianos: experiência de um centro de referência em cardiologia intervencionista

“…Os pacientes considerados para este estudo apresentavam cardiopatia isquêmica tratada com implantes de stents coronarianos no período de junho/1996 a dezembro/2000 no Instituto de Cardiologia do Rio Grande do Sul -Fundação Universitária de Cardiologia, Porto Alegre, RS. Foram excluídos desta análise os pacientes tratados com stents filamentares, já que este modelo de prótese não se encontra mais em uso clínico devido ao maior risco de eventos adversos (18). Todos os pacientes foram incluídos prospectivamente em um banco de dados Access, sendo comparadas as características clínicas, angiográficas e evolução clínica hospitalar e em um ano dos pacientes com e sem DM.…”