| Journal: | Arquivos brasileiros de endocrinologia e metabologia |
| Database: | PERIÓDICA |
| System number: | 000289558 |
| ISSN: | 0004-2730 |
| Authors: | Schaan, Beatriz D'Agord1 Quadros, Alexandre1 Sarmento-Leite, Rogerio1 Gottschall, Carlos A. M1 |
| Institutions: | 1Fundacao Universitaria de Cardiologia, Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul. Brasil |
| Year: | 2006 |
| Season: | Feb |
| Volumen: | 50 |
| Number: | 1 |
| Pages: | 38-45 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Estadística o encuesta |
| Approach: | Caso clínico, analítico |
| English abstract | We evaluated the influence of diabetes mellitus (DM) on clinical outcomes in patients with coronary artery disease treated with stent implantation. Between 1996 and 2000, 934 stents were implanted in 893 patients in our institution; 23% of them had DM. Clinical and angiographic characteristics and clinical outcomes of the patients with and without DM were prospectively included in a computerized database. Diabetics were older (61.5 ± 10 vs. 59.8 ± 11 years; p= 0.04) and had a higher prevalence of hypertension (69% vs. 62%; p= 0.09). The procedural clinical success rate (successful coronary stenting with residual stenosis < 30%, TIMI 3 flow and no in-hospital adverse clinical event) was lower in the diabetic group (88% vs. 92%; p= 0.05). In the 1-year follow up, diabetic patients showed higher rates of new target vessel revascularization (12.3% vs. 8%; p= 0.06), death (5.4% vs. 2.5%; p= 0.03) and major adverse cardiovascular events (MACE, new angioplasty, surgery, acute myocardial infarction or death: 16.3% vs. 9.3%; p= 0.003). Diabetes was independently associated to 1-year MACE on multivariate analysis (OR: 2.00; IC: 1.25­3.24; p= 0.004). We concluded that DM is associated with higher complication and restenosis rates and a higher risk of long-term major cardiovascular events in patients treated with coronary stent implantation |
| Portuguese abstract | Nosso objetivo foi avaliar a influência do diabetes mellitus (DM) na evolução clínica de pacientes com doença arterial coronariana tratada com implante de stents. Foram implantados 934 stents em 893 pacientes em nossa instituição de 1996 a 2000; 23% destes apresentavam DM. Características clínicas, angiográficas e desfechos clínicos dos pacientes com e sem DM foram prospectivamente incluídos em banco de dados computadorizado. O grupo DM tinha maior idade (61,5 ± 10 vs. 59,8 ± 11 anos; p= 0,04) e prevalência de hipertensão arterial (69% vs. 62%; p= 0,09). A taxa de sucesso clínico do procedimento (estenose residual < 30%, fluxo TIMI 3, ausência de eventos clínicos adversos na internação) foi menor nos pacientes com DM (88% vs. 92%; p= 0,05). Em 1 ano, os pacientes com DM apresentaram maiores taxas de revascularização do vaso-alvo (12,3% vs. 8%; p= 0,06), óbitos (5,4% vs. 2,5%; p= 0,03) e eventos cardiovasculares maiores (ECVM; nova angioplastia, cirurgia, infarto agudo do miocárdio ou óbito: 16,3% vs. 9,3%; p= 0,003). A presença de DM foi independentemente associada a ECVM na análise multivariada (OR: 2,00; IC: 1,25­3,24; p= 0,004). Concluímos que o DM associa-se a aumento do risco de complicações intra-hospitalares, re-estenose e eventos cardiovasculares maiores em pacientes submetidos ao implante de stents coronarianos |
| Disciplines: | Medicina |
| Keyword: | Endocrinología, Metabolismo y nutrición, Sistema cardiovascular, Diabetes mellitus, Angioplastia coronariana percutánea, Revascularización miocárdica, Cardiopatía isquémica |
| Keyword: | Medicine, Cardiovascular system, Endocrinology, Metabolism and nutrition, Diabetes mellitus, Percutaneous coronary angioplasty, Myocardial revascularization, Ischemic cardiopathy |
| Full text: | Texto completo (Ver HTML) |
