Arquivos Brasileiros de Cardiologia (Jul 2010)
Efetividade e segurança dos stents farmacológicos em um serviço de cardiologia em Curitiba-PR Efectividad y seguridad de los Stents farmacológicos en un servicio de cardiología en Curitiba-PR Effectiveness and safety of drug-eluting stents in a cardiology clinic in Curitiba, PR, Brazil
Abstract
FUNDAMENTO: A efetividade e segurança de stents farmacológicos (SF) ainda têm sido questionadas. OBJETIVO: O objetivo deste estudo foi avaliar a efetividade e segurança desses stents, e a incidência da revascularização da lesão tratada (RLT), além de identificar possíveis variáveis que influenciam a necessidade de RLT. MÉTODOS: Selecionaram-se 203 pacientes do Hospital Costantini que tiveram acompanhamento clínico no período de 1 a 3 anos. RESULTADOS: Observou-se o seguinte quadro: 470 lesões; 171 (84,24%) pacientes eram homens; 54 (26,6%), diabéticos; 131 (64,35%), hipertensos; 127 (62,56%), dislipidêmicos; 40 (19,70%), tabagistas; e 79 (38,92%) apresentavam história familiar de coronariopatia. Ainda: 49 (24,14%) pacientes apresentavam angina estável; 58 (28,57%), angina instável; e 6 (2,96%), infarto agudo do miocárdio. Desses pacientes, 85 (41,87%) eram assintomáticos, e 146 (71,92%), multiarteriais. Nas características das lesões, 77,45% foram B2/C (AHA/ACC). Taxus foi implantado em 73,62% dos pacientes. Em 381 (81,96%), constataram-se stents com diâmetro > 2,5 mm. O comprimento de stent era FUNDAMENTO: La efectividad y seguridad de stents farmacológicos (SF) han sido cuestionadas. OBJETIVO: El objetivo de este estudio fue evaluar la efectividad y seguridad de esos stents, y la incidencia de la revascularización de la lesión tratada (RLT), además de identificar posibles variables que influyen la necesidad de RLT. MÉTODOS: Se seleccionaron 203 pacientes del Hospital Costantini que tuvieron acompañamiento clínico en el período de 1 a 3 años. RESULTADOS: Se observó el siguiente cuadro: 470 lesiones; 171 (84,24%) pacientes eran hombres; 54 (26,6%), diabéticos; 131 (64,35%), hipertensos; 127 (62,56%), dislipidémicos; 40 (19,70%), tabaquistas; y 79 (38,92%) presentaban historia familiar de coronariopatía. Además: 49 (24,14%) pacientes presentaban angina estable; 58 (28,57%), angina inestable; y 6 (2,96%), infarto agudo de miocardio. De esos pacientes, 85 (41,87%) eran asintomáticos, y 146 (71,92%), multiarteriales. En las características de las lesiones, 77,45% fueron B2/C (AHA/ACC). Taxus fue implantado en 73,62% de los pacientes. En 381 (81,96%), se constataron stents con diámetro > 2,5 mm. El largo del stent era de BACKGROUND: The effectiveness and safety of drug-eluting stents (DES) have still been questioned. OBJECTIVE: The objective of this study was to evaluate the effectiveness and safety of these stents, as well as the incidence of target lesion revascularization (TLR), in addition to identifying possible variables influencing the need for TLR. METHODS: A total of 203 patients from Hospital Costantini who were clinically followed up for one to 3 years were selected. RESULTS: The sample characteristics were as follows: 470 lesions; 171 (84.24%) male patients; 54 (26.6%) had diabetes; 131 (64.35%) had hypertension; 127 (62.56%), dyslipidemia; 40 (19.70%) were smokers; and 79 (38.92%) had a family history of coronary artery disease. Also: 49 (24.14%) patients presented with stable angina; 58 (28.57%), unstable angina; and 6 (2.96%), myocardial infarction. Eighty five (41.87%) patients were asymptomatic, and 146 (71.92%), had multivessel disease. As for the characteristics of the lesions, 77.45% were B2/C (AHA/ACC). Taxus was implanted in 73.62% of the patients. Stents with diameter > 2.5 mm were used in 381 (81.96%) patients. The stent length was < 30 mm in 67.87% of the lesions, with a mean of 2.3 stents per patient. After follow-up, 19 patients (9.3%) underwent TLR. Four patients died (1.97%), two of them of MI (0.98%), one of stroke (0.49%), and one of abdominal aneurysm (0.49%). Also, one patient died of late thrombosis (0.49%), and one of reinfarction (0.49%). In the statistical analysis carried out, only the bifurcation lesions variable reached values close to the statistical significance level, with p < 0.06. CONCLUSION: In conclusion, drug-eluting stents have good effectiveness and safety profiles; the incidence of TLR was 9.3%, and we did not identify a variable correlated with the need for TLR.
