Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes
Background: Clinical in-stent restenosis (CISR) is the main limitation of coronary angioplasty with stent implantation. Objective: Describe the clinical and angiographic characteristics of CISR and the outcomes over a minimum follow-up of 12 months after its diagnosis and treatment. Methods: We anal...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cardiologia (SBC)
2015-05-01
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015000500005&lng=en&tlng=en |
| _version_ | 1828166686298079232 |
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| author | Barbara Campos Abreu Marino Guilherme Abreu Nascimento Walter Rabelo Marcos Antônio Marino Roberto Luiz Marino Antonio Luiz Pinho Ribeiro |
| author_facet | Barbara Campos Abreu Marino Guilherme Abreu Nascimento Walter Rabelo Marcos Antônio Marino Roberto Luiz Marino Antonio Luiz Pinho Ribeiro |
| author_sort | Barbara Campos Abreu Marino |
| collection | DOAJ |
| description | Background: Clinical in-stent restenosis (CISR) is the main limitation of coronary angioplasty with stent implantation. Objective: Describe the clinical and angiographic characteristics of CISR and the outcomes over a minimum follow-up of 12 months after its diagnosis and treatment. Methods: We analyzed in 110 consecutive patients with CISR the clinical presentation, angiographic characteristics, treatment and combined primary outcomes (cardiovascular death, nonfatal acute myocardial infarction [AMI]) and combined secondary (unstable angina with hospitalization, target vessel revascularization and target lesion revascularization) during a minimal follow-up of one year. Results: Mean age was 61 ± 11 years (68.2% males). Clinical presentations included acute coronary syndrome (ACS) in 62.7% and proliferative ISR in 34.5%. CISR was treated with implantation of drug-eluting stents (DES) in 36.4%, Bare Metal Stent (BMS) in 23.6%, myocardial revascularization surgery in 18.2%, balloon angioplasty in 15.5% and clinical treatment in 6.4%. During a median follow-up of 19.7 months, the primary outcome occurred in 18 patients, including 6 (5.5%) deaths and 13 (11.8%) AMI events. Twenty-four patients presented a secondary outcome. Predictors of the primary outcome were CISR with DES (HR = 4.36 [1.44–12.85]; p = 0.009) and clinical treatment for CISR (HR = 10.66 [2.53–44.87]; p = 0.001). Treatment of CISR with BMS (HR = 4.08 [1.75–9.48]; p = 0.001) and clinical therapy (HR = 6.29 [1.35–29.38]; p = 0.019) emerged as predictors of a secondary outcome. Conclusion: Patients with CISR present in most cases with ACS and with a high frequency of adverse events during a medium-term follow-up. |
| first_indexed | 2024-04-12T02:05:19Z |
| format | Article |
| id | doaj.art-0fce57cfe0f64bd8a1abbea473e01d7f |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-04-12T02:05:19Z |
| publishDate | 2015-05-01 |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-0fce57cfe0f64bd8a1abbea473e01d7f2022-12-22T03:52:32ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-41702015-05-01104537538610.5935/abc.20140216S0066-782X2015000500005Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical OutcomesBarbara Campos Abreu MarinoGuilherme Abreu NascimentoWalter RabeloMarcos Antônio MarinoRoberto Luiz MarinoAntonio Luiz Pinho RibeiroBackground: Clinical in-stent restenosis (CISR) is the main limitation of coronary angioplasty with stent implantation. Objective: Describe the clinical and angiographic characteristics of CISR and the outcomes over a minimum follow-up of 12 months after its diagnosis and treatment. Methods: We analyzed in 110 consecutive patients with CISR the clinical presentation, angiographic characteristics, treatment and combined primary outcomes (cardiovascular death, nonfatal acute myocardial infarction [AMI]) and combined secondary (unstable angina with hospitalization, target vessel revascularization and target lesion revascularization) during a minimal follow-up of one year. Results: Mean age was 61 ± 11 years (68.2% males). Clinical presentations included acute coronary syndrome (ACS) in 62.7% and proliferative ISR in 34.5%. CISR was treated with implantation of drug-eluting stents (DES) in 36.4%, Bare Metal Stent (BMS) in 23.6%, myocardial revascularization surgery in 18.2%, balloon angioplasty in 15.5% and clinical treatment in 6.4%. During a median follow-up of 19.7 months, the primary outcome occurred in 18 patients, including 6 (5.5%) deaths and 13 (11.8%) AMI events. Twenty-four patients presented a secondary outcome. Predictors of the primary outcome were CISR with DES (HR = 4.36 [1.44–12.85]; p = 0.009) and clinical treatment for CISR (HR = 10.66 [2.53–44.87]; p = 0.001). Treatment of CISR with BMS (HR = 4.08 [1.75–9.48]; p = 0.001) and clinical therapy (HR = 6.29 [1.35–29.38]; p = 0.019) emerged as predictors of a secondary outcome. Conclusion: Patients with CISR present in most cases with ACS and with a high frequency of adverse events during a medium-term follow-up.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015000500005&lng=en&tlng=enInfarto do MiocárdioStentsOclusão de Enxerto VascularReestenose CoronáriaIsquemia Miocárdica |
| spellingShingle | Barbara Campos Abreu Marino Guilherme Abreu Nascimento Walter Rabelo Marcos Antônio Marino Roberto Luiz Marino Antonio Luiz Pinho Ribeiro Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes Arquivos Brasileiros de Cardiologia Infarto do Miocárdio Stents Oclusão de Enxerto Vascular Reestenose Coronária Isquemia Miocárdica |
| title | Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes |
| title_full | Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes |
| title_fullStr | Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes |
| title_full_unstemmed | Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes |
| title_short | Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes |
| title_sort | clinical coronary in stent restenosis follow up after treatment and analyses of clinical outcomes |
| topic | Infarto do Miocárdio Stents Oclusão de Enxerto Vascular Reestenose Coronária Isquemia Miocárdica |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015000500005&lng=en&tlng=en |
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