RESUMO
AIM: To examine the impact of diabetes mellitus on procedural outcomes of patients who underwent percutaneous coronary intervention for chronic total occlusion. METHODS: We assessed the impact of diabetes mellitus on the outcomes of percutaneous coronary intervention for chronic total occlusion among 1308 people who underwent such procedures at 11 US centres between 2012 and 2015. RESULTS: The participants' mean ± sd age was 66 ± 10 years, 84% of the participants were men and 44.6% had diabetes. As compared with participants without diabetes, participants with diabetes were more likely to have undergone coronary artery bypass graft surgery (38 vs 31%; P = 0.006), and to have had previous heart failure (35 vs 22%; P = 0.0001) and peripheral arterial disease (19 vs 13%; P = 0.002). They also had a higher BMI (31 ± 6 kg/m2 vs 29 ± 6 kg/m2 ; P = 0.001), similar Japanese chronic total occlusion scores (2.6 ± 1.2 vs 2.5 ± 1.2; P = 0.82) and similar final successful crossing technique: antegrade wire escalation (46 vs 47%; P = 0.66), retrograde (30 vs 28%; P = 0.66) and antegrade dissection re-entry (24 vs 25%; P = 0.66). Technical (91 vs 90%; P = 0.80) and procedural (89 vs 89%; P = 0.93) success was similar in the two groups, as was the incidence of major adverse cardiac events (2.2 vs 2.5%; P = 0.61). CONCLUSIONS: In a contemporary cohort of people undergoing percutaneous coronary intervention for chronic total occlusion, nearly one in two (45%) had diabetes mellitus. Procedural success and complication rates were similar in people with and without diabetes.
Assuntos
Oclusão Coronária/cirurgia , Diabetes Mellitus/epidemiologia , Intervenção Coronária Percutânea/métodos , Sistema de Registros , Idoso , Índice de Massa Corporal , Comorbidade , Ponte de Artéria Coronária/estatística & dados numéricos , Oclusão Coronária/epidemiologia , Feminino , Insuficiência Cardíaca/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Doença Arterial Periférica/epidemiologia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento , Estados UnidosRESUMO
Nontuberculous mycobacteria are ubiquitous in the environment. Although rarely a cause of infection in immunocompetent individuals, increased risk and severity of infection are seen in patients who are immunocompromised, such as those with solid organ transplants. In this report, we describe the first case of disseminated endovascular Mycobacterium abscessus in a heart transplant recipient. A review of the literature regarding this infection in heart transplant recipients and its therapeutic options and concerns are summarized.