Evoluçäo temporal com a utilizaçäo da angioplastia coronariana primária no infarto agudo do miocárdio no Brasil. Análise dos preditores de sucesso e dos eventos adversos hospitalares em 9.434 pacientes / Primary coronary angioplasty in 9, 434 patients during acute myocardial infarction: predictors of major in- hospital adverse events from 1996 to 2000 in Brazil
Arq. bras. cardiol
; 79(4): 405-418, Oct. 2002. tab
Article
in Pt, En
| LILACS, SES-SP
| ID: lil-323361
Responsible library:
BR1.1
RESUMO
OBJECTIVE:
To verify the results after the performance of primary coronary angioplasty in Brazil in the last 4 years.METHODS:
During the first 24 hours of acute myocardial infarction onset, 9,434 (12.2 percent) patients underwent primary PTCA. We analyzed the success and occurrence of major in-hospital events, comparing them over the 4-year period.RESULTS:
Primary PTCA use increased compared with that of all percutaneous interventions (1996=10.6 percent vs. 2000=13.1 percent; p<0.001). Coronary stent implantation increased (1996=20 percent vs. 2000=71.9 percent; p<0.001). Success was greater (1998=89.5 percent vs. 1999=92.5 percent; p<0.001). Reinfarction decreased (1998=3.9 percent vs. 99=2.4 percent vs. 2000=1.5 percent; p<0.001) as did emergency bypass surgery (1996=0.5 percent vs. 2000=0.2 percent; p=0.01). In-hospital deaths remained unchanged (1996=5.7 percent vs. 2000=5.1 percent, p=0.53). Balloon PTCA was one of the independent predictors of a higher rate of unsuccessful procedures (odds ratio 12.01 [CI=95 percent] 1.58-22.94), and stent implantation of lower mortality rates (odds ratio 4.62 [CI=95 percent] 3.19-6.08).CONCLUSION:
The success rate has become progressively higher with a significant reduction in reinfarction and urgent bypass surgery, but in-hospital death remains nearly unchanged. Coronary stenting was a predictor of a lower death rate, and balloon PTCA was associated with greater procedural failure
Full text:
1
Index:
LILACS
Main subject:
Angioplasty, Balloon, Coronary
/
Myocardial Infarction
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
America do sul
/
Brasil
Language:
En
/
Pt
Journal:
Arq. bras. cardiol
Journal subject:
CARDIOLOGIA
Year:
2002
Type:
Article