Análise ultra-sonográfica da resposta vascular tardia das bordas de stents liberadores de drogas análogas ao sirolimus: comparação entre diabéticos e não-diabéticos / IVUS analysis of the late vascular response at the edges of sirolimus analogue-eluting stents: comparison among diabetic and non-diabetic patients
Rev. bras. cardiol. invasiva
; 14(4): 351-357, out.-dez. 2006. tab, ilus, graf
Article
in Pt
| LILACS, SES-SP
| ID: lil-441114
Responsible library:
BR1.1
RESUMO
Introdução:
A resposta vascular dos segmentos adjacentes aos stents liberadores de medicamentos continua sendo objeto de estudo, principalmente nos pacientes diabéticos (DM), nos quais a progressão da aterosclerose é mais freqüentemente observada. Recentemente, os fármacos Biolimus e Zotarolimus demonstraram eficácia semelhante ao Sirolimus na redução da hiperplasia intimal intra-stent.Objetivo:
Comparar a resposta vascular tardia nas bordas proximais (BP) e distais (BD), entre DM e não-diabéticos (NDM) tratados com stents liberadores de sirolimus ou fármacos análogos (Biolimus e Zotarolimus), avaliada pelo ultra-som intracoronário (USIC).Método:
Foram incluídos 153 pacientes (306 bordas) tratados com stents (53% Sirolimus, 26% Zotarolimus e 21% Biolimus) e divididos em dois grupos em relação à presença de diabetes DM, 122 bordas e NDM, 166 bordas; 18 bordas foram excluídas. As análises pelo USIC foram realizadas nos 5 mm proximal e distal aos stents após o implante (basal) e no seguimento tardio (± 6 meses). Os volumes do vaso (VV), do lúmen (VL) e da placa (VP) foram calculados pela regra de Simpson. A porcentagem de obstrução (% Obs) e a variação dos volumes (Delta - Δ) entre seguimento e basal foram também calculados. Reestenose das bordas foi definida como uma obstrução >50% no seguimento.Resultados:
A media para idade foi 58±9 anos, sendo 59% do sexo masculino. Não houve diferença nas características basais dos grupos...ABSTRACT
Introduction:
Late vascular response of the segments adjacent to proximal and distal edges of the drug-eluting stents is still not well established, particularly in diabetic patients who are prone to atherosclerosis plaque progression. Recently, new sirolimus-analogue eluting stents (Biolimus and Zotarolimus) have demonstrated potent antiproliferative effects.Objective:
To compare the late vascular responses at proximal (PE) and distal (DE) edges of sirolimus analogue-eluting stents in patients with and without diabetes (DM or NDM) using intravascular ultrasound (IVUS).Method:
306 IVUS edge analyses were performed in 153 patients treated with drug-eluting stents(53% Sirolimus, 26% Zotarolimus, 21% Biolimus). Patients were divided in two groups DM, 122 edges and NDM, 166 edges; 18 edges were excluded. IVUS analyses were performed post-intervention (PI) and after 6-month follow-up (FU) and included 5 mm distal and proximal to the stented segment. Vessel, lumen and plaque volumes were calculated by Simpons rule. Percentage of obstruction and volumes changes (FUminus PI values) were also calculated. Edge restenosis was defined as obstruction >50% at FU.Results:
The mean age was 58±9 y, and 59% were male. The baseline characteristics were similar between groups. In both groups, the entire lesion length was totally covered (stent length / lesion length was 1.51 and 1.52). There were no significant differences in edge volumes between the two groups...
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Index:
LILACS
Main subject:
Stents
/
Ultrasonography, Interventional
/
Coronary Vessels
/
Sirolimus
/
Coronary Restenosis
/
Diabetes Mellitus
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
Language:
Pt
Journal:
Rev. bras. cardiol. invasiva
Journal subject:
CARDIOLOGIA
/
CIRURGIA GERAL
Year:
2006
Type:
Article