Estudio comparativo de la angioplastia coronaria en pacientes con diabetes: resultados clínicos y angiográficos inmediatos y evolución clínica en el primer año / Comparative study of coronary angioplasty in diabetic patients: clinical and angiographic results and clinical evolution at 1 year of follow up

Background: The success of revascularization procedures for coronary artery disease could be lower in diabetic patients. Aim: To report the results of coronary angioplasty in diabetic and non diabetic patients. Patients and methods: All angioplasty procedures performed between 1996 and 1999 were recorded. Demographic data, procedure details, hospital outcome and evolution at one year of follow up were analyzed. Results: During the study period, 358 patients were treated; of these, 79 were diabetics. Despite the greater severity of coronary lesions among diabetic patients the clinical success of the procedure was 92.4 percent in diabetics and 91.8 percent in non diabetics. Hospital mortality was 1.3 pecent in diabetics and 0.7 percent in non diabetics. Major complications occurred in 3.8 percent of diabetics and 3.2 percent in non diabetics. One year survival was 95.9 percent for diabetics and 98 percent in non diabetics. There were five late cardiac deaths among non diabetics and 3 among diabetics during the year of follow up. The frequency of new revascularization procedures was 4.3 percent in diabetics and 8.3 percent in non diabetics. Event-free survival was 95.6 percent in diabetics and 89.2 percent in non diabetics. Conclusions: Results of angioplasty were similar in diabetic and non diabetic patients in terms of hospital outcome and late follow-up

Implante de prótesis endovasculares (stents) en el tratamiento de la cardiopatía coronaria: resultados angiográficos, clínicos inmediatos y tardíos / Endovascular stent placing in the treatment of coronary artery disease: angiographic, immediate and late clinical results

Background: Coronary revascularization allows a better survival and quality of life in high risk patients with coronary artery disease. Aim: To report the experience in stent placement as treatment for obstructive atherosclerotic coronary artery disease. Patients and methods: A prospective analysis of 105 stent placements. A morphological and quantitative analysis of coronary angiograms, using an electronic caliper, was performed. Patients were followed during their hospital stay and after discharge. Results: In four of 112 coronary lesions, it was not possible to liberate the stent and in 108, it was successfully placed (48 in anterior descending, 19 in circumflex, 36 in right coronary arteries and 5 in saphenous aortocoronary by-pass. Lesions with stent implantation were type A in 11 percent, B1 in 30 percent, B2 in 44 percent and C in 15 percent. Reference diameter was 3.13 ñ 0.58 mm. After placement, luminal diameter increased from 0 95 ñ 0.43 to 2.99 ñ 0.46 mm, with a final stenosis of 7.2 ñ 10.1 percent. Angiographic success was obtained in 99 percent and procedure success in 98 percent. Hospital mortality was 0.98 percent. After a mean of eight months follow up, 91 percent of patients is free of major cardiac events. In 17 percent angina recurred and 5 percent required a new revascularization. There were no late cardiac deaths, acute stent thrombosis or infarction in relation to the treated lesion. Conclusions: In these patients, stent placement has had excellent immediate and late results