Dapagliflozin in patients with cardiometabolic risk factors hospitalised with COVID-19 (DARE-19): a randomised, double-blind, placebo-controlled, phase 3 trial.

BACKGROUND: COVID-19 can lead to multiorgan failure. Dapagliflozin, a SGLT2 inhibitor, has significant protective benefits for the heart and kidney. We aimed to see whether this agent might provide organ protection in patients with COVID-19 by affecting processes dysregulated during acute illness. METHODS: DARE-19 was a randomised, double-blind, placebo-controlled trial of patients hospitalised with COVID-19 and with at least one cardiometabolic risk factor (ie, hypertension, type 2 diabetes, atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease). Patients critically ill at screening were excluded. Patients were randomly assigned 1:1 to dapagliflozin (10 mg daily orally) or matched placebo for 30 days. Dual primary outcomes were assessed in the intention-to-treat population: the outcome of prevention (time to new or worsened organ dysfunction or death), and the hierarchial composite outcome of recovery (change in clinical status by day 30). Safety outcomes, in patients who received at least one study medication dose, included serious adverse events, adverse events leading to discontinuation, and adverse events of interest. This study is registered with ClinicalTrials.gov, NCT04350593. FINDINGS: Between April 22, 2020 and Jan 1, 2021, 1250 patients were randomly assigned with 625 in each group. The primary composite outcome of prevention showed organ dysfunction or death occurred in 70 patients (11·2%) in the dapagliflozin group, and 86 (13·8%) in the placebo group (hazard ratio [HR] 0·80, 95% CI 0·58-1·10; p=0·17). For the primary outcome of recovery, 547 patients (87·5%) in the dapagliflozin group and 532 (85·1%) in the placebo group showed clinical status improvement, although this was not statistically significant (win ratio 1·09, 95% CI 0·97-1·22; p=0·14). There were 41 deaths (6·6%) in the dapagliflozin group, and 54 (8·6%) in the placebo group (HR 0·77, 95% CI 0·52-1·16). Serious adverse events were reported in 65 (10·6%) of 613 patients treated with dapagliflozin and in 82 (13·3%) of 616 patients given the placebo. INTERPRETATION: In patients with cardiometabolic risk factors who were hospitalised with COVID-19, treatment with dapagliflozin did not result in a statistically significant risk reduction in organ dysfunction or death, or improvement in clinical recovery, but was well tolerated. FUNDING: AstraZeneca.

Recovered after an extreme bottleneck and saved by ex situ management: Lessons from the Alagoas curassow (Pauxi mitu [Linnaeus, 1766]; Aves, Galliformes, Cracidae).

A pivotal debate on biodiversity conservation is whether the scarce budgets must be invested in critically endangered taxa or in those with higher chances to survive due to larger population sizes. Addressing the fate of extremely bottlenecked taxa is an ideal way to test this idea, but empirical cases are surprisingly limited. The reintroduction of the extinct-in-the-wild Alagoas curassow (Pauxi mitu) by Brazilian scientists in September 2019 added to the two other known cases of survival to bottlenecks of only two or three individuals. We exploit the reasons why this species has survived, and we report how investments to rescue the Alagoas curassow resulted in the protection of many other taxa, suggesting that in the face of the dramatic number of extinctions expected for the Anthropocene, integration must prevail over a choice.

Technical quality of fauna monitoring programs in the environmental impact assessments of large mining projects in southeastern Brazil.

Biodiversity monitoring is a key element of impact assessment follow-up activities, as it has the potential to generate relevant information about the actual impacts of approved projects on the environment. However, the effectiveness of such monitoring programs depends on issues such as technical quality. The extent to which this issue actually affects biodiversity monitoring is unclear. This knowledge gap was addressed in this study, whose main objective was to analyze the technical quality of fauna monitoring, using empirical data from large-scale mining enterprises in the state of Minas Gerais in southeastern Brazil. More specifically, this study aimed at analyzing: 1) whether license conditions related to fauna monitoring programs were being met by mining companies; 2) the extent to which fauna monitoring programs met a set of technical quality criteria; 3) whether there were significant differences among taxonomic groups; and, finally, 4) how fauna monitoring programs can be made more meaningful to decision-makers. A total of 236 fauna monitoring reports were analyzed. Findings indicated that, while companies complied with all license conditions, their fauna programs met, on average, 32% of the desirable technical requirements, and there were no significant differences among taxonomic groups. The main technical quality gaps were found to be lack of driving questions, hypothesis-testing and conceptual models, as well as lack of comparisons between control and impacted areas. Overall, findings indicated that the data generated in such programs have very limited value to decision-makers as they do not shed sufficient light on the actual impacts of mining activities on biodiversity. The study discusses a number of barriers to more meaningful fauna monitoring programs, and highlights the urgent need for revising current Terms of Reference.

Privatizar ou não privatizar? Uma análise longitudinal dos serviços de abastecimento de água no Brasil / To privatize or not to privatize? A longitudinal analysis of the Brazilian water supply services

RESUMO A privatização é frequentemente mencionada como uma potencial solução para os problemas dos serviços de abastecimento de água. Todavia, são raros os estudos sobre os reais impactos da privatização, sobretudo no Brasil. O objetivo deste trabalho foi comparar o desempenho dos prestadores públicos e privados no Brasil entre 2003 e 2013. A metodologia baseou-se na análise dos indicadores do Sistema Nacional de Informações sobre Saneamento, por meio de análises fatoriais e testes não paramétricos. Também testou-se a aplicação de modelos de regressão linear, embora sem sucesso. A análise visual dos boxplots sugeriram diferenças no desempenho entre prestadores público e privado em anos específicos. Essa situação foi confirmada por meio dos testes não paramétricos. Todavia, os serviços privatizados já tinham o melhor desempenho desde o início do período de análise, o que corrobora o argumento de que a privatização tende a ocorrer em municípios que já apresentam condições favoráveis de abastecimento de água. Estudos futuros são, finalmente, sugeridos.

ABSTRACT Privatization is often mentioned as a potential solution to water supply problems. However, few studies have addressed the real impacts of privatization, particularly in Brazil. The objective of this study was to compare the performance of public and private water supply services in Brazil between 2003 and 2013. The methodology was based on the analysis of the indicators of the Brazilian National Information System on Sanitation, through factor analyses and nonparametric tests. The study also conducted linear regression models, without success. The visual analysis of the boxplots suggested significant differences in the overall performance of public and private groups in specific years. This situation was confirmed in nonparametric tests. However, privatized services had the best performance since the beginning of the analysis period, a fact that corroborates the argument that privatization tends to occur in municipalities with more favorable water supply services. Future studies are, finally, suggested.

The use of administrative sanctions to prevent environmental damage in impact assessment follow-ups.

Scholars have long been highlighting the value of administrative sanctions in improving environmental policy enforcement. However, few studies have evaluated how such sanctions are implemented, particularly in the context of environmental impact assessments (EIA) and their respective follow-up programs. The main objective of this article was to evaluate how administrative sanctions have been used in EIA follow-ups, using the Brazilian state of Minas Gerais as the empirical context. More specifically it tried to understand what have been the main triggers, frequency, nature and financial values of the sanctions issued to noncompliant mining projects operating under the conditions of environmental licenses. First, through literature reviews, the study characterized the institutional and regulatory framework in which administrative sanctions are applied. Content analyzes of 29 infraction processes further revealed that lump sum fines are the preferred option of administrative sanction in EIA follow-ups. The analysis also revealed that the fines could be perceived as disproportionally small if one considers the size and financial power of non-compliant companies. The great majority of the fines were paid by developers: a fact that contradicts previous empirical findings and anecdotal evidence in Brazil. Overall, the study suggests that the impact of administrative sanctions in corporate behavior, while unclear, is likely small. The study concludes by discussing practical and academic implications.

Boas práticas de transparência, informatização e comunicação social no licenciamento ambiental brasileiro: uma análise comparada dos websites dos órgãos licenciadores estaduais / Good practices of transparency, electronic procedures, and social communication in Brazil's environmental impact assessment and licensing system: a comparative analysis of the websites of state-level agencies

RESUMO: O objetivo deste artigo foi analisar as boas práticas de transparência, informatização e comunicação social evidentes nos websites dos órgãos públicos estaduais e do distrito federal responsáveis pelo controle da avaliação de impacto e do licenciamento ambiental. A metodologia baseou-se em análises de conteúdo dos websites dos 27 entes federados, com base em uma lista de verificação de 28 boas práticas. Foram identificados níveis diversificados de atendimento a cada uma das boas práticas analisadas. O estudo também mostrou que os websites dos órgãos licenciadores estaduais variam muito em termos de atendimento às práticas analisadas, sugerindo a existência de diferenças significativas na capacidade institucional dos órgãos. Diversas boas práticas, sobretudo as relacionadas aos controles informatizados de processos e de participação social, têm um claro potencial de replicação em diferentes jurisdições. O artigo conclui com uma discussão das implicações da pesquisa e com sugestões de novos estudos.

ABSTRACT: This article analyzed the good practices of transparency, electronic procedures and social communication in the websites of State-level Public Agencies in charge of Environmental Impact Assessment (EIA) and Environmental Licensing in their jurisdictions. The methodology was based on content analyses of the websites of all 26 states and the federal district, based on a checklist of 28 good practices. It was found diverse levels of implementation of each good practice analyzed. The study also showed that the websites vary greatly in terms of good practice adoption, thus suggesting the existence of significant differences in institutional capacity across State-level agencies. Many good practices, particularly those related to electronic procedures and social participation, have a clear potential for replication across jurisdictions. The article concludes with a discussion of the research implications and suggesting future research agendas.

Gender Differences in the Neurobiology of Anxiety: Focus on Adult Hippocampal Neurogenesis.

Although the literature reports a higher incidence of anxiety disorders in women, the majority of basic research has focused on male rodents, thus resulting in a lack of knowledge on the neurobiology of anxiety in females. Bridging this gap is crucial for the design of effective translational interventions in women. One of the key brain mechanisms likely to regulate anxious behavior is adult hippocampal neurogenesis (AHN). This review paper aims to discuss the evidence on the differences between male and female rodents with regard to anxiety-related behavior and physiology, with a special focus on AHN. The differences between male and female physiologies are greatly influenced by hormonal differences. Gonadal hormones and their fluctuations during the estrous cycle have often been identified as agents responsible for sexual dimorphism in behavior and AHN. During sexual maturity, hormone levels fluctuate cyclically in females more than in males, increasing the stress response and the susceptibility to anxiety. It is therefore of great importance that future research investigates anxiety and other neurophysiological aspects in the female model, so that results can be more accurately applicable to the female population.

Análise da influência da tarifação em seis indicadores operacionais e de qualidade dos serviços de abastecimento de água no Brasil / Analysis of the effect of tariffs on six operational and quality indicators of water supply services in Brazil

Este estudo analisou em que medida os valores das tarifas médias de água podem afetar seis indicadores operacionais e de qualidade dos serviços de abastecimento de água no Brasil. A análise utilizou os dados do Sistema Nacional de Saneamento e seguiu duas etapas: aplicação do teste de Kruskal-Wallis para identificar as diferenças dos indicadores de qualidade dos prestadores de serviços entre oito faixas de tarifação; e a aplicação do teste de Mann-Whitney para identificar as diferenças entre os grupos de prestadores com tarifas médias abaixo e acima de R$ 0,50 por metro cúbico de água. O estudo mostra que a tarifação pode afetar o desempenho dos serviços de abastecimento de água, sobretudo nos padrões de consumo de água da população. O artigo é concluído com uma discussão sobre as limitações dos dados e da necessidade de estudos futuros.

This study analyzed the extent to which the values of water supply mean tariffs can affect six operational and quality indicators of urban water supply in Brazil. The analysis used data from the Brazilian National System of Sanitation Information, and followed two stages: application of the Kruskal-Wallis test to identify the differences of indicators among eight tariff blocks; and use of Mann-Whitney test to analyze potential differences of the indicators among water supply services that had mean water tariff above and below BRL 0.50 per cubic meter. The study shows that the water tariff can affect the performance of water supply services, most notably of the water consumption patterns. The article concludes by pointing out the limitations of the analyzed data, as well as by highlighting the need of future studies.

Mining communities from a resilience perspective: managing disturbance and vulnerability in Itabira, Brazil.

This paper applies the resilience lens to a social-ecological system characterized by the presence of large-scale mineral extraction operations. The system in question is the Brazilian community of Itabira, Minas Gerais, host to an iron ore operation of Vale, the world's second largest mining corporation. Utilizing a resilience assessment framework, this study describes the various components of the Itabira social-ecological system revealing the challenges brought about by mining's dominance. Data collection included literature reviews and semi-structured interviews with 29 individuals representing different stakeholder groups. Findings revealed that, despite recent efforts by government to regulate the industry, the mine continues to generate press and pulse disturbances that impact the resilience of the community. Operating from the standpoint that resilience depends largely upon the management capacity of stakeholders, the research identifies three ways to improve mining governance in Itabira. First, there is a need for local government to have more power in dealings with the corporation. Concurrent with this power, however, the municipality must demonstrate ownership over its fate, ideally through the creation of a sustainability plan. Finally, all key parties must demonstrate commitment to cooperating to resolve outstanding disturbances, even when these fall outside the regulatory approval process. While Itabira will remain a mining town for the foreseeable future, actions taken now to address challenges will only strengthen community well-being and sustainability moving forward.

Um esquecido marco do saneamento no Brasil: o sistema de águas e esgotos de Ouro Preto (1887-1890) / A forgotten mark of sanitation in Brasil: the water and sewage system of Ouro Preto (1887-1890)

Este artigo resgata, contextualiza e caracteriza o sistema de águas e esgotos de Ouro Preto, criado em fins da década de 1880 em reação a problemas sanitários e à necessidade de modernizar a antiga capital do estado brasileiro de Minas Gerais. Baseado em pesquisas documentais realizadas em arquivos públicos, revisões bibliográficas, entrevistas e inspeções de campo, o texto desfaz equívocos referentes à autoria e data de construção do sistema. A necessidade de restaurar a centenária estação de tratamento de esgotos é enfatizada, tendo em vista sua relevância na história do saneamento brasileiro. Hoje, em contraste com o passado, a cidade de Ouro Preto lança seus esgotos in natura nos córregos que lhe deram o ouro.

O uso de clevidipina em emergência hipertensiva: [revisão] / Clevidipine for hypertensive emergency: [review]

A emergência hipertensiva, forma mais grave de manifestação da hipertensão arterial, é uma entidade clínica prevalente com alta morbimortalidade associada. A clevidipina é uma droga pertencente ao grupo dos bloqueadores dos canais de cálcio. Suas características farmacocinéticas favorecem seu uso em emergências hipertensivas tornando-se uma alternativa promissora ao restrito arsenal terapêutico disponível em salas de emergências e unidades de tratamento intensivo. Nesta revisão, descrevemos aspectos de farmacodinâmica, farmacocinética e estudos clínicos que avaliaram a clevidipina no contexto da emergência hipertensiva, comparando-a com medicamentos tradicionalmente utilizados nesta situação.

Hypertensive emergency, is the most severe presentation of arterial hypertension, having high morbidity-mortality. Clevidipine is a calcium channel blocker. Its pharmacokinetics is favorable to use for hypertensive emergencies, rendering this drug a promising alternative to the restricted therapeutic armamentarium available both in the emergency room and intensive care unit. In this review we describe the pharmacodynamics, pharmacokinetics and clinical trials evaluating Clevidipine in emergency situations, comparing this drug to other traditionally used drugs in this condition.

Um esquecido marco do saneamento no Brasil: o sistema de águas e esgotos de Ouro Preto (1887-1890) / A forgotten mark of sanitation in Brasil: the water and sewage system of Ouro Preto (1887-1890)

Este artigo resgata, contextualiza e caracteriza o sistema de águas e esgotos de Ouro Preto, criado em fins da década de 1880 em reação a problemas sanitários e à necessidade de modernizar a antiga capital do estado brasileiro de Minas Gerais. Baseado em pesquisas documentais realizadas em arquivos públicos, revisões bibliográficas, entrevistas e inspeções de campo, o texto desfaz equívocos referentes à autoria e data de construção do sistema. A necessidade de restaurar a centenária estação de tratamento de esgotos é enfatizada, tendo em vista sua relevância na história do saneamento brasileiro. Hoje, em contraste com o passado, a cidade de Ouro Preto lança seus esgotos in natura nos córregos que lhe deram o ouro.(AU)

[A forgotten milestone of sanitation in Brazil: the water and sewage system of Ouro Preto (1887-1890)]. / Um esquecido marco do saneamento no Brasil: o sistema de águas e esgotos de Ouro Preto (1887-1890).

This article resurrects, contextualizes and characterizes the water and sewage system of Ouro Preto, created at the end of the 1880's in response to sanitary problems and the need to modernize the old capital of the Brazilian State of Minas Gerais. Based on documentary research undertaken in public archives, bibliographical reviews, interviews and field inspections, the text corrects mistakes regarding the authorship and construction date of the system. The need to restore the hundred year old sewage treatment station is emphasized, given its relevance in the history of Brazilian sanitation. Today, in contrast with the past, the city of Ouro Preto discharges its sewage in natura into the streams that gave it gold.

Clevidipine for hypertensive emergency. / O uso de clevidipina em emergência hipertensiva.

Hypertensive emergency, is the most severe presentation of arterial hypertension, having high morbidity-mortality. Clevidipine is a calcium channel blocker. Its pharmacokinetics is favorable to use for hypertensive emergencies, rendering this drug a promising alternative to the restricted therapeutic armamentarium available both in the emergency room and intensive care unit. In this review we describe the pharmacodynamics, pharmacokinetics and clinical trials evaluating Clevidipine in emergency situations, comparing this drug to other traditionally used drugs in this condition.

Intravascular ultrasound assessment of the novel AngioSculpt scoring balloon catheter for the treatment of complex coronary lesions.

BACKGROUND: Despite the advances in interventional cardiology, stent expansion remains an important predictor of success, impacting restenosis and thrombosis rates after either bare-metal (BMS) or drug-eluting stent implantation. Especially for the treatment of complex lesions (e.g., calcified lesions, in-stent restenosis, etc.), adequate lesion preparation might help improve procedural results as well as clinical outcomes. We sought to investigate the safety, feasibility and mechanism of action of a new scoring-balloon catheter, the AngioSculpt, comprised of a semicompliant balloon and a nitinol spiral cage designed to address complex lesions. METHODS: A total of 60 consecutive patients at two centers were prospectively enrolled in this first-in-man coronary study and divided into two groups according to the type of lesion treated: Group I: patients with de novo coronary lesions (n = 47) as a pretreatment strategy before BMS implantation, and Group II: patients with BMS restenosis (n = 17) as a standalone therapy. A subgroup of patients in each cohort was assigned to intravascular (IVUS) analysis. Patients in Group II were submitted to routine 6-month follow-up angiography. In Group I, angiographic restudy was contingent upon the presence of ischemia. Lesions longer than 20 mm in very tortuous vessels, in arterial or vein grafts, in the setting of acute myocardial infarction or with visible thrombus were excluded from this study. RESULTS: Success was achieved in all cases. The mean age of the study populations was 62 +/- 11.6 years (Group I) and 53 +/- 9.4 years (Group II), with 26% and 18% diabetics, respectively. In Group I, 73% of lesions were diffuse and fibrocalcified, while in Group II, 72% were classified as diffuse. No serious complications were observed in either group. Balloon slippage (or the "watermelon seed" phenomenon) was not observed. Significant acute gain was achieved in both groups (0.7 mm in Group I and 1.64 mm in Group II). A minimum final area (in-stent) 6.5 mm2 was achieved in 85% of the cases in Group I and in 82% of the cases in Group II. CONCLUSIONS: In this preliminary in vivo study, the use AngioSculpt(R) proved to be feasible and safe for the treatment of complex coronary lesions. Six-month results suggest the use of this novel device as an attractive option for the percutaneous approach of restenotic coronary lesions and should be assessed in a larger, more complex cohort of patients.

Intravascular ultrasound assessment of the novel angio sculpt scorig ballon catheter for the treatment of complex coronary lesions

Despite the advances in interventional cardiology, stenting expansion remains an important predictor of success, impacting resenosis and thrombosis rates after either bare-metal (BMS) or drug-eluting stent implantation.Especially for the treatment of complex lesions (e.g., calcified lesions, in stent restenosis, etc.), adequate lesion preparation might help improve procedural results as well clinical outcomes. We sought to investigate the safety, feasibility and mechanisc of action of a new scoring-balloon catheter, the Angiosculpt,, comprised of a semicompliant balloon and a nitinol cage designed to adress complex lesions. Methods: A total of 60 consecutive patients at two centers were prospectivelly enrolled in-this first-in-man coronary study and divided in two groups according to the type of the lesion treated...

Reestenose associada à fratura de stent com liberação de sirolimus / Stent fracture associated to restenosis in sirolimus eluting stent

Os autores descrevem um caso de fratura de stent Cypher. Inicialmente, a fratura foi acompanhada clinicalmente (paciente era assintomático, sem evidência clara de isquemia á investigação não-invasiva). Entretanto, durante seguimento tardio o paciente passou a apresentar sintomas de angina estável, necessitando de nova intervenção percutânea e, posteriormente, implante e novo stent farmacológico.

Reestenose associada à fratura de stent com liberação de sirolimus / Stent Fracture Associated to Restenosis in Sirolimus Eluting Sten

Os autores descrevem um caso de fratura de stent Cypher®. Inicialmente, a fratura foi acompanhada clinicamente (paciente era assintomático, sem evidência clara de isquemia à investigação não-invasiva). Entretanto, durante seguimento tardio, o paciente passou a apresentar sintomas de angina estável, necessitando de nova intervenção percutânea e, posteriormente, implante de novo stent farmacológico.

The authors describe a case of stent fracture following the use of Cypher®. Initially, the fracture was clinically approached (patient was asymptomatic with no clear evidence of ischemia in non-invasive assessment). However, during the long-term follow-up this patient started manifesting stable angina symptoms requiring new percutaneous intervention with additional drug-eluting stent implantation.

Unstable angina patients treated with percutaneous coronary intervention in the new millennium: what characterizes them?

OBJECTIVE: To identify clinical and angiographic profiles of patients with unstable angina seen at a tertiary hospital and treated with percutaneous coronary intervention (PCI). METHODS: Study of a consecutive series of 1413 patients, selected from a computerized database, who underwent percutaneous revascularization in the three-year period of 2002-2004. There were no inclusion/exclusion criteria. RESULTS: Systemic arterial hypertension (74%) and hypercholesterolemia (65%) were the classical risk factors for coronary disease most frequently observed. Coronary artery bypass grafting and history of myocardial infarction were found in 24% and 28% of the cases, respectively. The subgroups most commonly treated were the IIB (48%) and IIIB (28%). Clopidogrel was prescribed for 51% of the patients and glycoprotein IIb/IIIa inhibitors, for 7%. Multivessel disease evidenced by coronary angiography was detected in 42% of the cases. Type B2 or C lesions were treated in 64%, 94% of which in native vessels. Restenotic lesions were dilated in 5% of the patients. All interventions were performed using coronary stents, the majority of which (67%) were standard bare-metal stents. CONCLUSIONS: 1) Subgroups IIB and IIIB were the most frequently treated (76%); 2) Clopidogrel was the most prescribed antithrombotic agent (51%); 3) Multivessel coronary artery disease was found in 42% of the cases, most of which were complex target lesions located in native vessels; 4) Coronary stent implantation was the chief dilation technique used.

Pacientes com angina instável tratados por meio de intervenções coronarianas percutâneas no novo milênio: o que os caracteriza? / Unstable angina patients treated with percutaneous coronary intervention in the new millennium: what characterizes them?

OBJETIVO: Identificar os perfis clínico/angiográfico e relacionados ao procedimento de pacientes com angina instável atendidos em um hospital terciário e tratados por meio de intervenções coronarianas percutâneas. MÉTODOS: Estudo de uma casuística consecutiva de 1.413 pacientes, selecionados a partir de um banco de dados informatizado e revascularizados percutaneamente no triênio 2002-2004. Não houve critérios de inclusão/exclusão. RESULTADOS: Hipertensão arterial sistêmica (74 por cento) e hipercolesterolemia (65 por cento) foram os fatores de risco clássicos para doença coronariana mais observados. Antecedentes de infarto do miocárdio e cirurgia de revascularização miocárdica foram respectivamente observados em 28 por cento e 24 por cento dos casos. Os subgrupos mais comumente tratados foram o IIB (48 por cento) e IIIB (28 por cento). O clopidogrel foi prescrito a 51 por cento dos pacientes, enquanto os inibidores IIb IIIa foram utilizados em 7 por cento. Doença coronariana multiarterial na cinecoronariografia diagnóstica ocorreu em 42 por cento dos casos. Lesões-alvo tipo B2 ou C foram tratadas em 64 por cento, das quais 94 por cento situavam-se em vasos naturais. Lesões reestenóticas foram dilatadas em 5 por cento dos pacientes. Todas as intervenções foram realizadas utilizando os stents coronarianos, a maioria dos quais (67 por cento) do tipo convencional. CONCLUSÕES: 1) os subgrupos IIB e IIIB foram os mais comumente tratados (76 por cento); 2) o clopidogrel foi o antitrombótico mais prescrito (51 por cento); 3) a coronariopatia multiarterial foi observada em 42 por cento dos casos, com predomínio de lesões-alvo complexas e situadas em vasos naturais; 4) a técnica de dilatação predominante foi o implante dos stents coronarianos.

OBJECTIVE: To identify clinical and angiographic profiles of patients with unstable angina seen at a tertiary hospital and treated with percutaneous coronary intervention (PCI). METHODS: Study of a consecutive series of 1413 patients, selected from a computerized database, who underwent percutaneous revascularization in the three-year period of 2002-2004. There were no inclusion/exclusion criteria. RESULTS: Systemic arterial hypertension (74 percent) and hypercholesterolemia (65 percent) were the classical risk factors for coronary disease most frequently observed. Coronary artery bypass grafting and history of myocardial infarction were found in 24 percent and 28 percent of the cases, respectively. The subgroups most commonly treated were the IIB (48 percent) and IIIB (28 percent). Clopidogrel was prescribed for 51 percent of the patients and glycoprotein IIb/IIIa inhibitors, for 7 percent. Multivessel disease evidenced by coronary angiography was detected in 42 percent of the cases. Type B2 or C lesions were treated in 64 percent, 94 percent of which in native vessels. Restenotic lesions were dilated in 5 percent of the patients. All interventions were performed using coronary stents, the majority of which (67 percent) were standard bare-metal stents. CONCLUSIONS: 1) Subgroups IIB and IIIB were the most frequently treated (76 percent); 2) Clopidogrel was the most prescribed antithrombotic agent (51 percent); 3) Multivessel coronary artery disease was found in 42 percent of the cases, most of which were complex target lesions located in native vessels; 4) Coronary stent implantation was the chief dilation technique used.