RESUMEN
AIM: The MGuard Stent (MGS) was designed to prevent distal embolization of thrombus and has been shown to improve microcirculation in ST-elevation myocardial infarction (STEMI). However, there are no real world data comparing it with the bare metal stent (BMS). The aim of this study is to determine the efficacy and safety of the MGS in STEMI in the real world compared to the BMS. METHODS AND RESULTS: In total, 262 patients were included from a single centre, of which 35.9% had an MGS implanted. Two groups of 79 patients were established after propensity score matching, and they were similar in terms of baseline and periprocedural variables. The mean follow-up was 321 ± 12.94 days. There was no difference in mortality (7.6% in both groups), major adverse cardiac events (20.3% vs. 12.7%, P = 0.198), non-cardiac mortality, or non-fatal myocardial infarction (6.3% in both groups). Target lesion revascularization (TLR) was significantly higher in the MGS group (11.4% (9) vs. 1.3% (1) P < 0.01; RR 10.02 [1.23-81.16]). CONCLUSION: Our study is the first to compare the MGS with the BMS in STEMI in the real world, and it also appears to confirm that although the MGS is a safe device in STEMI that is not associated with increased mortality, it is associated with a higher long-term TLR rate. © 2014 Wiley Periodicals, Inc.
Asunto(s)
Angioplastia Coronaria con Balón/instrumentación , Metales , Infarto del Miocardio/terapia , Stents , Anciano , Angioplastia Coronaria con Balón/efectos adversos , Angioplastia Coronaria con Balón/mortalidad , Reestenosis Coronaria/etiología , Trombosis Coronaria , Femenino , Humanos , Estimación de Kaplan-Meier , Modelos Logísticos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/mortalidad , Oportunidad Relativa , Puntaje de Propensión , Modelos de Riesgos Proporcionales , Diseño de Prótesis , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , España , Factores de Tiempo , Resultado del TratamientoRESUMEN
La diabetes mellitus constituye un factor de riesgo importante de padecerenfermedades cardiovasculares, como la enfermedad arterial coronaria,la enfermedad cerebrovascular o la enfermedad arterial periférica. Así,con respecto a la población general, los pacientes con diabetes presentanuna prevalencia hasta 10 veces superior de aterosclerosis con enfermedadarterial coronaria signifi cativa asociada, y un riesgo de padeceralgún episodio cardiovascular de 2 a 4 veces también superior. En consecuencia,las enfermedades cardiovasculares, en especial la enfermedadarterial coronaria, son la principal causa de muerte de los pacientes condiabetes. Por ello, es muy importante la prevención y el correcto tratamientode la enfermedad cardiovascular en este tipo de pacientes. En este artículose revisan las indicaciones actuales sobre las distintas técnicas derevascularización miocárdica y sus perspectivas futuras en el tratamientode la enfermedad arterial coronaria del paciente con diabetes(AU)
Diabetes mellitus represents an important risk factor to develop cardiovasculardiseases as coronary artery disease, cerebral vasculardisease or peripheral artery disease. Diabetic patients have a prevalenceof atherosclerosis with significant coronary artery disease tentimes higher than in the general population, and the risk of cardiovascularadverse events is two to four times greater. Consequently,cardiovascular diseases and specifically, significant coronary arterydisease, are the main cause of death in people with diabetes. Preventionand optimal treatment are especially important in this particularpopulation. In this article we have reviewed the current indicationsfor the different techniques of myocardial revascularization, andthe future perspectives of these techniques in the treatment of thecoronary artery disease in the diabetic patient(AU)