RESUMO
The present study aimed to determine the relationship between the prevalence of cardiovascular risk factors and the number and severity of coronary artery atherosclerotic lesions obtained by coronary angiography. We reviewed and analyzed 1642 records from consecutive patients at the Catheter Laboratory of Talca Regional Hospital in Chile between March 2018 and May 2019. Patients were stratified according to the presence and severity of atherosclerotic lesions: 632 (38.5%) had no lesions or <30% stenosis and 1010 (61.5%) had at least one coronary atherosclerotic lesion with ≥30% stenosis (CALS-30). CALS-30 was more frequent in males, smokers, and patients with diabetes and/or hypertension (all p-values < 0.02). Serum potassium, glycaemia, creatinine and glomerular filtration rates were also associated with CALS-30 (all p-values < 0.01) in males. The age and the proportion of males with CALS-30 increased with the number of risk factors (p-values for trends < 0.001). Our results showed a stronger association between the accumulation of risk factors and CALS-30 in women than in men. Serum potassium levels were inversely associated with CALS-30 in men but not in women.
RESUMO
Introdução: Embora os stents farmacológicos tenham reduzido de forma inconteste o crescimento neointimal e sua consequência clínica direta, a reestenose, questionamentos acerca de sua segurança a longo prazo têm motivado o desenvolvimento de novas tecnologias. A aplicação sistêmica de fármacos antiproliferativos teria o potencial de solucionar o problema da reestenose e ao mesmo tempo amenizar a questão da segurança tardia inerente aos polímeros sintéticos. Recentemente, estudo investigando a administração intravenosa de uma solução de paclitaxel ligado à albumina (ABI-007) produziu efeito discreto na redução da formação de tecido neointimal. Este trabalho teve como objetivo avaliar, por meio da angiografia e do ultrassom intracoronário (USIC) seriados, a efetividade da aplicação intracoronária do ABI-007 na supressão da hiperplasia neointimal após implante de stents não-farmacológicos. Método: Entre novembro de 2006 e maio de 2007, pacientes portadores de lesões coronárias de novo, com extensão < 18 mm, em vasos nativos de 2,5 mm a 3,5 mm de diâmetro, foram submetidos a intervenção coronária percutânea com implante de stents não-farmacológicos, seguida de injeção intracoronária de 70 mg/m² de ABI-007. Avaliação com angiografia e USIC foi programada para todos os pacientes imediatamente após o procedimento e aos seis meses de seguimento. Desfecho primário era a perda luminal tardia (QCA) e o porcentual de obstrução volumétrica gerado pela hiperplasia neointimal (USIC) aos seis meses...
Background: Although drug-eluting stents have proven to be highly effective in decreasing neointimal hyperplasia and its direct clinical consequence, restenosis, concernsregarding their long-term safety have led to the development of new technologies. The systemic use of antiproliferative drugs may resolve restenosis while minimizing the longterm safety issues inherent to synthetic polymers. Recently, a study investigating the intravenous administration of albumin-bound paclitaxel (ABI-007) showed that it produced a mild effect on the reduction of neointimal tissue formation. The present study was aimed at investigating, by means of serial angiography and intravascular ultrasound (IVUS), the efficacy of intracoronary ABI-007 administration inthe suppression of neointimal hyperplasia after bare-metal stent implantation. Method: From November 2006 and May 2007, patients with de novo coronary lesions < 18 mm were submitted to percutaneous coronary intervention using bare-metal stents, followed by a 70 mg/m² intracoronaryinjection of ABI-007. Angiography and IVUS assessment was planned for all of the patients immediately after theprocedure and at the six-month follow-up...
