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Diabetes e Doença Cardiovascular:prognóstico após cinco anos de revascularização percutânea
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Advisor(s)
Abstract(s)
Fundamentos: O diabetes mellitus (DM) é reconhecidamente fator de risco cardiovascular. Sabendose que a intervenção coronariana percutânea (ICP) melhora o prognóstico da doença coronariana (DC), pretendemos verificar se esse efeito é similar em doentes diabéticos (D) e não diabéticos (ND). Objetivo: Analisar o prognóstico em longo prazo do DM em pacientes submetidos a ICP. Métodos: Estudo de coorte, unicêntrico, retrospectivo, envolvendo pacientes consecutivos submetidos à ICP, eletiva ou de urgência, entre janeiro 2002 e dezembro 2003. Definiram-se dois grupos: pacientes com DM (D) e sem DM (ND). Compararam-se as variáveis clínicas e angiográficas da ICP com o resultado clínico ao final de cinco anos. Definiram-se como eventos maiores cardiovasculares (EMC): morte, nova síndrome coronariana aguda, acidente vascular encefálico (AVE) e nova revascularização cirúrgica ou ICP. Foram ainda avaliadas as taxas de trombose de stent, revascularização do vaso-alvo (RVA) e revascularização da lesão-alvo (RLA). Resultados: O seguimento em cinco anos foi 94%. Foram realizadas 446 ICP em 406 pacientes, média de idade
=63,0±11 anos, 70,4% masculino. Destes, 128 (31,5%) eram do grupo D. Em cinco anos o valor de EMC foi 50,7% para D e 36,7% para N. Encontrou-se mortalidade global de 28,1% vs. 14,4% (p=0,0016) e mortalidade cardiovascular de 15,6% vs. 8,3% (p=0,039), respectivamente, para D vs. ND. Os restantes parâmetros não foram estatisticamente significativos. Não houve diferenças em termos de trombose de stent e tipos de stent utilizados nos dois grupos.
Background: Diabetes Mellitus (DM) is a recognized cardiovascular risk factor, and knowing that percutaneous coronary intervention (PCI) improves prognoses of coronary artery disease (CAD), we intend to ascertain whether this effect is similar in diabetic (D) and nondiabetic (ND) patients. Objective: To analyze the long term impact of DM in patients undergoing PCI. Methods: Retrospective unicentric cohort study of consecutive patients undergoing elective or urgent PCI between January 2002 and December 2003, divided into two groups: diabetic (D) and non-diabetic (ND). Clinical, angiographic and coronary intervention PCI profiles were compared to clinical outcome at 5 years. Major cardiovascular events (MACE) were defined as death, new acute coronary syndrome (ACS), stroke (S), and new surgical (CABG) or percutaneous (PCI) revascularization. The stent thrombosis, target vessel revascularization (TVR) and target lesion revascularization (TLR) rates were also evaluated. Results: The five year follow-up rate was 94%. During the study, 446 PCIs were performed on 406 patients; 63.0±11 years old, 70.4% male. Among them, 128 (31.5%) were D. At the five-year follow-up, the MACE rate was 50.7% for D and 36.7% for ND (p=0.01). The global mortality rates were 28.1% vs 14.4% (p=0.0016) and the cardiovascular mortality rates were 15.6% vs. 8.3% (p=0.039) for D and ND respectively. The remaining parameters were not statistically significant. No differences were noted between stent thrombosis and the stent types used in both groups.
Background: Diabetes Mellitus (DM) is a recognized cardiovascular risk factor, and knowing that percutaneous coronary intervention (PCI) improves prognoses of coronary artery disease (CAD), we intend to ascertain whether this effect is similar in diabetic (D) and nondiabetic (ND) patients. Objective: To analyze the long term impact of DM in patients undergoing PCI. Methods: Retrospective unicentric cohort study of consecutive patients undergoing elective or urgent PCI between January 2002 and December 2003, divided into two groups: diabetic (D) and non-diabetic (ND). Clinical, angiographic and coronary intervention PCI profiles were compared to clinical outcome at 5 years. Major cardiovascular events (MACE) were defined as death, new acute coronary syndrome (ACS), stroke (S), and new surgical (CABG) or percutaneous (PCI) revascularization. The stent thrombosis, target vessel revascularization (TVR) and target lesion revascularization (TLR) rates were also evaluated. Results: The five year follow-up rate was 94%. During the study, 446 PCIs were performed on 406 patients; 63.0±11 years old, 70.4% male. Among them, 128 (31.5%) were D. At the five-year follow-up, the MACE rate was 50.7% for D and 36.7% for ND (p=0.01). The global mortality rates were 28.1% vs 14.4% (p=0.0016) and the cardiovascular mortality rates were 15.6% vs. 8.3% (p=0.039) for D and ND respectively. The remaining parameters were not statistically significant. No differences were noted between stent thrombosis and the stent types used in both groups.
Description
Keywords
Diabetes mellitus Fatores de risco Doença das coronárias Prognóstico Angioplastia Estudos de coortes Madeira Island Região Autónoma da Madeira Cohort studies Portugal
Citation
Rev Bras Cardiol. 2012;25(2):126-131
Publisher
Sociedade Brasileira de Cardiologiado Estado do Rio de Janeiro