oaioai:doaj.org/article:3b96ab9514ac41caa86472390626ae94

Evolução clínica muito tardia de pacientes com infarto agudo do miocárdio submetidos a angioplastia primária Very late clinical progression of patients with acute myocardial infarction submitted to primary angioplasty

Abstract

FUNDAMENTO: Informações sobre a evolução clínica, em longo período, de pacientes submetidos a reperfusão mecânica são escassas. OBJETIVO: O objetivo deste estudo é descrever a evolução clínica a longo prazo de pacientes submetidos a implante de stent primário. MÉTODOS: Entre janeiro de 1998 e dezembro de 2003, foi estudada uma coorte não concorrente fixa de 202 pacientes (média de idade = 61,2 ± 7,7 anos; 74,7% homens e 25,3% mulheres) submetidos a implante de stent primário. Foi realizado seguimento clínico de todos os pacientes e avaliada a ocorrência de óbitos, infarto agudo do miocárdio (IAM), acidente vascular encefálico (AVE) e revascularização do miocárdio (RM) cirúrgica ou percutânea. Foram construídas curvas de sobrevida de Kaplan-Meier para os eventos óbito, óbitos/IAM, óbitos/IAM/AVE e cardiovasculares maiores (ECVM). RESULTADOS: Em 91,5% dos pacientes o procedimento foi bem-sucedido. Na fase hospitalar, a mortalidade foi de 3,4%; o reinfarto, de 0,9%; o AVE, de 1,8%; e a RM de urgência, de 1,4%. O seguimento clínico variou de 29 a 100 meses (média = 58,7 ± 19,7 meses). A estimativa da sobrevida livre de óbito foi de 93,6%; a da sobrevida livre de óbito/IAM, de 89,6%; a da sobrevida livre de óbito/IAM/AVE, de 87,1%; e a da sobrevida livre de ECVM, de 71,3%. CONCLUSÃO: O implante de stent primário apresentou excelentes resultados na fase hospitalar. O seguimento clínico muito tardio demonstrou que esses bons resultados iniciais foram mantidos.BACKGROUND: Information on the clinical progression, in the long term, of patients submitted to mechanical reperfusion is scarce. OBJECTIVE: The objective of this study is to describe the long-term clinical progression of patients submitted to primary stenting. METHODS: Between January 1998 and December 2003 we studied a non-concurring cohort with a fixed population of 202 patients (mean age = 61.2 ± 7.7 years; 74.7% males and 25.3% females) submitted to primary stenting. All the patients were followed up clinically and we assessed the occurrence of deaths, acute myocardial infarction (AMI), cerebral vascular accident (CVA) and surgical or percutaneous myocardial revascularization (MR). Kaplan-Meier survival curves were built for the following events: death, deaths/AMI, deaths/AMI/CVA and major cardiovascular events (MCE). RESULTS: In 91.5% of the patients the procedure was successful. During hospital stay, mortality was 3.4%; reinfarction was 0.9%; CVA was 1.8%; and urgent MR was 1.4%. Clinical follow-up varied from 29 to 100 months (mean = 58.7 ± 19.7 months). Death-free survival was estimated at 93.6%; death/AMI-free survival at 89.6%; death-AMI/CVA-free survival at 87.1%; and MCE-free survival at 71.3% CONCLUSION: Primary stenting presented excellent results during hospital stay. Very late clinical follow-up demonstrated that these good initial results have held up

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oaioai:doaj.org/article:3b96ab9514ac41caa86472390626ae94Last time updated on 12/18/2014

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