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2012, Número 2

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Rev Mex Cardiol 2012; 23 (2)


Análisis comparativo de angioplastia versus cirugía en la coronariopatía multivaso; perspectiva de un hospital comunitario

Solís-Olivares CA, Solís-Soto JM

Idioma: Español
Referencias bibliográficas: 22
Paginas: 64-71
Archivo PDF: 67.26 Kb.


RESUMEN

Introducción: Hasta 60% de los casos tratados con intervención coronaria percutánea (ICP) o cirugía (CRVC) tienen enfermedad coronaria de múltiples vasos (ECMV). Objetivo: Comparar la evolución clínica de estos pacientes después de su comparativo, de una cohorte tratada por ECMV con CRVC o ICP más stents farmacoactivos o bioactivos entre enero de 2004 a julio de 2011. Se utilizó expediente clínico, consignando eventos cardiovasculares adversos. Resultados: Ingresaron 134 pacientes, predominando varones con enfermedad trivascular y angina estable con un seguimiento de 35.7 ± 20.4 meses. El grupo quirúrgico tuvo más dislipidemia (41.9 vs 36.7%), diabetes (59.5 vs 38.3%), hipertensión arterial (67.6 vs 60%), infarto del miocardio antiguo (37.8 vs 23.3%) y lesión tipo C en la arteria descendente anterior (63.9 vs 30.4%), p ‹ 0.05 para todas. Los tratados con ICP tuvieron más necesidad de revascularización repetida (30.50 vs 2.73%) p ‹ 0.01, recurrencia de angina (44 vs 20%), ergometrías positivas (39 vs 18%), hospitalizaciones (25 vs 9%) y deterioro funcional según la New York Heart Association III o IV (22 vs 11%), p ‹ 0.05 para todos. Conclusión: En pacientes de un hospital comunitario con ECMV, la ICP presenta una recurrencia superior de isquemia y revascularización repetida comparada con la CRVC.


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