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ISSN 0188-2198 (Print)

2004, Number 3

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Rev Mex Cardiol 2004; 15 (3)

Interventionism treatment in patients with unstable angina postinfarction: TIMI influence. Experience of an Hospital Centre, follow up to long term

Ogaz GE, Palacios RJM, Muñiz GA, Cantú RS, Cruz RO, Reyes DS, Jáuregui RO, Martínez BP

Language: Spanish
References: 41
Page: 118-130
PDF size: 127.74 Kb.


ABSTRACT

Background: To evaluate the safety , efficacy and the effect of coronary artery ballon angioplasty and stenting (TPCA) in patients (pts) with unstable angina post-Ami (UAPAMI). We show our experience in 172 (pts) patients with TPCA whom undergoing transluminal angioplasty with or without stent implantation. Methods: From April 2000 to Nov 2003,172 pts, who were underselection from 440 total group of patients under diagnosis from Unstable Angina. We take this subgroup of patients (pts) from post-AMI Unstable Angina subgroup, treated in our hospital. The mean age was 66.4 ± 9.8 years, 53% male and 47% female, without differences in demographic statements like, arterial hypertension (AH); Diabetes Mellitus, Hyperlipidaemia; Smoking. Just Obesity means differences in TIMI 3 group P ‹ 0.01. Results: The 172 pts. were separated in two groups. TIMI 3 and Non TIMI 3 based on distal perfusion at the moment of coronary angiography. The study has included schedule from 4 coronary arteries: 1. MCD main coronary artery disease, 2. LAD, 3.-CX and RCA this included posterior branch and posterior descending artery. The vessel diameter shows that Non T3 group has smallest arteries and calcified too with statistical significance and included presence of intracoronary thrombus this reflects wide influence of short and long term prognosis as we seen at the 6 months results with functional Class I in TIMI3 group with P ‹ 0.05 compared with Non TIMI 3 Group. The lesion in type A, B1, B2 and C has demonstrated significantly statistical differences in lesion type B2 and C relationship with poor prognosis and Non TIMI 3 group has this tendency. Combined MACES including death, cardiac surgery, or TPCA needed, fatal and non fatal AMI, Angina. shows significant responses in TIMI 3 in compared with Non TIMI3 group in (Post-Tpca) or in hospital with P ‹0. 006 in favor to TIMI 3 Group and to 6 months P ‹ 0.04. Conclusion: The results reflects the Trial statements in favor to an aggressive treatments in pts with unstable angina or with unstable angina in post AMI pts. The observational Trials demonstrates the needs for previous treatment with glycoprotein inhibitors likes tirofiban or abciximab with better results in favor preventing poor flow or Non reflow phenomenon in the treated vessels. The Stents application demonstrates better short and long term results in compared with pts. treated with balloon angioplasty alone with statistical differences even ejection fraction, presence of intracoronary thrombus has an invaluable prognosis end point knowing the group of pts, with better long term prognosis. Angina at 6 months reflects itself an invaluable prognosis and it demonstrates being non invasive method demonstrating the best clinical end point from the TIMI 3 and Non TIMI 3 groups in our study.


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