[The benefit of a coronary stent in the reduction of major cardiac complications in acute coronary syndromes].
To assess the incidence of in-hospital major adverse cardiac events (MACE), we analyzed 694 procedures in 613 consecutive patients during one year period. Patient population included 550 (79.2%) patients with unstable angina, 43 (6.2%) with stable angina and 101 (14.5%) with acute myocardial infarction. Elective percutaneous transluminal coronary angioplasty (PTCA) was performed in 593 (85.4%) patients, rescue PTCA in 7 (1%), and primary PTCA in 94 (13.5%). Angiographic lesion morphology was as follows: type A 30%; type B 58%; type C 12%. We compared patient population who received stent with PTCA-balloon only. Technical success was 95% and clinical success was achieved in 80% of the cases. Overall mortality was 1% in the stent group and 3% in the conventional PTCA. The incidence of MACE was 4% and 15.1% in the stent and angioplasty balloon groups respectively. We found a dramatic impact on reduction of the incidence of acute complications in the groups with stenting for unstable angina (p = 0.0001) and acute myocardial infarction (p = 0.0001). The major clinical advantage of stenting over balloon angioplasty was a lower need for repeated procedures.
Martínez-Ríos
M A
MA
Departamento de Hermodinámica del Instituto Nacional de Cardiología Ignacio Chávez, INCICH, México, D. F.
Eid-Lidt
G
G
Luna Guerra
J
J
Villavicencio Fernández
R
R
Ban Hayashi
E
E
Gaspar Hernández
J
J
Peña Duque
M A
MA
D000208:Acute Disease; D000789:Angina, Unstable / Q000150:complications / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome