[Comparative study between the therapeutic effects of surgical myocardial revascularization and coronary angioplasty in equivalent ischemic situations: analysis through myocardial scintigraphy with 99mTc-Sestamibi].
OBJECTIVE
To assess the myocardial ischemic load to previous and after myocardial revascularization.


METHODS
Ninety-six randomized patients, carriers of multivessel coronary artery disease, stable angina, preserved left ventricular function, and exercise-induced myocardial ischemia treated with revascularization (SMR) or coronary angioplasty (TCA). Myocardial scintigraphy with 99mTc-Sestamibi was performed prior to and 6 months after myocardial revascularization.


RESULTS
The SMR determined a significant greater index of complete revascularization (p=0.001), an increase in the number of maximum ergometric tests (p=0.001) and reduction in the number of positive ergometric tests with exercise angina (p=0.018). Both procedures provided an important improvement in the functional class of angina (p=0.001), an increase in the average value of double peak product (p=0.009), and the time of exercise tolerance (p<0.001), besides the reduction in the average value of the summed of exercise score (p<0.001) and the difference of the summed of scores (p<0.001) in both groups.


CONCLUSIONS
TCA and SMR did not differ significantly concerning the reduction of myocardial ischemic load 6 months after the procedure. The myocardial revascularization was more complete with the SMR than the TCA, but it did not represent a significant factor for the reduction myocardial ischemic load.
Moreira
Anellys E L C
AE
Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP. anellys@cardiol.br
Hueb
Whady A
WA
Soares
Paulo Rogério
PR
Meneghetti
José Cláudio
JC
Jorge
Maria Clementina P
MC
Chalela
William A
WA
Martinez Filho
Eulogio E
EE
Oliveira
Sérgio Almeida de
SA
Jatene
Fábio Biscegli
FB
Ramires
José Antônio Franchini
JA
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D009204:Myocardial Revascularization / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi