RESUMEN
Saphenous vein graft (SVG) intervention has been associated with an increased incidence of distal embolization. Long lesions and lesions associated with thrombus are particularly at increased risk. This study was performed to determine whether abciximab may decrease this risk in high risk SVG angioplasty. From June 1994 to June 1998, 84 patients with at least one high risk factor, i.e., lesion length >20 mm or angiographic evidence of thrombus, underwent Transluminal extraction atherectomy (TEC) procedure followed by balloon dilatation or stenting. Of these 84 patients, 37 who had procedure after September 1995 underwent TEC with abciximab (Abciximab Group) and 47 who had their procedure before that date had TEC without abciximab thereby serving as historic control (Non-Abciximab Group). All patients had normal pre-procedure CK and CK-MB. Total creatine kinase (CK) and CK-MB were measured every 8 hr post-procedure for 24 hr. Baseline demographics, angiographic characteristics, incidence of LV dysfunction and triple vessel disease were similar between the two groups. Graft age was similar between two groups (122 +/- 70 vs. 117 +/- 54 months). Graft diameter, pre and post-procedure percent stenoses were not different between the two groups. Stents were used in 65% in the Abciximab group and 45% in Non-Abciximab group (P = 0. 14). There was no in-hospital repeat PTCA, urgent bypass surgery, or cardiac death. There was no difference between the two groups in regards to the incidence of any elevation of total CK (27% vs. 21. 3%) or CK-MB (54% vs. 51%). When used in conjunction with TEC in treating high risk vein graft lesions, abciximab did not reduce post procedure CK-MB elevation in this patient population.
Asunto(s)
Angioplastia Coronaria con Balón/métodos , Anticuerpos Monoclonales/administración & dosificación , Aterectomía/métodos , Puente de Arteria Coronaria/efectos adversos , Creatina Quinasa/efectos de los fármacos , Oclusión de Injerto Vascular/tratamiento farmacológico , Fragmentos Fab de Inmunoglobulinas/administración & dosificación , Isoenzimas/efectos de los fármacos , Inhibidores de Agregación Plaquetaria/administración & dosificación , Vena Safena/trasplante , Abciximab , Anciano , Distribución de Chi-Cuadrado , Angiografía Coronaria , Puente de Arteria Coronaria/métodos , Enfermedad Coronaria/cirugía , Creatina Quinasa/análisis , Forma MB de la Creatina-Quinasa , Femenino , Estudios de Seguimiento , Oclusión de Injerto Vascular/diagnóstico por imagen , Oclusión de Injerto Vascular/terapia , Rechazo de Injerto , Humanos , Isoenzimas/análisis , Persona de Mediana Edad , Probabilidad , Medición de Riesgo , Resultado del TratamientoRESUMEN
This study examined whether estrogen replacement therapy (ERT) in postmenopausal women impacts intermediate and long-term outcome after successful coronary stenting. Our findings offer evidence that ERT significantly reduces target lesion revascularization after intracoronary stenting in postmenopausal patients who are on ERT before the intervention.