Asunto(s)
Aneurisma Coronario/etiología , Paclitaxel/efectos adversos , Sirolimus/efectos adversos , Stents/efectos adversos , Adulto , Angioplastia Coronaria con Balón/efectos adversos , Sistemas de Liberación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Paclitaxel/administración & dosificación , Sirolimus/administración & dosificaciónAsunto(s)
Aorta Torácica/patología , Enfermedades de la Aorta/complicaciones , Hematoma/complicaciones , Obstrucción de la Arteria Renal/complicaciones , Anciano , Enfermedades de la Aorta/patología , Aortografía , Femenino , Hematoma/patología , Humanos , Obstrucción de la Arteria Renal/patología , Tomografía Computarizada por Rayos X , Ultrasonografía Doppler en ColorRESUMEN
Hydroxymethylglutaryl coenzyme-A reductase inhibitors, or statins, have been shown to decrease mortality rates in patients who have coronary artery disease. It has been postulated that part of the mortality benefit conferred by statins is due to a decrease in ventricular arrhythmias. We assessed the effect of statin therapy on recurrent ventricular arrhythmias in 281 patients who developed coronary artery disease after implantable cardioverter-defibrillator placement. Statin therapy was associated with a significant decrease in the risk of ventricular arrhythmia that would require implantable cardioverter-defibrillator therapy.
Asunto(s)
Enfermedad de la Arteria Coronaria/terapia , Desfibriladores Implantables , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Fibrilación Ventricular/terapia , Anciano , Femenino , Humanos , Masculino , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Prevención SecundariaAsunto(s)
Cateterismo Cardíaco/efectos adversos , Cateterismo Cardíaco/métodos , Arteria Radial/diagnóstico por imagen , Arteria Radial/fisiopatología , Ultrasonografía Doppler , Angioplastia Coronaria con Balón/métodos , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/terapia , Femenino , Humanos , Masculino , Medición de Riesgo , Sensibilidad y Especificidad , Grado de Desobstrucción Vascular , Vasoconstricción/fisiología , Vasodilatación/fisiologíaRESUMEN
BACKGROUND: Prior reports have suggested that women have increased mortality compared to men following percutaneous coronary intervention (PCI). It remains unclear if this difference is secondary to sex or other confounding variables. METHODS: We sought to examine the characteristics and outcomes of 18039 consecutive women and men undergoing PCI at The Cleveland Clinic Foundation from 1992-2002. RESULTS: Procedural success rates were similar in both sexes, but the female cohort had a greater incidence of access site hematoma (5% vs. 2%, P < .0001) and blood product transfusion (12% vs. 4%, P < .0001) following PCI. The rate of myocardial infarction (MI) at 1 year was slightly higher among females (10% vs. 9%, P = .004), but revascularization rates were not significantly different between sexes. One-year mortality was also higher in the female cohort (7% vs. 5%, P < .0001). After adjustment in a multivariate model, the Cox proportional hazard ratio for mortality in females was 1.01 (95% CI 0.93-1.11, P = .78). The hazard ratio for the combined endpoint of death or MI was 1.05 (95% CI 0.97-1.13, P = .23). CONCLUSIONS: After adjustment for differences in comorbidities, the risk for long-term mortality is not significantly different between sexes following PCI. However, there is a greater incidence of post-procedural bleeding complications among women.
Asunto(s)
Angioplastia Coronaria con Balón/mortalidad , Enfermedad Coronaria/terapia , Anciano , Comorbilidad , Enfermedad Coronaria/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Infarto del Miocardio/mortalidad , Infarto del Miocardio/terapia , Hemorragia Posoperatoria/epidemiología , Modelos de Riesgos Proporcionales , Factores Sexuales , Resultado del TratamientoRESUMEN
The association between peripheral vascular disease and outcomes after percutaneous coronary intervention was examined in the Do Tirofiban and Reopro Give Similar Efficacy Outcome Trial (TARGET). After adjustments in a multivariate model, a history of peripheral vascular disease was found to be associated with a two- to threefold increase in mortality at 1 year after coronary stent placement.