Rev. Bras. Cardiol. Invasiva.2017;25(1-4):27-30.
Percutaneous coronary intervention in large vessels
DOI: 10.31160/JOTCI2017;25(1-4)A0007
ABSTRACT
Background:
Percutaneous coronary intervention (PCI) in large vessels has peculiarities that have been little explored in studies. Our objective was to evaluate temporal trends over the last 10 years and in-hospital outcomes for this population.
Methods:
Using data from the National Center for Cardiovascular Interventions (CENIC), procedures performed between June 2006 and March 2016 were analyzed. The data were divided into three periods (2006-2008, 2009-2011 and 2012-2016). Clinical, angiographic, therapeutic and in-hospital outcome data were considered.
Results:
The sample comprised 35,065 patients and 35,837 procedures. The mean age was 61.7 years. In addition, 72.1% of patients were male, and 19.6% had diabetes mellitus. The success rate was high (98.7%) with increased use over time for drug-eluting stents, the radial access route and approaches to lesions in the left main coronary artery. A significant reduction in in-hospital mortality was observed, favoring contemporary interventions. The main variables correlating with death in a multiple logistic regression model included ST-segment elevation myocardial infarction, left main coronary artery lesions and left ventricular dysfunction.
Conclusions:
A reduction in mortality associated with percutaneous treatment of large vessels was noted. The effect of adopting measures capable of favorably influencing outcomes, such as the increased use of drug-eluting stents and radial approach, requires confirmation by studies methodologically directed to this investigational hypothesis.
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