Abstract

COTO VALLDEPERAS, Esteban  and  GUTIERREZ JAIKEL, Luis. Resultados clínicos y complicaciones de la angioplastía coronaria con STENT en el Hospital México (Costa Rica) en el período 2005-2007. Rev. costarric. cardiol [online]. 2009, vol.11, n.2, pp.13-19. ISSN 1409-4142.

Clinical outcomes and complications of percutaneous coronary angioplasty with stent placement: México Hospital, San José, Costa Rica, 2005-2007 Background: Percutaneous coronary angioplasty (PTCA), which is usually performed with stent placement, is a safe and effective interventional treatment for ischemic heart disease. This is a very prevalent form of coronary heart disease and has a significant morbidity and mortality in the general population. The purpose of this study is to describe the outcomes obtained with PTCA/stent placement at the México Hosptial during the period between January 2005 and December 2007. Methodology: A retrospective, observational cohort study was performed by way of a clinical chart review of 285 patients treated with coronary artery interventions during the study period. An analysis of results was performed on all patients and a comparison between diabetic and nondiabetic patients was also made. Results: Total annual mortality was 2.75%. Reintervention was required in 8.07% of cases: 4.56% due to restenosis, 1.05% due to late thrombosis -i.e. 5.61% was due to occlusion of a native coronary artery segment not involved in the initial intervention-, and 2.46% due to treatment of new lesions. Complications were noted in 2.75% of patients (included major bleeding in 1.75%), acute stent thrombosis in 2.5% and subacute thrombosis in 1.4%. There was a higher incidence of late stent thrombosis in diabetic patients compared to nondiabetics (3.75% vs. 0%), as well as reintervention (12.5% vs. 6.34%) and restenosis of treated vessels (7.5% vs. 3.41%). Reduction or elimination of angina was achieved in 91.95% of patients, with no difference between diabetic and nondiabetic patients. Conclusion: Global mortality was slightly higher at México Hosptial than in comparable studies. However, occlusion of a native coronary artery segment not involved in the initial procedure and the need for reintervention were lower. Thrombotic complications were more frequent than in comparable series. As observed in other series, diabetes mellitus was a statistically significant risk factor for late thrombotic events.

Keywords : coronary stent; angioplasty; restenosis; thrombosis.

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