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Coronary restenosis: seventeen years summarized…
Session:
Posters (Sessão 3 - Écran 6) - Doença Coronária e Cuidados Intensivos 4 - Vários
Speaker:
Carla Marques Pires
Congress:
CPC 2022
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Carla Marques Pires; Carlos Galvão Braga; Rui Teles; Helder Pereira; Rui Ferreira; Marco Costa; Pedro Canas da Silva; Filipe Seixo; Pedro Braga; Pedro Costa Ferreira; Francisco Pereira Machado; Luis Bernardes; João Costa; Eduardo Infante de Oliveira; em Nome Dos Investigadores do Registo Nacional de Cardiologia de Intervenção.
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">INTRODUCTION: </span></span></strong><br /> <span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">Recurrence of symptoms after percutaneous coronary intervention (PCI) could be explained by disease progression, incomplete revascularization, or procedure failure, including coronary restenosis.</span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">AIMS: </span></span></strong><br /> <span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">To characterize the population with coronary restenosis in Portugal and the use of intravascular ultrasound (IVUS) in this population.</span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">METHODS: </span></span></strong><br /> <span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">A multicentric retrospective observational study was performed. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">In this study we characterize the population with repeated PCI due to coronary restenosis in the last 17 years (2002-2018) in Portugal. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">We also evaluate the tendency, over the years, of repeated PCI due to coronary restenosis and of usage of IVUS as adjuvant tool to diagnose and treat this procedure failure.<br /> Lastly, a multivariate analysis was performed to assess if the use of IVUS had impact on follow-up primary endpoint (death/myocardial infarction).</span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">RESULTS</span></span></strong><br /> <span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">This study analyzed 6494 patients (mean age: 65 years; 79% male gender) with repeated PCI due to coronary restenosis.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">These patients had a high prevalence of cardiovascular risk factors (75% had arterial hypertension, 69% dyslipidemia, 43% smoking habits and 37% Mellitus diabetes) and 9% had chronic kidney disease. Regarding echocardiographic data, to highlight that 15% had an ejection fraction lower than 50%. Additionally, most patients (65%) had multivessel disease, however just 36% underwent complete revascularization. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">Considering clinical presentation, in 45% of analyzed patients the PCI due to coronary restenosis was performed during acute coronary syndrome (ACS).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">The present study revealed a progressive increased of PCI due to coronary restenosis in the last 17 years (p<0,001). During this period, there was not a statistically significant increase of use of IVUS as adjuvant tool. IVUS was used, preferentially, in older patients (p=0.01), with higher prevalence of ejection fraction lower than 30% (p=0,002) and less frequently during ACS (p<0,001).<br /> Lastly, the use of IVUS in study subjects had no impact on follow-up primary endpoint in multivariate analysis. </span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">CONCLUSION</span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Calibri Light",sans-serif">:<br /> This study suggests that PCI due to coronary restenosis has been significantly increasing in the last 17 years. Despite current guidelines, this study did not reveal an increase usage of IVUS neither an improvement of clinical outcomes with this adjuvant tool.</span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"> </p>
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