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Search Results: 1 - 10 of 7722 matches for " Galo Alfredo Maldonado;Abizaid "
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Evolu??o clínica tardia dos stents farmacológicos: seguran?a e eficácia até cinco anos do Registro DESIRE
Sousa, Amanda Guerra de Moraes Rego;Costa Junior, José Ribamar;Moreira, Adriana;Costa, Ricardo Alves da;Cano, Manuel Nicolas;Andrade, Galo Alfredo Maldonado;Abizaid, Alexandre Antonio Cunha;Feres, Fausto;Mattos, Luiz Alberto Piva e;Staico, Rodolfo;Pavanello, Ricardo;Egito, Enilton Sergio Tabosa do;Sousa, José Eduardo Moraes Rego;
Revista Brasileira de Cardiologia Invasiva , 2007, DOI: 10.1590/S2179-83972007000300006
Abstract: background: indications for the implantation of sirolimusand paclitaxel-eluting stents are expanding and include complex lesions and subsets of patients with clinical and demographic characteristics very different from those of early pivotal randomized trials. the desire registry was planned to monitor the safety of both cypher? and taxus? stent available in brazil since 2002. methods and results: from may 2002 through march 2007, 2043 patients treated with one or more than one stent (either cypher? or taxus?) at hospital do cora??o da associa??o do sanatório sírio were included in this registry. mean age was 63.8 (11.3) years; 76.6% were male and 28.4% had diabetes. a total of 2,415 lesions were treated and 2,983 stents were implanted: 2,608 cypher? and 375 taxus?. acute and subacute (<30 days); late thrombosis (31 days - 360 days) and very late thrombosis (>360 days) occurred in 0.34%, 0.73% and 0.34% of the patients, adding up to a 1.42% overall rate. likewise, the major adverse cardiac event rate was low and added up to 8.6% (154 patients), including: 45 (2.51%) cardiac deaths; 50 (2.8%) myocardial infarctions and 59 (3.3%) of additional revascularizations. conclusions: this long-term analysis of the desire registry shows the high efficacy and safety profiles of drug-eluting stents, with a low thrombosis rate, which is similar to those of randomized trials.
Safety and efficacy of coronary stent implantation. Acute and six month outcomes of 1,126 consecutive patients treated in 1996 and 1997
Mattos, Luiz Alberto;Pinto, Ibraim;Abizaid, Alexandre;Abizaid, Andrea;Chaves, Aurea;Feres, Fausto;Maldonado, Galo;Tanajura, Luiz;Centemero, Marinella;Sousa, Amanda G. M. R.;Sousa, J. Eduardo;
Arquivos Brasileiros de Cardiologia , 1999, DOI: 10.1590/S0066-782X1999000700003
Abstract: purpose: the authors analyzed the 30-day and 6-month outcomes of 1,126 consecutive patients who underwent coronary stent implantation in 1996 and 1997. methods: the 30-day results and 6-month angiographic follow-up were analyzed in patients treated with coronary stents in 1996 and 1997. all patients underwent coronary stenting with high-pressure implantation (>12 atm) and antiplatelet drug regimen (aspirin plus ticlopidine). results: during the study period, 1,390 coronary stents were implanted in 1,200 vessels of 1,126 patients; 477 patients were treated in the year 1996 and 649 in 1997. the number of percutaneous procedures performed using stents increased significantly in 1997 compared to 1996 (64 % vs 48%, p=0.0001). the 30-day results were similar in both years; the success and stent thrombosis rates were equal (97% and 0.8%, respectively). the occurrence of new q wave mi (1.3% vs 1.1%, 1996 vs 1997, p=ns), emergency coronary bypass surgery (1% vs 0.6%, 1996 vs 1997, p=ns) and 30-day death rates (0.2% vs 0.5%, 1996 vs 1997, p=ns) were similar. the 6-month restenosis rate was 25% in 1996 and 27% in 1997 (p= ns); the target vessel revascularization rate was 15% in 1996 and 16% in 1997 (p = ns). conclusions: intracoronary stenting showed a high success rate and a low incidence of 30-day occurrence of new major coronary events in both periods, despite the greater angiographic complexity of the patients treated with in 1997. these adverse variables did not have a negative influence at the 6-month clinical and angiographic follow-up, with similar rates of restenosis and ischemia-driven target lesion revascularization rates.
Acute myocardial infarction in progressively elderly patients. A comparative analysis of immediate results in patients who underwent primary percutaneous coronary intervention
Mattos, Luiz Alberto;Zago, Alexandre;Chaves, áurea;Pinto, Ibraim;Tanajura, Luiz;Staico, Rodolfo;Centemero, Marinella;Feres, Fausto;Maldonado, Galo;Cano, Manoel;Abizaid, Andréa;Abizaid, Alexandre;Sousa, Amanda G.M.R.;Sousa, J. Eduardo;
Arquivos Brasileiros de Cardiologia , 2001, DOI: 10.1590/S0066-782X2001000100006
Abstract: objective: analysis of the in-hospital results, in progressively elderly patients who undergo primary percutaneous coronary intervention (pci) in the first 24 hours of ami. methods: the patients were divided into three different age groups (60/69, 70/79, and 380 years) and were treated from 7/95 until 12/99. the primary success rate and the occurrence of major clinical events were analyzed at the end of the in-hospital phase. coronary stent implantation and abciximab use were employed at the intervencionist discretion. results: we analyzed 201 patients with age ranging from 60 to 93 years, who underwent primary pci. patients with ages above 70 were more often female (p=.015). those with ages above 80 were treated later with pci (p=.054), and all of them presented with total occlusion of the infarct-related artery. coronary stents were implanted in 30% of the patients. procedural success was lower in 380 year old patients (p=.022), and the death rate was higher in 370 years olds (p=.019). reinfarction and coronary bypass surgery were uncommon events. a trend occurred toward a higher combined incidence of major in-hospital events according to increased age (p=.064). conclusion: elderly patients (370 years) presented with adverse clinical and angiographic profiles and patients 380 years of age obtained reduced timi 3 flow success rates after primary ptca, and those 370 years had a higher death rate.
Influence of balloon pressure inflation in patients undergoing primary coronary stent implantation during acute myocardial infarction: a quantitative coronary angiography analysis
Mattos, Luiz Alberto;Sousa, Amanda G.M.R.;Chaves, áurea;Feres, Fausto;Pinto, Ibraim;Tanajura, Luiz;Centemero, Marinella;Abizaid, Alexandre;Seixas, Ana C.;Abizaid, Andréa;Maldonado, Galo;Staico, Rodolfo;Sousa, J. Eduardo M.R.;
Arquivos Brasileiros de Cardiologia , 2003, DOI: 10.1590/S0066-782X2003000300002
Abstract: objective:to verify the influence of moderate- or high-pressure balloon inflation during primary coronary stent implantation for acute myocardial infarction. methods: after successful coronary stent implantation, 82 patients were divided into 2 groups according to the last balloon inflation pressure: group 1 (312 to <16 atm) and group 2 (316 to 20 atm), each with 41 cases. all patients underwent late coronary angiography. results: in group 1, the mean stent deployment pressure was 13.58±0.92 atm, and in the group 2 it was 18.15±1.66 atm. stents implanted with moderate pressures (312 to <16 atm) had a significantly smaller postprocedural minimal lumen diameter, compared to with those with higher pressure, with lesser acute gain (2.7± 0.4 mm vs 2.9±04 mm; p=0.004), but the late lumen loss (0,9±0,8 mm vs 0,9±0,6 mm) and the restenosis (22% vs. 17.1%) and target-vessel revascularization rates (9.8% vs 7.3%) were similar between the groups. conclusion: during ami stenting, the use of high pressures (316 atm) did not cause a measurable improvement in late outcome, either in the late loss, its index, and the net gain, or in clinical and angiographic restenosis rates.
Impacto dos stents farmacológicos no tratamento percutaneo de les?es coronárias em bifurca??o: resultados clínicos tardios de um estudo comparativo incluindo pacientes do "mundo-real"
Mendes, Alaor;Sousa, Amanda G. M. R.;Costa, Ricardo A.;Moreira, Adriana;Costa Jr., José Ribamar;Maldonado, Galo;Cano, Manuel N.;Lima, André;Staico, Rodolfo;Feres, Fausto;Mattos, Luiz A.;Abizaid, Alexandre;Siqueira, Dimytri;Berwanger, Otávio;Sousa, J. Eduardo;
Revista Brasileira de Cardiologia Invasiva , 2008, DOI: 10.1590/S2179-83972008000400008
Abstract: background: historically, percutaneous coronary interventions (pci) in bifurcation lesions are associated with high rates of complications, especially due to suboptimal results in the lateral branch (lb) and the need for target lesion revascularization (tlr) during long-term follow-up. we assess the impact of drug-eluting stents in the late clinical follow-up of non-selected patients with bifurcation lesions coming from the daily clinical practice. methods: since may, 2002, 195 patients with bifurcation lesions were treated consecutively at two clinical centers [drugeluting stent (des) group = 89; non drug-eluting stent (ndes) group = 106] and followed up for two years. results: the two groups presented similar clinical profiles including mean age of 63 years and 25% with diabetes mellitus. the majority of lesions had significant involvement of the two branches (78% vs. 76%; p = 0.82), the provisional lb stent strategy was used in the majority of cases (75% des vs. 89% ndes; p = 0.45), and the angiographic success in the lateral branch (timi 3 flow, residual stenosis < 50% without dissection) was achieved in 80% vs. 78% (p = 0.56) in the des and ndes groups, respectively. after 24 months of follow-up, the des group showed a higher survival free of tlr (97.8% vs. 82.1%; p < 0.0001), resulting in higher survival free of major adverse cardiac events (mace) (93.3% vs. 77.4%; p = 0.003). stent thrombosis occurred in 2 patients in each group. conclusions: in non-selected patients from the "real-world", the use of des to treat bifurcation coronary lesions was superior to the use of ndes stents in the long-term clinical follow-up, especially with respect to their clinical effectiveness in reducing the rates of tlr, with consequent increase in survival free from mace, without compromising long-term safety.
Implante de múltiplos stents farmacológicos para o tratamento da doen?a multiarterial em paciente diabética
Maldonado, Galo;Quizhpe, Arturo Ricardo;Costa Jr, José de Ribamar;Centemero, Marinella;Abizaid, Alexandre;Feres, Fausto;Costa, Ricardo;Staico, Rodolfo;Mattos, Luiz Alberto;Chaves, áurea;Paiva, Julio;Nunes, Paulo Márcio;Sousa, Amanda MR;Sousa, J. Eduardo Moraes Rego;
Revista Brasileira de Cardiologia Invasiva , 2007, DOI: 10.1590/S2179-83972007000300019
Abstract: the incidence of diabetes mellitus has continuously risen over recent years. patients with this chronic condition have a higher risk of developing coronary artery disease. unfortunately, due to the frequent diffuse involvement of multiple vessels, the long term outcomes after percutaneous intervention, whether by balloon catheter or bare-metal stent, has always been poor and frequently inferior to cardiac surgery for this subset of patients. recently, the introduction of drug-eluting stents (des) has brought new hope to treat patients with more complex diseases percutaneously. in this paper we report a successful percutaneous approach of a 63-year-old insulin dependent diabetic patient treated with nine des (taxustm, boston scientific).
Experiência inicial com o uso de stents eluidores de everolimus em pacientes do mundo real: seguimento clínico de um ano
Chamié, Daniel;Feres, Fausto;Costa Jr., J. Ribamar;Abizaid, Alexandre;Costa, Ricardo A.;Siqueira, Dimytri;Staico, Rodolfo;Maldonado, Galo;Mattos, Luiz Alberto;Centemero, Marinella;Chaves, áurea;Tanajura, Luiz Fernando;Sousa, Amanda G. M. R.;Sousa, J. Eduardo;
Revista Brasileira de Cardiologia Invasiva , 2009, DOI: 10.1590/S2179-83972009000400011
Abstract: background: everolimus-eluting stents have proved to be safe and effective in the treatment of low-risk, selected patients, from randomized trials. nonetheless, studies assessing their impact on more complex real-world patients are rare. method: we prospectively evaluated 193 patients treated with everolimus-eluting stents alone. the only exclusion criteria were: in-stent restenosis of another drug-eluting stent, percutaneous coronary intervention of a saphenous vein graft and acute myocardial infarction with st segment elevation. the primary endpoint was the incidence of major adverse cardiac events (mace), defined as the composite of cardiac death, myocardial infarction and target vessel revascularization. results: mean age was 60.6 ± 11.8 years. half of the patients were women and 36.8% were diabetics. multivessel disease was found in 61.6% of the patients. patients had 1.8 ± 0.66 lesion treated in 1.73 ± 0.9 vessel, with a mean of 2.27 ± 0.9 stents per patient. the majority (70.6%) of the lesions were type b2/c, true bifurcations were treated in 37.3% of the cases and moderate to severe calcifications were observed in 17.4% of the lesions. the 1-year mace rate was 6.7%, mainly due to the occurrence of in-hospital events. there was only one (0.5%) case of probable subacute stent thrombosis. no cases of late stent thrombosis were observed. conclusions: the present analysis suggests that the use of everolimus eluting stents is safe and effective in the treatment of complex patients from the daily clinical practice, with low major adverse cardiac events rate in the 1-year follow-up. longer follow-up with a larger number of patients is required to confirm these promising results.
Evolu??o clínica tardia de pacientes multiarteriais tratados por revasculariza??o percutanea e cirúrgica
Centemero, Marinella;Sousa, J. Eduardo;Jatene, Adib D.;Paulista, Paulo Paredes;Souza, Luis Carlos Bento;Sousa, Amanda G. M. R.;Feres, Fausto;Staico, Rodolfo;Mattos, Luiz Alberto;Abizaid, Alexandre;Maldonado, Galo;Tanajura, Luiz Fernando;Chaves, áurea;Lasave, Leandro;
Revista Brasileira de Cardiologia Invasiva , 2007, DOI: 10.1590/S2179-83972007000100009
Abstract: background: patients with multivessel disease treated percutaneously have similar outcomes when compared to those submitted to surgical procedures in terms of major cardiac events, although the former require new revascularization procedures more frequently. objective: to assess long-term clinical outcomes after coronary artery bypass graft (cabg) for the treatment of multivessel disease versus surgical procedures to treat multivessel disease determining death, ami, and stroke incidence rates, as well as new interventions. methods: a randomized study carried out between april, 1997 and june, 1998 included 66 patients submitted to non-drug eluting stenting (33p) and surgery (33p). results: clinical follow-up results after 8 years have shown no significant difference between the two groups in terms of survival free of mace events (death, stroke or ami): stenting: 74% x cabg: 85.1%; p= not significant). additional revascularizations were more frequent in the stenting group as compared to the surgery group (15 p - 45% x 5 p - 15%, respectively, p=0.01). consequently, survival rates without mace and repeated revascularization was significantly lower in patients assigned to stenting when compared to those assigned to cabg (49% x 80.5%, respectively, p=0.0082). conclusion: percutaneous revascularization with non-drug eluting stenting for the treatment of multivessel disease offers the same degree of protection against mace (death, stroke and ami) as compared to cabg. however, stenting is associated with a greater need of repeated revascularization and lower total event-free survival rates.
Preditores e impacto clínico intra-hospitalar do sangramento associado à interven??o coronária percutanea
Zukowski, Cleverson Neves;Costa Jr., J. Ribamar;Costa, Ricardo;Esteves, Vinícius;Staico, Rodolfo;Siqueira, Dimytri;Mattos, Luiz Alberto;Maldonado, Galo;Braga, Sérgio;Chaves, áurea J.;Abizaid, Alexandre;Feres, Fausto;Sousa, Amanda G. M. R.;Sousa, J. Eduardo;
Revista Brasileira de Cardiologia Invasiva , 2010, DOI: 10.1590/S2179-83972010000300009
Abstract: background: percutaneous coronary intervention (pci)related bleeding is a frequent complication whose prognosis is often neglected. several studies have shown the adverse clinical impact of bleeding, especially increased short and long-term mortality rates. the purpose of this study was to evaluate predictors and clinical impact of this complication in a large cohort of patients undergoing pci. methods: we performed a prospective analysis of 2,892 consecutive patients undergoing elective or urgent pci from january/2008 to june/2009. patients with and without bleeding were compared for clinical, angiographic and procedure-related variables as well as in-hospital clinical outcomes. multiple logistic regression analysis was performed to determine the influence and independence of bleeding predictors. results: procedure-related bleeding was identified in 1.7% of the patients. taking in account only patients with acute coronary syndrome (acs) the incidence increased to 3.4%. multivariate analysis identified acs [odds ratio (or) 3.96, 95% confidence interval (95% ci) 1.45-11.42], use of glycoprotein iib/iia inhibitors (or 2.55, 95% ci 1.68-3.87), chronic renal failure (or 2.34, 95% ci 1.11-3.49), killip iv (or 2.32, 95% ci 1.54-3.5) and femoral access (or 1.72, 95% ci 1.19-3.14) as independent predictors of bleeding. procedure-related bleeding was associated with in-hospital acute renal failure (16.7% vs. 1.6%; p < 0.001) and in-hospital mortality (10.4% vs. 0.7%; p < 0.001). conclusions: the present study demonstrates that periprocedural bleeding, more frequently observed in patients with acs, is a predictor of in-hospital major clinical adverse events, including increased mortality rates.
Stents farmacológicos vs. stents n?o-farmacológicos no tratamento de enxertos de veia safena
Collet, Carlos A.;Costa Jr., J. Ribamar;Sousa, Amanda G. M. R.;Feres, Fausto;Moreira, Adriana;Costa, Ricardo;Staico, Rodolfo;Almeida, Alejandro;Siqueira, Dimytri;Cano, Manuel;Maldonado, Galo;Abizaid, Alexandre;Sousa, J. Eduardo;
Revista Brasileira de Cardiologia Invasiva , 2011, DOI: 10.1590/S2179-83972011000200005
Abstract: background: although drug-eluting stents have markedly reduced restenosis and the need for repeat lesion revascularization in the vast majority of clinical and angiographic scenarios, the benefit of these devices for the treatment of saphenous-vein graft (svg) lesions is yet to be defined. the aim of our study was to compare the rate of major adverse clinical events (mace) between drug-eluting stents and bare-metal stents in svg lesions in non-selected patients. methods: patients treated in two tertiary hospitals between may 2006 and january 2009 were included. the primary objective was to compare the incidence of mace between drug-eluting stents and bare-metal stents during hospitalization and in the long-term follow-up. results: overall, 308 patients were consecutively enrolled and divided according to the type of stent deployed (209 with drug-eluting stents and 99 with bare-metal stents). mean age was 68 years and svg mean age was 10.9 years. in the in-hospital phase there was a trend towards higher mace in the drug-eluting stents group (12% vs. 5.1%; p = 0.06). the incidence of mace in up to 24 months was equivalent between groups (17.2% for the drug-eluting stents group vs. 18.2% for the bare-metal stents group; p = 0.87). definite/probable stent thrombosis was similar in both groups (2.3% for the drug-eluting stents group vs. 2% for bare-metal stents group; p = 0.94). conclusions: in this real world series of complex patients there was no long-term safety concerns related to the use of drug-eluting stents in the treatment of svg lesions, with similar rates of cardiac death/myocardial infarction/stent thrombosis in both groups.
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