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Perfil Aterosclerótico da Artéria Carótida como Preditor de Risco para Reestenose após Implante de Stent Coronário
Authors:  ssia da Silva Antico Rodrigues,Rodrigo Bazan,Fabrí  cio Moreira Reis,Caroline F. S. Mazeto Pupo da Silveira,Lí  via Maria Severino Hueb,Fá  bio Cardoso de Carvalho,Hé  lio Rubens de Carvalho Nunes,Katashi Okoshi,Joã  o Carlos Hueb,Silmé  ia Garcia Zanati Bazan
Affiliation:1. Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina Campus de Botucatu, BotucatuSP, Brasil, Universidade Estadual Paulista Julio de Mesquita Filho - Faculdade de Medicina Campus de Botucatu, Botucatu, SP – Brasil; 1. BotucatuSP, Brazil, Universidade Estadual Paulista Julio de Mesquita Filho - Faculdade de Medicina Campus de Botucatu, Botucatu, SP – Brazil
Abstract:Background:The incidence of restenosis of the coronary artery after a bare-metal stent implant has been lower than in simple balloon angioplasty; however, it still shows relatively high rates.Objective:The aim of this study was to find new risk indicators for in-stent restenosis using carotid ultrasonography, that, in addition to the already existing indicators, would help in decision-making for stent selection.Methods:We carried out a cross-sectional prospective study including 121 consecutive patients with chronic coronary artery disease who had undergone percutaneous coronary intervention with repeat angiography in the previous 12 months. After all cases of in-stent restenosis were identified, patients underwent carotid ultrasonography to evaluate carotid intima-media thickness and atherosclerosis plaques. The data were analyzed by Cox multiple regression. The significance level was set a p<0.05.Results:Median age of patients was 60 years (1st quartile = 55, 3rd quartile = 68), and 64.5% of patients were male. Coronary angiography showed that 57 patients (47.1%) presented in-stent restenosis. Fifty-five patients (45.5%) had echolucent atherosclerotic plaques in carotid arteries and 54.5% had echogenic plaques or no plaques. Of patients with who had echolucent plaques, 90.9% presented coronary in-stent restenosis. Of those who had echogenic plaques or no plaques, 10.6% presented in-stent restenosis. The presence of echolucent plaques in carotid arteries increased the risk of coronary in-stent restenosis by 8.21 times (RR=8.21; 95%CI: 3.58-18.82; p<0.001).Conclusions:The presence of echolucent atherosclerotic plaques in carotid artery constitutes a risk predictor of coronary instent restenosis and should be considered in the selection of the type of stent to be used in coronary angioplasty.
Keywords:Coronary Artery Disease   Atherosclerosis   Coronary restenosis   Stents   Angioplasty   Balloon   Coronary   Carotid Arteries/ultrasonography   Plaque   Atherosclerotic
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