Artículos de revistas
Effects of Optimal Medical Treatment With or Without Coronary Revascularization on Angina and Subsequent Revascularizations in Patients With Type 2 Diabetes Mellitus and Stable Ischemic Heart Disease
CIRCULATION, v.123, n.14, p.1492-+, 2011
DAGENAIS, Gilles R.
FAXON, David P.
LAGO, Rodrigo M.
FRYE, Robert L.
Bypass Angioplasty Revascularizati
Background-In the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial, an initial strategy of coronary revascularization and optimal medical treatment (REV) compared with an initial optimal medical treatment with the option of subsequent revascularization (MED) did not reduce all-cause mortality or the composite of cardiovascular death, myocardial infarction, and stroke in patients with type 2 diabetes mellitus and stable ischemic heart disease. In the same population, we tested whether the REV strategy was superior to the MED strategy in preventing worsening and new angina and subsequent coronary revascularizations. Methods and Results-Among the 2364 men and women (mean age, 62.4 years) with type 2 diabetes mellitus, documented coronary artery disease, and myocardial ischemia, 1191 were randomized to the MED and 1173 to the REV strategy preselected in the percutaneous coronary intervention (796) and coronary artery bypass graft (377) strata. Compared with the MED strategy, the REV strategy at the 3-year follow-up had a lower rate of worsening angina (8% versus 13%; P < 0.001), new angina (37% versus 51%; P = 0.001), and subsequent coronary revascularizations (18% versus 33%; P < 0.001) and a higher rate of angina-free status (66% versus 58%; P = 0.003). The coronary artery bypass graft stratum patients were at higher risk than those in the percutaneous coronary intervention stratum, and had the greatest benefits from REV. Conclusions-In these patients, the REV strategy reduced the occurrence of worsening angina, new angina, and subsequent coronary revascularizations more than the MED strategy. The symptomatic benefits were observed particularly for high-risk patients.
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Ausência de arteriosclerose na porção intramiocárdica das artérias coronárias: Um mistério a ser resolvido? Ramalli Jr, Edvaldo Luiz; Braga, Leonardo Henrique; Evora, Patricia Martinez; Albuquerque, Agnes Afrodite Sumarelli; Celotto, Andrea Carla; Mota, André Lupp; Evora, Paulo Roberto Barbosa
Ausência de arteriosclerose na porção intramiocárdica das artérias coronárias: Um mistério a ser resolvido? Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Laboratory of Vascular Reactivity and Endothelial Function; Laboratory of Biomedical Vascular Reactivity and Endothelial Function; Universidade de São (2011-07-01)Several studies show that portions of intramyocardial coronary arteries are spared of arteriosclerosis, involving morphological, embryological, biochemical and pathophysiological aspects. Endothelial function is significantly ...
Echeverri Arcila, Darío (2017)