243 Ischemic Heart Disease Flashcards
Definition of “primary success” or adequate dilation in PCI
Increase in luminal diameter >20% to a residual diameter obstruction <50% with relief of angina
Most common clinical indication for PCI
Symptom-limiting angina pectoris, despite medical therapy, accompanied by evidence of ischemia during a stress test
Incidence of recurrent stenosis of dilated vessels within 6 months after PCI using bare metal stents
~20%
Incidence of angina recurrence within 6 months after PCI with bare metal stents
~10%
Factors associated with higher risk of restenosis after PCI
- Diabetes mellitus
- Arteries with small caliber
- Incomplete dilation of the stenosis
- Long stents
- Occluded vessels
- Obstructed vein grafts
- Dilation of the LAD
- Stenoses containing thrombi
After implantation of a bare metal stent, duration of administration:
- Aspirin
- Thienopyridine
- Aspirin: indefinitely
- Thienopyridine: 1-3 months
They prevent thrombosis during and shortly after PCI with stenting, but there is NO evidence that they reduce the incidence of restenosis
After implantation of a drug-eluting stent, duration of administration:
- Aspirin
- Thienopyridine
- Aspirin: indefinitely
2. Thienopyridine: 1 year
Incidence of occlusion of venous grafts during the first postoperative year after CABG
10-20% in the first postoperative year
2% per year during the next 5-7 years then 4% per year thereafter
Risk factors associated with a higher perioperative mortality rate during CABG (5)
- CHF and/or LV dysfunction
- Advanced age (>80)
- Reoperation
- Urgent need
- Diabetes mellitus
