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Figure 1
ABC
Original Article

Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients

Márcio A. M. Truffa et al. Gustavo M.P. Alves Fernando Bernardi Antonio Esteves Filho … Expedito Ribeiro Micheli Z. Galon André Spadaro Luiz J. Kajita Raul Arrieta Pedro A. Lemos

Background:

Advantages and disadvantages of ad hoc percutaneous coronary intervention have been described. However little is known about the radiation exposure of that procedure as compared with the staged intervention.

Objective:

To compare the radiation dose of the ad hoc percutaneous coronary intervention with that of the staged procedure

Methods:

The dose-area product and total Kerma were measured, and the doses of the diagnostic and therapeutic procedures were added. In addition, total fluoroscopic time and number of acquisitions were evaluated.

Results:

A total of 568 consecutive patients were treated with ad hoc percutaneous coronary intervention (n = 320) or staged percutaneous coronary intervention (n = 248). On admission, the ad hoc group had less hypertension (74.1% vs 81.9%; p = 0.035), dyslipidemia (57.8% vs. 67.7%; p = 0.02) and three-vessel disease (38.8% vs. 50.4%; p = 0.015). The ad hoc group was exposed to significantly lower radiation doses, even after baseline characteristic adjustment between both groups. The ad hoc group was exposed to a total dose-area product of 119.7 ± 70.7 Gycm2, while the staged group, to 139.2 ± 75.3 Gycm2 (p < 0.001).

Conclusion:

Ad hoc percutaneous coronary intervention reduced radiation exposure as compared with diagnostic and therapeutic procedures performed at two separate times.

  • Angioplasty
  • balloon
  • cardiac
  • Catheterization
  • coronary
  • Coronary Angiography
  • Fluoroscopy
  • Radiation Monitoring
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Creative Commons Attribution (CC BY) Creative Commons license
08/09/2015 DOI: 10.5935/abc.20150110
Figure 1
ABC
Anatomopathological Session

Case 4/2014 – A 66-Year-Old Man with Acute Myocardial Infarction and Death in Asystole after Primary Coronary Angioplasty

Wilma Noia Ribeiro et al. Alice Tatsuko Yamada Luiz Alberto Benvenuti

Clinical Aspects

This clinical case reports on a 66-year-old hypertensive patient, long-term smoker, who sought medical care due to acute chest pain. The main diagnostic hypothesis for this clinical case is of acute coronary syndrome.

Chest pain is one of the most common reasons for seeking emergency care and remains a challenge for the clinician, due to the difficulty in differentiating between non-emergency diagnoses and those of high morbidity and mortality, such as acute coronary syndrome (ACS), aortic dissection and pulmonary thromboembolism.

[…]

  • Angioplasty
  • balloon
  • coronary
  • Heart Arrest
  • Myocardial Infarction
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01/09/2014 DOI: 10.5935/abc.20140129
Resistance to clopidogrel: prevalence and associate variables
ABC
Artigo Original

Resistance to clopidogrel: prevalence and associate variables

Fabrício Braga da Silva et al. Gustavo Luiz Gouvêa de Almeida Junior Augusto Neno José Kezen … Milena Spelta Alessandra Godomiczer Renato Villela Bruno Hellmuth Sergio Salles Xavier Roberto Hugo da Costa Lins

BACKGROUND: The dual antiplatelet therapy with acetylsalicylic acid (ASA) and clopidogrel is the cornerstone of treatment for patients undergoing angioplasty with coronary stent implantation. However, some of these patients, despite the use of aspirin and clopidogrel, are not effectively anti-aggregated, a phenomenon known as resistance to antiplatelet agents. Its prevalence, as well as the conditions associated with it, is unknown in our country. OBJECTIVE: To determine the prevalence of clopidogrel resistance, as well as variables associated with it. METHODS: Patients admitted for elective angioplasty in chronic use of ASA and clopidogrel between January 2007 and January 2010 were studied. One hour after the procedure, platelet aggregation was measured using optical aggregometry with adenosine diphosphate 5 mmoles / l as agonist. At that moment, in a cross-sectional cohort, we determined the prevalence of clopidogrel resistance, defined as the value of platelet aggregation > 43% and a logistic regression model to the variables associated with it. RESULTS: A total of 205 patients were analyzed (66.4 ± 11 years, 61.5% males). The prevalence of clopidogrel resistance was 38.5% (95% CI: 31.9 – 45.2%). Blood glucose (OR = 1.014; 95%CI: 1.004 – 1.023), previous myocardial infarction (OR = 2.320; 95%CI: 1.1103 – 4.892) and therapeutic response to ASA (OR = 1.057; 95%CI: 1.017 – 1.099) were the variables independently associated with clopidogrel resistance. CONCLUSION: The prevalence of clopidogrel resistance was high. Glycemia, acute myocardial infarction and response to ASA were variables associated with it. A better understanding of this phenomenon is necessary considering the new antiplatelet aggregant agents.

  • Angioplasty
  • balloon
  • coronary
  • Coronary Disease
  • drug resistance
  • Platelet Aggregation Inhibitors
  • Stents
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Creative Commons Attribution (CC BY) Creative Commons license
27/11/2012 DOI: 10.1590/S0066-782X2012005000107 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Truffa MAM, Alves GM, Bernardi F, Esteves Filho A, Ribeiro E, Galon MZ, Spadaro A, et al. Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients. Arquivos Brasileiros de Cardiologia 2015;105(5):487-92.

Electronic Document Format (ABNT)

Truffa, Márcio A. M.; Alves, Gustavo M.P.; Bernardi, Fernando; Esteves Filho, Antonio; Ribeiro, Expedito; Galon, Micheli Z.; Spadaro, André; Kajita, Luiz J.; Arrieta, Raul; Lemos, Pedro A.. Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients. Arquivos Brasileiros de Cardiologia, v. 105, n. 5, p. 487-492, Sep. 2015.

Electronic Document Format (APA)

Truffa, M. A. M., Alves, G. M., Bernardi, F., Esteves Filho, A., Ribeiro, E., Galon, M. Z., Spadaro, A., Kajita, L. J., Arrieta, R., & Lemos, P. A. (2015). Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients. Arquivos Brasileiros de Cardiologia, 105(5), 487-492.

Electronic Document Format (ISO)

Truffa, Márcio A. M. and Alves, Gustavo M.P. and Bernardi, Fernando and Esteves Filho, Antonio and Ribeiro, Expedito and Galon, Micheli Z. and Spadaro, André and Kajita, Luiz J. and Arrieta, Raul and Lemos, Pedro A.. Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients. Arquivos Brasileiros de Cardiologia [online]. 2015, vol. 105, n. 5, [cited 2026-10-14], pp. 487-492. Available from: <https://journals.cardiol.br/en/article/does-ad-hoc-coronary-intervention-reduce-radiation-exposure-analysis-of-568-patients/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Ribeiro WN, Yamada AT, Benvenuti LA. Case 4/2014 – A 66-Year-Old Man with Acute Myocardial Infarction and Death in Asystole after Primary Coronary Angioplasty. Arquivos Brasileiros de Cardiologia 2014;103(3):e31-6.

Electronic Document Format (ABNT)

Ribeiro, Wilma Noia; Yamada, Alice Tatsuko; Benvenuti, Luiz Alberto. Case 4/2014 – A 66-Year-Old Man with Acute Myocardial Infarction and Death in Asystole after Primary Coronary Angioplasty. Arquivos Brasileiros de Cardiologia, v. 103, n. 3, p. e31-e36, Aug. 2014.

Electronic Document Format (APA)

Ribeiro, W. N., Yamada, A. T., & Benvenuti, L. A. (2014). Case 4/2014 – A 66-Year-Old Man with Acute Myocardial Infarction and Death in Asystole after Primary Coronary Angioplasty. Arquivos Brasileiros de Cardiologia, 103(3), e31-e36.

Electronic Document Format (ISO)

Ribeiro, Wilma Noia and Yamada, Alice Tatsuko and Benvenuti, Luiz Alberto. Case 4/2014 – A 66-Year-Old Man with Acute Myocardial Infarction and Death in Asystole after Primary Coronary Angioplasty. Arquivos Brasileiros de Cardiologia [online]. 2014, vol. 103, n. 3, [cited 2026-10-14], pp. e31-e36. Available from: <https://journals.cardiol.br/en/article/case-4-2014-a-66-year-old-man-with-acute-myocardial-infarction-and-death-in-asystole-after-primary-coronary-angioplasty/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Silva FB, Almeida Junior GLG, Neno A, Kezen J, Spelta M, Godomiczer A, Villela R, et al. Resistance to clopidogrel: prevalence and associate variables. Arquivos Brasileiros de Cardiologia 2012;99(6):1135-41.

Electronic Document Format (ABNT)

Silva, Fabrício Braga da; Almeida Junior, Gustavo Luiz Gouvêa de; Neno, Augusto; Kezen, José; Spelta, Milena; Godomiczer, Alessandra; Villela, Renato; Hellmuth, Bruno; Xavier, Sergio Salles; Lins, Roberto Hugo da Costa. Resistance to clopidogrel: prevalence and associate variables. Arquivos Brasileiros de Cardiologia, v. 99, n. 6, p. 1135-1141, Nov. 2012.

Electronic Document Format (APA)

Silva, F. B. , Almeida Junior, G. L. G. , Neno, A., Kezen, J., Spelta, M., Godomiczer, A., Villela, R., Hellmuth, B., Xavier, S. S., & Lins, R. H. C. (2012). Resistance to clopidogrel: prevalence and associate variables. Arquivos Brasileiros de Cardiologia, 99(6), 1135-1141.

Electronic Document Format (ISO)

Silva, Fabrício Braga da and Almeida Junior, Gustavo Luiz Gouvêa de and Neno, Augusto and Kezen, José and Spelta, Milena and Godomiczer, Alessandra and Villela, Renato and Hellmuth, Bruno and Xavier, Sergio Salles and Lins, Roberto Hugo da Costa. Resistance to clopidogrel: prevalence and associate variables. Arquivos Brasileiros de Cardiologia [online]. 2012, vol. 99, n. 6, [cited 2026-10-14], pp. 1135-1141. Available from: <https://journals.cardiol.br/en/article/resistance-to-clopidogrel-prevalence-and-associate-variables/>. ISSN 0066-782X

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