Introducción: La angioplastía coronaria percutánea es un procedimiento seguro y eficaz para tratar la cardiopatía isquémica, enfermedad de alta prevalencia y gran impacto en la morbilidad y mortalidad en la población. El propósito de este trabajo consistió en cuantificar los resultados obtenidos con esta terapia en el período comprendido entre enero del año 2005 y diciembre del año 2007 en el Hospital México de Costa Rica. Metodología: Se realizó un estudio observacional retrospectivo de una cohorte de 285 pacientes intervenidos en ese período, mediante revisión de expedientes. Se realizó un análisis descriptivo de todos los pacientes y de los subgrupos de pacientes diabéticos y no diabéticos. Resultados: Se documentó una mortalidad global a un año de 2.74%; reintervención de 8.07%: 4.56% restenosis, 1.05% trombosis tardía -es decir, 5.61% por "falla del vaso tratado"- y 2.46% de reintervenciones de lesiones nuevas. Ocurrieron complicaciones en 2.75% (sangrado mayor 1.75%), trombosis aguda de stent en 2.5% y trombosis subaguda en 1.4%. En los pacientes diabéticos se detectó, en comparación con pacientes no diabéticos, mayor incidencia de trombosis tardía de stent (3.75% vs. 0%), reintervención (12.5% vs. 6.34%) y reestenosis (7.5% vs. 3.41%) del vaso tratado. Se logró reducción o supresión de síntomas anginosos en el 91.95% de los casos, sin diferencias entre pacientes diabéticos y no diabéticos. Conclusión: La mortalidad global fue discretamente mayor que a nivel mundial, pero la "falla del vaso tratado" y la necesidad de reintervención fueron menores. Las complicaciones trombóticas fueron más frecuentes que en estudios comparables a nivel mundial y la diabetes mellitus fue un factor estadísticamente significativo para eventos trombóticos tardíos.

Clinical outcomes and complications of percutaneous coronary angioplasty with stent placement: México Hospital, San José, Costa Rica, 2005-2007 Background: Percutaneous coronary angioplasty (PTCA), which is usually performed with stent placement, is a safe and effective interventional treatment for ischemic heart disease. This is a very prevalent form of coronary heart disease and has a significant morbidity and mortality in the general population. The purpose of this study is to describe the outcomes obtained with PTCA/stent placement at the México Hosptial during the period between January 2005 and December 2007. Methodology: A retrospective, observational cohort study was performed by way of a clinical chart review of 285 patients treated with coronary artery interventions during the study period. An analysis of results was performed on all patients and a comparison between diabetic and nondiabetic patients was also made. Results: Total annual mortality was 2.75%. Reintervention was required in 8.07% of cases: 4.56% due to restenosis, 1.05% due to late thrombosis -i.e. 5.61% was due to occlusion of a native coronary artery segment not involved in the initial intervention-, and 2.46% due to treatment of new lesions. Complications were noted in 2.75% of patients (included major bleeding in 1.75%), acute stent thrombosis in 2.5% and subacute thrombosis in 1.4%. There was a higher incidence of late stent thrombosis in diabetic patients compared to nondiabetics (3.75% vs. 0%), as well as reintervention (12.5% vs. 6.34%) and restenosis of treated vessels (7.5% vs. 3.41%). Reduction or elimination of angina was achieved in 91.95% of patients, with no difference between diabetic and nondiabetic patients. Conclusion: Global mortality was slightly higher at México Hosptial than in comparable studies. However, occlusion of a native coronary artery segment not involved in the initial procedure and the need for reintervention were lower. Thrombotic complications were more frequent than in comparable series. As observed in other series, diabetes mellitus was a statistically significant risk factor for late thrombotic events.