One-year outcome in multivessel coronary disease patients undergoing coronary stenting

Citation
S. De Servi et al., One-year outcome in multivessel coronary disease patients undergoing coronary stenting, CATHET C IN, 48(4), 1999, pp. 343-349
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
ISSN journal
1522-1946 → ACNP
Volume
48
Issue
4
Year of publication
1999
Pages
343 - 349
Database
ISI
SICI code
1522-1946(199912)48:4<343:OOIMCD>2.0.ZU;2-0
Abstract
The purpose of this study was to assess 1-year clinical outcome of patients with multivessel coronary artery disease (CAD) who underwent coronary sten ting and were prospectively enrolled in the Registro Implanto Stent Endocor onarico (RISE). Of 939 consecutive patients included in the registry, 377 p atients with angiographic evidence of multivessel CAD had a 1-year clinical follow-up. All patients underwent PTCA and single or multiple stenting in at least one vessel. Angiographic optimization was usually performed by usi ng high-pressure balloon dilation. After the procedure, continuation of asp irin (at least 250 mg/day) was recommended, whereas the use of anticoagulat ion or ticlopidine was determined by the physician in charge of the patient in the various centers. Major adverse cardiac events were defined as death , Q-wave or non-Q-wave myocardial infarction and target vessel revasculariz ation. Mean age of patients (311 men, 66 women) was 60 +/- 10 years. Global ly, there were 596 stents implanted (72% Palmaz-Schatz stents) in 434 vesse ls. In about 75% of the procedures, an inflation pressure > 12 atm was used , Angiographic success rate was 98.5%, After stenting, 77% of patients rece ived antiplatelet treatment with ticlopidine and aspirin. During hospitaliz ation, there were 34 major adverse cardiac events in 24 patients. At 1-year follow-up, 309 patients were alive and event-free; cumulative incidence of death, myocardial infarction, and repeat revascularization were 2.9%, 4.7% , and 10.8%, respectively, By Cox regression analysis, multiple stents impl antation (HR 1.72, 95% CI 1-2.97), left anterior descending artery revascul arization (HR 1.86, 95% CI 1.01-3.42), use of inflation pressure > 12 atm ( HR 0.93, 95% CI 0.89-0.97), ticlopidine therapy (HR 0.41, 95% CI 0.23-0.74) , and stent length (HR 1.03, 95% CI 1.01-1.05) were associated with 1-year major cardiac events. In patients with multivessel CAD undergoing stent imp lantation in at least one vessel, 1-year follow-up is favorable and the nee d for repeat revascularization procedures, based on clinical data, is lower than previously reported for conventional PTCA. Cathet. Cardiovasc. Interv ent 48:343-349, 1999. (C) 1999 Wiley-Liss, Inc.