Coronary artery disease progression late after successful stent implantation

40Citations
Citations of this article
48Readers
Mendeley users who have this article in their library.

Abstract

Objectives: This study sought to define the importance of 5-year coronary artery disease (CAD) progression after successful stenting. Background: Safety concerns regarding first-generation drug-eluting stents mandate 5-year follow-up studies. However, only limited data exist on the long-term importance of CAD progression relative to late stentrelated problems. Methods: This study followed for 5 years, 428 consecutive patients randomized to drug-eluting versus bare-metal stents with successful stenting documented by freedom from symptoms/events and no ischemic perfusion defects (PDs) after 6 months. Rest/stress scintigraphic scans were repeated after 60 months. Late events and new PDs in areas remote from stented vessels indicated CAD progression. Results: During follow-up, 110 of 428 (25.7%) patients had 150 clinical events: 43 patients (10%) died, 36 (8.4%) suffered a myocardial infarction, and 71 (16.6%) needed repeat revascularization. Event rates were lower in remote versus target-vessel areas (9.8% vs. 14.3%, p = 0.019). Remote myocardial infarction and repeat revascularization accounted for 46 of 124 (37.1%) nonfatal events and were similar for both stent types. Five-year scintigraphic studies in patients without follow-up events showed 23.3% new PDs, 71% of which were asymptomatic. Remote defects accounted for 37.5% PDs and were similar for both stent types. Conclusions: Even 5 years after stenting, target-vessel events and/or new PDs remained more frequent than CAD progression assessed by remote events and/or new PDs. Still, remote events accounted for almost 40% of all events with a similar rate of additional new PDs, often silent, and independent of stent type. This documents the importance of CAD progression and stresses the need to differentiate remote from target-vessel events/PDs in long-term stent safety studies. (Basel Stent Kosten-Effektivitts Trial [BASKET]; ISRCTN75663024) © 2012 American College of Cardiology Foundation.

Cite

CITATION STYLE

APA

Zellweger, M. J., Kaiser, C., Jeger, R., Brunner-La Rocca, H. P., Buser, P., Bader, F., … Pfisterer, M. (2012). Coronary artery disease progression late after successful stent implantation. Journal of the American College of Cardiology, 59(9), 793–799. https://doi.org/10.1016/j.jacc.2011.11.024

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free