|
|
||||||||||
|
J Am Coll Cardiol, 1998; 32:590-595 © 1998 by the American College of Cardiology Foundation |





* Mayo Clinic, Rochester, Minnesota, USA
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Brown University/Rhode Island Hospital, Providence, Rhode Island, USA
Manuscript received January 15, 1998; revised manuscript received April 27, 1998, accepted May 8, 1998.
Address for correspondence: Kevin E. Kip, University of Pittsburgh, Graduate School of Public Health, Epidemiology Data Coordinating Center, 127 Parran Hall, 130 DeSoto Street, Pittsburgh, Pennsylvania
kip{at}edc.gsph.pitt.edu
Objectives. We examined the influence of an initial "stent-like" result on long-term outcome in patients in the 198586 NHLBI PTCA Registry.
Background. Stent use in selected patients is associated with improved angiographic and short-term clinical outcome; however, due to potential for in-stent restenosis and high costs of stents, there is interest in a strategy of more optimal dilatation to achieve a "stent-like" result without a stent. The long-term outcome of patients with a "stent-like" percutaneous transluminal coronary angioplasty (PTCA) remains unknown.
Methods. Ten-year outcome was compared between 225 successfully treated patients with and 1,764 successfully treated patients without an initial "stent-like" result (
1 lesion dilated to
10% stenosis). The sample had 75% and 80% power, respectively, to detect an absolute difference of 8% in the 10-year rate of death and myocardial infarction (MI) between the two groups.
Results. Ten-year rates of death and MI were similar between the stent-like and nonstent-like groups (22.3% vs. 22.2%, 17.6% vs. 17.9%), however, there was less target lesion revascularization in the stent-like group (30.2% vs. 36.8%). In subgroup analysis of patients with multivessel disease, those with a stent-like result had less follow-up bypass surgery (25.2% vs. 32.7%), yet more repeat PTCA (53.8% vs. 42.7%). These findings were unaffected by adjustment for differences in baseline characteristics between the two patient groups.
Conclusions. Achievement of an initial stent-like result via balloon angioplasty alone may not appreciably reduce the long-term risk of death or MI, nor confer equivalent clinical benefit as achieving a stent-like result with a stent.
| ||||||||||||||||||||||
This article has been cited by other articles:
![]() |
D. S. Pinto, G. W. Stone, S. G. Ellis, D. A. Cox, J. Hermiller, C. O'Shaughnessy, J. T. Mann, R. Mehran, Y. Na, M. Turco, et al. Impact of Routine Angiographic Follow-Up on the Clinical Benefits of Paclitaxel-Eluting Stents: Results From the TAXUS-IV Trial J. Am. Coll. Cardiol., July 4, 2006; 48(1): 32 - 36. [Abstract] [Full Text] [PDF] |
||||
![]() |
U Dietz, N Holz, C Dauer, and H Lambertz Shortening the stent length reduces restenosis with bare metal stents: matched pair comparison of short stenting and conventional stenting Heart, January 1, 2006; 92(1): 80 - 84. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. A. Cox, G. W. Stone, C. L. Grines, T. Stuckey, D. J. Cohen, J. E. Tcheng, E. Garcia, G. Guagliumi, R. S. Iwaoka, M. Fahy, et al. Outcomes of optimal or "stent-like"balloon angioplasty in acutemyocardial infarction: the CADILLAC trial J. Am. Coll. Cardiol., September 17, 2003; 42(6): 971 - 977. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. J. Cantor, A. S. Hellkamp, E. D. Peterson, J. P. Zidar, P. A. Cowper, M. H. Sketch Jr, J. E. Tcheng, R. M. Califf, and E. M. Ohman Achieving optimal results with standard balloon angioplasty: can baseline and angiographic variables predict stent-like outcomes? J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1883 - 1890. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. W. Serruys, B. de Bruyne, S. Carlier, J. E. Sousa, J. Piek, T. Muramatsu, C. Vrints, P. Probst, R. Seabra-Gomes, I. Simpson, et al. Randomized Comparison of Primary Stenting and Provisional Balloon Angioplasty Guided by Flow Velocity Measurement Circulation, December 12, 2000; 102(24): 2930 - 2937. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Di Mario, J. W. Moses, T. J. Anderson, R. Bonan, T. Muramatsu, A. C. Jain, J. Suarez de Lezo, S. Y. Cho, M. Kern, I. T. Meredith, et al. Randomized Comparison of Elective Stent Implantation and Coronary Balloon Angioplasty Guided by Online Quantitative Angiography and Intracoronary Doppler Circulation, December 12, 2000; 102(24): 2938 - 2944. [Abstract] [Full Text] [PDF] |
||||
![]() |
S.-W Park, C.W Lee, M.-K Hong, J.-J Kim, G.-Y Cho, D.-Y Nah, and S.-J Park Randomized comparison of coronary stenting with optimal balloon angioplasty for treatment of lesions in small coronary arteries Eur. Heart J., November 1, 2000; 21(21): 1785 - 1789. [Abstract] [PDF] |
||||
![]() |
J. Al Suwaidi, P. B. Berger, and D. R. Holmes Jr Coronary Artery Stents JAMA, October 11, 2000; 284(14): 1828 - 1836. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. J. Cantor, E. D. Peterson, J. J. Popma, J. P. Zidar, M. H. Sketch Jr., J. E. Tcheng, and E. M. Ohman Provisional stenting strategies: systematic overview and implications for clinical decision-making J. Am. Coll. Cardiol., October 1, 2000; 36(4): 1142 - 1151. [Abstract] [Full Text] [PDF] |
||||
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |