Document Detail

Acute and long-term outcome after Palmaz-Schatz stenting: analysis from the New Approaches to Coronary Intervention (NACI) registry.
MedLine Citation:
PMID:  9409695     Owner:  NLM     Status:  MEDLINE    
The randomized Stent Restenosis Study (STRESS) and Belgium Netherlands Stent (Benestent) trials established that elective use of Palmaz-Schatz stents (PSSs) in native coronary arteries with de novo lesions is associated with increased procedural success and reduced restenosis. However there are other clinical indications for which stents are commonly used (unplanned use, vein grafts, restenosis lesions) that are not addressed in these studies. From 1990-1992, 688 lesions in 628 patients were treated with PSSs in the New Approaches to Coronary Intervention (NACI) registry. Angiographic core laboratory readings were available for 543 patients (595 lesions, of which 106 were stented for unplanned indications, 239 were in saphenous vein bypass grafts, and 296 were previously treated). The cohort of patients in whom stents were placed for unplanned indications had more women, current smokers, and had a higher incidence of recent myocardial infarction (MI). Patients who underwent stenting of saphenous vein grafts were older, had a higher incidence of diabetes mellitus, unstable angina, prior MI, and congestive heart failure. Lesion success was similar in all cohorts (98%), but procedural success was significantly higher for planned stenting (96% vs 87%; p < 0.01). Predictors of adverse events in-hospital were presence of a significant left main stenosis and stenting for unplanned indication. The incidence of target lesion revascularization by 30 days was significantly higher for patients undergoing unplanned stenting due to a higher risk for stent thrombosis. Recent MI, stenting in native lesion, and small postprocedural minimum lumen diameter independently predicted target lesion revascularization at 30 days. Independent predictors of death, Q-wave myocardial infarction, or target lesion revascularization at 1 year included severe concomitant disease, high risk for surgery, left main disease, stenting in the left main coronary artery, and low postprocedure minimum lumen diameter.
J P Carrozza; R A Schatz; C J George; M B Leon; S B King; J W Hirshfeld; R C Curry; R J Ivanhoe; M Buchbinder; M W Cleman; S Goldberg; D Ricci; J J Popma; R D Safian; D S Baim
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  80     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-01-08     Completed Date:  1998-01-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  78K-88K     Citation Subset:  AIM; IM    
Interventional Cardiology Section, Beth Israel-Deaconess Medical Center, Boston, Massachusetts 02215, USA.
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MeSH Terms
Coronary Angiography
Coronary Disease / mortality,  radiography,  therapy*
Equipment Design
Evaluation Studies as Topic
Follow-Up Studies
Middle Aged
Multicenter Studies as Topic
Myocardial Revascularization / statistics & numerical data
Risk Factors
Stents / statistics & numerical data*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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