Document Detail

Exercise stress test results in patients with bare metal stents or drug-eluting stents: pathophysiological and clinical implications.
MedLine Citation:
PMID:  20827029     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Drug-eluting stents (DES) have reduced restenosis following percutaneous coronary intervention (PCI), but they seem to be associated with increased coronary endothelial dysfunction compared to bare metal stents (BMS). No data are available about the prognostic value of exercise stress test (EST) in PCI patients in the DES era.
METHODS AND RESULTS: The 160 patients with coronary artery disease (CAD) who underwent PCI with either BMS (n=86) or DES (n=74) were studied. EST was performed 1 month after PCI. DES patients had a higher rate of positive EST compared to BMS patients (49% vs 32%; P=0.03). At a median follow-up of 18 months DES showed a lower rate of target vessel revascularization (TVR) (hazard ratio (HR) 0.37, P=0.07), but a higher rate of acute myocardial infarction (AMI) (HR 3.33, P=0.08). At multivariate Cox-regression time to 1 mm ST and low-workload ischemia were independent predictors of AMI (HR 0.96, P=0.03; and HR 6.24, P=0.009, respectively), as well as of TVR (HR 0.96, P=0.007; and HR 6.43, P=0.001, respectively).
CONCLUSIONS: DES implantation is associated with a higher rate of positive EST, compared to BMS, 1 month after PCI, likely due to a higher prevalence of endothelial dysfunction. EST seems to be helpful in predicting clinical outcome in patients with coronary stent implantation.
Roberto Nerla; Antonio Di Monaco; Gregory A Sgueglia; Irma Battipaglia; Giulia Careri; Gaetano Pinnacchio; Pierpaolo Tarzia; Gaetano Antonio Lanza; Filippo Crea
Related Documents :
16445329 - Paradoxical effects of aurintricarboxylic acid and rg-13577: acute thrombosis and in-st...
11981719 - Description of a reusable device for the temporary stenting of the open sternum.
16444619 - Stent implantation for the unprotected left main coronary artery. the long-term outcome...
9741529 - Validation of the in vivo intravascular ultrasound measurement of in-stent neointimal h...
15512379 - The efficiency of hysterosalpingo-contrastsonography (hycosy) in the evaluation of tuba...
12194339 - 3d dosimetry study of 188re liquid balloon for intravascular brachytherapy using bang p...
9763909 - Complete atrioventricular heart block in congenital hypothyroidism.
23893689 - Proposal for the use in emergency departments of cardiac troponins measured with the la...
11416269 - The rational for the use of à -blockers in the treatment of congestive heart failure.
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-09-04
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-11-30     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2372-8     Citation Subset:  IM    
Department of Cardiovascular Medicine, Catholic University of Sacred Heart.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*
Coronary Artery Disease / physiopathology,  therapy*
Coronary Vessels / physiopathology
Drug-Eluting Stents*
Endothelium, Vascular / physiopathology
Exercise Test*
Exercise Tolerance*
Logistic Models
Middle Aged
Myocardial Infarction / etiology,  physiopathology
Predictive Value of Tests
Proportional Hazards Models
Prosthesis Design
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Reg. No./Substance:
Comment In:
Circ J. 2010 Nov;74(11):2293-4   [PMID:  20962425 ]

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

Previous Document:  Addition of losartan to angiotensin-converting enzyme inhibitors improves insulin resistance in pati...
Next Document:  Kinetic polymerization behavior of fluorinated monomers for dental use.