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    
Abstract/OtherAbstract:
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.
Authors:
Roberto Nerla; Antonio Di Monaco; Gregory A Sgueglia; Irma Battipaglia; Giulia Careri; Gaetano Pinnacchio; Pierpaolo Tarzia; Gaetano Antonio Lanza; Filippo Crea
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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    
Affiliation:
Department of Cardiovascular Medicine, Catholic University of Sacred Heart.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*
Coronary Artery Disease / physiopathology,  therapy*
Coronary Vessels / physiopathology
Drug-Eluting Stents*
Endothelium, Vascular / physiopathology
Exercise Test*
Exercise Tolerance*
Female
Humans
Italy
Logistic Models
Male
Metals*
Middle Aged
Myocardial Infarction / etiology,  physiopathology
Predictive Value of Tests
Proportional Hazards Models
Prosthesis Design
Retrospective Studies
Risk Assessment
Risk Factors
Stents*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Metals
Comments/Corrections
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


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