Document Detail

Target lesion revascularization after bare-metal or drug-eluting stents: clinical presentations and outcomes.
MedLine Citation:
PMID:  20516505     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We sought to examine the clinical presentations and subsequent clinical outcomes of patients undergoing target lesion revascularization (TLR) after either bare-metal stent (BMS) or drug-eluting stent (DES) placement. BACKGROUND: The widely held notion that BMS TLR is benign has recently been challenged. While DES substantially reduce TLR, little is known about the clinical syndromes accompanying DES TLR and the long-term clinical outcomes after TLR. METHODS: The clinical syndrome at the time of hospitalization when TLR was performed and subsequent clinical outcomes after TLR were assessed in 1,147 BMS patients and 1,246 DES patients who were followed for 3 years. Patients were considered to have TLR when repeat target lesion PCI was required including those with myocardial infarction (MI) and stent thrombosis. RESULTS: At 3 years, the overall incidence of TLR was higher after BMS compared to DES 98/1,147 (9.2%) vs. 56/1,246 (4.5%); p < 0.001. The clinical presentations at the time of TLR were not always benign with non-STelevation myocardial infarction (N-STEMI) or STEMI in 25% of BMS vs. 34% DES; p = 0.217. The risk of non-fatal MI or death outcomes over 3 years were significantly worse in those with TLR compared to those without TLR; hazard ratio (HR) 2.65 (2.00-3.52), independent of stent type. CONCLUSIONS: The clinical presentation at the time of TLR is not always a benign clinical event and identifies a subgroup of stent-treated patients at high risk for non-fatal MI or death in the 3 years following the index percutaneous coronary intervention, independent of stent type.
Kevin R Hayes; Robert J Applegate; Matthew T Sacrinty; Michael A Kutcher; Sanjay K Gandhi; Renato M Santos; William C Little
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  266-70     Citation Subset:  IM    
Wake Forest University School of Medicine, Section of Cardiology, Winston-Salem, NC 27157-1045, USA.
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MeSH Terms
Acute Coronary Syndrome / diagnosis,  mortality,  therapy
Angioplasty, Transluminal, Percutaneous Coronary / mortality*,  statistics & numerical data*
Coronary Restenosis / diagnosis,  mortality*,  therapy*
Coronary Thrombosis / diagnosis,  mortality,  therapy
Drug-Eluting Stents / statistics & numerical data*
Follow-Up Studies
Middle Aged
Myocardial Infarction / diagnosis,  mortality,  therapy
Proportional Hazards Models
Retreatment / mortality,  statistics & numerical data
Retrospective Studies
Risk Factors
Stents / statistics & numerical data
Treatment Outcome
Reg. No./Substance:
Comment In:
J Invasive Cardiol. 2010 Jun;22(6):271-2   [PMID:  20516506 ]

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