title: Non-elective intra-coronary stenting: are the clinical outcomes comparable to elective stenting at 6 months?
abstract: The aim of this study was to compare prospectively the clinical outcome of patients treated with intra-coronary stents as a non-elective/bailout procedure for acute or threatened vessel closure, with those undergoing elective stenting at 6 months. Sixty-four patients (60.2+/-11.7 y) who underwent non-elective stenting for abrupt or threatened vessel closure and/or sub-optimal results were prospectively compared with 68 patients (62+/-10.0 y) who were stented electively. All patients had broadly similar pre-procedural clinical profiles. However, patients in the elective group had a higher incidence of previous PTCA (10.2% vs. 0%, P = 0.01) and bypass surgery (30.9% vs. 6.3%, P = 0.0003) compared with the non-elective group. A total of 158 stents (1.19 per patient) were implanted in 132 patients with a procedural success rate of 99.3%. At 6 months follow-up there was no statistical difference in the primary composite end-point of death, myocardial infarction and the need of repeat revascularisation (10.9% vs. 5.8%, P = 0.35) between the two groups. However, patients in the non-elective group showed a higher incidence of unstable angina compared with the elective group (25% vs. 1.4%, P = 0.0004). The findings of this study suggest that stents (single or multiple) can be effectively implanted in non-elective situations with no increase in the incidence of death, non-fatal myocardial infarction, and the need of repeat revascularisation at 6 months compared with elective stenting.
authors.affiliation: Division of Cardiology, National Heart and Lung Institute, Imperial College, Royal Brompton Hospital, London, UK. atena30@hotmail.com
authors.forename: F R
authors.initials: FR
authors.lastname: Amin
authors.forename: M
authors.initials: M
authors.lastname: Yousufuddin
authors.forename: R
authors.initials: R
authors.lastname: Stables
authors.forename: A S
authors.initials: AS
authors.lastname: Kurbaan
authors.forename: J
authors.initials: J
authors.lastname: Clague
authors.forename: J S
authors.initials: JS
authors.lastname: Coats
authors.forename: U
authors.initials: U
authors.lastname: Sigwart
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017023:Coronary Angiography; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D019233:Retreatment; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome