Long-term clinical and angiographic follow-up after coronary stent placement in native coronary arteries.
BACKGROUND
Although coronary stents have been proved effective in reducing clinical cardiac events for up to 3 to 5 years, longer term clinical and angiographic outcomes have not yet been fully clarified.


RESULTS
To evaluate longer term (7 to 11 years) outcome, clinical and angiographic follow-up information was analyzed in 405 patients with successful stenting in native coronary arteries. Primary or secondary stabilization, which was defined as freedom from death, coronary artery bypass grafting, and target lesion-percutaneous coronary intervention (TL-PCI) during the 14 months after the initial procedure or after the last TL-PCI, was achieved in 373 patients (92%) overall. Only 7 patients (1.7%) underwent TL-PCI more than twice. After the initial 14-month period, freedom from TL-PCI reached a plateau at 84.9% to 80.7% over 1 to 8 years. However, quantitative angiographic analysis in 179 lesions revealed a triphasic luminal response characterized by an early restenosis phase until 6 months, an intermediate-term regression phase from 6 months to 3 years, and a late renarrowing phase beyond 4 years. Minimal luminal diameter in 131 patients with complete serial data were 2.62+/-0.4 mm immediately after stenting, 2.0+/-0.49 mm at 6 months, 2.19+/-0.49 mm at 3 years, and 1.85+/-0.56 mm beyond 4 years (P<0.0001).


CONCLUSIONS
The efficacy and safety of coronary stenting seemed to be clinically sustained at 7 to 11 years of follow-up. However, late luminal renarrowing beyond 4 years was common, which demonstrates the need for further follow-up.
Kimura
Takeshi
T
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Abe
Kenichi
K
Shizuta
Satoshi
S
Odashiro
Keita
K
Yoshida
Yoshinori
Y
Sakai
Koyu
K
Kaitani
Kazuaki
K
Inoue
Katsumi
K
Nakagawa
Yoshihisa
Y
Yokoi
Hiroyoshi
H
Iwabuchi
Masashi
M
Hamasaki
Naoya
N
Nosaka
Hideyuki
H
Nobuyoshi
Masakiyo
M
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality*; D003331:Coronary Vessels; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*; D015996:Survival Rate