Impact of radiation dose on late clinical outcome after intracoronary radiation therapy: three-year follow-up of Long WRIST.
To determine the safety and efficacy, including the impact, on the late recurrence rate of an incremental gamma-radiation dose from 15 to 18 Gy, we report the 3-year clinical outcome of Washington Radiation for In-Stent Restenosis Trial for Long Lesions (Long WRIST). One hundred eighty patients with recurrent in-stent restenosis (ISR) were enrolled in the Long WRIST series and treated with (192)Ir with 1 month of antiplatelet therapy. Between 6 months and 3 years, the need for repeat revascularization was low and similar among the three groups. At 3 years, target lesion revascularization (TLR) and major adverse cardiac events (MACE) were less frequent in the 18 Gy group than in the 15 Gy group (P = 0.12 for TLR, P < 0.05 for MACE) and less frequent in the 15 Gy group as compared to the placebo group (P < 0.05 for TLR and MACE). At 3 years, a higher dose of 18 Gy with (192)Ir continues to improve the outcome of patients treated for ISR when compared to patients treated with 15 Gy or placebo.
Cheneau
Edouard
E
Division of Cardiology, Washington Hospital Center, Washington, District of Columbia, USA.
Canos
Daniel
D
Pinnow
Ellen
E
Ajani
Andrew E
AE
Satler
Lowell F
LF
Pichard
Augusto D
AD
Kent
Kenneth M
KM
Lindsay
Joseph
J
Waksman
Ron
R
D000704:Analysis of Variance; D001918:Brachytherapy / Q000379:methods*; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D015607:Stents; D016896:Treatment Outcome
D007496:Iridium Radioisotopes