Long-term outcome of first-generation metallic coronary stent implantation in patients with coronary artery disease: observational study over a decade.
BACKGROUND
In the era of drug-eluting stents, percutaneous coronary intervention (PCI) has been considered an established therapeutic modality for patients with coronary artery disease (CAD). However, little is known about the long-term prognosis.


RESULTS
Using data obtained from a single-center registry for cases of first-generation bare metallic stent (BMS) implantation, a 10-year follow-up study in patients with CAD was performed. Data for 125 serial patients (aged 62+/-9 years, 104 males) in whom a BMS was successfully implanted was analyzed. Cardiac death (n=16 [12.8%]), including sudden cardiac death (n=9 [7.2%]), non-cardiac death (n=17 [13.6%]) and non-fatal acute myocardial infarction (n=16 [12.8%]) were documented. At 10 years, cumulative probabilities of target and non-target lesion revascularization were 20.5% and 41.5%, respectively, and only 39.2% of the patients were free from cardiac events (cardiac death/myocardial infarction/unplanned revascularization). Age and left ventricular ejection fraction (LVEF) were significant predictors of total death, and LVEF and the use of diuretics were predictors of cardiac events.


CONCLUSIONS
Stabilization of the initial stented site was relatively good and the majority of cardiac events might have originated in non-target lesions. Prevention of systemic arteriosclerosis progression is important for patients with CAD, even after successful PCI.
Fujii
Noriyuki
N
Department of Cardiology, Sakakibara Heart Institute, Japan Research Promotion Society for Cardiovascular Diseases, Tokyo, Japan. norifuji2002@yahoo.co.jp
Asano
Ryuta
R
Nagayama
Masatoshi
M
Tobaru
Tetsuya
T
Misu
Kazuhiko
K
Hasumi
Eriko
E
Hosoya
Yumiko
Y
Iguchi
Nobuo
N
Aikawa
Masaru
M
Watanabe
Hiroyuki
H
Umemura
Jun
J
Sumiyoshi
Tetsuya
T
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001161:Arteriosclerosis / Q000401:mortality / Q000517:prevention & control; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D012042:Registries; D015996:Survival Rate; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality / Q000628:therapy