title: Synergy between direct coronary stenting technique and use of the novel thin strut cobalt chromium Skylor™ stent: the MACE in follow up patients treated with Skylor stent [MILES Study].
abstract: BACKGROUND
  Despite significant improvements in stent platform, currently available bare-metal stents (BMS) are still associated with restenosis. Thin-strut design cobalt-chromium alloys hold the promise of improving results of BMS, especially when implanted with direct technique. We performed an observational study to appraise outcomes of the novel Skylor™ stent, stratifying outcomes according to stenting technique.
  
  
  RESULTS
  We included all consecutive patients undergoing coronary stenting with Skylor™ at 2 centers between 2006 and 2009. The primary end-point was the long-term rate of major adverse cardiac events (MACE, i.e. death, myocardial infarction (MI), coronary artery bypass grafting (CABG) or target vessel revascularization (TVR)). As pre-specified analysis, we compared patients undergoing direct stenting versus those stent implantation following predilation. A total of 1020 patients were included (1292 Skylor™ stents), with procedural success obtained in 99%. Comparing patients undergoing direct stenting (66%) versus pre-dilation (34%) at 16±7 months of follow-up, MACE had occurred in, respectively, 8% versus 14% (p=0.001), with death in 1% versus 2= (p=0.380), MI in 1% versus 2% (p=0.032), CABG in 0.2% versus 2% (p=0.012), and TVR in 6% versus 9% [p=0.071]. Even at multivariable analysis with propensity adjustment, direct stenting was associated with significantly fewer MACE [hazard ratio 0.60 [0.38-0.93], p=0.024].
  
  
  CONCLUSIONS
  This observational study suggests the presence of a beneficial synergy between direct coronary stenting technique and use of the novel thin-strut cobalt-chromium Skylor™ stent in real-world patients undergoing PCI.
authors: Unità di Cardiologia Invasiva, Clinica Pineta Grande, Castelvolturno, Italy. arturogiordano@tin.it
authors: Arturo
authors: A
authors: Giordano
authors: Michele
authors: M
authors: Polimeno
authors: Nicola
authors: N
authors: Corcione
authors: Luciano
authors: L
authors: Fattore
authors: Luigi
authors: L
authors: Di Lorenzo
authors: Giuseppe
authors: G
authors: Biondi-Zoccai
authors: Paolo
authors: P
authors: Ferraro
authors: Maria Fiammetta
authors: MF
authors: Romano
mesh_terms: D000368:Aged; D002858:Chromium Alloys / Q000627:therapeutic use; D023903:Coronary Restenosis / Q000209:etiology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation* / Q000379:methods; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects* / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D002858:Chromium Alloys