title: Frequency of Angina Pectoris After Percutaneous Coronary Intervention and the Effect of Metallic Stent Type.
abstract: Although metallic coronary stents significantly reduce angina pectoris compared with optimal medical therapy, angina after percutaneous coronary intervention (PCI) remains frequent. We, therefore, sought to compare the incidence of any angina during the 1 year after PCI among the spectrum of commercially available metallic stents. Metallic stent type was classified as bare metal stent, Cypher, Taxus Express, Xience V, Promus Element, and Resolute. The primary end point was patient-reported angina within 1 year of PCI. Multivariable logistic regression was performed to assess the independent association of stent type with any angina at 1 year. Overall, 8,804 patients were queried in regard to angina symptoms; 32.3% experienced angina at some point in the first year after PCI. Major adverse cardiovascular events, a composite of all-cause mortality, target vessel revascularization, and Q-wave myocardial infarction, increased with angina severity: 6.8% for patients without angina, 10.0% for patients with class 1 or 2 angina, and 19.7% for patients with class 3 or 4 angina (p <0.001 for trend). After multivariable adjustment, there was no significant association between stent type and angina at 1 year after PCI. Baseline Canadian Cardiovascular Society class 3 or 4 angina, history of coronary artery bypass grafting, and history of PCI were associated with a higher likelihood of angina at 1 year; increasing age, male gender, presentation with acute coronary syndrome, and higher stented length were associated with less angina. In conclusion, metallic stent type is not associated with the occurrence of angina at up to 1 year after PCI.
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gaglia
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lipinski
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Jiaxiang
authors.initials: J
authors.lastname: Gai
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Edward
authors.initials: E
authors.lastname: Koifman
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Sarkis
authors.initials: S
authors.lastname: Kiramijyan
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Smita
authors.initials: S
authors.lastname: Negi
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Toby
authors.initials: T
authors.lastname: Rogers
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Arie
authors.initials: A
authors.lastname: Steinvil
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: William O
authors.initials: WO
authors.lastname: Suddath
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.affiliation: Section of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia. Electronic address: ron.waksman@medstar.net.
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology* / Q000209:etiology; D002423:Cause of Death / Q000639:trends; D003324:Coronary Artery Disease / Q000601:surgery*; D004219:District of Columbia / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011379:Prognosis; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate / Q000639:trends; D013997:Time Factors