title: Is a bare-metal stent still useful for improving the outcome of percutaneous coronary intervention? From the FU-Registry.
abstract: Percutaneous coronary intervention (PCI) with a drug-eluting stent (DES) is increasingly being used for the treatment of coronary artery diseases. However, the role and effectiveness of PCI with a bare metal stent (BMS) have not yet been established.
  
  
  
  Among the 2197 patients (2653 lesions) treated with PCI from 2003 to 2012 at three institutions in Fukuoka, 859 patients (1032 lesions) without acute coronary syndrome and in whom we were able to perform follow-up coronary angiography after stent placement and collect detailed data were selected for this study. Among the patients treated by BMS, the cut-off lesion reference for the development of in-stent restenosis (ISR) was calculated by comparing patients with and without ISR. In all patients with a lesion reference above/below the cut-off point of BMS-ISR, medium-term clinical and angiographic outcomes were compared between the BMS and DES groups.
  
  
  
  In patients treated with a BMS, the lesion reference [odds ratio 0.68, 95% confidence interval (CI) 0.43-0.97, p=0.03] was strongly correlated with ISR, and the area under the receiver operating characteristic curve was 0.704, with moderate accuracy. Calculation of the cut-off lesion reference for BMS-ISR, using a relative cumulative frequency distribution and a sensitivity/specificity curve, showed that the cut-off lesion reference for BMS-ISR was 3.08mm, and the sensitivity/specificity was 60.4%. For the DES and BMS groups in cases with a lesion reference over 3.08mm, BMS placement did not correlate with ISR (odds ratio 0.98, 95% CI 0.85-1.12), and there was also no correlation between BMS and major adverse cardiac events.
  
  
  
  In patients with a lesion reference≧3.08mm, medium-term clinical and angiographic outcomes were equivalent between the use of a DES and BMS. Thus, BMS placement is well worth considering, especially in patients with a lesion reference≧3.08mm, in whom double-antiplatelet therapy needs to be stopped at an early stage.
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Kouki
authors: K
authors: Gondo
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Amane
authors: A
authors: Ike
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Masahiro
authors: M
authors: Ogawa
authors: Department of Cardiology, Fukuoka University Chikushi Hospital, Fukuoka, Japan; Division of Cardiology, Hakujyuji Hospital, Fukuoka, Japan.
authors: Kazuyuki
authors: K
authors: Shirai
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Makoto
authors: M
authors: Sugihara
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Hiroaki
authors: H
authors: Nishikawa
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Atsushi
authors: A
authors: Iwata
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Akira
authors: A
authors: Kawamura
authors: Department of Cardiology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors: Ken
authors: K
authors: Mori
authors: Department of Biochemistry, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Bo
authors: B
authors: Zhang
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Shin'ichiro
authors: S
authors: Miura
authors: Department of Biochemistry, Fukuoka University School of Medicine, Fukuoka, Japan.
authors: Shin'ichiro
authors: S
authors: Yasunaga
authors: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan. Electronic address: saku-k@fukuoka-u.ac.jp.
authors: Keijiro
authors: K
authors: Saku
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy; D023903:Coronary Restenosis / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012042:Registries; D015607:Stents
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Bare-metal stent; Double-antiplatelet therapy; Drug-eluting stent; In-stent restenosis; Percutaneous coronary intervention