Long-term outcome of first-generation metallic coronary stent implantation in patients with coronary artery disease: observational study over a decade

Circ J. 2007 Sep;71(9):1360-5. doi: 10.1253/circj.71.1360.

Abstract

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.

Methods and 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.

Publication types

  • Clinical Trial

MeSH terms

  • Acute Disease
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary*
  • Arteriosclerosis / mortality
  • Arteriosclerosis / prevention & control
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / mortality*
  • Coronary Artery Disease / therapy*
  • Death, Sudden, Cardiac / epidemiology
  • Death, Sudden, Cardiac / etiology
  • Drug-Eluting Stents* / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy
  • Predictive Value of Tests
  • Registries
  • Survival Rate
  • Treatment Outcome
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / mortality
  • Ventricular Dysfunction, Left / therapy