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Long-term outcome poor after Palmaz-Schatz stent implantation

המידע באדיבות www.medicontext.co.il
Last Updated: 2001-08-07 13:02:20 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – The long-term clinical outcome of Palmaz-Schatz intracoronary stenting is relatively poor, researchers report. They say that the disappointing results are partly due to in-stent restenosis but more often to progression of coronary atherosclerosis at nonstented sites.

Dr. Jean Fajadet, of Clinique Pasteur in Toulouse, France, and colleagues followed 426 consecutive patients for at least 8 years after Palmaz-Schatz stent implantation. Three patients died before hospital discharge, according to the team's report in the July 1st issue of The American Journal of Cardiology.

During 8 to 10 years of followup, 59 patients (13.9%) died, including 39 of cardiac causes; 47 patients (11.1%) experienced MI and 188 patients (44.4%) required target or nontarget vessel coronary revascularization.

"After the initial 1-year period, the freedom of repeat intervention on the stented site…reached a plateau," Dr. Fajadet's group report. "In contrast, target vessel revascularization and nontarget vessel revascularization continued to increase, indicating that late revascularization was performed predominantly to treat progressive disease at non-target sites rather than late deterioration at the stent site itself."

"The late course after coronary stenting appears to be dominated by the progressive effects of the underlying atherosclerotic disease rather than the effect of specific interventional procedures," the authors conclude.

Multivariate analyses showed that unstable angina, lower left ventricular ejection fraction, and saphenous vein graft stenting independently predicted death during follow-up. Independent predictors of the composite endpoint of death, MI, and coronary revascularization included hypertension, unstable angina, multivessel disease, and multiple stent implantation.

Am J Cardiol 2001;88:10-16.

-Westport Newsroom 203 319 2700

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