Elective Palmaz-Schatz intracoronary stenting demonstrated 88% absolute survival and 56% event-free survival at 3 years, with 85% of stent-site revascularizations occurring within 1 year.
Cohort (n=65)
Long-term follow-up after Palmaz-Schatz stenting demonstrates that stent-site revascularizations occur predominantly within the first year, whereas late revascularizations are driven by disease progression in nonstented segments.
OBJECTIVES: Our goals were to examine late clinical outcome in a cohort of patients who electively received Palmaz-Schatz intracoronary stents, to identify specific predictors of outcome and to determine the time course of the development of ischemic cardiac events after stenting. BACKGROUND: Short-term results of Palmaz-Schatz intracoronary stenting have been promising, with a reduction in both angiographic restenosis and clinical cardiac events up to 1 year after stenting. METHODS: We analyzed the clinical outcomes in 65 consecutive patients who underwent stenting at least 3 years before analysis. Demographic, clinical and procedural predictors of survival and event-free survival, defined as freedom from myocardial infarction, stent-site percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery or death, were analyzed at a mean follow-up of 39 +/- 17 months. RESULTS: Absolute survival and event-free survival at 3 years were 88% and 56%, respectively. Three-year freedom from stent-site revascularization was 66%. Predictors of decreased long-term survival (p 24 months), no patients had stent-site stenoses requiring revascularization, whereas 11% of patients required revascularization in nonstented coronary segments. CONCLUSIONS: Clinical predictors of worse long-term outcome included diabetes mellitus, higher angina score at follow-up, smaller stent deployment balloon size and greater number of stents at implantation. During follow-up, the majority of adverse events and stent-site revascularizations occurred early after stenting, and disease progression in nonstented vessels accounted for the majority of late revascularization events.
Klugherz et al. (Mon,) conducted a cohort in Coronary artery disease requiring stenting (n=65). Palmaz-Schatz intracoronary stenting was evaluated on Survival and event-free survival (freedom from myocardial infarction, stent-site percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery or death). Elective Palmaz-Schatz intracoronary stenting demonstrated 88% absolute survival and 56% event-free survival at 3 years, with 85% of stent-site revascularizations occurring within 1 year.