ASSA14-12-01 Long-term outcome of bare-metal stent implantation in patients with coronary artery stenosis

Abstract

Objectives To evaluate the long-term effects of bare-metal stent (BMS) implantation in patients with coronary artery stenosis or occlusion lesions and with symptoms of angina pectoris. Methods 224 patients with serious stenosis (75% to 100%) of a native coronary artery presenting with symptoms of angina pectoris were enrolled from1 Mach, 2001 to 1 Mach, 2010. Among them there were 123 cases with hypertension (54.9%), 52 cases with diabetes mellitus (23.2%), 3 cases (1.3%) with old myocardial infarction and 32 cases (14.3%) with hyperlipidemia. 74 patients (33.0%) were smoker. The coronary angiography showed that the type 1 lesion characteristics were 95 cases (42.4%), type 2a lesion characteristics were 50 cases (22.3%), type 2b lesion characteristics were 46 cases (20.5%) and type 3 lesion characteristics were 33 cases (14.7%). Single coronary vessel lesion was 143 cases (63.8%), double coronary vessel lesions were 64 cases (28.6%) and three coronary vessel lesions were 17 (7.6%). BMS was implanted in the ischemia related coronary lesion. The diameter of the implanted stents was (3.16 ± 0.42) mm with length of (18.38 ± 6.15) mm. After the procedure of PCI recommended antiplatelet regimen included clopidogrel and aspirin for 2 months and followed by chronic aspirin therapy. All patients were followed for 24 to 157 months with an average of (93.50 ± 39.20) months. The main endpoint of follow-up was the occurrence of the first major adverse cardiac event (MACE), defined as death due to all cause, nonfatal recurrent myocardial infarction, and target lesion revascularisation (TLR) and target vessel revascularisation (TVR), heart failure with III class and over, very late thrombosis in stent and stroke. Results Complete clinical status was available in 224 patients to the end of follow-up. The combined cumulative MACE rate was 37.5% (84 cases) with an average of 4.81% per year. The number of death due to all cause was 32 cases (14.29%) with an average of 1.83% per year. The rate of TLR was 14.29% (32 cases) with an average of 1.83% per year. The rate of TVR was 6.25% (14 cases) with an average of 0.80% per year. The rate of heart failure with III class was 1.33% (3 cases). CABG was need in 2 cases (0.89%). The very late thrombosis in stent (1 case, 0.45%) presenting STEMI was very low. 2 case (0.89%) died to cerebral haemorrhage occurring within 24 month after the PCI. Conclusions It was the low incidence rate of MACE in the long-term follow-up for more than 2 years that BMS was used to treat unselective coronary artery stenosis lesions.