Abstract
BackgroundData from a large patient population regarding very long-term outcomes after BMS implantation are inadequate. This study aimed to evaluate the very long-term (8–17 years) clinical and long-term (3–5 years) angiographic outcomes after intracoronary bare-metal stenting (BMS).Methods and ResultsFrom the Cardiovascular Atherosclerosis and Percutaneous TrAnsluminal INterventions (CAPTAIN) registry, a total of 2391 patients with 2966 lesions treated with 3190 BMSs between November 1995 and May 2004 were evaluated. In total, 1898 patients with 2364 lesions, and 699 patients with 861 lesions underwent 6-month and 3- to 5- year angiographic follow-up, respectively. During a mean follow-up period of 149±51 months, 18.6% of the patients died (including 10.8% due to cardiac death), 6.1% developed reinfarction, 16.2% had target lesion revascularization (including 81% of the patients within the first year), 14.5% underwent new lesion stenting (including 72% of the patients after 3 years), 2.4% underwent coronary bypass surgery, and 1.6% had definite stent thrombosis. The overall cardiovascular event-free survival rate was 58.5%. The 6-month angiographic study indicated a 20% restenosis rate. The minimal luminal diameter increased from 0.65±0.44 mm to 3.02±0.46 mm immediately after stenting, decreased to 2.06±0.77 mm at the 6-month follow-up, and increased to 2.27±0.68 mm at the 3- to 5-year follow-up.ConclusionsThis study provides clinical and angiographic results from a large population of patients who underwent BMS implantations after a long-term follow-up period (149±51 months). The progression of coronary atherosclerosis developed over time, and presented with new lesion required stent implantation. The follow-up angiographic findings reconfirmed the late and sustained improvement in luminal diameter between 6 months and 3–5 years.
Highlights
The progression of coronary atherosclerosis developed over time, and presented with new lesion required stent implantation
Percutaneous coronary intervention (PCI) with bare-metal stents (BMSs) has been shown to reduce procedural complications and late restenosis compared with balloon angioplasty in randomized trials [1,2]
BMSs are still used in PCI, especially for simple lesions, despite the superiority of drug-eluting stents (DESs)
Summary
Percutaneous coronary intervention (PCI) with bare-metal stents (BMSs) has been shown to reduce procedural complications and late restenosis compared with balloon angioplasty in randomized trials [1,2]. Several studies have shown baremetal stenting to be beneficial in mid-term [5,6,7], long-term [8,9,10] and very long-term follow-up [11]. This study aimed to evaluate the very long-term (8–17 years) clinical and long-term (3–5 years) angiographic outcomes of a large sample (2391 consecutive patients) who underwent BMS implantation, and identify specific predictors of clinical cardiovascular events and 6-month angiographic in-stent restenosis. Data from a large patient population regarding very long-term outcomes after BMS implantation are inadequate. This study aimed to evaluate the very long-term (8–17 years) clinical and long-term (3–5 years) angiographic outcomes after intracoronary bare-metal stenting (BMS)
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