PW150 Predictive Factors of Long-Term Cardiovascular Death After A First Myocardial Infarction: A 9.6-Year Follow-Up Study

Abstract

Introduction: Although drug eluting stents (DES) are known to minimize the risk of restenosis, some of the cases are still selecting plain old balloon angioplasty (POBA) for some reasons. Objectives: The aim of this study is to clarify the characteristics and trends of POBA in current DES era. Methods: We examined the cases of POBA performed in our institute during years of 2008 to 2012 retrospectively. For control, bare metal stents (BMS) and DES implantation done in 2011 were analyzed. Results: During the period, 85 POBA, 63 BMS, 132 DES cases were identified. POBA cases were significantly older than BMS (69.5+/-10.7, 64.0+/-10.1, 67.6+/-9.5 year-old, POBA, BMS, DES, respectively, p<0.05). The device used were significantly smaller diameter in POBA than others (2.69+/-0.55, 3.07+/-0.49, 2.94+/-0.41 mm, POBA, BMS, DES, respectively, p<0.01). Within 218 cases (POBA 63, BMS 47, DES 108) completed follow up angiography, the rate of restenosis was significantly higher in POBA than BMS and DES (39.7%, 14.9%, 3.7%, POBA, BMS, DES, respectively, p<0.001). Unlike other strategies, restenosis cases in POBA used significantly larger devices than the other (2.90+/-0.64 vs. 2.61+/-0.49 mm, restenosis or not, p<0.05). After extracting the cases unable to classify, we create 3 categories for the reason of selecting POBA. 1; stent delivery failure or expected difficulty for stent delivery due to calcification etc. (n1⁄414), 2; intervention for in-stent restenosis or stent thrombosis (n1⁄434), 3; successful POBA for small vessels without complication (n1⁄414). According to it, category 1 showed significantly high probability for restenosis than others (1; 10/14, 71.4%, 2; 12/34, 35.3%, 3; 2/14, 14.3%, p<0.05) while category 3 showed nearly as good as BMS. Conclusion: POBA was done for older cases with smaller devices and showed significantly high probability for restenosis. We can interpret the categories of reason for POBA as follows; category 1 for negative selection, 3 for positive selection. Cases forced to select POBA had still unfavorable results whereas cases intentionally avoid stent implantation had tolerable outcome in current DES era. Disclosure of Interest: None Declared