Abstract
In the modern era of percutaneous coronary interventions (PCI), drug-eluting stents are commonly used to reduce the risk of restenosis.1 With the development of second-generation drug-eluting stents, there has been a significant reduction in the incidence of restenosis with rates ranging from 6% to 10% in most clinical trials,2 with emerging evidence for a reduction in late myocardial infarction (MI). Numerically, the rate of clinical restenosis is now close to the rate of MI, 1 to 2 years after a PCI.1 However, among patients with multivessel coronary artery disease (CAD) there remains uncertainty regarding the risk of restenosis, stent thrombosis (ST), and possible late MI.3 Interventional cardiologists are, therefore, faced with a dilemma in trading off the various risks of adverse events (such as the need for repeat revascularization and periprocedural MI) during decision-making for the most appropriate use of PCI. Article see p 772 In this issue of Circulation: Cardiovascular Interventions , Stolker and colleagues4 report on the use and need for repeat revascularization in a large contemporary registry. The EVENT Registry was a prospective observational registry designed to study PCI in clinical practice in 55 US centers. A total of 10,144 patients were included; ≈5%, ST-segment–elevation myocardial infarction (STEMI); 40% other acute coronary syndromes; and 49% with stable CAD. Analysis of 4 main outcomes was undertaken; ST, target lesion revascularization (TLR), target vessel revascularization, or other vessel revascularization. TLR was defined as repeat PCI or bypass graft placement for restenosis at the lesion treated during index PCI, or occurring within 5 mm of the PCI site (edge effect) as determined clinically by the investigator at each site. Target vessel revascularization …
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call