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Two-year Outcomes in Primary Angioplasty with Bare-Metal Stents
Abstracts
393
Conclusion: Using two domain areas from the U22 questionnaire enabled patients with the same clinical priority to be stratified by symptom load. Further development of a national scoring tool should incorporate self-assessment of symptoms to aid stratification.
Conclusion: The use of BMS in the PAMI has low rates of two-year adverse clinical events in the setting of large calibre vessels.
doi:10.1016/j.hlc.2011.03.050
Two-Year Outcomes with Everolimus Drug-Eluting Stent—A Single Centre Registry
Two-year Outcomes in Primary Angioplasty with BareMetal Stents M. Liang 1,∗ , J. Wong 1 , A. Puri 2 , J. Hii 1 , C. Nunn 1 , G. Devlin 1 1 Department 2 CSM
of Cardiology, Waikato Hospital, New Zealand Medical University, Lucknow, India
Background: Bare metal stents (BMS) are still frequently used in ST-elevation myocardial infarction (STEMI) patients as it has been hypothesised that the thrombotic milieu in this setting is a risk factor for stent thrombosis particularly if drug-eluting stents are used. Few data exist for outcomes longer than one-year, thus we reviewed our primary angioplasty (PAMI) registry and reported the longer term outcomes in patients with STEMI treated with BMS. Methods: 271 STEMI patients underwent PAMI with BMS from August 2006 to August 2010. PAMI was defined as a coronary intervention performed as the primary treatment modality for STEMI presenting within 12 hours of onset of symptoms. Rescue PAMI was excluded. Outcomes assessed included death, myocardial infarction (MI), target-vessel revascularisation (TVR) and definite stent thrombosis as per ARC definition. Results: 225 patients had 338 BMS inserted: mean age is 62 ± 11 yrs, 75% male. The mean stent diameter and length was 3.2 ± 0.5 mm and 18 ± 6 mm, respectively. The infarct vessels were Left Main 3%, Left Anterior Descending 49%, Left Circumflex 9%, Right Coronary Artery 38%, Ramus Intermedius and grafts 1%. The mean follow-up was 24 ± 14 months. The accumulated clinical outcomes in this study cohort was death 12%, MI 6%, Stent Thrombosis 1%(both were subacute), Repeated Coronary Angiogram 11.5% and need for repeat intervention 5%. Kaplan-Meier 2 year survival is 89% with majority of mortality occurred within one year.
doi:10.1016/j.hlc.2011.03.051
M. Liang 1,∗ , A. Puri 2 , C. Lowry 1 , L. Hyde 1 , G. Devlin 1 1 Department of Cardiology, Waikato Hospital, Hamilton, New
Zealand Medical University, Lucknow, India
2 CSM
Background: Multiple randomised controlled trials have demonstrated excellent clinical outcomes with Everolimus eluting stents (EES). Limited data exists on real world outcomes which frequently involve “off-label” use. We report a single centre experience with EES including medium to long term major adverse cardiovascular events (MACE) defined as all-cause mortality, myocardial infarction (MI) and target vessel revascularisation(TVR). Methods: All consecutive patients underwent percutaneous coronary intervention (PCI) with EES (PROMUSTM , Boston Scientific, Natick USA; XIENCE VTM , Abbott Vascular, Santa Clara USA) between March 2007 to September 2009 recorded in our coronary intervention registry were included in this study. All patients were prescribed lifelong aspirin and 75 mg/day clopidogrel for 6–12 months. Results: 403 consecutive patients (mean age 64 ± 12 years, 71% males) were included in this study. A total of 690 stents were deployed in 568 lesions in 510 vessels; average of 1.7 stents per patient. Indications for PCI were stable angina in 11%, unstable angina in 39%, NSTEMI in 43%, and STEMI 7%. Procedural success was achieved in 99.4%. Vessels treated were LAD in 47%, RCA in 24%, LCX in 23%, and LM/Intermediate/Grafts in 6%. The mean stent length was 18.2 ± 9.2 mm with a mean stent diameter of 2.7 ± 6 mm. During a median follow-up of 23 months, 3% of patients had an MI, 3% underwent TVR, 4% died with 1 (<0.5%) case of definite stent thrombosis. The cumulative MACE was 11%. The Kaplan Meier 2-year survival and MACE free survival were 95% and 89% respectively. Conclusion: Everolimus eluting stent appears safe in a real world setting with satisfactory median term outcomes which include low rates of TVR and other adverse events. doi:10.1016/j.hlc.2011.03.052
ABSTRACTS
Heart, Lung and Circulation 2011;20:376–419
393
Conclusion: Using two domain areas from the U22 questionnaire enabled patients with the same clinical priority to be stratified by symptom load. Further development of a national scoring tool should incorporate self-assessment of symptoms to aid stratification.
Conclusion: The use of BMS in the PAMI has low rates of two-year adverse clinical events in the setting of large calibre vessels.
doi:10.1016/j.hlc.2011.03.050
Two-Year Outcomes with Everolimus Drug-Eluting Stent—A Single Centre Registry
Two-year Outcomes in Primary Angioplasty with BareMetal Stents M. Liang 1,∗ , J. Wong 1 , A. Puri 2 , J. Hii 1 , C. Nunn 1 , G. Devlin 1 1 Department 2 CSM
of Cardiology, Waikato Hospital, New Zealand Medical University, Lucknow, India
Background: Bare metal stents (BMS) are still frequently used in ST-elevation myocardial infarction (STEMI) patients as it has been hypothesised that the thrombotic milieu in this setting is a risk factor for stent thrombosis particularly if drug-eluting stents are used. Few data exist for outcomes longer than one-year, thus we reviewed our primary angioplasty (PAMI) registry and reported the longer term outcomes in patients with STEMI treated with BMS. Methods: 271 STEMI patients underwent PAMI with BMS from August 2006 to August 2010. PAMI was defined as a coronary intervention performed as the primary treatment modality for STEMI presenting within 12 hours of onset of symptoms. Rescue PAMI was excluded. Outcomes assessed included death, myocardial infarction (MI), target-vessel revascularisation (TVR) and definite stent thrombosis as per ARC definition. Results: 225 patients had 338 BMS inserted: mean age is 62 ± 11 yrs, 75% male. The mean stent diameter and length was 3.2 ± 0.5 mm and 18 ± 6 mm, respectively. The infarct vessels were Left Main 3%, Left Anterior Descending 49%, Left Circumflex 9%, Right Coronary Artery 38%, Ramus Intermedius and grafts 1%. The mean follow-up was 24 ± 14 months. The accumulated clinical outcomes in this study cohort was death 12%, MI 6%, Stent Thrombosis 1%(both were subacute), Repeated Coronary Angiogram 11.5% and need for repeat intervention 5%. Kaplan-Meier 2 year survival is 89% with majority of mortality occurred within one year.
doi:10.1016/j.hlc.2011.03.051
M. Liang 1,∗ , A. Puri 2 , C. Lowry 1 , L. Hyde 1 , G. Devlin 1 1 Department of Cardiology, Waikato Hospital, Hamilton, New
Zealand Medical University, Lucknow, India
2 CSM
Background: Multiple randomised controlled trials have demonstrated excellent clinical outcomes with Everolimus eluting stents (EES). Limited data exists on real world outcomes which frequently involve “off-label” use. We report a single centre experience with EES including medium to long term major adverse cardiovascular events (MACE) defined as all-cause mortality, myocardial infarction (MI) and target vessel revascularisation(TVR). Methods: All consecutive patients underwent percutaneous coronary intervention (PCI) with EES (PROMUSTM , Boston Scientific, Natick USA; XIENCE VTM , Abbott Vascular, Santa Clara USA) between March 2007 to September 2009 recorded in our coronary intervention registry were included in this study. All patients were prescribed lifelong aspirin and 75 mg/day clopidogrel for 6–12 months. Results: 403 consecutive patients (mean age 64 ± 12 years, 71% males) were included in this study. A total of 690 stents were deployed in 568 lesions in 510 vessels; average of 1.7 stents per patient. Indications for PCI were stable angina in 11%, unstable angina in 39%, NSTEMI in 43%, and STEMI 7%. Procedural success was achieved in 99.4%. Vessels treated were LAD in 47%, RCA in 24%, LCX in 23%, and LM/Intermediate/Grafts in 6%. The mean stent length was 18.2 ± 9.2 mm with a mean stent diameter of 2.7 ± 6 mm. During a median follow-up of 23 months, 3% of patients had an MI, 3% underwent TVR, 4% died with 1 (<0.5%) case of definite stent thrombosis. The cumulative MACE was 11%. The Kaplan Meier 2-year survival and MACE free survival were 95% and 89% respectively. Conclusion: Everolimus eluting stent appears safe in a real world setting with satisfactory median term outcomes which include low rates of TVR and other adverse events. doi:10.1016/j.hlc.2011.03.052
ABSTRACTS
Heart, Lung and Circulation 2011;20:376–419