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Titolo:
Baseline clinical and angiographic variables associated with long-term outcome after successful intracoronary stent implantation
Autore:
Mathew, V; Grill, DE; Scott, CG; Garratt, KN; Holmes, DR;
Indirizzi:
Mayo Clin, Div Cardiovasc Dis & Internal Med, Rochester, MN 55905 USA MayoClin Rochester MN USA 55905 & Internal Med, Rochester, MN 55905 USA
Titolo Testata:
AMERICAN JOURNAL OF CARDIOLOGY
fascicolo: 7, volume: 84, anno: 1999,
pagine: 789 - 794
SICI:
0002-9149(19991001)84:7<789:BCAAVA>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY SURGERY; BALLOON ANGIOPLASTY; CASS REGISTRY; DIABETES-MELLITUS; RESTENOSIS RATES; PLACEMENT; DISEASE; INTERVENTIONS; LESIONS; GRAFT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Mathew, V Mayo Clin, Div Cardiovasc Dis, 200 1st St SW, Rochester, MN 55905 USA Mayo Clin 200 1st St SW Rochester MN USA 55905 ter, MN 55905 USA
Citazione:
V. Mathew et al., "Baseline clinical and angiographic variables associated with long-term outcome after successful intracoronary stent implantation", AM J CARD, 84(7), 1999, pp. 789-794

Abstract

Although randomized studies have demonstrated improved outcomes with stents over balloon angioplasty in straightforward coronary narrowings in low-risk patients, this advantage is less clear for complex lesions and high-riskpatients. This study was designed to identify clinical and angiographic variables that are associated with long-term outcome after stent implantation. We identified 1,709 patients undergoing successful stent placement without in-hospital major adverse events. We analyzed clinical, lesional, and procedural variables to determine their correlation with outcome. Mean duration of follow-up was 1.6 +/- 1.4 years. Cox proportional-hazards models and stepwise methods were used ta assess which covariates were potentially related to each end point. The occurrence of death/myocardial infarction (MI) was associated with any history of congestive heart failure (relative risk [RR] 3.3, 95% confidence interval [CI] 2.3 to 4.7, p < 0.0001), procedure within 24 hours of MI (RR 2.3, CI 1.3 to 4.1, p = 0.0048), vein graft intervention (RR 1.8, CI 1.3 to 2.6, p = 0.0007), and prior MI (RR 1.8, CI 1.2 to 2.6, p = 0.004). Repeat revascularization was associated with multivessel stent placement (RR 1.8, CI 1.2 to 2.8, p = 0.006) and stent for abrupt closure (RR 1.7, CF 1.1 to 2.7, p = 0.03), but was less frequent with de novo lesions and right coronary artery lesions (RR 0.6, CI 0.5 to 0.8, p = 0.0007,and RR 0.8, CI 0.6 to 1.0, P = 0.05, respectively). The cumulative end point of death/MI/repeat revascularization was associated with congestive heart failure (88 1.7, CI 1.3 to 2.2, p < 0.0001), multivessel stent placement (RR 1.6, CI 1.1 to 2.3, p = 0.03), warfarin therapy (RR 1.4, Cl 1.2 to 1.8,p = 0.001), and procedure within 24 hours of MI (RR 1.5, CI 1.1 to 2.1, p = 0.02), but was less frequent with complete revascularization and right coronary:artery intervention (RR 0.8, CI 0.7 to 0.99, p 0.04, and BR 0.7, CI 0.6 to 0.9, p = 0.009, respectively). Thus, this study demonstrates that there are readily identifiable characteristics in patients treated successfully with stents that are associated with long-term outcome. (C) 1999 by Excerpta Medica, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 01:33:57