Long-Term Follow-up Results in Coronary Angioplasty with Stent Implant. Conarec V Registry

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Abstract

Background

Intracoronary stenting has demonstrated its usefulness in reducing some of the complications of percutaneous transluminal coronary angioplasty. Although it has become widespread amongst interventionist cardiologists, current long term outcomes are unknown in our country.

Objectives

To assess long term evolution of a group of patients undergoing stent angioplasty and compare it with a group of patients with no stenting.

Material and method

One thousand two hundred and ninety five (1,295)patients who underwent percutaneous transluminal coronary angioplasty were included in a prospective and consecutive way. Events at follow-up were analyzed (x = 14.4 ± 7.8 months). Only patients considered clinical success were assessed (n = 1,115), defined as angiographic success (< 30% residual lesion after angioplasty) without major in-hospital events (death, acute myocardial infarction, and/or urgent coronary bypass surgery).

Results

Follow-up was accomplished in 1,023 clinical success patients (91.7%). Fifty-two percent of these (n= 532) had a stent implant. Stent-treated patients were predominantly male (82.3% versus 76.2%, p= 0.01), had a greater proportion of previous per-cutaneous transluminal coronary angioplasty (15.8%versus 11.6%, p= 0.052) and smaller percent-age of acute myocardial infarction as precipitating event for percutaneous transluminal coronary angioplasty (14.1% versus 24%, p < 0.001). Stent was placed in de novo lesions in 81.5%. During follow-up acute myocardial infarction occurrence in the stented group was 1.5%, need for new coronary angioplasty 10.5%, coronary surgery 5.6% and mortality 2.8%. In the group with no stent acute myocardial infarction presented in 2.2%, need for new angioplasty 12.2%, coronary surgery 7.1% and mortality 4.5%. The incidence of major events was 18.4% in the stended group and 23.6% in the group with no stent (p = 0.04). When angina pectoris is added to all the events (total clinical events), the difference between groups increases(23.7% versus30.1%, p = 0.019).

Conclusions

A greater percentage of stents was placed in de novo lesions. Despite noting a smaller incidence of total events by using this device, there were no significative differences in major complications orin the need for new revascularization procedures. Observed results are comparable to those seen in the literature.