Long-term (≥8 years) outcome after Plamaz-Schatz stent implantation

The purpose of this single-center study was to evaluate the long-term (greater than or equal to8 years) outcome of Palmaz-Schatz infracoronary stenting and to identify independent predictors of outcome. Although short-term results of Palmaz-Schatz intracoronary stenting have been promising, with a reduction in both angiographic restenosis and clinical cardiac events vp to 3 years, longer-term follow-up has not been established. We analyzed clinical outcome ire 426 consecutive patients at least 8 years after coronary stenting. Demographic, clinical, and procedural predictors Of restenosis, survival, and event-free survival, defined as freedom from death, myocardial infarction(MI), and coronary revascularization (target stented site, target vessel: and any revascularization) were analyzed. Before discharge, 28 patients (6.6%) sustained at least 1 major cardiovascular event: 3 deaths (0.7%), 18 Mls (4.2%), and 17 repeat revascularizations. Surviving patients were followed for 8.9 years (interquartile range 8.4 to 9.4). After discharge, 59 patients (13.9%) died, 47 (11.1%) sustained an MI, and 188 (44.4%) underwent coronary revascularization. The 8-year event-free survival (freedom from death, freedom from death/MI/target-stented site revascularization, and freedom from death/MI/any coronary revascularization) was (mean +/- SE) 0.86 +/- 0.01, 0.62 +/- 0.03, and 0.47 +/- 0.02, respectively. Unstable angina, lower left ventricular ejection fraction, and saphenous vein graft stenting were found to be independent predictors of death during follow-up. Hypertension, unstable angina, multivessel disease, and multiple stent implantation were found to be independent predictors of the composite of death/MI/any coronary revascularization during follow-vp. This study provided a useful assessment of very longterm outcome in survival, event-free survival, and predictors of major cardiac events 8 to 10 years after Palmaz-Schatz stent implantation. (C) 2001 by Excerpta Medica, Inc.