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Long-term analysis of conventional coronary balloon angioplasty and an initial "stent-like" result. The NHLBI PTCA Registry.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Holmes, D. R. Kip, Kevin E. Yeh, Wanlin Kelsey, Sheryl F. Detre, Katherine M. Williams, David O. |
| Copyright Year | 1998 |
| Abstract | OBJECTIVES We examined the influence of an initial "stent-like" result on long-term outcome in patients in the 1985-86 NHLBI PTCA Registry. BACKGROUND Stent use in selected patients is associated with improved angiographic and short-term clinical outcome; however, due to potential for in-stent restenosis and high costs of stents, there is interest in a strategy of more optimal dilatation to achieve a "stent-like" result without a stent. The long-term outcome of patients with a "stent-like" percutaneous transluminal coronary angioplasty (PTCA) remains unknown. METHODS Ten-year outcome was compared between 225 successfully treated patients with and 1,764 successfully treated patients without an initial "stent-like" result ( > or = 1 lesion dilated to < or = 10% stenosis). The sample had 75% and 80% power, respectively, to detect an absolute difference of 8% in the 10-year rate of death and myocardial infarction (MI) between the two groups. RESULTS Ten-year rates of death and MI were similar between the stent-like and non-stent-like groups (22.3% vs. 22.2%, 17.6% vs. 17.9%), however, there was less target lesion revascularization in the stent-like group (30.2% vs. 36.8%). In subgroup analysis of patients with multivessel disease, those with a stent-like result had less follow-up bypass surgery (25.2% vs. 32.7%), yet more repeat PTCA (53.8% vs. 42.7%). These findings were unaffected by adjustment for differences in baseline characteristics between the two patient groups. CONCLUSIONS Achievement of an initial stent-like result via balloon angioplasty alone may not appreciably reduce the long-term risk of death or MI, nor confer equivalent clinical benefit as achieving a stent-like result with a stent. |
| Starting Page | 175 |
| Ending Page | 178 |
| Page Count | 4 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://www.onlinejacc.org/content/accj/32/3/590.full.pdf |
| PubMed reference number | 9741498v1 |
| Volume Number | 32 |
| Issue Number | 3 |
| Journal | Journal of the American College of Cardiology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Angioplasty, Balloon Angioplasty, Balloon, Coronary Cessation of life Coronary Artery Bypass Surgery Dilate procedure Eighty Myocardial Infarction Paget's Disease, Mammary Patients Percutaneous Transluminal Coronary Angioplasty Registries Stenosis (invertebrate) Stent Device Component Stent, device Subgroup A Nepoviruses bypass revascularization |
| Content Type | Text |
| Resource Type | Article |
