Non-elective intra-coronary stenting: are the clinical outcomes comparable to elective stenting at 6 months?

Int J Cardiol. 1999 Oct 31;71(2):121-7. doi: 10.1016/s0167-5273(99)00124-2.

Abstract

The aim of this study was to compare prospectively the clinical outcome of patients treated with intra-coronary stents as a non-elective/bailout procedure for acute or threatened vessel closure, with those undergoing elective stenting at 6 months. Sixty-four patients (60.2+/-11.7 y) who underwent non-elective stenting for abrupt or threatened vessel closure and/or sub-optimal results were prospectively compared with 68 patients (62+/-10.0 y) who were stented electively. All patients had broadly similar pre-procedural clinical profiles. However, patients in the elective group had a higher incidence of previous PTCA (10.2% vs. 0%, P = 0.01) and bypass surgery (30.9% vs. 6.3%, P = 0.0003) compared with the non-elective group. A total of 158 stents (1.19 per patient) were implanted in 132 patients with a procedural success rate of 99.3%. At 6 months follow-up there was no statistical difference in the primary composite end-point of death, myocardial infarction and the need of repeat revascularisation (10.9% vs. 5.8%, P = 0.35) between the two groups. However, patients in the non-elective group showed a higher incidence of unstable angina compared with the elective group (25% vs. 1.4%, P = 0.0004). The findings of this study suggest that stents (single or multiple) can be effectively implanted in non-elective situations with no increase in the incidence of death, non-fatal myocardial infarction, and the need of repeat revascularisation at 6 months compared with elective stenting.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angina, Unstable / diagnostic imaging
  • Angina, Unstable / mortality
  • Angina, Unstable / therapy*
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Coronary Angiography
  • Emergencies*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy*
  • Prospective Studies
  • Recurrence
  • Retreatment
  • Stents*
  • Survival Analysis
  • Treatment Outcome