Recommended Conferences

Clinical Pharmacy and Pharmacology

Paris, France
 

A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease

Author(s): Fischman DL, Leon MB, Baim DS, Schatz RA, Savage MP, et al.

Abstract

Background: Coronary-stent placement is a new technique in which a balloon-expandable, stainless-steel, slotted tube is implanted at the site of a coronary stenosis. The purpose of this study was to compare the effects of stent placement and standard balloon angioplasty on angiographically detected restenosis and clinical outcomes.

Methods: We randomly assigned 410 patients with symptomatic coronary disease to elective placement of a Palmaz-Schatz stent or to standard balloon angioplasty. Coronary angiography was performed at base line, immediately after the procedure, and six months later.

Results: The patients who underwent stenting had a higher rate of procedural success than those who underwent standard balloon angioplasty (96.1 percent vs. 89.6 percent, P = 0.011), a larger immediate increase in the diameter of the lumen (1.72 +/- 0.46 vs. 1.23 +/- 0.48 mm, P < 0.001), and a larger luminal diameter immediately after the procedure (2.49 +/- 0.43 vs. 1.99 +/- 0.47 mm, P < 0.001). At six months, the patients with stented lesions continued to have a larger luminal diameter (1.74 +/- 0.60 vs. 1.56 +/- 0.65 mm, P = 0.007) and a lower rate of restenosis (31.6 percent vs. 42.1 percent, P = 0.046) than those treated with balloon angioplasty. There were no coronary events (death; myocardial infarction; coronary-artery bypass surgery; vessel closure, including stent thrombosis; or repeated angioplasty) in 80.5 percent of the patients in the stent group and 76.2 percent of those in the angioplasty group (P = 0.16). Revascularization of the original target lesion because of recurrent myocardial ischemia was performed less frequently in the stent group than in the angioplasty group (10.2 percent vs. 15.4 percent, P = 0.06).

Conclusions: In selected patients, placement of an intracoronary stent, as compared with balloon angioplasty, results in an improved rate of procedural success, a lower rate of angiographically detected restenosis, a similar rate of clinical events after six months, and a less frequent need for revascularization of the original coronary lesion.

Similar Articles

Physiological basis of clinically used coronary hemodynamic indices

Author(s): Spaan JA, Piek JJ, Hoffman JI, Siebes M

Pressure-flow relations in coronary circulation

Author(s): Hoffman JI, Spaan JA

Pathophysiology of coronary artery disease

Author(s): Libby P, Theroux P

Multicentric inflammation in epicardial coronary arteries of patients dying of acute myocardial infarction

Author(s): Spagnoli LG, Bonanno E, Mauriello A, Palmieri G, Partenzi A, et al.

Chest pain relief by nitroglycerin does not predict active coronary artery disease

Author(s): Henrikson CA, Howell EE, Bush DE, Miles JS, Meininger GR, et al.

Exercise-induced ST depression in the diagnosis of coronary artery disease

Author(s): Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, et al.

Effect of myocardial ischemia on cardiac troponin I and T

Author(s): Carlson RJ, Navone A, McConnell JP, Burritt M, Castle MC, et al.

Prevalence and determinants of troponin T elevation in the general population

Author(s): Wallace TW, Abdullah SM, Drazner MH, Das SR, Khera A, et al.

Utility of myocardial perfusion imaging in patients with low-risk treadmill scores

Author(s): Poornima IG, Miller TD, Christian TF, Hodge DO, Bailey KR, et al.

Magnetic resonance spectroscopy in myocardial disease

Author(s): Hudsmith LE, Neubauer S

Accuracy of MSCT coronary angiography with 64-slice technology: first experience

Author(s): Leschka S, Alkadhi H, Plass A, Desbiolles L, Grünenfelder J, et al.

Characteristics of coronary plaques before angiographic progression determined by Multi-Slice CT

Author(s): Leber AW, von Ziegler F, Becker A, Becker CR, Reiser M, et al.

Influence of heart rate on the diagnostic accuracy of dual-source computed tomography coronary angiography

Author(s): Ropers U, Ropers D, Pflederer T, Anders K, Kuettner A, et al.

Radiation dose in computed tomography of the heart

Author(s): Morin RL, Gerber TC, McCollough CH

Radiation exposure during cardiac CT: effective doses at multi-detector row CT and electron-beam CT

Author(s): Hunold P, Vogt FM, Schmermund A, Debatin JF, Kerkhoff G, et al.

Prognostic value of dobutamine stress myocardial contrast perfusion echocardiography

Author(s): Tsutsui JM, Elhendy A, Anderson JR, Xie F, McGrain AC, et al.

N Engl J Med 331: 489-495

Author(s): Serruys PW, de Jaegere P, Kiemeneij F, Macaya C, Rutsch W, et al.

Major clinical events after coronary stenting

Author(s): Sutton JM, Ellis SG, Roubin GS, Pinkerton CA, King SB 3rd, et al.

Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease

Author(s): Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, et al.

Coronary revascularization in context

Author(s): Lange RA, Hillis LD

Coronary artery disease in Saudi Arabia

Author(s): Al-Nozha MM, Arafah MR, Al-Mazrou YY, Al-Maatouq MA, Khan NB, et al.

Diabetes mellitus in Saudi Arabia

Author(s): Al-Nozha MM, Al-Maatouq MA, Al-Mazrou YY, Al-Harthi SS, Arafah MR, et al.

Obesity in Saudi Arabia

Author(s): Al-Nozha MM, Al-Mazrou YY, Al-Maatouq MA, Arafah MR, Khalil MZ, et al.

Metabolic syndrome in Saudi Arabia

Author(s): Al-Nozha M, Al-Khadra A, Arafah MR, Al-Maatouq MA, Khalil MZ, et al.

Hypertension in Saudi Arabia

Author(s): Al-Nozha MM, Abdullah M, Arafah MR, Khalil MZ, Khan NB, et al.

Hyperlipidemia in Saudi Arabia

Author(s): Al-Nozha MM, Arafah MR, Al-Maatouq MA, Khalil MZ, Khan NB, et al.

Interaction between fatness and fitness on CVD risk factors in Asian youth

Author(s): Jekal Y, Kim ES, Im JA, Park JH, Lee MK, et al.

Body fatness and clustering of cardiovascular disease risk factors in Portuguese children and adolescents

Author(s): Ribeiro JC, Guerra S, Oliveira J, Andersen LB, Duarte JA, et al.

Changes in secondary prevention of coronary artery disease in the post-discharge period over the decade 1997-2007

Author(s): Pajak A, Jankowski P, Kawecka-Jaszcz K, Surowiec S, Wolfshaut R, et al.

Secondary prevention through cardiac rehabilitation: from knowledge to implementation

Author(s): Piepoli MF, Corrá U, Benzer W, Bjarnason-Wehrens B, Dendale P, et al.

Secondary prevention of coronary artery disease in hospital practice over the decade 1996-2006

Author(s): Jankowski P, Kawecka-Jaszcz K, Pajak A, Surowiec S, Wolfshaut R, et al.