Clinical long-term outcome of coronary stenting in current practice

Introduction. Published Stress and Benestent studies, obtained in selected populations under technical conditions that do not reflect present practice with intercoronary stenting showed a clinical benefit of coronary stenting. Objective. To assess clinical longterm outcome of coronary stenting in current practice and to compare coronary lesions with and without Stress/Benestent criteria. Methods. 216 consecutive patients with successful placement of 279 stents in 256 lesions and no major in-hospital events. Mean clinical follow-up was 16.7 +/- 10.4 months. Standard technique included seven types, high pressure balloon inflation (15.6 +/- 2.2 atm) and poststenting treatment of four weeks with aspirin and ticlopidine. Results. Cumulative rates of target lesion revascularization were 9.7% at 6 months, 13,5% at 12 months and 15,1% at 18, 24 and 36 months. Cumulative rates of combined clinical end-point (death, myocardial infarction and target lesion revascularization) were 11.3%, at 6 months, 13.9% at 1 year, 19.3% at 2 years and 21.1% at 3 years. No Stress/Benestent lesions were 193; 75%, and had a higher incidence of target lesion revascularization (17.9 vs 7.5%, Log Rank = 0.015) and combined clinical endpoint (22.4 vs 10%, Log Rank = 0.025), than Stress/Benestent lesions. Conclusion. Coronary stenting of no Stress/Benestent lesions have a less favourable clinical longterm outcome. However, clinical outcome in a nonselected population at the present time is similar to the old Stress/Benestent studies, probably because of technical improvements.