In-hospital and late clinical outcomes of direct stenting strategy versus stenting after predilatation for the treatment of coronary artery lesions.

Alidoosti, Mohammad; Salarifar, Mojtabal; Kassaian, Seyed Ebrahim; Zeinali, Alimohammad Haji; Dehkordi, Maria Raissi; Fathollahi, Mahmood Sheikh

In-hospital and late clinical outcomes of direct stenting strategy versus stenting after predilatation for the treatment of coronary artery lesions.

Date

2008-07-27

Authors

Alidoosti, Mohammad

Salarifar, Mojtabal

Kassaian, Seyed Ebrahim

Zeinali, Alimohammad Haji

Dehkordi, Maria Raissi

Fathollahi, Mahmood Sheikh

Abstract

BACKGROUND: Direct stenting without balloon dilatation may reduce procedural costs and duration, and hypothetically, the restenosis rate. This study was designed to compare the in-hospital and long-term outcomes of direct stenting (DS) versus stenting after predilatation (PS) in our routine clinical practice. METHODS: One thousand six hundred and three patients treated with stenting for single coronary lesions were enrolled into a prospective registry. Patients with acute myocardial infarction (MI) within the preceding 48 hours, highly calcified lesions, total occlusions, or lesion in a saphenous graft were excluded. The baseline, angiographic, and procedural data, in-hospital outcomes and follow-up data were recorded in our database, and analyzed with appropriate statistical methods. RESULTS: Eight hundred and fifty-seven patients (53.5%) were treated with DS, whereas 746 of them (46.5%) underwent PS. In the DS group, lesions were shorter in length, larger in diameter, and had lower pre-procedural diameter stenosis. Type C and diffuse lesions and drug-eluting stents were less frequent (p < 0.001). In univariate analysis, dissection and non-Q-wave MI occurred less frequently in this group (0.2% and 0.6% vs 3.9% and 2.1%, p < 0.001 and p 7 = 0.01, respectively). However, the cumulative major adverse cardiac events (MACE) did not differ significantly (4.9% vs 4.6%, p = 0.79). In multivariate analysis, direct stenting reduced the risk of dissection (OR = 0.07, 95% CI: 0.01-0.33), but, neither the cumulative endpoint of MACE (OR = 1.1, 95% CI = 0.58-2.11, p = 0.7) nor its constructing components were different between the groups. CONCLUSIONS: Direct stenting in real world has at least similar long-term outcomes with patients treated with stenting after predilatation and is associated with lower dissection rate.

Citation

Alidoosti M, Salarifar M, Kassaian SE, Zeinali AH, Dehkordi MR, Fathollahi MS. In-hospital and late clinical outcomes of direct stenting strategy versus stenting after predilatation for the treatment of coronary artery lesions. Indian Heart Journal. 2008 Jul-Aug; 60(4): 318-24