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Effect of direct stenting on clinical outcome in patients treated with percutaneous coronary intervention on saphenous vein graft.

Abstract：

BACKGROUND:Percutaneous coronary intervention (PCI) of saphenous vein graft (SVG) is associated with frequent postprocedural enzyme elevation and late cardiac events. New strategies are proposed to minimize distal embolization and to improve the outcome of patients treated with stenting for SVG lesions. The objectives of the current study were to examine direct stenting (DS) strategy of PCI in SVG lesions and its effects on creatine-kinase (CK) release, major adverse cardiac events (MACE), and late outcome when compared to conventional stenting (CS). METHODS:A consecutive series of 527 patients treated with stent implantation for SVG stenosis was analyzed. In this cohort, 170 patients with 229 lesions were treated with DS and 357 patients with 443 lesions were treated with CS. The inhospital and 12-month follow-up events were recorded and reported. RESULTS:Baseline clinical and postprocedural angiographic characteristics were similar between the 2 groups except for higher preprocedural prevalence of thrombus-containing lesions in the DS group. Patients in the DS group had less CK-MB release (P <.001), and less non-Q-wave myocardial infarction (P =.024). Multivariate analysis detected unstable angina (odds ratio [OR] = 1.8, P =.03) as a correlate for non-Q-wave MI; DS was inversely associated with non-Q-wave myocardial infarction (OR = 0.65, P =.04). At 1 year, the target lesion revascularization-MACE was significantly lower in the DS group (P =.021). Multivariate analysis showed that DS (OR = 0.47, P =.007) was associated with reduction of the target lesion revascularization-MACE. CONCLUSIONS:When feasible, DS may be the best approach for treating SVG stenosis.

journal_name

Am Heart J

journal_title

American heart journal

authors

Leborgne L,Cheneau E,Pichard A,Ajani A,Pakala R,Yazdi H,Satler L,Kent K,Suddath WO,Pinnow E,Canos D,Waksman R

doi

10.1016/S0002-8703(03)00309-0

subject

Has Abstract

pub_date

2003-09-01 00:00:00

pages

501-6

issue

3

eissn

0002-8703

issn

1097-6744

pii

S0002870303003090

journal_volume

146

pub_type

杂志文章

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