[Acute and long-term clinical results of bare metal coronary stenting]. / Resultados clínicos inmediatos y alejados del implante de stents metálicos no recubiertos. Se justifica un reemplazo total por los stents liberadores de drogas?

ABSTRACT

BACKGROUND: Since the introduction of stents in 1994, improved clinical results have boosted the development of coronary angioplasty in Chile. Drug eluting stents, that have a reduced rate of restenosis, are being increasingly used. AIM: To assess the acute and long-term results of bare metal stent implantation. PATIENTS AND METHODS: Acute and long-term clinical, procedural and angiographic results were assessed in non acute myocardial infarction patients undergoing coronary stent implantation between August 1996 and December 2003. RESULTS: During the study period, 932 patients aged 30 to 87 years (194 women) had at least one stent implanted. Twenty two percent were diabetic, 33% had recent myocardial infarction, 53% unstable angina and 22% stable angina. Angiographic and clinical success were 99.6% and 98.2%, respectively. In hospital death was 0.5%. During a mean follow-up of 19.1 months, all cause mortality was 3.9%, cardiac death 1.9% and survival free of major cardiac ischemic events was 85.3%. Only 6.4% of lesions underwent target vessel revascularization (TVR). Independent predictors of TVR were previous surgery, left anterior descending artery, small post stent minimum luminal diameter. Ostial location, in-stent restenosis, and younger age were non significant predictors. CONCLUSIONS: Acute and long-term results of bare metal stents in this population were excellent. An intriguingly low rate of TVR was seen. Selective bare metal stenting should continue in lesions and patients with a low risk of clinical restenosis.