Author + information
- S1936879815020518-bbfe4b1a6caf8afb1be83f37a64f1642Michael A. Gaglia Jr.,
- S1936879815020518-5b7636d8d04484081f5f4924f987cae2Michael J. Lipinski,
- S1936879815020518-43188b297454714a1e633ce32956ff39Rebecca Torguson,
- S1936879815020518-931563e2cf56fef96b8356fb1cdb589cJiaxiang Gai,
- S1936879815020518-280150bfca3f0be2b424079de79e87c6Itsik Ben-Dor,
- S1936879815020518-63cc9128768f56a887abd28d9d69cc0dNelson L. Bernardo,
- S1936879815020518-3f814a525997240b2228bcc00424a4baWilliam O. Suddath,
- S1936879815020518-1afcf597a9ea0e6a884d08efd238ef1fLowell F. Satler,
- S1936879815020518-6a643b5155cb73800c3dcdf29c00727cAugusto D. Pichard and
- S1936879815020518-772b1cb1fca98a9f26e1e7f8bddc725bRon Waksman
Although metallic coronary stents significantly reduce angina pectoris when compared to optimal medical therapy, angina after percutaneous coronary intervention (PCI) remains frequent. We therefore sought to compare the incidence of any angina during the 1 year after PCI among the spectrum of commercially available metallic stents.
Metallic stent type was classified as: bare metal stent, Cypher, Taxus Express, Xience V, Promus Element, and Resolute. The primary endpoint was patient-reported angina within 1 year of PCI. Multivariable logistic regression was performed to assess the independent association of stent type with any angina at 1 year.
Overall, 8804 patients were queried in regard to angina symptoms; 32.3% experienced angina at some point in the first year after PCI (Figure). Major adverse cardiovascular events (MACE), a composite of all-cause mortality, target vessel revascularization, and Q-wave myocardial infarction, increased with angina severity: 6.8% for patients without angina, 10.0% for patients with class 1 or 2 angina, and 19.7% for patients with class 3 or 4 angina (p<0.001 for trend). After multivariable adjustment, there was no significant association between stent type and angina at 1 year after PCI. Baseline Canadian Cardiovascular Society class 3 or 4 angina, history of coronary artery bypass grafting, and history of PCI were associated with a higher likelihood of angina at 1 year; increasing age, male gender, presentation with acute coronary syndrome, and higher stented length were associated with less angina.
Metallic stent type is not associated with the occurrence of angina at up to 1 year after PCI. In addition, angina after PCI is frequent, and worsening severity of angina is associated with higher rates of MACE at 1 year.