Three-year outcomes related to coronary stenting; a registry-based real-life population study

Area of Science:

• Cardiology
• Interventional Cardiology
• Public Health

Background:

• Coronary artery disease (CAD) management has advanced with new medications and interventions.
• Real-world data on long-term outcomes after percutaneous coronary intervention (PCI) is crucial for treatment optimization.
• Understanding outcomes based on clinical presentation and stent type is essential for personalized patient care.

Purpose of the Study:

• To evaluate long-term outcomes in a real-life cohort of CAD patients after PCI.
• To compare outcomes based on the clinical presentation (STEMI, NSTEMI, unstable, stable CAD).
• To assess the impact of stent type (new-generation drug-eluting stents vs. bare-metal stents) on patient outcomes.

Main Methods:

• Observational study of 789 consecutive patients undergoing PCI.
• Three-year follow-up period.
• Primary composite outcome: Major Adverse Cardiac Events (MACE), including all-cause mortality, myocardial infarction, and target lesion revascularization.

Main Results:

• New-generation drug-eluting stents (DES-2) were associated with significantly lower adjusted rates of MACE compared to bare-metal stents (HR 0.47).
• Patients presenting with STEMI or NSTEMI had higher crude mortality rates than those with unstable or stable CAD, though this association diminished after adjustments for NSTEMI.
• While 45% of smokers quit, only 36% achieved recommended cholesterol levels, indicating varying success in lifestyle modification.

Conclusions:

• The overall prognosis for CAD patients undergoing PCI in this cohort was favorable.
• NSTEMI presentation was not associated with a worse outcome than stable CAD, irrespective of comorbidities.
• DES-2 demonstrated a significant reduction in MACE compared to bare-metal stents, without impacting mortality, highlighting its effectiveness in improving patient prognosis.