TY - JOUR
T1 - Intracoronary stenting and angiographic results
T2 - Strut thickness effect on restenosis outcome (ISAR-STEREO) trial
AU - Kastrati, Adnan
AU - Mehilli, Julinda
AU - Dirschinger, Josef
AU - Dotzer, Franz
AU - Schühlen, Helmut
AU - Neumann, Franz Josef
AU - Fleckenstein, Martin
AU - Pfafferott, Conrad
AU - Seyfarth, Melchior
AU - Schömig, Albert
PY - 2001/6/12
Y1 - 2001/6/12
N2 - Background - Increased thrombogenicity and smooth muscle cell proliferative response induced by the metal struts compromise the advantages of coronary stenting. The objective of this randomized, multicenter study was to assess whether a reduced strut thickness of coronary stents is associated with improved follow-up angiographic and clinical results. Methods and Results - A total of 651 patients with coronary lesions situated in native vessels >2.8 mm in diameter were randomly assigned to receive 1 of 2 commercially available stents of comparable design but different thickness: 326 patients to the thin-strut stent (strut thickness of 50 μm) and 325 patients to the thick-strut stent (strut thickness of 140 μm). The primary end point was the angiographic restenosis (≥50% diameter stenosis at follow-up angiography). Secondary end points were the incidence of reinterventions due to restenosis-induced ischemia and the combined rate of death and myocardial infarctions at 1 year. The incidence of angiographic restenosis was 15.0% in the thin-strut group and 25.8% in the thick-strut group (relative risk, 0.58; 95% CI, 0.39 to 0.87; P=0.003). Clinical restenosis was also significantly reduced, with a reintervention rate of 8.6% among thin-strut patients and 13.8% among thick-strut patients (relative risk, 0.62; 95% CI, 0.39 to 0.99; P=0.03). No difference was observed in the combined 1-year rate of death and myocardial infarction. Conclusions - The use of a thinner-strut device is associated with a significant reduction of angiographic and clinical restenosis after coronary artery stenting. These findings may have relevant implications for the currently most widely used percutaneous coronary intervention.
AB - Background - Increased thrombogenicity and smooth muscle cell proliferative response induced by the metal struts compromise the advantages of coronary stenting. The objective of this randomized, multicenter study was to assess whether a reduced strut thickness of coronary stents is associated with improved follow-up angiographic and clinical results. Methods and Results - A total of 651 patients with coronary lesions situated in native vessels >2.8 mm in diameter were randomly assigned to receive 1 of 2 commercially available stents of comparable design but different thickness: 326 patients to the thin-strut stent (strut thickness of 50 μm) and 325 patients to the thick-strut stent (strut thickness of 140 μm). The primary end point was the angiographic restenosis (≥50% diameter stenosis at follow-up angiography). Secondary end points were the incidence of reinterventions due to restenosis-induced ischemia and the combined rate of death and myocardial infarctions at 1 year. The incidence of angiographic restenosis was 15.0% in the thin-strut group and 25.8% in the thick-strut group (relative risk, 0.58; 95% CI, 0.39 to 0.87; P=0.003). Clinical restenosis was also significantly reduced, with a reintervention rate of 8.6% among thin-strut patients and 13.8% among thick-strut patients (relative risk, 0.62; 95% CI, 0.39 to 0.99; P=0.03). No difference was observed in the combined 1-year rate of death and myocardial infarction. Conclusions - The use of a thinner-strut device is associated with a significant reduction of angiographic and clinical restenosis after coronary artery stenting. These findings may have relevant implications for the currently most widely used percutaneous coronary intervention.
KW - Coronary disease
KW - Restenosis
KW - Stents
KW - Trials
UR - http://www.scopus.com/inward/record.url?scp=0035849543&partnerID=8YFLogxK
U2 - 10.1161/01.CIR.103.23.2816
DO - 10.1161/01.CIR.103.23.2816
M3 - Article
C2 - 11401938
AN - SCOPUS:0035849543
SN - 0009-7322
VL - 103
SP - 2816
EP - 2821
JO - Circulation
JF - Circulation
IS - 23
ER -