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Frequency of Angina Pectoris After Percutaneous Coronary Intervention and the Effect of Metallic Stent Type.

by Gaglia, Michael AJ; Torguson, Rebecca; Lipinski, Michael J; Gai, Jiaxiang; Koifman, Edward; Kiramijyan, Starkis; Negi, Smita; Rogers, Toby; Steinvil, Arie; Suddath, William O; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron.
Citation: American Journal of Cardiology. 117(4):526-31, 2016 Feb 15..Journal: The American journal of cardiology.Published: 2016ISSN: 0002-9149.Full author list: Gaglia MA Jr; Torguson R; Lipinski MJ; Gai J; Koifman E; Kiramijyan S; Negi S; Rogers T; Steinvil A; Suddath WO; Satler LF; Pichard AD; Waksman R.UI/PMID: 26739394.Subject(s): Aged | *Angina Pectoris/ep [Epidemiology] | Angina Pectoris/et [Etiology] | Cause of Death/td [Trends] | *Coronary Artery Disease/su [Surgery] | District of Columbia/ep [Epidemiology] | Electrocardiography | Female | Follow-Up Studies | Humans | Incidence | Male | Middle Aged | *Percutaneous Coronary Intervention/ae [Adverse Effects] | Prognosis | Prosthesis Design | Retrospective Studies | *Stents | Survival Rate/td [Trends] | Time FactorsInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1016/j.amjcard.2015.11.036 (Click here) Abbreviated citation: Am J Cardiol. 117(4):526-31, 2016 Feb 15.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Although metallic coronary stents significantly reduce angina pectoris compared with 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 end point 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, 8,804 patients were queried in regard to angina symptoms; 32.3% experienced angina at some point in the first year after PCI. Major adverse cardiovascular events, 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. In conclusion, metallic stent type is not associated with the occurrence of angina at up to 1 year after PCI.Copyright © 2016 Elsevier Inc. All rights reserved.

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