Non-elective intra-coronary stenting: are the clinical outcomes comparableto elective stenting at 6 months?

The aim of this study was to compare prospectively the clinical outcome of patients treated with intra-coronary stents as a non-elective/bailout proce dure for acute or threatened vessel closure, with those undergoing elective stenting at 6 months. Sixty-four patients (60.2+/-11.7 y) who underwent no n-elective stenting for abrupt or threatened vessel closure and/or sub-opti mal results were prospectively compared with 68 patients (62+/-10.0 y) who were stented electively. All patients had broadly similar pre-procedural cl inical profiles. However, patients in the elective group had a higher incid ence of previous PTCA (10.2% vs. 0%, P = 0.01) and bypass surgery (30.9% vs . 6.3%, P = 0.0003) compared with the non-elective group. A total of 158 st ents (1.19 per patient) were implanted in 132 patients with a procedural su ccess rate of 99.3%. At 6 months follow-up there was no statistical differe nce in the primary composite end-paint of death, myocardial infarction and the need of repeat revascularisation (10.9% vs. 5.8%, P =0.35) between the two groups. However,:patients in the non-elective group showed a higher inc idence of unstable angina compared with the elective group (25% vs. 1.4%, P = 0.0004). The findings of this study suggest that stents (single or multi ple) can be effectively implanted in non-elective situations with no increa se in the incidence of death, non-fatal myocardial infarction, and the need Of repeat revascularisation at 6 months compared with elective stenting. ( C) 1999 Elsevier Science Ireland Ltd. All rights reserved.