The purpose of this study was to assess 1-year clinical outcome of patients
with multivessel coronary artery disease (CAD) who underwent coronary sten
ting and were prospectively enrolled in the Registro Implanto Stent Endocor
onarico (RISE). Of 939 consecutive patients included in the registry, 377 p
atients with angiographic evidence of multivessel CAD had a 1-year clinical
follow-up. All patients underwent PTCA and single or multiple stenting in
at least one vessel. Angiographic optimization was usually performed by usi
ng high-pressure balloon dilation. After the procedure, continuation of asp
irin (at least 250 mg/day) was recommended, whereas the use of anticoagulat
ion or ticlopidine was determined by the physician in charge of the patient
in the various centers. Major adverse cardiac events were defined as death
, Q-wave or non-Q-wave myocardial infarction and target vessel revasculariz
ation. Mean age of patients (311 men, 66 women) was 60 +/- 10 years. Global
ly, there were 596 stents implanted (72% Palmaz-Schatz stents) in 434 vesse
ls. In about 75% of the procedures, an inflation pressure > 12 atm was used
, Angiographic success rate was 98.5%, After stenting, 77% of patients rece
ived antiplatelet treatment with ticlopidine and aspirin. During hospitaliz
ation, there were 34 major adverse cardiac events in 24 patients. At 1-year
follow-up, 309 patients were alive and event-free; cumulative incidence of
death, myocardial infarction, and repeat revascularization were 2.9%, 4.7%
, and 10.8%, respectively, By Cox regression analysis, multiple stents impl
antation (HR 1.72, 95% CI 1-2.97), left anterior descending artery revascul
arization (HR 1.86, 95% CI 1.01-3.42), use of inflation pressure > 12 atm (
HR 0.93, 95% CI 0.89-0.97), ticlopidine therapy (HR 0.41, 95% CI 0.23-0.74)
, and stent length (HR 1.03, 95% CI 1.01-1.05) were associated with 1-year
major cardiac events. In patients with multivessel CAD undergoing stent imp
lantation in at least one vessel, 1-year follow-up is favorable and the nee
d for repeat revascularization procedures, based on clinical data, is lower
than previously reported for conventional PTCA. Cathet. Cardiovasc. Interv
ent 48:343-349, 1999. (C) 1999 Wiley-Liss, Inc.