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PROKINETIC BMS IN ACS
Table 2.
Baseline Angiographic Characteristics
%
Vessel treated
LAD
36.4
D1
5.7
CX
10.7
M1
7.9
M2
4.3
RCA
27.9
Rt. PLB
2.1
Rt. PDA
4.3
SVG
0.7
Lesion location
Ostial
5.0
Proximal
37.1
Mid
45.7
Distal
12.1
Lesion type
A
11.4
B1
25.0
B2
42.1
C
21.4
Lesion properties
Bend
>
45
◦
17.1
Calcification
6.4
Thrombus
32.9
Total occlusion
22.9
Coronary Anatomy and Lesion Demographics.
Forty-five percent of the patients had single-vessel,
35% had double-vessel, and 20% had triple-vessel
disease. Main lesion characteristics are listed in
Table 2. Sixty four percent of lesions were either
type B2 or C. The left anterior descending (LAD)
was the most treated native artery and lesions in by-
pass grafts represented 0.7%. Thrombus was found
in 31.7% of lesions and 21.8% lesions were totally
occluded.
Procedural Characteristics.
Predilation was per-
formed in 99.3% of the lesions while postdilation was
needed in 7.1% of the lesions. In 0.7%, direct stenting
was performed. These figures represent the standard
technique in our catheterization laboratory. All patients
were treated with 5,000 U of heparin during PCI, and
35.9% were treated with IIb-IIIa antagonist. Patients
were either on aspirin before index hospitalization or
were treated with aspirin 100 mg upon hospitalization
and for life (except for one patient who had an allergy
to aspirin). All patients were loaded with 300–600 mg
clopidogrel during the index procedure and then treated
with clopidogrel 75 mg once daily. Patients were in-
Table 3.
MACE (Hierarchical) and Stent Thrombosis at 6 Months
and 1-Year Follow-Up
% (Patients)
% (Patients)
Event
at 6 Months
at 12 Months
MACE
∗
8.5 (10)
11.1 (13)
Death
2.6 (3)
4.3 (5)
MI
3.4 (4)
4.3 (5)
QWMI
1.7 (2)
2.6 (3)
NQWMI
1.7 (2)
1.7 (2)
TLR
2.6 (3)
2.6 (3)
PCI
∗∗
1.7 (2)
1.7 (2)
CABG
1.7 (2)
1.7 (2)
TVR
0
0
Thrombosis
1.8 (2)
1.8 (2)
Acute
0.9 (1)
0.9 (1)
Subacute
0.9 (1)
0.9 (1)
Late
0
0
∗
MACE- Hierarchical and defined as any death, any MI, TLR (PCI
or CABG).
∗∗
One patient had restenosis of a Prokinetic treated with Endeavor
stent implantation, which also restenosed and therefore the patient
was referred for CABG.
structed to take clopidogrel for 9–12 months; however,
the actual treatment duration is not known.
Stents.
Average stent length was 16.4
±
6.2 (8–
45) and average stent diameter was 2.8
±
0.6 (2–5)
mm. Twenty three percent of the lesions were less
than 10 mm in length, 60% were 10–20, and 17 were
more than 20 mm in length (including overlapping
stents).
Procedural and Clinical Outcomes.
Procedural
success was achieved in 99.1% of lesions; in one
patient the stent could not pass through a previ-
ously stented tortuous more proximal segment. Clinical
success with Thrombolysis in Myocardial Infarction
(TIMI) flow grade 3 was achieved in 97.4% of 117
patients. Two patients had slow flow (TIMI flow 1 or
2), and one patient had no coronary flow (TIMI flow
0). MACE are given in Table 3. The incidence of car-
diac death, myocardial infarction (MI), and TLR was
2.6%, 3.4%, and 2.6%, respectively, at 6 months, and
4.3%, 4.3%, and 2.6%, respectively, at 12 months—
exceptionally low figures in this group of patients.
There was no target lesion revascularization TVR.
There was one case of acute thrombosis in a patient
with inferior wall MI who underwent PCI to both
right coronary artery (RCA) and circumflex coronary
artery (CX) coronary arteries (the culprit lesion was
not certain). Another patient had balloon angioplasty
to both mid and distal RCA and stent implantation to
Vol. 23, No. 4, 2010
Journal of Interventional Cardiology
379