To the top

Page Manager: Webmaster
Last update: 9/11/2012 3:13 PM

Tell a friend about this page
Print version

Stent-Related Adverse Eve… - University of Gothenburg, Sweden Till startsida
To content Read more about how we use cookies on

Stent-Related Adverse Events >1 Year After Percutaneous Coronary Intervention.

Journal article
Authors Mahesh V Madhavan
Ajay J Kirtane
Björn Redfors
Philippe Généreux
Ori Ben-Yehuda
Tullio Palmerini
Umberto Benedetto
Giuseppe Biondi-Zoccai
Pieter C Smits
Clemens vonBirgelen
Roxana Mehran
Thomas McAndrew
Patrick W Serruys
Martin B Leon
Stuart J Pocock
Gregg W Stone
Published in Journal of the American College of Cardiology
Volume 75
Issue 6
Pages 590-604
ISSN 1558-3597
Publication year 2020
Published at
Pages 590-604
Language en
Keywords PCI, clinical trials, late events, major adverse cardiovascular events, stents
Subject categories Cardiovascular medicine


The majority of stent-related major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) are believed to occur within the first year. Very-late (>1-year) stent-related MACE have not been well described.The purpose of this study was to assess the frequency and predictors of very-late stent-related events or MACE by stent type.Individual patient data from 19 prospective, randomized metallic stent trials maintained at a leading academic research organization were pooled. Very-late MACE (a composite of cardiac death, myocardial infarction [MI], or ischemia-driven target lesion revascularization [ID-TLR]), and target lesion failure (cardiac death, target-vessel MI, or ID-TLR) were assessed within year 1 and between 1 and 5 years after PCI with bare-metal stents (BMS), first-generation drug-eluting stents (DES1) and second-generation drug-eluting stents (DES2). A network meta-analysis was performed to evaluate direct and indirect comparisons.Among 25,032 total patients, 3,718, 7,934, and 13,380 were treated with BMS, DES1, and DES2, respectively. MACE rates within 1 year after PCI were progressively lower after treatment with BMS versus DES1 versus DES2 (17.9% vs. 8.2% vs. 5.1%, respectively, p < 0.0001). Between years 1 and 5, very-late MACE occurred in 9.4% of patients (including 2.9% cardiac death, 3.1% MI, and 5.1% ID-TLR). Very-late MACE occurred in 9.7%, 11.0%, and 8.3% of patients treated with BMS, DES1, and DES2, respectively (p < 0.0001), linearly increasing between 1 and 5 years. Similar findings were observed for target lesion failure in 19,578 patients from 12 trials. Findings were confirmed in the network meta-analysis.In this large-scale, individual patient data pooled study, very-late stent-related events occurred between 1 and 5 years after PCI at a rate of ∼2%/year with all stent types, with no plateau evident. New approaches are required to improve long-term outcomes after PCI.

Page Manager: Webmaster|Last update: 9/11/2012

The University of Gothenburg uses cookies to provide you with the best possible user experience. By continuing on this website, you approve of our use of cookies.  What are cookies?