Objectives: We examined long-term outcomes and predictors of major adverse cardiac events after the full metal jacket (FMJ) stent implantation.
Background: The FMJ procedure has been used to treat diffuse coronary artery disease (CAD), but long-term outcomes remain unknown.
Methods: The study population consisted of 347 consecutive patients (352 lesions) who had been treated for de novo diffuse CAD with FMJ stents (stent length ≥ 60 mm).
Results: The mean age was 61.0 ± 10.1 years, and the stent length was 71.9 ± 13.7 mm. The procedural success rate was 97.7%. Major in-hospital complications (one death and two acute stent thromboses) occurred in three patients (0.7%). The median follow-up was 101 months (interquartile range, 95-108 months). During follow-up, there were 60 deaths (33 cardiac), 20 myocardial infarctions, and 94 revascularizations. Definite stent thrombosis occurred in 12 patients. The event-free survival rate for cardiac death, cardiac death/myocardial infarction, or cardiac death/myocardial infarction/target lesion revascularization was 90.5 ± 1.6, 85.8 ± 1.9, and 71.6 ± 2.5% at 8 years, respectively. Left ventricular dysfunction (ejection fraction < 45%) was an independent predictor of cardiac death (OR: 4.88; 95% CI: 1.81-13.13; P = 0.002). Left ventricular dysfunction and a stent length > 80 mm were significantly related to cardiac death/myocardial infarction. Likewise, a stent length > 80 mm was an independent predictor of cardiac death/myocardial infarction/target lesion revascularization (OR: 2.45; 95% CI: 1.16-5.19; P = 0.019).
Conclusion: Long-term outcomes appear favorable after FMJ procedures, and left ventricular dysfunction and a stent length > 80 mm are major predictors of major adverse cardiac events. These findings might be useful in identifying the most suitable treatments for patients with very diffuse CAD. © 2013 Wiley Periodicals, Inc.
Keywords: diffuse coronary lesion; full metal jacket stents; long-term outcomes.
© 2013 Wiley Periodicals, Inc.