Exercise stress test results in patients with bare metal stents or drug-eluting stents: Pathophysiological and clinical implications

Roberto Nerla, Antonio di Monaco, Gregory A. Sgueglia, Irma Battipaglia, Giulia Careri, Gaetano Pinnacchio, Pierpaolo Tarzia, Gaetano Antonio Lanza, Filippo Crea

Research output: Contribution to journalArticle

Abstract

Background: Drug-eluting stents (DES) have reduced restenosis following percutaneous coronary intervention (PCI), but they seem to be associated with increased coronary endothelial dysfunction compared to bare metal stents (BMS). No data are available about the prognostic value of exercise stress test (EST) in PCI patients in the DES era. Methods and Results: The 160 patients with coronary artery disease (CAD) who underwent PCI with either BMS (n=86) or DES (n=74) were studied. EST was performed 1 month after PCI. DES patients had a higher rate of positive EST compared to BMS patients (49% vs 32%; P=0.03). At a median follow-up of 18 months DES showed a lower rate of target vessel revascularization (TVR) (hazard ratio (HR) 0.37, P=0.07), but a higher rate of acute myocardial infarction (AMI) (HR 3.33, P=0.08). At multivariate Cox-regression time to 1 mm ST and lowworkload ischemia were independent predictors of AMI (HR 0.96, P=0.03; and HR 6.24, P=0.009, respectively), as well as of TVR (HR 0.96, P=0.007; and HR 6.43, P=0.001, respectively). Conclusions: DES implantation is associated with a higher rate of positive EST, compared to BMS, 1 month after PCI, likely due to a higher prevalence of endothelial dysfunction. EST seems to be helpful in predicting clinical outcome in patients with coronary stent implantation.

Original languageEnglish
Pages (from-to)2372-2378
Number of pages7
JournalCirculation Journal
Volume74
Issue number11
DOIs
Publication statusPublished - Nov 2010

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Keywords

  • Coronary stent implantation
  • Exercise stress testing
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Nerla, R., di Monaco, A., Sgueglia, G. A., Battipaglia, I., Careri, G., Pinnacchio, G., Tarzia, P., Lanza, G. A., & Crea, F. (2010). Exercise stress test results in patients with bare metal stents or drug-eluting stents: Pathophysiological and clinical implications. Circulation Journal, 74(11), 2372-2378. https://doi.org/10.1253/circj.CJ-10-0379