Comparison of the Incidence of Acute Coronary Event After Balloon Angioplasty vs. Stenting in Native Coronary Arteries

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Objectives We sought to determine the incidence of acute coronary events after coronary stenting in comparison to that after plain old balloon angioplasty (POBA). Background Although coronary stenting is proven to be effective in reducing the incidence of restenosis, the long-term outcome in terms of acute coronary events has not been clarified. Methods Study subjects were 1,507 patients with 2,780 native coronary artery lesions treated by POBA (n=1,400) or stenting (n=1,380). Lesion stabilization, which was defined as freedom from restenosis confirmed by follow-up angiography 3 months after POBA and 6 months after stenting, was achieved in all subjects. All patients were clinically monitored for symptoms for at least 1 year after angioplasty, and the incidence of angiographically confirmed acute coronary event was compared between groups. Results The clinical follow-up period was significantly longer in the POBA group than in the stent group (8.4 ± 5.0 years vs. 5.9 ± 3.0 years, p<0.0001). Acute coronary events occurred in association with 32 lesions (1.2% overall); the incidence was 1.1% (15 of 1,400) after POBA and 1.2% (17 of 1,380) after stenting. Freedom from acute coronary events related to the treated lesions was similar between the two groups. (p=0.0518 by log-rank test). Conclusion In terms of acute coronary events, the long-term clinical outcome of stenting is equivalent to that of POBA.