{"id":"485e6562baaa","type":"article","url":"https://hartvaat.nl/2020/02/18/stent-gerelateerde-events-1-jaar-na-pci/","title":"Stent-gerelateerde events >1 jaar na PCI","title_en":"Stent-Related Adverse Events >1 Year After Percutaneous Coronary Intervention.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2019.11.058","source_url":"https://doi.org/10.1016/j.jacc.2019.11.058","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 von Birgelen","Roxana Mehran","Thomas McAndrew","Patrick W Serruys","Martin B Leon","Stuart J Pocock","Gregg W Stone"],"significance":5,"published":"2020-02-18","source_date":"2020-02-18","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/pci-percutane-coronaire-interventie/"],"congress":"","summary_en":"This analysis of late stent-related events (>1 year post-PCI) showed that stent-related MACE continues beyond the first year, informing long-term follow-up and antiplatelet therapy duration decisions.","created":"2026-07-03T10:28:26Z","updated":"2026-07-03T13:27:36Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse van late (>1 jaar) stent-gerelateerde complicaties na PCI. Langetermijnveiligheid van coronaire stents.","abstract_original":"BACKGROUND: 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. OBJECTIVES: The purpose of this study was to assess the frequency and predictors of very-late stent-related events or MACE by stent type. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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."}