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Cardiovascular medicine
Long term outcome after intracoronary β radiation therapy
  1. G Sianos,
  2. A Hoye,
  3. F Saia,
  4. W van der Giessen,
  5. P Lemos,
  6. P J de Feyter,
  7. P C Levendag,
  8. R van Domburg,
  9. P W Serruys
  1. Department of Interventional Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands
  1. Correspondence to:
    Dr Georgios Sianos
    Department of Interventional Cardiology, Erasmus MC Rotterdam, Thoraxcentre Bd 404, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands; g.sianoserasmusmc.nl

Abstract

Objectives: To determine the long term outcome after intracoronary β radiation therapy (IRT).

Setting: Tertiary referral centre.

Methods: The rate of major adverse cardiac events (MACE) was retrospectively determined in 301 consecutive patients who were treated with IRT. MACE was defined as death, myocardial infarction, or any reintervention. Long term clinical outcome was obtained from an electronic database of hospital records and from questionnaires to the patients and referring physicians. Long term survival status was assessed by written inquiries to the municipal civil registries.

Results: The mean (SD) follow up was 3.6 (1.2) years. The cumulative incidence of MACE at six months was 19.1%, at one year 36.4%, and at four years 58.3%. The target lesion revascularisation (TLR) rate at six months was 12.9%, at one year 28.3%, and at four years 50.4%. From multivariate analysis, dose < 18 Gy was the most significant predictor of TLR. At four years the cumulative incidence of death was 3.8%, of myocardial infarction 13.4%, and of coronary artery bypass surgery 11.3%. Total vessel occlusion was documented in 12.3% of the patients.

Conclusions: In the long term follow up of patients after IRT, there are increased adverse cardiac events beyond the first six months.

  • BENESTENT, Belgian Netherlands stent
  • BERT, beta energy restenosis trial
  • CABG, coronary artery bypass grafting
  • GRANITE, gamma radiation to atheromatous neointima using intracoronary therapy in Europe
  • IRT, intracoronary β radiation therapy
  • MACE, major adverse cardiac events
  • SCRIPPS, Scripps coronary radiation to inhibit proliferation post-stenting
  • TLR, target lesion revascularisation
  • TVR, target vessel revascularisation
  • WRIST, Washington radiation for in-stent restenosis trial
  • long term outcome
  • brachytherapy
  • de novo lesions
  • in-stent restenosis
  • radiation therapy

https://doi.org/10.1136/hrt.2004.038026

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    Footnotes

    • No financial support was received for this study.