Effects of coronary stents on cardiovascular outcomes in broad-based clinical practice.

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Abstract
CORONARY ARTERY stenting is now the predominant method of percutaneous coronary intervention (PCI), with an estimated 500,000 patients receiving a stent in 1998.1 Despite the explosive growth in the use of stents, primarily justified by the reduction in restenosis demonstrated in randomized trials,2-7 data have not been available to support this effect in broad-based clinical practice. Of equal importance, no randomized trial has shown a direct reduction in the number of cardiac deaths or myocardial infarctions (MIs) from coronary stenting itself. In fact, several trials have shown a nonsignificant excess of some cardiac events in patients receiving coronary stents,3,4,6 although these studies lacked statistical power to detect clinically meaningful differences.