11 LONG-TERM OUTCOMES OF SINGLE VERSUS MULTIVESSEL STENTING IN A PUBLIC HEALTH SYSTEM PATIENT POPULATION WITH UNIFORM BARE METAL STENT SELECTION, ADJUNCTIVE GLYCOPROTEIN IIB/IIIA INHIBITION AND LONG-TERM DUAL ANTIPLATELET THERAPY

Background Published data suggest that lower socioeconomic status may adversely impact health outcomes in patients with coronary artery disease. Data regarding post-PCI outcomes are particularly limited in this population. We assessed event-free survival in public health system (PHS) patients undergoing single (SV) vs multivessel (MV) PCI with procedural glycoprotein (Gp) IIb/IIIa inhibition and long-term dual antiplatelet therapy with aspirin and clopidogrel. Methods 280 consecutive patients (205 SV, 75 MV) undergoing PCI at Cook County Hospital, with uniform Medtronic AVE bare metal stent use, procedural Gp IIb/IIIa inhibition and intended long-term ASA/clopidogrel use were followed as a prospective cohort for occurrence of the composite MACE endpoint (death, MI, urgent TVR) and all-cause mortality. Clinical, demographic and procedural data were compiled and analyzed with missing angiographic data adjudicated by blinded review. Kaplan-Meier life table analyses were performed for the cohort, using the Wilcoxon and log-rank tests for survivor functions. Results Demographic variables and risk factors were similar between SV and MV groups except smoking (80.6% vs 19.4%, p Conclusions Single and multivessel PCI with bare-metal stent use, adjunctive GPIIb/IIIa inhibition and long-term clopidogrel therapy was associated with excellent event-free survival in the PHS population studied. Despite a sizeable subset of high-risk patients, these estimates are comparable to historical, non-PHS control populations undergoing bare metal stenting.