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(Circulation. 2004;109:e9004-e9005.)
© 2004 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Brachytherapy and In-Stent Restenosis

Five years after the beginning of the Washington Radiation for In-Stent Restenosis Trial (WRIST), a double-blind, randomized study to evaluate the effect of intracoronary radiation therapy for patients with in-stent restenosis, the treatment remains effective in reducing target-lesion restenosis and the need for target-lesion and target-vessel revascularization, said investigators reporting the trial in the present issue of Circulation ( Circulation. 2004;109:340–344[Abstract/Free Full Text]). However, the effect, first reported 6 months after the radiation treatment, declined in the remaining 41/2 years, according to the authors, who were led by Ron Waksman, MD, of Washington Hospital Center in Washington, DC.

At 6 months, target-lesion revascularization was 14% in the irradiated patients, compared with 62% in the patients who received placebo. Between 6 and 60 months, however, target-lesion revascularization was 21.6% in the irradiated patients versus 4.7% in the group that received placebo. The composite major adverse cardiac event rate during the period between 6 and 60 months was 27.7% in the irradiated group versus 6.1% in the placebo group.

The late thrombosis rate at 6 months was 7.7% in the irradiated group versus 3.3% in the placebo group. At 24 months, however, the late thrombosis rate was 12.3% in the irradiated group versus 6.2% in the placebo group. However, there was no further late thrombosis in either group, and the authors felt that this might reflect the need for long antiplatelet therapy. The subjects in the WRIST trial received only 1 month of antiplatelet therapy.

The authors wrote: "Despite increases in late . . . [Full Text of this Article]