Journal article
Second generation drug-eluting stents versus bare-metal stents for percutaneous coronary intervention of the proximal left anterior descending artery: An analysis of the BASKET-PROVE I and II trials.
- Mangione FM Department of Cardiovascular Medicine, Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, Massachusetts.
- Biering-Sørensen T Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
- Nochioka K Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Clinical Research, Innovation and Education Center, Tohoku University Hospital, Tohoku, Japan.
- Jatene T Department of Cardiovascular Medicine, Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, Massachusetts.
- Silvestre OM Department of Cardiovascular Medicine, Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, Massachusetts.
- Hansen KW Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
- Sørensen R Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
- Jensen JS Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
- Jorgensen PG Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
- Jeger R Department of Cardiology, University Hospital, Basel, Switzerland.
- Kaiser C Department of Cardiology, University Hospital, Basel, Switzerland.
- Pfisterer M Department of Cardiology, University Hospital, Basel, Switzerland.
- Galatius S Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
- 2017-07-20
Published in:
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. - 2018
coronary disease
coronary stenosis
revascularization
Aged
Coronary Artery Disease
Coronary Stenosis
Drug Therapy, Combination
Drug-Eluting Stents
Female
Humans
Male
Metals
Middle Aged
Myocardial Infarction
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors
Prosthesis Design
Randomized Controlled Trials as Topic
Risk Factors
Stents
Time Factors
Treatment Outcome
English
OBJECTIVES
To compare mid-term outcomes between patients undergoing proximal left anterior descending artery (LAD) percutaneous coronary intervention (PCI) with second generation drug-eluting stent (DES) or bare-metal stent (BMS).
BACKGROUND
PCI with BMS and first-generation DES have shown to be safe options for the treatment of proximal LAD stenosis, however associated with considerable reintervention rates. Overall, second-generation DES has proven to be superior to BMS and first-generation DES, nevertheless, its effect for proximal LAD PCI has not previously been reported.
METHODS
We analyzed 2-year outcomes of 1,100 patients from the BASKET-PROVE I and II trials, referred for proximal LAD PCI with second generation DES (n = 680) or BMS (n = 420).
RESULTS
The cumulative 2-year incidence of major adverse cardiac events (MACE, composite of cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR)) was lower in second generation DES than in BMS treated patients (7.3% vs. 12.3%; HR 0.57, 95% CI 0.39/0.85), mainly driven by a reduced rate of TVR (3.7% vs. 10.0%; HR 0.35, CI 0.21/0.58). No difference was found in cardiac death (1.9% vs. 1.9%; HR 1.01, CI 0.42/2.44) and MI (4.4% vs. 4.7%; HR 0.93, CI 0.53/1.64). The benefit of DES use seemed to be more prominent in female patients with a reduction in MACE (P for interaction = 0.025).
CONCLUSIONS
In patients with proximal LAD stenosis, treatment with second-generation DES was associated with reduced 2-year rates of adverse cardiac events and TVR compared to BMS, with reintervention rates similar to those earlier reported from bypass surgery.
To compare mid-term outcomes between patients undergoing proximal left anterior descending artery (LAD) percutaneous coronary intervention (PCI) with second generation drug-eluting stent (DES) or bare-metal stent (BMS).
BACKGROUND
PCI with BMS and first-generation DES have shown to be safe options for the treatment of proximal LAD stenosis, however associated with considerable reintervention rates. Overall, second-generation DES has proven to be superior to BMS and first-generation DES, nevertheless, its effect for proximal LAD PCI has not previously been reported.
METHODS
We analyzed 2-year outcomes of 1,100 patients from the BASKET-PROVE I and II trials, referred for proximal LAD PCI with second generation DES (n = 680) or BMS (n = 420).
RESULTS
The cumulative 2-year incidence of major adverse cardiac events (MACE, composite of cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR)) was lower in second generation DES than in BMS treated patients (7.3% vs. 12.3%; HR 0.57, 95% CI 0.39/0.85), mainly driven by a reduced rate of TVR (3.7% vs. 10.0%; HR 0.35, CI 0.21/0.58). No difference was found in cardiac death (1.9% vs. 1.9%; HR 1.01, CI 0.42/2.44) and MI (4.4% vs. 4.7%; HR 0.93, CI 0.53/1.64). The benefit of DES use seemed to be more prominent in female patients with a reduction in MACE (P for interaction = 0.025).
CONCLUSIONS
In patients with proximal LAD stenosis, treatment with second-generation DES was associated with reduced 2-year rates of adverse cardiac events and TVR compared to BMS, with reintervention rates similar to those earlier reported from bypass surgery.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1002/ccd.27200
- PMID 28722266
- Persistent URL
- https://sonar.ch/global/documents/231980
Statistics
Document views: 15
File downloads: