Document Detail

First generation versus new generation drug-eluting stents for the treatment of ostial/midshaft lesions in unprotected left main coronary artery: The Milan and New-Tokyo (MITO) registry.
MedLine Citation:
PMID:  25099758     Owner:  NLM     Status:  Publisher    
Objectives To compare the clinical outcomes following unprotected left main coronary artery (ULMCA) percutaneous coronary intervention (PCI) of ostial/midshaft lesions between first and new generation drug-eluting stents (DES). Background Clinical outcomes after treatment of ostial/midshaft lesions in ULMCA with first generation DES were favorable. However, to date, data regarding treatment for those lesion subsets with new generation DES have not been reported. Methods A total of 219 patients with ostial/midshaft lesions in ULMCA treated with first (n=139) or new generation DES (n=80) were analyzed. Results There was a higher prevalence of IVUS use (35.2% vs. 50.0%, p=0.032) and post-dilation (70.5% vs. 93.8%, p <0.001) with larger maximum balloon diameter (3.81±0.45 vs. 4.08±0.44, p <0.001) in the new generation DES group. At a median follow-up period of 730 days, there were no significant differences in the propensity-score adjusted analyses, for major adverse cardiac events (MACE) defined as composite endpoint of all-cause death, myocardial infarction and target vessel revascularization (HR [new vs. first generation DES]: 1.22; 95% CI: 0.64 to 2.31; p=0.549). Of note, target lesion revascularization rates at 2-years were only 0.9% and 2.7%, for first and new generation DES groups, respectively (p=0.339). On multivariable analysis, SYNTAX score (HR: 1.06; 95% CI: 1.02-1.11, p=0.006) and EuroSCORE (HR: 1.14; 95% CI: 1.00-1.31, p=0.051) were independent predictors for MACE. Conclusions This study suggests that new generation DES for ostial/midshaft lesions in ULMCA are associated with favorable clinical outcomes, similar to those observed with first generation DES. © 2014 Wiley Periodicals, Inc.
Toru Naganuma; Alaide Chieffo; Kensuke Takagi; Vasileios F Panoulas; Satoru Mitomo; Alessandro Sticchi; Azeem Latib; Tadashi Miyazaki; Katsumasa Sato; Charis Costopoulos; Yusuke Fujino; Matteo Montorfano; Mauro Carlino; Sunao Nakamura; Antonio Colombo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-6
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Wiley Periodicals, Inc., a Wiley company.
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