| Five-Year Outcomes in Patients With Chronic Total Coronary Occlusion Treated With Drug-Eluting vs Bare-Metal Stents: A Case-Control Study. | |
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MedLine Citation:
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PMID: 23265094 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Limited data exist on long-term safety and effectiveness of drug-eluting stents (DESs) in true chronic total coronary occlusion (CTO) settings. We evaluated 5-year clinical outcomes of patients with CTO treated successfully with DES vs bare-metal stent (BMS). METHODS: We compared the 5-year clinical outcomes of 156 patients treated with DES implantation with outcomes of a historical cohort of 159 patients treated with BMS. Primary end point was freedom from major adverse cardiac events (MACEs; defined as death, myocardial infarction [MI], and target lesion revascularization [TLR]); secondary end points were freedom from target vessel failure (TVF; combination of target vessel revascularization, MI, and cardiac death) and TLR at 5 years. RESULTS: After 5 years, the DES group had significantly superior event-free survival from MACE (84% vs 69%; log rank P < 0.001), TVF (71% vs 84%; P = 0.002), and TLR (77% vs 92%; P = 0.0001), compared with the BMS group. The Cox proportional hazards model identified BMS vs DES (adjusted hazard ratio [HR] = 3.37; 95% confidence interval [CI], 1.85-6.17; P = 0.001), final minimal lumen diameter (HR, 0.27; 95% CI, 0.14-0.52; P = 0.0001), and stent length (HR, 1.01; 95% CI, 1.00-1.03; P = 0.03) as independent predictors of MACE at 5-year follow-up. Twelve (7%) and 7 (4%) stent thromboses occurred in the DES and BMS groups (P = 0.23), respectively. CONCLUSIONS: After 5 years, DESs were superior to BMSs in reducing MACE, TVF, and TLR in patients with CTO and should be the preferred strategy. |
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Authors:
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Francesco De Felice; Rosario Fiorilli; Antonio Parma; Carmine Musto; Marco Stefano Nazzaro; Massimiliano Scappaticci; Pierpaolo Confessore; Elena Guerra; Flavia Belloni; Roberto Violini |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-19 |
Journal Detail:
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Title: The Canadian journal of cardiology Volume: - ISSN: 1916-7075 ISO Abbreviation: Can J Cardiol Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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UO Cardiologia Interventistica Azienda Ospedaliera S. Camillo Forlanini, Roma, Italy. Electronic address: f.defelice@lycos.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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