Document Detail


One-Year Outcome of Small-Vessel Disease Treated with Sirolimus-Eluting Stents: A Subgroup Analysis of the e-SELECT Registry.
MedLine Citation:
PMID:  23240727     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: To investigate the characteristics and one-year outcomes following sirolimus-eluting CYPHER Select Plus stent (SES) implantation in small (SmVD) and non-small vessel disease (NSmVD) in the international e-SELECT registry. Background: Large-scale registry data are lacking on DES outcomes in SmVD treatment. Methods: There were 4,700 SmVD (at least one vessel with estimated reference vessel diameter [RVD] < 2.5 mm, excluding 283 patients with unknown RVD vessels) and 10,139 NSmVD only patients. Results: The SmVD population was older, with more women, diabetics, and vessels treated, higher mean Charlson Comorbidity Index score (CCI), shorter lesions, and less STEMI presentation. The 1-year stent thrombosis (ST) rate (primary end-point), was significantly higher (1.3% vs. 0.7%) in SmVD versus NSmVD, mainly driven by early events. One-year major adverse cardiac event (MACE), myocardial infarction (MI), and clinically indicated target-lesion revascularization (TLR) rates were significantly higher in SmVD although death and major bleeding rates were similar in both groups. Complication rates were similar between pure (3,188 patients; only RVD < 2.5 mm) and mixed (1,795 patients; some RVD < 2.5 mm or unknown RVD) SmVD. Multivariate predictors for 1-year MACE in SmVD included saphenous vein graft or bifurcation lesions, major bleeding, any antiplatelet therapy discontinuation within 1 month, age, number of stents implanted, CCI, acute coronary syndrome, and insulin-dependent diabetes mellitus. Conclusion: SES implantation for SmVD occurs more frequently in women, diabetics, and those with multivessel disease and comorbidities. One-year ST, MACE, MI, and clinically indicated TLR rates are higher, although low overall, in SmVD or mixed SmVD patients while death rates are similar to NSmVD. (J Interven Cardiol 2012;**:1-10).
Authors:
Runlin Gao; Alexandre Abizaid; Adrian Banning; Antonio L Bartorelli; Vladimír Džavík; Stephen Ellis; Myung Ho Jeong; Victor Legrand; Christian Spaulding; Philip Urban;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-13
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  -     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
©2012, Wiley Periodicals, Inc.
Affiliation:
Cardiovascular Institute and Fu Wai Hospital, Beijing, China Instituto Dante Pazzanese de Cardiologia, São Paolo, Brazil John Radcliffe Hospital, Oxford, United Kingdom Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy Peter Munk Cardiac Centre, University Health Network, Toronto, Canada Cleveland Clinic Foundation, Cleveland, Ohio The Heart Center of Chonnam National University Hospital, GwangJu, Korea Centre Hospitalier Universitaire, Liège, Belgium Cardiology Department, European Hospital Georges Pompidou, Assistance Publique Hôpitaux de Paris and INSERM U 970, Paris Descartes University, Paris, France La Tour Hospital, Geneva, Switzerland.
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