| Patient selection to enhance the long-term benefit of first generation drug-eluting stents for coronary revascularisation procedures. Insights from a large multicentre registry. | |
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MedLine Citation:
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PMID: 19577984 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To evaluate the long-term clinical outcome after drug-eluting stents (DES) implantation, and to test if patient selection could enhance their net clinical benefit. METHODS AND RESULTS: We assessed the incidence of major adverse cardiac events (MACE=death, acute myocardial infarction, and target vessel revascularisation, TVR) and angiographic stent thrombosis (ST) during 3-year follow-up in a prospective multicentre registry. Propensity-score analysis to adjust for different clinical, angiographic and procedural characteristics was performed. Overall, 14,115 patients enrolled in the registry received solely BMS (n=9,565) or DES (n=4,550). The incidence of definite ST was 0.6% for BMS and 1.3% for DES (p=0.003). The propensity-score adjusted incidence of cardiac death and myocardial infarction was similar between the two groups (DES 11.9% vs. BMS 12.1%, HR 0.90, 95% CI 0.77-1.04), whereas DES were associated with lower rates of TVR (DES 11.6% vs. BMS 15.2%, HR 0.67, 95% CI 0.59-0.76). The efficacy of DES in reducing TVR increased with increasing likelihood of TVR at baseline. CONCLUSIONS: The beneficial effect of DES in reducing new revascularisations compared to BMS extends out to three years without a significantly worse overall safety profile. The benefit seems more evident in patients with the highest baseline risk of clinical restenosis. |
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Authors:
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Francesco Saia; Giancarlo Piovaccari; Antonio Manari; Paolo Guastaroba; Luigi Vignali; Elisabetta Varani; Andrea Santarelli; Alberto Benassi; Armando Liso; Gianluca Campo; Stefano Tondi; Fabio Tarantino; Rossana De Palma; Antonio Marzocchi |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology Volume: 5 ISSN: 1774-024X ISO Abbreviation: - Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-07-06 Completed Date: 2009-07-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101251040 Medline TA: EuroIntervention Country: France |
Other Details:
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Languages: eng Pagination: 57-66 Citation Subset: IM |
Affiliation:
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Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi, Italy. francescosaia@hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angioplasty, Transluminal, Percutaneous Coronary / adverse effects, instrumentation* Coronary Angiography Coronary Artery Disease / mortality, radiography, therapy* Coronary Restenosis / etiology, prevention & control Coronary Thrombosis / etiology, prevention & control Drug-Eluting Stents* Female Heart Diseases / etiology, mortality, prevention & control*, radiography Humans Incidence Italy / epidemiology Male Metals* Middle Aged Myocardial Infarction / etiology, prevention & control Patient Selection* Proportional Hazards Models Prospective Studies Prosthesis Design Registries Risk Assessment Stents* Time Factors Treatment Outcome |
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Reg. No./Substance:
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0/Metals |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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