Document Detail


Prognostic impact of using drug-eluting-stents on outcome and strategy in multivessel PCI: Data from the Frankfurt MV-PCI registry.
MedLine Citation:
PMID:  23084576     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Drug-eluting-stents (DES) reduce clinical restenosis, but have mostly failed to demonstrate a reduction in death or myocardial infarction. The aim of this study was to evaluate the prognostic impact of the introduction of DES in patients undergoing multivessel percutaneous coronary intervention (MV-PCI). METHODS: Survival was assessed in 679 consecutive patients, who underwent PCI in at least two main vessels. Follow-up was available in 667 patients (98%) with a mean follow-up of 4.8±2.5 years. We compared several scenarios: firstly, patients receiving at least one DES (≥1 DES group) vs. bare metal stent (BMS)-only patients (BMS only); secondly, the population was divided into a pre-DES-era (2000-2003; N=257) and a DES-era (2004-2006; N=422). RESULTS: 316 patients (47%) were treated for acute myocardial infarction (MI; N=176 ST-elevation MI; N=140 non-ST-elevation MI). On average, 2.2±0.4 vessels were treated and 212 patients received at least one DES. The DES group showed a higher number of diseased (2.5±0.6 vs. 2.4±0.5; p=0.02) and treated vessels (2.2±0.5 vs. 2.1±0.3; p<0.01) and received more stents (3.3±1.4 vs. 3.0±1.1; p<0.01). The BMS group presented more frequently with acute MI (55% vs. 29%; p<0.01). The DES group showed more complex disease as evidenced by a higher SYNTAX-Score (17.4±8.5 vs. 14.5±8.3; p<0.01). Restricting the survival analysis to patients with stable coronary artery disease, a significant prognostic advantage was found for patients received at least one DES compared to the BMS group (hazard ratio 0.58, 95% confidence interval 0.34-0.99) in the multivariate cox-regression-analysis. CONCLUSION: The introduction of DES leads to extension of treatment to more complex patients. The use of DES is associated with improved survival in stable patients undergoing MV-PCI.
Authors:
Thomas Schwietz; Joachim R Ehrlich; Salvatore De Rosa; Stephan Fichtlscherer; Volker Schächinger; Gregor Baier; Rafael Laskowski; Andreas M Zeiher; Ioakim Spyridopoulos; Ralf Lehmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-17
Journal Detail:
Title:  Journal of cardiology     Volume:  -     ISSN:  1876-4738     ISO Abbreviation:  J Cardiol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Cardiology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, D-60590 Frankfurt, Germany.
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