| A retrospective analysis of consecutive patients undergoing nonurgent percutaneous coronary intervention comparing bare metal stents with drug-eluting stents using the National Institute for Clinical Excellence criteria. | |
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MedLine Citation:
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PMID: 21048499 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: In the National Institute for Clinical Excellence (NICE) guidelines, lesions with a reference vessel diameter of less than 3.0 mm or lesions with a length of greater than 15 mm are considered carrying a high risk of restenosis. In contrast, lesions with a reference vessel diameter of at least 3.0 mm or a lesion length of 15 mm or less are considered at low risk of restenosis. We performed a retrospective analysis of consecutive patients undergoing nonurgent percutaneous coronary intervention (PCI) comparing bare metal stent (BMS) with drug-eluting stent (DES) using the NICE guidelines. METHODS AND RESULTS: Between 2003 and 2007, a total of 3883 patients underwent a nonurgent PCI for a de-novo coronary lesion; 2050 patients were considered to be at low risk and 1833 patients were considered at high risk of restenosis according to the NICE criteria. In the low-risk group, the 1-year composite of cardiac death, myocardial infarction, and target vessel revascularization was 10.5% in the BMS group and 11.1% in the DES group (P=0.85). Target lesion revascularization (TLR) was 5.3% by PCI and 1.6% by coronary artery bypass grafting (CABG) in the BMS group and 4.0 and 3.0% in the DES group (P=0.59 and P=0.24). In the high-risk group, the composite of cardiac death, myocardial infarction, and target vessel revascularization was 12.1 and 11.0% in the BMS and DES groups (P=0.48). TLR was 6.7% by PCI and 1.3% by CABG in the BMS group and 3.9 and 2.8% in the DES group (P=0.01; P=0.02). Definite stent thrombosis (ST) was 0.8% in the BMS-treated patients and 1.7% in the DES-treated patients (P=0.09). CONCLUSION: In patients with lesions carrying a low risk of restenosis, no differences were observed between BMS and DES in composite end points, TLR, or ST at 1-year follow-up. In patients with lesions carrying a high risk of restenosis, patients treated with BMS had a significantly higher rate of TLR by PCI, but a significantly lower rate of TLR by CABG compared with patients treated with DES. A nonsignificant lower rate of definite ST was observed in the BMS group compared with the DES group. |
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Authors:
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Marcel A M Beijk; Karel T Koch; Jan G P Tijssen; José P S Henriques; Jan Baan; Marije M Vis; Martin G Meesterman; Jan J Piek; Robbert J de Winter |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Coronary artery disease Volume: 22 ISSN: 1473-5830 ISO Abbreviation: Coron. Artery Dis. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: England |
Other Details:
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Languages: eng Pagination: 32-9 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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