Long-term outcome of percutaneous catheter intervention for de novo coronary bifurcation lesions with drug-eluting stents or bare-metal stents - 05/08/11
, Michael Gick, MD, Rolf-Peter Kienzle, MS, Hans-Peter Bestehorn, MD, Klaus-Dieter Werner, MD, Thomas Comberg, MD, Min Zhao, MD, Heinz Joachim Buettner, MD, Franz-Josef Neumann, MDRésumé |
Background |
The purpose of this study was to assess the long-term risks and benefits of drug-eluting stents (DESs) compared with bare-metal stents (BMSs) for treatment of coronary bifurcation lesions.
Methods |
Our registry comprised 1,038 patients treated for coronary bifurcation lesion according to the provisional T-stenting strategy who were followed up for 3 years.
Results |
Target lesion revascularization rates were 24.3% for BMSs (n = 337), 15.6% for sirolimus-eluting stents (SESs, n = 422), and 17.3% for paclitaxel-eluting stents (PESs, n = 279) (P = .003 BMSs vs DESs, P = .54 SESs vs PESs). The respective incidences were 11.4%, 9.5%, and 14.8% (P = .65, P = .13) for death and myocardial infarction and 9.9%, 6.5%, and 10.6% (P = .72, P = .19) for death. Propensity score adjusted hazard ratios (95% CI) for DESs versus BMSs were 0.49 (0.35-0.68, P < .001) for target lesion revascularization, 0.94 (0.64-1.40, P = .078) for death and myocardial infarction, and 0.85 (0.55-1.32, P = .47) for death. We did not find any significant differences between SESs and PESs, except for an increased risk of death after PESs compared with SESs (but not BMSs) in the subgroup receiving a side-branch stent (adjusted hazard ratio 2.45, 95% CI 1.05-5.73, P = .035).
Conclusions |
Compared with BMSs, both PESs and SESs substantially reduced the long-term need for repeated revascularization but did not increase the risk of death and myocardial infarction.
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Vol 159 - N° 3
P. 454-461 - mars 2010 Retour au numéro
Article précédent
- Does “late catch-up” exist in drug-eluting stents: Insights from a serial quantitative coronary angiography analysis of sirolimus versus paclitaxel-eluting stents
- Kyung Woo Park, Chi-Hoon Kim, Hae-Young Lee, Hyun-Jae Kang, Bon-Kwon Koo, Byung-Hee Oh, Young-Bae Park, Hyo-Soo Kim
- Clopidogrel use and clinical events after drug-eluting stent implantation: Findings from the HealthCore Integrated Research Database
- John L. Petersen, John J. Barron, Bradley G. Hammill, Mark J. Cziraky, Kevin J. Anstrom, Peter M. Wahl, Eric L. Eisenstein, Mitchell W. Krucoff, Robert M. Califf, Kevin A. Schulman, Lesley H. Curtis
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