1. Two‐year outcomes after percutaneous coronary intervention with drug‐eluting stents or bare‐metal stents in elderly patients with coronary artery disease
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Thomas Cuisset, Olivier Varenne, Didier Carrié, Stéphane Cook, Salvatore Brugaletta, Christian Spaulding, Kris Bogaerts, Eduardo Pinar-Bermudez, Peter Sinnaeve, Manel Sabaté, José Francisco Díaz Fernández, Marie Claude Morice, Josepa Mauri Ferre, Giorgios Sideris, Philippe Commeau, Sasko Kedev, Emmanuel Teiger, Philippe Garot, Alexandre Lafont, Investigators, Gérard Helft, Rami El Mahmoud, Thomas Hovasse, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), University of Fribourg, Université Paris Diderot - Paris 7 (UPD7), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP)-Université Sorbonne Paris Nord, Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Privé Jacques Cartier [Massy], Hôpital Ambroise Paré [AP-HP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CERC - Centre d'études et de recherche sur les contentieux - EA 3164 (CERC), Université de Toulon (UTLN), Service de Cardiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University St Cyril and Methodius [Skopje, Macedonia] (USCM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Juan Ramón Jiménez University Hospital [Huelva, Spain] (JRJUH), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Hospital Clínico Universitario Virgen de la Arrixaca = University Hospital Virgen de la Arrixaca [Murcia], Hôpital universitaire Germans Trias i Pujol [Badalona, Spain] (HUGTP), Polyclinique Les Fleurs - ELSAN [Ollioules] (PLF), Cardiovascular European Research Center [Massy] (CERC), Prémilleux, Annick, and Université de Fribourg = University of Fribourg (UNIFR)
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Cardiac & Cardiovascular Systems ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary artery disease ,0302 clinical medicine ,Risk Factors ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,education.field_of_study ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,DUAL ANTIPLATELET THERAPY ,Drug-Eluting Stents ,PCI ,General Medicine ,3. Good health ,[SDV] Life Sciences [q-bio] ,Treatment Outcome ,TRIALS ,Drug-eluting stent ,Cardiology ,Stents ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,medicine.medical_specialty ,short DAPT ,Population ,Revascularization ,Prosthesis Design ,elderly patients ,drug eluting stents ,03 medical and health sciences ,Percutaneous Coronary Intervention ,SENIOR ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,education ,Aged ,OLDER ,Science & Technology ,business.industry ,Percutaneous coronary intervention ,medicine.disease ,Conventional PCI ,Cardiovascular System & Cardiology ,business ,bare metal stents ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
OBJECTIVES: Report the results at 2 years of the patients included in the SENIOR trial. BACKGROUND: Patients above 75 years of age represent a fast-growing population in the cathlab. In the SENIOR trial, patients treated by percutaneous coronary intervention (PCI) with drug eluting stent (DES) and a short duration of P2Y12 inhibitor (1 and 6 months for stable and unstable coronary syndromes, respectively) compared with bare metal stents (BMS) was associated with a 29% reduction in the rate of all-cause mortality, myocardial infarction (MI), stroke, and ischaemia-driven target lesion revascularization (ID-TLR) at 1 year. The results at 2 years are reported here. METHODS AND RESULTS: We randomly assigned 1,200 patients (596[50%] to the DES group and 604[50%] to the BMS group). At 2 years, the composite endpoint of all-cause mortality, MI, stroke and ID-TLR had occurred in 116 (20%) patients in the DES group and 131 (22%) patients in the BMS group (RR 0.90 [95%CI 0.72-1.13], p = .37). IDTLR occurred in 14 (2%) patients in the DES group and 41 (7%) patients in the BMS group (RR 0.35 [95%CI 0.16-0.60], p = .0002). Major bleedings (BARC 3-5) occurred in 27(5%) patients in both groups (RR 1.00, [95%CI 0.58-1.75], p = .99). Stent thrombosis rates were low and similar between DES and BMS (0.8 vs 1.3%, (RR 0.52 [95%CI 0.01-1.95], p = .27). CONCLUSION: Among elderly PCI patients, a strategy combining a DES together with a short duration of DAPT is associated with a reduction in revascularization up to 2 years compared with BMS with very few late events and without any increased in bleeding complications or stent thrombosis. https://doi.org/10.1002/ccd.29159 ispartof: CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS vol:97 issue:5 pages:E607-E613 ispartof: location:United States status: published
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- 2020
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