Back to Search Start Over

3-Year Clinical Outcome of Patients With Chronic Total Occlusion Treated With Drug-Eluting Stents

Authors :
Antonio Parma
Marco Stefano Nazzaro
Giorgia Caferri
Carmine Musto
Francesco De Felice
Rosario Fiorilli
Roberto Violini
Fernando Sbraga
Source :
JACC: Cardiovascular Interventions. (12):1260-1265
Publisher :
American College of Cardiology Foundation. Published by Elsevier Inc.

Abstract

ObjectivesThe aim of this study was to evaluate whether percutaneous coronary intervention (PCI) with drug-eluting stent (DES) reduces major adverse cardiac events (MACE) in patients with chronic coronary total occlusions (CTO) compared with bare-metal stent (BMS) during 3-year follow-up.BackgroundThe long-term prognosis of patients with CTO treated with PCI and DES implantation is poorly investigated.MethodsWe compared the 3-year clinical outcome of 124 patients with CTO after successful PCI with DES implantation with that of 159 patients with CTO previously treated with BMS. MACE were defined as death, myocardial infarction, and target lesion revascularization (repeat PCI or coronary artery bypass surgery) and were considered as combined primary end point.ResultsAfter 3 years, the composite end point was significantly lower in the DES than in the BMS group: 18% versus 28%, respectively, (p < 0.05). The difference was due to the reduction of target lesion revascularization with DES compared with BMS—8% versus 21%, respectively, (p < 0.004). The Cox proportional hazards model identified: DES versus BMS (adjusted hazard ratio [HR]: 0.338, 95% confidence interval [CI]: 0.19 to 0.60, p = 0.0001), lesion length (HR: 1.033, 95% CI: 1.008 to 1.058, p = 0.012), and final minimal lumen diameter (HR: 0.456, 95% CI: 0.232 to 0.898, p = 0.023) as independent predictors of MACE at 3-year follow-up.ConclusionsAfter 3 years, DES were superior to BMS in reducing MACE in patients with CTO and should be considered the preferred treatment strategy.

Details

Language :
English
ISSN :
19368798
Issue :
12
Database :
OpenAIRE
Journal :
JACC: Cardiovascular Interventions
Accession number :
edsair.doi.dedup.....b9559bbc4ba1a4dde8f53fb345a1cc0f
Full Text :
https://doi.org/10.1016/j.jcin.2009.09.013