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3-Year Clinical Outcome of Patients With Chronic Total Occlusion Treated With Drug-Eluting Stents
- 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.
- Subjects :
- Bare-metal stent
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Myocardial Infarction
Kaplan-Meier Estimate
bare-metal stent
Prosthesis Design
Risk Assessment
Disease-Free Survival
Coronary Restenosis
Coronary artery bypass surgery
Risk Factors
Internal medicine
medicine
drug-eluting stent
Humans
cardiovascular diseases
Angioplasty, Balloon, Coronary
chronic total occlusion
Aged
Proportional Hazards Models
Retrospective Studies
Chi-Square Distribution
business.industry
Patient Selection
Stent
Percutaneous coronary intervention
Drug-Eluting Stents
Thrombosis
Middle Aged
Surgery
Logistic Models
Treatment Outcome
Coronary Occlusion
Drug-eluting stent
Cardiovascular Diseases
Metals
Conventional PCI
Chronic Disease
Cardiology
Female
Stents
business
Cardiology and Cardiovascular Medicine
Mace
TIMI
Subjects
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