Percutaneous Intervention in Diffuse Coronary Disease: Overlapping Versus Single Very Long Stent Technique. Results From the OVERLONG Registry

Angiology ◽  
2021 ◽  
pp. 000331972110146
Author(s):  
Martín Negreira-Caamaño ◽  
José Abellán-Huerta ◽  
Fernando Lozano-Ruiz-Poveda ◽  
Ignacio Sánchez-Pérez ◽  
María T. López-Lluva ◽  
...  
Keyword(s):  
Independent Predictor ◽  
Percutaneous Treatment ◽  
Cardiovascular Death ◽  
Target Lesion ◽  
Major Adverse Cardiovascular Events ◽  
Diffuse Coronary Artery Disease ◽  
Contrast Volume ◽  
Stent Length ◽  
Artery Disease

Background: Both stent length and stent overlap are associated with worse outcomes in the percutaneous treatment of diffuse coronary artery disease (dCAD). However, evidence comparing these issues is scarce. We aimed to compare the results between the use of single very long stent (VLS) and ≥2 overlapping stents (OS) in the treatment of dCAD. Methods: Seven hundred twenty-four consecutive lesions were included: 275 treated with a single VLS (≥40 mm) and 449 with ≥2 OS. Procedural characteristics were assessed, and survival analysis was performed to compare the incidence of major adverse cardiovascular events (MACE; composite of cardiovascular death, nonfatal myocardial infarction, target lesion revascularization [TLR], or stent thrombosis) during a median follow-up of 31 months. Results: Procedures with VLS required less contrast volume (268 ± 122 vs 302 ± 113 cm3; P < .01), fluoroscopy time (16 ± 8 vs 21 ± 16 minutes; P < .01), and procedure duration (37 ± 18 vs 47 ± 27 minutes; P < .01) than the OS procedures. The VLS group showed lower incidence of MACE (4.4% vs 10.7%; P < .01), driven mainly by lower TLR rate (1.1% vs 4.7%; P < .01). The use of OS was an independent predictor of MACE. Conclusions: In this study, the use of VLS for the treatment of dCAD was associated with better outcomes compared to OS.

Clinical outcomes of patients with diffuse coronary artery disease following physiology-guided treatment strategy: insights from AJIP registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Warisawa ◽  
C.M Cook ◽  
J.P Howard ◽  
D Nour ◽  
S Doi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Treatment Strategy ◽  
Target Lesion ◽  
Major Adverse Cardiovascular Events ◽  
Diffuse Disease ◽  
Diffuse Coronary Artery Disease ◽  
Artery Disease

Abstract Background Physiology-guided treatment strategy improves clinical outcomes of patients with coronary artery disease. However, it has not been fully evaluated whether such guideline-based strategy is useful for patients with diffuse coronary artery disease as well, which is known to be one of the major factors affecting morbidity and mortality. Purpose The aim of this study was to clarify clinical outcomes of patients with diffuse coronary artery disease whose treatment strategy was based on coronary physiology. Methods From an international multicentre registry of iFR-pullback, consecutive 1067 patients (1185 vessels) with stable angina were included in whom coronary lesions were deferred or revascularized according to the iFR cutoff: 0.89. The physiological pattern of disease was classified according to the iFR-pullback recording as predominantly physiologically diffuse (n=463) or predominantly physiologically focal (n=722). Major adverse cardiovascular events (MACEs), defined as a composite of cardiac death, non-fatal myocardial infarction, and ischemia-driven target lesion revascularization during follow-up period, were compared between diffuse and focal groups, in both deferred and revascularized groups, respectively. Results Mean age was 67.1±10.7 years and 75.8% of patients were men. Median iFR was 0.88 (interquartile range: 0.80 to 0.92). At a median follow-up period of 18 months, no significant differences in MACEs were found between diffuse and focal groups, in both iFR-based deferred and revascularized groups. In the deferred group (n=480), MACEs occurred in 6.9% patients (15/217) in the diffuse group and 8.0% patients (21/263) in the focal group (p=0.44). In the revascularized group (n=705), MACEs occurred in 8.9% patients (22/246) in the diffuse group and 7.2% patients (33/459) in the focal group (p=0.49). Conclusions Despite potentially higher risks in patients with diffuse coronary artery disease, clinical outcomes of those patients were comparable to those of patients without diffuse disease, as long as treatment strategy was based on the physiology guidance, which is globally recommended by international guidelines. Funding Acknowledgement Type of funding source: None

Abstract 3346: Percutaneous Treatment Of Unprotected Left Main Coronary Stenoses With Paclitaxel-eluting Stents. Mid-term Results Of A French Prospective Multicenter Study (friend Register)

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Didier Carrié ◽  
Hélène Eltchaninoff ◽  
Thierry Lefèvre ◽  
Marc Silvestri ◽  
Gérard Levy ◽  
...  
Keyword(s):  
Percutaneous Treatment ◽  
Target Lesion ◽  
Side Branch ◽  
Left Main ◽  
Balloon Inflation ◽  
Global Rate ◽  
Stent Length ◽  
Mid Term Results ◽  
Q Wave

Purpose : We assessed early and mid-term results of patients (pts) treated for ULMCA disease in the FRIEND registry. Methods: After ethical committee approval and informed consent, all consecutive pts with unprotected left main stenoses treated with Taxus stents were included in a multicenter prospective study from 23 centers. Major adverse cardiacl events (MACCE) : death, myocardial infarction, stroke, target lesion (TLR), target vessel revascularisation (TVR), acute, sub-acute and late thrombosis were adjudicated at 1and 6 months by an independent committee. Immediate and 9-month angiographic results were assessed by a central core lab. For the distal lesion of ULMCA, a strategy of main branch stenting with provisional T-stenting of the side branch followed by kissing balloon inflation was strongly recommanded. Results : From December 2005 to July 2006, 155 pts were included, mean age 68 ± 11 years, 83 % male, 31 % unstable angina, 25% diabetics, 46 % 3-vessel disease. The mean Euroscore was 4.2 ± 2.8 (estimated in-hospital mortality rate after surgery 4.1%). The LM reference diameter was 3.6 ± 0.5mm. LM lesion was ostial-proximal in 28 %,mid shaft 18 % and distal 66%. In this group, 72 % were located at the bifurcation including LAD, LCX or both ostia affected. All patients were successfully treated on the LM (stent length 15.7 ± 5.2 mm) and a final kissing balloon inflation was performed in 90%. Apart from the LM stenosis, a total of 1.2 ± 0.8 lesions were treated during the hospitalisation (total stent length 47 ± 16mm). In-hospital MACCE rate was 4.5 % : death in 2.6% (3 acute stent thrombosis at day 2, 3, 5 and 1 before PCI) ; 2 Pts had asymptomatic non-Q-wave MI,1 pt Q-wave MI and 1CABG. At 9-month follow-up (122 pts) there was one extra-cardiac death, no cardiac failure and 3 pts (2.5 %) had recurrence of symptoms. The global rate of event-free survival was 93.5 % with a very low angiographic restenosis rate of 3 %. Conclusion: LM PCI using the TAXUS stent is feasible and safe. Preliminary results showed favourable 9-month follow-up. Stenting deserves to be considered a safe and effective alternative to CABG in institutions performing large numbers of PCIs. Adjudicated clinical and angiographic long-term (9-month) data are warranted and will be available for presentation.

scholarly journals One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry

2019 ◽  
Vol 109 (7) ◽  
pp. 845-856 ◽  
Author(s):  
Sean S. Scholz ◽  
Lucas Lauder ◽  
Sebastian Ewen ◽  
Saarraaken Kulenthiran ◽  
Nikolaus Marx ◽  
...  
Keyword(s):  
Small Vessel Disease ◽  
Reference Population ◽  
Target Lesion ◽  
Bleeding Complications ◽  
Major Adverse Cardiovascular Events ◽  
Artery Disease ◽  
One Year ◽  
Target Lesion Failure ◽  
New Generation

Abstract Background Chronic kidney disease (CKD) is highly prevalent in patients with coronary artery disease (CAD). Objective The outcome following revascularization using contemporary technologies (new-generation abluminal sirolimus-eluting stents with thin struts) in patients with CKD (i.e., glomerular filtration rate of < 60 mL/min/1.73m2) and in patients with hemodialysis (HD) is unknown. Methods e-Ultimaster is a prospective, single-arm, multi-center registry with clinical follow-up at 3 months and 1 year. Results A total of 19,475 patients were enrolled, including 1466 patients with CKD, with 167 undergoing HD. Patients with CKD had a higher prevalence of overall comorbidities, multiple/small vessel disease (≤ 2.75 mm), bifurcation lesions, and more often left main artery treatments (all p < 0.0001) when compared with patients with normal renal function (reference). CKD patients had a higher risk of target lesion failure (unadjusted OR, 2.51 [95% CI 2.04–3.08]), target vessel failure (OR, 2.44 [95% CI 2.01–2.96]), patient-oriented composite end point (OR, 2.19 [95% CI 1.87–2.56]), and major adverse cardiovascular events (OR, 2.34 [95% CI 1.93–2.83, p for all < 0.0001]) as reference. The rates of target lesion revascularization (OR, 1.17 [95% CI 0.79–1.73], p = 0.44) were not different. Bleeding complications were more frequently observed in CKD than in the reference (all p < 0.0001). Conclusion In this worldwide registry, CKD patients presented with more comorbidities and more complex lesions when compared with the reference population. They experienced higher rate of adverse events at 1-year follow-up. Graphic abstract

scholarly journals Cardiovascular consequences of discontinuing low-dose rivaroxaban in people with chronic coronary or peripheral artery disease

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318758
Author(s):  
Gilles R Dagenais ◽  
Leanne Dyal ◽  
Jacqueline J Bosch ◽  
Darryl P Leong ◽  
Victor Aboyans ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Low Dose ◽  
Cardiovascular Death ◽  
Stroke Rate ◽  
Early Stopping ◽  
Peripheral Artery ◽  
Once Daily ◽  
Registration Number ◽  
Artery Disease

ObjectiveIn patients with chronic coronary or peripheral artery disease enrolled in the Cardiovascular Outcomes for People Using Anticoagulation Strategies trial, randomised antithrombotic treatments were stopped after a median follow-up of 23 months because of benefits of the combination of rivaroxaban 2.5 mg two times per day and aspirin 100 mg once daily compared with aspirin 100 mg once daily. We assessed the effect of switching to non-study aspirin at the time of early stopping.MethodsIncident composite of myocardial infarction, stroke or cardiovascular death was estimated per 100 person-years (py) during randomised treatment (n=18 278) and after study treatment discontinuation to non-study aspirin (n=14 068).ResultsDuring randomised treatment, the combination compared with aspirin reduced the composite (2.2 vs 2.9/100 py, HR: 0.76, 95% CI 0.66 to 0.86), stroke (0.5 vs 0.8/100 py, HR: 0.58, 95% CI 0.44 to 0.76) and cardiovascular death (0.9 vs 1.2/100 py, HR: 0.78, 95% CI 0.64 to 0.96). During 1.02 years after early stopping, participants originally randomised to the combination compared with those randomised to aspirin had similar rates of the composite (2.1 vs 2.0/100 py, HR: 1.08, 95% CI 0.84 to 1.39) and cardiovascular death (1.0 vs 0.8/100 py, HR: 1.26, 95% CI 0.85 to 1.86) but higher stroke rate (0.7 vs 0.4/100 py, HR: 1.74, 95% CI 1.05 to 2.87) including a significant increase in ischaemic stroke during the first 6 months after switching to non-study aspirin.ConclusionDiscontinuing study rivaroxaban and aspirin to non-study aspirin was associated with the loss of cardiovascular benefits and a stroke excess.Trial registration numberNCT01776424.

scholarly journals Association between post-balloon angioplasty dissection and primary patency in complex femoropopliteal artery disease: 2-year clinical outcomes of the AcoArt I trial

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110065
Author(s):  
Hao Ren ◽  
Jie Liu ◽  
Jiwei Zhang ◽  
Baixi Zhuang ◽  
Weiguo Fu ◽  
...  
Keyword(s):  
Balloon Angioplasty ◽  
Cox Regression ◽  
Target Lesion ◽  
Transluminal Angioplasty ◽  
Outcome Data ◽  
Primary Patency ◽  
Cox Regression Analysis ◽  
Femoropopliteal Artery ◽  
Artery Disease

Objective To assess the association between post-balloon angioplasty dissection and the mid-term results of the AcoArt I trial evaluating complex femoropopliteal artery disease. Methods The outcome data for 144 patients from the AcoArt 1 trial were reanalysed. These patients were randomly divided into percutaneous transluminal angioplasty (PTA) and drug-coated balloons (DCB) groups. The primary endpoint was the primary patency (PP) rate and clinically-driven target lesion revascularisation at 24 months. Results After 24 months of follow-up, the PP rate of dissection cases in the PTA group was lower vs non-dissection cases. In patients receiving a bailout stent for dissection, the PP rate in the PTA group was lower vs the DCB group. Cox regression analysis showed that dissection decreased the PP rate; mild dissection reduced the PP rate as follows: 52%, PTA group and 19%, DCB group. With severe dissection, the PP rate reduction was as follows: 75%, PTA group and 73%, DCB group. Conclusions The mid-term follow-up showed that post-balloon angioplasty dissection reduced the PP rate in the PTA group but not in the DCB group. Additionally, in patients receiving a bailout stent for dissection, the DCB group had a better PP rate than the PTA group.

scholarly journals Treatment of de novo coronary artery lesions with paclitaxel drug coated balloons (DCB) in diabetic and non-diabetic patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K.M.Z Mohd Saad Jalaluddin
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
De Novo ◽  
Target Lesion ◽  
Diabetic Group ◽  
Target Lesion Revascularization ◽  
Diabetic Patients ◽  
Coronary Artery Lesions ◽  
Artery Disease

Abstract Background Drug-coated balloon has been widely used to treat In-Stent Restenosis as recommended by ESC/EACT coronary intervention guideline. However, trials of effectiveness of DCB in treating de novo lesions in diabetic patients are limited. This study will highlight the impact of DCB in diabetic patients with only de novo lesions against non-diabetic patients. Aim To compare the outcomes of Paclitaxel Drug Coated Balloon (DCB) in Diabetic and non-diabetic patients with only de novo coronary artery disease. Methods A retrospective, single center study was conducted from January 2016 till December 2018. All diabetic and non-diabetic patients underwent angioplasty to only de novo coronary artery lesions were included in the study. Patients' baseline characteristic, angiographic data, post procedural and 12 months follow-up outcomes including major adverse coronary artery event (MACE), target lesion revascularization (TLR) and myocardial infarction (MI) are compared. Results A total of 1257 patients (726 diabetic and 531 non-diabetic patients) with total 1385 de novo coronary artery lesions (791 lesions in diabetic group and 594 lesions in non-diabetic group) were included in this study. Mean age for non-diabetic group was 57.6±10.6 years and diabetic group was 59.6±9.6 years with male predominance (91.1% in non-diabetic group, n=484 and 79.2% in diabetic group, n=575). Majority of diabetic group has hypertension (83.7%, n=608 vs 58.6%, n+311), chronic renal failure (10.3%, n=75 vs 1.9%, n=10), documented coronary artery disease (55.6%, n=404 vs 47.5%, n=252) and previous coronary angioplasty 39.5%, n=287 vs 28.8%, n=153). Adequate pre-dilatation was done in both groups (98.5%, n=585 in non-diabetic group and 99.4%, n=786 in diabetic group; p=0.000). Mean DCB diameter and length were almost similar in both groups. Mean residual stenosis after DCB was 11.15±16.9% in non-diabetic group and 13.13±13.4% in the diabetic group (p=0.008). 74.6% of non-diabetic group (n=396) and 77.1% of diabetic group (n=560) were on double antiplatelet therapy for 12 months. 86.8% (n=461) of non-diabetic and 88.4% (n=642) of diabetic patients were available for follow up. MACE events were significantly higher (p=0.000) in diabetic group (4.3%, n=31) as compare to non-diabetic group (0.6%, n=3). Target lesion revascularization (TLR) and myocardial infarction (MI) was also significantly higher in diabetic group (TLR 1.4%, N=10 vs 0.6%, n=3, p=0.049; MI 2.6%, n=19 vs 0.4%, n=2, p=0.002). Conclusion Treating de novo coronary lesions in diabetic patients with DCB associated with significantly higher MACE events, target lesion revascularization and myocardial infarction. Diabetic patients appear to have a greater volume of atherosclerotic plaque and increased propensity for atherosclerotic plaque rupture. Funding Acknowledgement Type of funding source: None

scholarly journals Precise Percutaneous Coronary Intervention of LAD Ostial Stenosis by Using Afzal’s Technique: An easy but Innovative Procedure

2016 ◽  
Vol 9 (1) ◽  
pp. 49-54
Author(s):  
Afzalur Rahman ◽  
Farhana Ahmed ◽  
Mohammad Arifur Rahman ◽  
Syed Nasir Uddin ◽  
Md Zillur Rahman ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
De Novo ◽  
Coronary Revascularization ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Special Technique ◽  
Stent Deployment ◽  
Percutaneous Coronary ◽  
Stent Length

Background: The ostial left anterior descending coronary artery (LAD) lesion is an important target for coronary revascularization because its location subtends a large territory of myocardium. Ostial lesions have a reputation of being fibrotic, calcified, and relatively rigid. Greater degraees of rigidity and recoil resulted in lower acute gain and higher rates of target lesion revascularization (TLR) following percutaneous coronary intervention (PCI). In addition, procedural complications such as dissections, vessel closure and myocardial infarction were more frequent. Aim of the study was to evaluate a simple but innovative technique to deal with significant LAD ostial lesion.Methods: This prospective study was conducted between January 2010 and February 2013. Patients with significant angiographic de novo ostial LAD artery stenoses were identified and screened for study eligibility. An ostial stenosis was defined as an angiographic narrowing of e” 70% located within 3 mm of the vessel origin. Study included all consecutive patients with ostial lesions who underwent elective PCI and stent deployment. The study population consisted of 36 patients.Results: Among 36 patients 27 (75%) were male. mean age was 55.75 ± 8.07 years. 21 (58.3%) had diabetes, 15 (41.7%) hypertension, 21 (58.3%) hypercholesterolemia, 24 (66.66%) were smoker and 18 (50%) had F/H of CAD. Among them 6 (16.7%) had STEMI, 9 (25%) had NSTEMI, 12 (33.3%) had UA and 9 (25%) CSA. CAG showed 15 (41.7%) SVD, 15 (41.7%) DVD and 6 (16.7%) were TVD. LAD ostial stenosis were 83.16 ± 10.14%. Considering procedural characteristics, DES were 33 (91.7%) and BMS were 3 (8.3%). DES polymers were Evarolimus 15 (41.7%), Zotarolimus 12 (33.3%) and Biolimus 6 (16.7%). Mean stent length were 21.75 ± 8.07 mm. Mean stent diameter were 2.83 ± 0.28 mm. Minimum follow up time was 9 months and maximum follow up time was 44 months. There were no MACE but Angina (CCS II) were 2 (5.55%) and LVF (NYHA II) were 1(2.77%).Conclusion: Precise placement of LAD ostial stent is always challenging. Several technique applied but results not always satisfactory. Our strategies were precise location of stent implantation at ostium by adopting special technique of simultaneous balloon placement from distal LM to proximal LCX preventing unwanted stent movement during its placement and also properly guiding us for precise stent placement at the ostium. Parked balloon from distal LM to LCX will also be helpful for quick measure for any plaque shifting into LCX.Cardiovasc. j. 2016; 9(1): 49-54

Subcutaneous and single-chamber transvenous defibrillators: a nationwide matched control study

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Bodin ◽  
A Bisson ◽  
B Pierre ◽  
J Herbert ◽  
N Clementy ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Propensity Score ◽  
Cardiovascular Death ◽  
Implantable Cardioverter Defibrillators ◽  
Matched Cohort ◽  
Icd Implantation ◽  
Baseline Characteristics ◽  
Artery Disease ◽  
Cardioverter Defibrillators

Abstract Funding Acknowledgements Type of funding sources: None. Introduction / Background Subcutaneous implantable cardioverter–defibrillators (S-ICD) was designed to avoid complications of single-chamber transvenous implantable cardioverter-defibrillators (VVI ICD) by using an entirely extra-thoracic placement. Purpose Our objective was to compare outcomes following first VVI ICD or S-ICD implantation in an exhaustive nationwide matched cohort. Methods This French longitudinal cohort study was based on the national hospitalization database covering hospital care from for the entire population. All adults (age ≥18 years) hospitalized in French hospitals From January 1, 2010 to September 1, 2020, who underwent a VVI ICD or S-ICD implantation were included. Patients with a previous pacemaker or ICD or with a history of infective endocarditis were excluded. Multivariable analyses for clinical outcomes during the whole follow-up in the groups of interests were performed using a Cox model with all baseline characteristics and reporting hazard ratio. Owing to the non-randomized nature of the study, and considering for significant differences in baseline characteristics, propensity-score matching was also used to control for potential confounders of the treatment outcome relationship. Results 21,667 patients were included in the cohort, 19,493 patients had a transvenous VVI ICD and 2,174 had a subcutaneous ICD. Mean age was 61.2 ± 13.2 years in the VVI ICD group and 52.3 ± 17.5 years in the S-ICD goup. Coronary artery disease was present in 71.6% of patients with a VVI ICD and 48.2% of patients with a S-ICD. Mean follow-up was 28.8 ± 31.8 months. S-ICD patients had a significant higher rate of all-cause death (HR: 1.684, 95%CI: 1.309-2.165, p &lt; 0.001). There were no significant differences in cardiovascular death (HR: 1.092, 95%CI: 0.697-1.711, p = 0.70) and infective endocarditis (HR: 0.354, 95%CI: 0.067-1.433, p = 0.15) between the two groups Using propensity score, 1,582 patients with VVI ICD were matched 1:1 with S-ICD patients. Mean follow-up was 4.5 ± 7.2 months. In the matched analysis, there were no significant differences in all-cause death (HR: 1.090, 95%CI: 0.728-1.633, p = 0.68) and cardiovascular death (HR: 1.167, 95%CI: 0.603-2.260, p = 0.65) between the two groups. A trend toward a lower risk of infective endocarditis in the S-ICD group was also observed without reaching significance (HR : 0.219, 95%CI: 0.047-1.017, p = 0.053). A sensitivity analysis in patients with coronary artery disease in the matched cohort was performed. Same trends were observed without significant differences in all-cause death and cardiovascular death. Conclusion Our nationwide study highlighted a higher risk of all-cause death in patients treated with subcutaneous which however was not statistically significant after propensity score matching. No differences regarding cardiovascular mortality was found. An interesting trend toward diminution of infective endocarditis was also observed without reaching significancy.

Abstract 12022: Long-Term Clinical Outcomes of Everolimus-Eluting Stents versus Sirolimus-Eluting Stents: Systematic Review and a Meta-Analysis of 14 Randomized Control Trials, Focused on Stent Thrombosis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
TOSHIAKI TOYOTA ◽  
Hiroki Shiomi ◽  
Takeshi Morimoto ◽  
Takeshi Kimura
Keyword(s):  
Clinical Outcomes ◽  
Stent Thrombosis ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Target Lesion ◽  
Pooled Analysis ◽  
Significant Difference ◽  
Artery Disease

Background: We sought to compare the long-term clinical outcomes between everolimus-eluting stent (EES) and sirolimus-eluting stents (SES) with a meta-analysis method. The long-term clinical outcomes, especially stent thrombosis (ST), after EES versus SES implantation has not been clearly defined among trials directly comparing the 2 types of stents. Methods: We searched PubMed, Cochrane database, and ClinicalTrials.gov. for trials comparing outcomes between EES (Xience V/Promus) and SES (Cypher select/Cypher select plus) in patients with native coronary artery disease using randomized controlled trial (RCT) design. We selected the article reporting the longest follow-up outcomes from each RCT. The outcome measure was all-cause death, myocardial infarction (MI), definite ST, and target-lesion revascularization (TLR). ST was further classified as those occurring early (<=30 days), late (30-365 days), or very late (<365 days). Results: We identified 14 RCT comparing EES and SES including 2 trials reporting the longest follow-up outcomes as a pooled analysis. We analyzed 13,434 randomly assigned patients with the weighted follow-up period of 2.1 years (Follow-up <=1-year: 7 trials, and 3191 patients; >1-year: 7 trials, and 10243 patients). EES as compared to SES was associated with significantly lower risks for overall ST, and early ST (pooled odds ratio (OR) 0.49, 95% confidence interval (CI) 0.30-0.81, P=0.01, and OR 0.42, 95% CI 0.18-0.99, P=0.046, respectively), while there was no significant difference in the risk for late ST and very late ST (OR 0.49, 95% CI 0.17-1.43, P=0.19, and OR 0.66, 95% CI 0.23-1.85, P=0.43, respectively). EES as compared to SES was also associated with significantly lower risks for TLR (OR 0.84, 95% CI 0.71-0.99, P=0.04). There was no significant difference in the risk for all-cause death, and MI between EES and SES. (OR 0.91, 95% CI 0.78-1.07, P=0.11, and OR 0.92, 95% CI 0.75-1.13, P=0.44, respectively). Conclusions: In the current meta-analysis of 14 RCT directly comparing EES with SES, implantation of EES as compared to SES implantation was associated with significantly lower risk for definite ST and TLR.

Previous malignancy is an independent predictor of follow-up mortality after percutaneous treatment of mitral valve regurgitation by means of MitraClip

2017 ◽  
Vol 35 (2) ◽  
pp. e12239 ◽  
Author(s):  
Alper Öner ◽  
Hüseyin Ince ◽  
Liliya Paranskaya ◽  
Guido Schröder ◽  
Mohammad Sherif ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Independent Predictor ◽  
Percutaneous Treatment ◽  
Mitral Valve Regurgitation ◽  
Valve Regurgitation
Sign in / Sign up

Export Citation Format

Share Document