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Comparison of first- and second-generation drug-eluting stent efficacies for treating left main and/or three-vessel disease: a propensity matched study
- Source :
- Heart and Vessels. 31:1930-1942
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- The efficacy of second-generation drug-eluting stent (DES) for the treatment of left main disease (LM) and/or three vessel disease (3VD) remains unclear. We compared 2-year outcomes of second- versus first -generation DES implantation among patients with LM and/or 3VD and to assess the differential of risk by complexity of coronary artery disease using synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) scores. Between April 2007 and December 2012, 341 patients with LM and/or 3VD were treated by percutaneous coronary intervention; 154 with first-generation DES and 137 with second-generation DES. After propensity matching, 101 patients remained in each group. The rate of target lesion revascularization (TLR) and major adverse cardiac event (MACE) were compared. TLR and MACE at 2 years were more common in the first- compared with second-generation DES group (TLR 19.8 vs. 8.9 %; p = 0.016, MACE 24.8 vs. 10.9 %; p = 0.008). In patients with low (0-22) and intermediate (23-32) SYNTAX scores, TLR and MACE tended to occur more often with first-generation DES group. In patients with high SYNTAX scores (≧33), TLR and MACE were significantly more common with first-generation DES group (TLR 29.0 vs. 11.1 %; p = 0.035, MACE 35.5 vs. 13.9 %; p = 0.034). Compared with first-generation DES, second-generation DES proved beneficial in reducing risk of TLR and MACE in patients with LM and/or 3VD, particularly among those with high SYNTAX scores (≧33).
- Subjects :
- Male
medicine.medical_specialty
Pathology
Time Factors
medicine.medical_treatment
Coronary Artery Disease
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Prosthesis Design
Coronary artery disease
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Propensity Score
Aged
Proportional Hazards Models
Retrospective Studies
Aged, 80 and over
business.industry
Stent
Percutaneous coronary intervention
Drug-Eluting Stents
Middle Aged
Vascular surgery
medicine.disease
Cardiac surgery
Logistic Models
Treatment Outcome
Drug-eluting stent
Multivariate Analysis
Propensity score matching
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Mace
Subjects
Details
- ISSN :
- 16152573 and 09108327
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Heart and Vessels
- Accession number :
- edsair.doi.dedup.....3a064cfc230455fa3d3e6989e145c9ae