Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry
Background: Restenosis rates are low in large coronary vessels = 3.5 mm after bare-metal stent (BMS) implantation. The benefit of drug-eluting stents (DES) in large vessels is not established. Objective: We aim to assess clinical outcomes after deployment of BMS compared to DES in patients with larg...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
| Published: |
Elsevier Ireland Ltd.
2008
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| Online Access: | http://hdl.handle.net/20.500.11937/39046 |
| _version_ | 1848755483906670592 |
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| author | Yan, B. Ajani, A. New, G. Duffy, S. Farouque, O. Shaw, J. Sebastian, M. Lew, R. Brennan, A. Andrianopoulos, N. Reid, Christopher Clark, D. |
| author_facet | Yan, B. Ajani, A. New, G. Duffy, S. Farouque, O. Shaw, J. Sebastian, M. Lew, R. Brennan, A. Andrianopoulos, N. Reid, Christopher Clark, D. |
| author_sort | Yan, B. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Restenosis rates are low in large coronary vessels = 3.5 mm after bare-metal stent (BMS) implantation. The benefit of drug-eluting stents (DES) in large vessels is not established. Objective: We aim to assess clinical outcomes after deployment of BMS compared to DES in patients with large coronary vessels = 3.5 mm. Methods: We analysed 672 consecutive patients undergoing percutaneous coronary interventions with = 3.5 mm stent implantation in native coronary artery de-novo lesions from the Melbourne Interventional Group (MIG) registry. Baseline characteristics, 30-day and 12-month outcomes of patients receiving BMS were compared to DES. Multivariate analysis was performed to identify predictors of major adverse cardiac events [MACE, consisting of death, myocardial infarction (MI) and target vessel revascularisation (TVR)]. Results: Of the 672 PCIs performed in 844 lesions, DES was implanted in 39.5% (n = 333) and BMS in 60.5% (n = 511) of lesions. Patients who received DES compared to BMS were older, more likely to be diabetic, had left ventricular dysfunction < 45% or complex lesions. Significantly fewer patients who presented with ST-elevation MI received DES compared to BMS. There were no significant differences in 12-month mortality (0.5 vs. 2.9%, p = 0.07), TVR (3.6 vs. 4.8%, p = 0.54), MI (6.3 vs. 3.4%, p = 0.15), stent thrombosis (0.9 vs. 1.0%, p = 0.88), or MACE (9.4 vs. 9.4%, p = 0.90) in patients who received DES vs. BMS. Stent length = 20 mm was the only independent predictor of 12-month MACE (Odds Ratio 2.07, 95% CI 1.14-3.76, p = 0.02). Conclusion: In this registry, BMS implantation in large native coronary vessels = 3.5 mm was associated with a low risk of MACE and repeat revascularization at 12 months that was comparable to DES. © 2008 Elsevier Ireland Ltd. All rights reserved. |
| first_indexed | 2025-11-14T08:57:02Z |
| format | Journal Article |
| id | curtin-20.500.11937-39046 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T08:57:02Z |
| publishDate | 2008 |
| publisher | Elsevier Ireland Ltd. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-390462017-09-13T14:20:53Z Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry Yan, B. Ajani, A. New, G. Duffy, S. Farouque, O. Shaw, J. Sebastian, M. Lew, R. Brennan, A. Andrianopoulos, N. Reid, Christopher Clark, D. Background: Restenosis rates are low in large coronary vessels = 3.5 mm after bare-metal stent (BMS) implantation. The benefit of drug-eluting stents (DES) in large vessels is not established. Objective: We aim to assess clinical outcomes after deployment of BMS compared to DES in patients with large coronary vessels = 3.5 mm. Methods: We analysed 672 consecutive patients undergoing percutaneous coronary interventions with = 3.5 mm stent implantation in native coronary artery de-novo lesions from the Melbourne Interventional Group (MIG) registry. Baseline characteristics, 30-day and 12-month outcomes of patients receiving BMS were compared to DES. Multivariate analysis was performed to identify predictors of major adverse cardiac events [MACE, consisting of death, myocardial infarction (MI) and target vessel revascularisation (TVR)]. Results: Of the 672 PCIs performed in 844 lesions, DES was implanted in 39.5% (n = 333) and BMS in 60.5% (n = 511) of lesions. Patients who received DES compared to BMS were older, more likely to be diabetic, had left ventricular dysfunction < 45% or complex lesions. Significantly fewer patients who presented with ST-elevation MI received DES compared to BMS. There were no significant differences in 12-month mortality (0.5 vs. 2.9%, p = 0.07), TVR (3.6 vs. 4.8%, p = 0.54), MI (6.3 vs. 3.4%, p = 0.15), stent thrombosis (0.9 vs. 1.0%, p = 0.88), or MACE (9.4 vs. 9.4%, p = 0.90) in patients who received DES vs. BMS. Stent length = 20 mm was the only independent predictor of 12-month MACE (Odds Ratio 2.07, 95% CI 1.14-3.76, p = 0.02). Conclusion: In this registry, BMS implantation in large native coronary vessels = 3.5 mm was associated with a low risk of MACE and repeat revascularization at 12 months that was comparable to DES. © 2008 Elsevier Ireland Ltd. All rights reserved. 2008 Journal Article http://hdl.handle.net/20.500.11937/39046 10.1016/j.ijcard.2008.06.046 Elsevier Ireland Ltd. restricted |
| spellingShingle | Yan, B. Ajani, A. New, G. Duffy, S. Farouque, O. Shaw, J. Sebastian, M. Lew, R. Brennan, A. Andrianopoulos, N. Reid, Christopher Clark, D. Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry |
| title | Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry |
| title_full | Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry |
| title_fullStr | Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry |
| title_full_unstemmed | Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry |
| title_short | Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry |
| title_sort | are drug-eluting stents indicated in large coronary arteries? insights from a multi-centre percutaneous coronary intervention registry |
| url | http://hdl.handle.net/20.500.11937/39046 |