Spot Drug-Eluting Stenting for Long Coronary Stenoses: Long-term Results of a Randomized Clinical Study
| Autor: | Theodoros Zografos, Efthalia Tzanalaridou, Socrates Korovesis, Eleftherios Giazitzoglou, Bernhard Meier, Demosthenes G. Katritsis |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Drug medicine.medical_specialty Ticlopidine Time Factors medicine.medical_treatment media_common.quotation_subject Coronary Angiography Risk Assessment Severity of Illness Index law.invention Coronary Restenosis Lesion Randomized controlled trial law medicine Humans Radiology Nuclear Medicine and imaging Angioplasty Balloon Coronary Enoxaparin Ultrasonography Interventional Proportional Hazards Models media_common Aspirin business.industry Proportional hazards model Anticoagulants Stent Percutaneous coronary intervention Drug-Eluting Stents Long term results Clopidogrel Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | Journal of Interventional Cardiology. 24:437-441 |
| ISSN: | 0896-4327 |
| DOI: | 10.1111/j.1540-8183.2011.00662.x |
| Popis: | Background: Preliminary results of a randomized trial have suggested that total lesion coverage with drug-eluting stents (DES) is not necessary in the presence of diffuse disease of nonuniform severity. In the present study, we report long-term results of this trial. Methods: Consecutive, consenting patients with a long (>20 mm) coronary lesion of nonuniform severity and indication for percutaneous coronary intervention were randomized to full stent coverage of the atherosclerotic lesion with multiple, overlapping (full DES group, n = 90) or spot stenting of the hemodynamically significant parts of the lesion only (defined as diameter stenosis > 50%) (spot DES group, n = 89). Results: At a follow-up of 2–7 years, 30 patients with full DES (33.3%) and 12 patients (13.5%) with spot DES had a major adverse cardiac event (MACE) (P = 0.015). Cox proportional hazard model showed that the risk for MACE was almost 65% lower among patients who were subjected to spot DES compared to those who underwent full DES (HR = 0.35, 95% CI = 0.18–0.68, P = 0.002). This association remained significant even after controlling for age, sex, and lesion length, and the type of stent used (HR = 0.41, 95% CI = 0.20–0.81, P = 0.011). Conclusions: In the presence of diffuse disease of nonuniform severity, selective stenting of only the significantly stenosed parts of the lesion confers better long-term results compared to total lesion coverage with DES. (J Interven Cardiol 2011;24:437–441) |
| Databáze: | OpenAIRE |
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