Outcomes in patients undergoing multivessel percutaneous coronary intervention using sirolimus-eluting stents: A report from the e-SELECT registry

Florim Cuculi, Adrian P. Banning, Alexander Abizaid, Antonio L. Bartorelli, Ana C. Baux, Vladimir Džavík, Stepehen Ellis, Runlin Gao, David Holmes, Myung H. Jeong, Victor Legrand, Franz Josef Neumann, Maria Nyakern, Christian Spaulding, Hans Peter Stoll, Stephen Worthley, Philip Urban, Emanuele Barbato, Alaide Chieffo, Christoph NaberLisette Okkels Jensen, Koichi Sano, Vankeepvram Srinivas

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Aims: Performing percutaneous coronary intervention (PCI) to multiple coronary lesions during the same procedure has potential economic and social advantages. However comprehensive outcome data of real world practice in a large population is limited. We aimed to compare short- and long-term outcomes between patients with multi-vessel coronary artery disease who either underwent single- or multivessel PCI within the e-SELECT registry. Methods and results: The e-SELECT registry combines data collected at 320 medical centres in 56 countries where patients received CYPHER Select® or CYPHER Select® Plus sirolimus-eluting stent (SES). Rates of myocardial infarction and major adverse cardiac event (MACE) (defined as any death, myocardial infarction or target lesion revascularisation) were compared between patients undergoing single-vessel versus multivessel PCI. A total of 15,147 patients who satisfied the inclusion criteria were included in the e-SELECT registry. Two thousand two hundred and seventy-eight (2,278) subjects (15%) underwent multivessel PCI and 12,869 (85%) had single-vessel PCI. The mean age was higher in the multivessel PCI group (63 vs. 62 years, p<0.001) and there was a higher prevalence of diabetes mellitus (32.4 vs. 30.0%, p=0.02). Lesions were more complex in the single-PCI group while pre- and post-dilatation were less common in the multivessel PCI group. Myocardial infarction within the first 30 days post PCI was more common in the multivessel PCI group (1.9 vs. 0.8%, p<0.001) and most of the infarctions were periprocedural (1.3 vs. 0.6%, p=0.001). Mortality and myocardial infarction at one-year were higher in the multivessel PCI group resulting in a significantly higher MACE (6.1 vs. 4.6%, p=0.005). Conclusions: Overall procedural and one year outcomes were excellent for both single- and multivessel procedures. However despite lower lesion complexity, performing multivessel PCI was associated with higher rates of periprocedural myocardial infarction and MACE when compared to single-vessel PCI in the e-SELECT registry.

Original languageEnglish (US)
Pages (from-to)962-968
Number of pages7
JournalEuroIntervention
Volume7
Issue number8
DOIs
StatePublished - Dec 2011

Keywords

  • Complex lesions
  • Coronary artery disease
  • Drug-eluting stent
  • Sirolimus-eluting stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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