TY - JOUR
T1 - Outcomes in patients undergoing multivessel percutaneous coronary intervention using sirolimus-eluting stents
T2 - A report from the e-SELECT registry
AU - Cuculi, Florim
AU - Banning, Adrian P.
AU - Abizaid, Alexander
AU - Bartorelli, Antonio L.
AU - Baux, Ana C.
AU - Džavík, Vladimir
AU - Ellis, Stepehen
AU - Gao, Runlin
AU - Holmes, David
AU - Jeong, Myung H.
AU - Legrand, Victor
AU - Neumann, Franz Josef
AU - Nyakern, Maria
AU - Spaulding, Christian
AU - Stoll, Hans Peter
AU - Worthley, Stephen
AU - Urban, Philip
AU - Barbato, Emanuele
AU - Chieffo, Alaide
AU - Naber, Christoph
AU - Jensen, Lisette Okkels
AU - Sano, Koichi
AU - Srinivas, Vankeepvram
PY - 2011/12
Y1 - 2011/12
N2 - 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.
AB - 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.
KW - Complex lesions
KW - Coronary artery disease
KW - Drug-eluting stent
KW - Sirolimus-eluting stent
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UR - http://www.scopus.com/inward/citedby.url?scp=84855364855&partnerID=8YFLogxK
U2 - 10.4244/EIJV7I8A152
DO - 10.4244/EIJV7I8A152
M3 - Article
C2 - 22157482
AN - SCOPUS:84855364855
SN - 1774-024X
VL - 7
SP - 962
EP - 968
JO - EuroIntervention
JF - EuroIntervention
IS - 8
ER -