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Complete versus incomplete revascularization in patients with multivessel disease undergoing percutaneous coronary intervention with drug-eluting stents.
Catheter Cardiovasc Interv. 2008 Oct 01; 72(4):448-56.CC

Abstract

OBJECTIVES

To investigate the long-term prognostic implications of complete versus incomplete revascularization in multivessel coronary artery disease (MVD) patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES).

BACKGROUND

Coronary artery bypass grafting (CABG) in patients with MVD provides better outcomes when complete revascularization is achieved. There is a paucity of data on the outcomes of complete versus incomplete revascularization of MVD patients undergoing PCI, and currently there is no data available with DES.

METHODS

Patients with MVD undergoing PCI with DES (sirolimus- or paclitaxel-eluting stent) were included. Comparisons of long-term outcomes between completely versus incompletely revascularized patients were made. The primary outcome measure was the composite of cardiac death, nonfatal myocardial infarction (MI), or any revascularization. Secondary endpoints were the components of the composite endpoint.

RESULTS

A total of 508 patients were considered for this analysis: 212 (41.7%) and 296 (58.3%) had complete and incomplete revascularization, respectively. The median follow-up was 27.0 (interquartile range: 23.0-37.1) months. After adjusting for baseline characteristics, the hazard ratio (HR, 95% confidence interval) for complete revascularization was 0.43 (0.29-0.63, P < 0.0001) for the primary composite endpoint. Complete revascularization was associated with better outcomes for components of the composite endpoint: 0.37 (0.15-0.92, P = 0.03) for cardiac death, 0.34 (0.16-0.75 P = 0.008) for the composite of cardiac death or MI and 0.45 (0.29-0.69, P = 0.0003) for any repeat revascularization. This association was confirmed in a propensity-matched population.

CONCLUSIONS

Complete revascularization with DES of MVD patients is associated with lower rates of long-term adverse events.

Authors+Show Affiliations

Division of Cardiology, University of Catania, Catania, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18814218

Citation

Tamburino, Corrado, et al. "Complete Versus Incomplete Revascularization in Patients With Multivessel Disease Undergoing Percutaneous Coronary Intervention With Drug-eluting Stents." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 72, no. 4, 2008, pp. 448-56.
Tamburino C, Angiolillo DJ, Capranzano P, et al. Complete versus incomplete revascularization in patients with multivessel disease undergoing percutaneous coronary intervention with drug-eluting stents. Catheter Cardiovasc Interv. 2008;72(4):448-56.
Tamburino, C., Angiolillo, D. J., Capranzano, P., Dimopoulos, K., La Manna, A., Barbagallo, R., Tagliareni, F., Mangiafico, S., Guzman, L. A., Galassi, A. R., & Bass, T. A. (2008). Complete versus incomplete revascularization in patients with multivessel disease undergoing percutaneous coronary intervention with drug-eluting stents. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 72(4), 448-56. https://doi.org/10.1002/ccd.21666
Tamburino C, et al. Complete Versus Incomplete Revascularization in Patients With Multivessel Disease Undergoing Percutaneous Coronary Intervention With Drug-eluting Stents. Catheter Cardiovasc Interv. 2008 Oct 1;72(4):448-56. PubMed PMID: 18814218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complete versus incomplete revascularization in patients with multivessel disease undergoing percutaneous coronary intervention with drug-eluting stents. AU - Tamburino,Corrado, AU - Angiolillo,Dominick J, AU - Capranzano,Piera, AU - Dimopoulos,Konstantinos, AU - La Manna,Alessio, AU - Barbagallo,Rossella, AU - Tagliareni,Francesco, AU - Mangiafico,Sarah, AU - Guzman,Luis A, AU - Galassi,Alfredo R, AU - Bass,Theodore A, PY - 2008/9/25/pubmed PY - 2008/12/24/medline PY - 2008/9/25/entrez SP - 448 EP - 56 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 72 IS - 4 N2 - OBJECTIVES: To investigate the long-term prognostic implications of complete versus incomplete revascularization in multivessel coronary artery disease (MVD) patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES). BACKGROUND: Coronary artery bypass grafting (CABG) in patients with MVD provides better outcomes when complete revascularization is achieved. There is a paucity of data on the outcomes of complete versus incomplete revascularization of MVD patients undergoing PCI, and currently there is no data available with DES. METHODS: Patients with MVD undergoing PCI with DES (sirolimus- or paclitaxel-eluting stent) were included. Comparisons of long-term outcomes between completely versus incompletely revascularized patients were made. The primary outcome measure was the composite of cardiac death, nonfatal myocardial infarction (MI), or any revascularization. Secondary endpoints were the components of the composite endpoint. RESULTS: A total of 508 patients were considered for this analysis: 212 (41.7%) and 296 (58.3%) had complete and incomplete revascularization, respectively. The median follow-up was 27.0 (interquartile range: 23.0-37.1) months. After adjusting for baseline characteristics, the hazard ratio (HR, 95% confidence interval) for complete revascularization was 0.43 (0.29-0.63, P < 0.0001) for the primary composite endpoint. Complete revascularization was associated with better outcomes for components of the composite endpoint: 0.37 (0.15-0.92, P = 0.03) for cardiac death, 0.34 (0.16-0.75 P = 0.008) for the composite of cardiac death or MI and 0.45 (0.29-0.69, P = 0.0003) for any repeat revascularization. This association was confirmed in a propensity-matched population. CONCLUSIONS: Complete revascularization with DES of MVD patients is associated with lower rates of long-term adverse events. SN - 1522-726X UR - https://www.unboundmedicine.com/medline/citation/18814218/Complete_versus_incomplete_revascularization_in_patients_with_multivessel_disease_undergoing_percutaneous_coronary_intervention_with_drug_eluting_stents_ L2 - https://doi.org/10.1002/ccd.21666 DB - PRIME DP - Unbound Medicine ER -