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Second generation drug‐eluting stents versus bare‐metal stents for percutaneous coronary intervention of the proximal left anterior descending artery: An analysis of the BASKET‐PROVE I and II trials
Author(s) -
Mangione Fernanda Marinho,
BieringSørensen Tor,
Nochioka Kotaro,
Jatene Tannas,
Silvestre Odilson Marcos,
Hansen Kim Wadt,
Sørensen Rikke,
Jensen Jan Skov,
Jorgensen Peter Godsk,
Jeger Raban,
Kaiser Christoph,
Pfisterer Matthias,
Galatius Søren
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27200
Subject(s) - medicine , conventional pci , mace , percutaneous coronary intervention , cardiology , myocardial infarction , stent , drug eluting stent , stenosis , bare metal stent , revascularization
Objectives To compare mid‐term outcomes between patients undergoing proximal left anterior descending artery (LAD) percutaneous coronary intervention (PCI) with second generation drug‐eluting stent (DES) or bare‐metal stent (BMS). Background PCI with BMS and first‐generation DES have shown to be safe options for the treatment of proximal LAD stenosis, however associated with considerable reintervention rates. Overall, second‐generation DES has proven to be superior to BMS and first‐generation DES, nevertheless, its effect for proximal LAD PCI has not previously been reported. Methods We analyzed 2‐year outcomes of 1,100 patients from the BASKET‐PROVE I and II trials, referred for proximal LAD PCI with second generation DES ( n = 680) or BMS ( n = 420). Results The cumulative 2‐year incidence of major adverse cardiac events (MACE, composite of cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR)) was lower in second generation DES than in BMS treated patients (7.3% vs. 12.3%; HR 0.57, 95% CI 0.39/0.85), mainly driven by a reduced rate of TVR (3.7% vs. 10.0%; HR 0.35, CI 0.21/0.58). No difference was found in cardiac death (1.9% vs. 1.9%; HR 1.01, CI 0.42/2.44) and MI (4.4% vs. 4.7%; HR 0.93, CI 0.53/1.64). The benefit of DES use seemed to be more prominent in female patients with a reduction in MACE ( P for interaction = 0.025). Conclusions In patients with proximal LAD stenosis, treatment with second‐generation DES was associated with reduced 2‐year rates of adverse cardiac events and TVR compared to BMS, with reintervention rates similar to those earlier reported from bypass surgery.