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Self‐expandable sirolimus‐eluting stents compared to second‐generation drug‐eluting stents for the treatment of the left main: A propensity score analysis from the SPARTA and the FAILS‐2 registries
Author(s) -
Montefusco Antonio,
D'Ascenzo Fabrizio,
Gili Sebastiano,
Smolka Grzegorz,
Chieffo Alaide,
Baumbach Andreas,
Escaned Javier,
Sganzerla Paolo,
Tomassini Francesco,
Secco Gioel Gabrio,
Ugo Fabrizio,
Tamburino Corrado,
Nicolino Annamaria,
Mancone Massimo,
Poli Arnaldo,
Yew KuanLeong,
Cirillo Plinio,
Wanha Wojciech,
Pastormerlo Luigi Emilio,
di Summa Roberto,
Sardella Gennaro,
Colombo Antonio,
Gaita Fiorenzo,
Cortese Bernardo
Publication year - 2019
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.27809
Subject(s) - medicine , mace , propensity score matching , myocardial infarction , cardiology , stent , unstable angina , drug eluting stent , restenosis , sirolimus , surgery , percutaneous coronary intervention
Objectives To compare the effectiveness and safety of self‐expandable, sirolimus‐eluting Stentys stents (SES) and second‐generation drug‐eluting stents (DES‐II) for the treatment of the unprotected left main (ULM). Background SES may provide a valuable option to treat distal ULM, particularly when significant caliber gaps with side branches are observed. Methods Patients from the multicenter SPARTA ( clinicaltrials.gov : NCT02784405) and FAILS2 registries were included. Propensity‐score with matching was performed to account for the lack of randomization. Primary end‐point was the rate of major adverse cardiovascular events (MACE, a composite of all cause death, myocardial infarction, target lesion revascularization [TLR], unstable angina and definite stent thrombosis [ST]). Single components of MACE were the secondary end‐points. Results Overall, 151 patients treated with SES and 1270 with DES‐II were included; no differences in MACE rate at 250 days were observed (9.8% vs. 11.5%, P = 0.54). After propensity score with matching, 129 patients treated with SES and 258 with DES‐II, of which about a third of female gender, were compared. After a follow‐up of 250 days, MACE rate did not differ between the two groups (9.9% vs. 8.5%, P = 0.66), as well as the rate of ULM TLR (1.6% vs. 3.1%, P = 0.36) and definite ST (0.8% vs. 1.2%, P = 0.78). These results were consistent also when controlling for the treatment with provisional vs. 2‐stents strategies for the ULM bifurcation. Conclusion SES use for ULM treatment was associated with a similar MACE rate compared to DES‐II at an intermediate‐term follow‐up. SES might represent a potential option in this setting.