CBS - The 17th Left Main & Coronary Bifurcation Summit, CBS2025

科学研究

Randomized study of doxorubicin-based chemotherapy regimens, with and without sildenafil, with analysis of intermediate cardiac markers Impact of Transcatheter Mitral Valve Repair on Preprocedural and Postprocedural Hospitalization Rates Drug-Drug Interactions of Common Cardiac Medications and Chemotherapeutic Agents The Art of SAPIEN 3 Transcatheter Mitral Valve Replacement in Valve-in-Ring and Valve-in-Mitral-Annular-Calcification Procedures Short-Term Oral Anticoagulation Versus Antiplatelet Therapy Following Transcatheter Left Atrial Appendage Closure Endoplasmic reticulum stress in doxorubicin-induced cardiotoxicity may be therapeutically targeted by natural and chemical compounds: A review Risk of Cardiovascular Diseases Among Older Breast Cancer Survivors in the United States: A Matched Cohort Study High Coronary Shear Stress in Patients With Coronary Artery Disease Predicts Myocardial Infarction Treatment Effects of Pulmonary Artery Denervation for Pulmonary Arterial Hypertension Stratified by REVEAL Risk Score: Results from PADN-CFDA Trial Does pulsed field ablation regress over time? A quantitative temporal analysis of pulmonary vein isolation

Sort by hits |<<... 167 168 169 170 171 172 173 ...>>|

Original ResearchVolume 13, Issue 12, June 2020

JOURNAL：JACC: Cardiovascular Interventions Article Link

Coronary Calcification and Long-Term Outcomes According to Drug-Eluting Stent Generation

P Guedeney, BE Claessen, GW Stone et al. Keywords: 2nd generation DES vs. 1st generation DES; moderate or severe calcification lesions; 5-year outcome

ABSTRACT

OBJECTIVES - The aim of this study was to evaluate the long-term impact of coronary artery calcification (CAC) on outcomes after percutaneous coronary intervention and the respective performance of first- and second-generation drug-eluting stents (DES).

BACKGROUND - Whether contemporary DES have improved the long-term prognosis after percutaneous coronary intervention in lesions with severe CAC is unknown.

METHODS - Individual patient data were pooled from 18 randomized trials evaluating DES, categorized according to the presence of angiography core laboratory–confirmed moderate or severe CAC. Major endpoints were the patient-oriented composite endpoint (death, myocardial infarction [MI], or any revascularization) and the device-oriented composite endpoint of target lesion failure (cardiac death, target vessel MI, or ischemia-driven target lesion revascularization). Multivariate Cox proportional regression with study as a random effect was used to assess 5-year outcomes.

RESULTS - A total of 19,833 patients were included. Moderate or severe CAC was present in 1 or more target lesions in 6,211 patients (31.3%) and was associated with increased 5-year risk for the patient-oriented composite endpoint (adjusted hazard ratio [adjHR]: 1.12; 95% confidence interval [CI]: 1.05 to 1.20) and target lesion failure (adjHR: 1.21; 95% CI: 1.09 to 1.34), as well as death, MI, and ischemia-driven target lesion revascularization. In patients with CAC, use of second-generation DES compared with first-generation DES was associated with reductions in the 5-year risk for the patient-oriented composite endpoint (adjHR: 0.88; 95% CI: 0.78 to 1.00) and target lesion failure (adjHR: 0.73; 95% CI: 0.61 to 0.87), as well as death or MI, ischemia-driven target lesion revascularization, and stent thrombosis. The relative treatment effects of second-generation compared with first-generation DES were consistent in patients with and without moderate or severe CAC, although outcomes were consistently better with contemporary devices.

CONCLUSIONS - In this large-scale study, percutaneous coronary intervention of target lesion moderate or severe CAC was associated with adverse patient-oriented and device-oriented adverse outcomes at 5 years. These detrimental effects were mitigated with second-generation DES.

科研文章

荐读文献

Coronary Calcification and Long-Term Outcomes According to Drug-Eluting Stent Generation

ABSTRACT