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

科学研究

Screening for Atrial Fibrillation With Electrocardiography US Preventive Services Task Force Recommendation Statement Optimal medical therapy improves clinical outcomes in patients undergoing revascularization with percutaneous coronary intervention or coronary artery bypass grafting: insights from the Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) trial at the 5-year follow-up Changes in high-sensitivity troponin after drug-coated balloon angioplasty for drug-eluting stent restenosis Healthy Behavior, Risk Factor Control, and Survival in the COURAGE Trial Alirocumab Reduces Total Nonfatal Cardiovascular and Fatal Events in the ODYSSEY OUTCOMES Trial Effects of Liraglutide on Cardiovascular Outcomes in Patients With Diabetes With or Without Heart Failure Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials Transverse partial stent ablation with rotational atherectomy for suboptimal culotte technique in left main stem bifurcation Effect of Side Branch Predilation in Coronary Bifurcation Stenting With the Provisional Approach - Results From the COBIS (Coronary Bifurcation Stenting) II Registry Positive remodelling of coronary arteries on computed tomography coronary angiogram: an observational study

Sort by hits |<<... 64 65 66 67 68 69 70 ...>>|

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