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Outcomes in patients undergoing multivessel percutaneous coronary intervention using sirolimus-eluting stents: a report from the e-SELECT registry

Identifieur interne : 006855 ( Main/Exploration ); précédent : 006854; suivant : 006856

Outcomes in patients undergoing multivessel percutaneous coronary intervention using sirolimus-eluting stents: a report from the e-SELECT registry

Auteurs : Florim Cuculi [Royaume-Uni] ; Adrian P. Banning [Royaume-Uni] ; Alexander Abizaid [Brésil] ; Antonio L. Bartorelli [Italie] ; Ana C. Baux [Belgique] ; Vladimir Dzavik [Canada] ; Stepehen Ellis [États-Unis] ; Runlin Gao [République populaire de Chine] ; David Holmes [États-Unis] ; Myung H. Jeong [Corée du Sud] ; Victor Legrand [Belgique] ; Franz-Josef Neumann [Allemagne] ; Maria Nyakern [Belgique] ; Christian Spaulding [France] ; Hans-Peter Stoll [Belgique] ; Stephen Worthley [Australie] ; Philip Urban [Suisse]

Source :

RBID : Pascal:12-0050786

Descripteurs français

English descriptors

Abstract

Aims: Performing percutaneous coronary intervention (PCI) to multiple coronary lesions during the same procedure has potential economic and social advantages. However comprehensive outcome data of real world practice in a large population is limited. We aimed to compare short- and long-term outcomes between patients with multivessel coronary artery disease who either underwent single- or multivessel PCI within the e-SELECT registry. Methods and results: The e-SELECT registry combines data collected at 320 medical centres in 56 countries where patients received CYPHER Select® or CYPHER Select® Plus sirolimus-eluting stent (SES). Rates of myocardial infarction and major adverse cardiac event (MACE) (defined as any death, myocardial infarction or target lesion revascularisation) were compared between patients undergoing single-vessel versus multivessel PCI. A total of 15,147 patients who satisfied the inclusion criteria were included in the e-SELECT registry. Two thousand two hundred and seventy-eight (2,278) subjects (15%) underwent multivessel PCI and 12,869 (85%) had single-vessel PCI. The mean age was higher in the multivessel PCI group (63 vs. 62 years, p<0.001) and there was a higher prevalence of diabetes mellitus (32.4 vs. 30.0%, p=0.02). Lesions were more complex in the single-PCI group while pre- and post-dilatation were less common in the multivessel PCI group. Myocardial infarction within the first 30 days post PCI was more common in the multivessel PCI group (1.9 vs. 0.8%, p<0.001) and most of the infarctions were periprocedural (1.3 vs. 0.6%, p=0.001). Mortality and myocardial infarction at one-year were higher in the multivessel PCI group resulting in a significantly higher MACE (6.1 vs. 4.6%, p=0.005). Conclusions: Overall procedural and one year outcomes were excellent for both single- and multivessel procedures. However despite lower lesion complexity, performing multivessel PCI was associated with higher rates of periprocedural myocardial infarction and MACE when compared to single-vessel PCI in the e-SELECT registry.


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Le document en format XML

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<name sortKey="Dzavik, Vladimir" sort="Dzavik, Vladimir" uniqKey="Dzavik V" first="Vladimir" last="Dzavik">Vladimir Dzavik</name>
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<name sortKey="Jeong, Myung H" sort="Jeong, Myung H" uniqKey="Jeong M" first="Myung H." last="Jeong">Myung H. Jeong</name>
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<name sortKey="Legrand, Victor" sort="Legrand, Victor" uniqKey="Legrand V" first="Victor" last="Legrand">Victor Legrand</name>
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<name sortKey="Neumann, Franz Josef" sort="Neumann, Franz Josef" uniqKey="Neumann F" first="Franz-Josef" last="Neumann">Franz-Josef Neumann</name>
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<name sortKey="Nyakern, Maria" sort="Nyakern, Maria" uniqKey="Nyakern M" first="Maria" last="Nyakern">Maria Nyakern</name>
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<country>Belgique</country>
<wicri:noRegion>Cordis Clinical Research Europe</wicri:noRegion>
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<name sortKey="Spaulding, Christian" sort="Spaulding, Christian" uniqKey="Spaulding C" first="Christian" last="Spaulding">Christian Spaulding</name>
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<inist:fA14 i1="12">
<s1>Department of Cardiology, Cochin Hospital, Assistance Publique Hôpitaux de Paris and INSERM U 970, Paris Descartes University</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>14 aut.</sZ>
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<country>France</country>
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<region type="region">Île-de-France</region>
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<name sortKey="Stoll, Hans Peter" sort="Stoll, Hans Peter" uniqKey="Stoll H" first="Hans-Peter" last="Stoll">Hans-Peter Stoll</name>
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<name sortKey="Worthley, Stephen" sort="Worthley, Stephen" uniqKey="Worthley S" first="Stephen" last="Worthley">Stephen Worthley</name>
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<s2>Adelaide</s2>
<s3>AUS</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<wicri:noRegion>Cardiovascular investigation unit Royal Adelaide Hospital</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Urban, Philip" sort="Urban, Philip" uniqKey="Urban P" first="Philip" last="Urban">Philip Urban</name>
<affiliation wicri:level="1">
<inist:fA14 i1="14">
<s1>La Tour Hospital</s1>
<s2>Geneva</s2>
<s3>CHE</s3>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>Suisse</country>
<wicri:noRegion>La Tour Hospital</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">EuroIntervention</title>
<title level="j" type="abbreviated">EuroIntervention</title>
<idno type="ISSN">1774-024X</idno>
<imprint>
<date when="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">EuroIntervention</title>
<title level="j" type="abbreviated">EuroIntervention</title>
<idno type="ISSN">1774-024X</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Angioplasty</term>
<term>Antibiotic</term>
<term>Antineoplastic agent</term>
<term>Atherectomy</term>
<term>Complexes</term>
<term>Coronary artery</term>
<term>Coronary heart disease</term>
<term>Drug eluting stent</term>
<term>Human</term>
<term>Immunosuppressive agent</term>
<term>Instrumentation therapy</term>
<term>Lesion</term>
<term>Patient</term>
<term>Percutaneous route</term>
<term>Prognosis</term>
<term>Sirolimus</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Cardiopathie coronaire</term>
<term>Pronostic</term>
<term>Homme</term>
<term>Malade</term>
<term>Angioplastie</term>
<term>Artère coronaire</term>
<term>Athérectomie</term>
<term>Stent à élution médicamenteuse</term>
<term>Voie percutanée</term>
<term>Sirolimus</term>
<term>Immunodépresseur</term>
<term>Complexe</term>
<term>Lésion</term>
<term>Traitement instrumental</term>
<term>Antibiotique</term>
<term>Anticancéreux</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Homme</term>
<term>Antibiotique</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Aims: Performing percutaneous coronary intervention (PCI) to multiple coronary lesions during the same procedure has potential economic and social advantages. However comprehensive outcome data of real world practice in a large population is limited. We aimed to compare short- and long-term outcomes between patients with multivessel coronary artery disease who either underwent single- or multivessel PCI within the e-SELECT registry. Methods and results: The e-SELECT registry combines data collected at 320 medical centres in 56 countries where patients received CYPHER Select® or CYPHER Select® Plus sirolimus-eluting stent (SES). Rates of myocardial infarction and major adverse cardiac event (MACE) (defined as any death, myocardial infarction or target lesion revascularisation) were compared between patients undergoing single-vessel versus multivessel PCI. A total of 15,147 patients who satisfied the inclusion criteria were included in the e-SELECT registry. Two thousand two hundred and seventy-eight (2,278) subjects (15%) underwent multivessel PCI and 12,869 (85%) had single-vessel PCI. The mean age was higher in the multivessel PCI group (63 vs. 62 years, p<0.001) and there was a higher prevalence of diabetes mellitus (32.4 vs. 30.0%, p=0.02). Lesions were more complex in the single-PCI group while pre- and post-dilatation were less common in the multivessel PCI group. Myocardial infarction within the first 30 days post PCI was more common in the multivessel PCI group (1.9 vs. 0.8%, p<0.001) and most of the infarctions were periprocedural (1.3 vs. 0.6%, p=0.001). Mortality and myocardial infarction at one-year were higher in the multivessel PCI group resulting in a significantly higher MACE (6.1 vs. 4.6%, p=0.005). Conclusions: Overall procedural and one year outcomes were excellent for both single- and multivessel procedures. However despite lower lesion complexity, performing multivessel PCI was associated with higher rates of periprocedural myocardial infarction and MACE when compared to single-vessel PCI in the e-SELECT registry.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Australie</li>
<li>Belgique</li>
<li>Brésil</li>
<li>Canada</li>
<li>Corée du Sud</li>
<li>France</li>
<li>Italie</li>
<li>Royaume-Uni</li>
<li>République populaire de Chine</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Lombardie</li>
<li>Oxfordshire</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Milan</li>
<li>Oxford</li>
<li>Paris</li>
<li>Pékin</li>
</settlement>
</list>
<tree>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Cuculi, Florim" sort="Cuculi, Florim" uniqKey="Cuculi F" first="Florim" last="Cuculi">Florim Cuculi</name>
</region>
<name sortKey="Banning, Adrian P" sort="Banning, Adrian P" uniqKey="Banning A" first="Adrian P." last="Banning">Adrian P. Banning</name>
</country>
<country name="Brésil">
<noRegion>
<name sortKey="Abizaid, Alexander" sort="Abizaid, Alexander" uniqKey="Abizaid A" first="Alexander" last="Abizaid">Alexander Abizaid</name>
</noRegion>
</country>
<country name="Italie">
<region name="Lombardie">
<name sortKey="Bartorelli, Antonio L" sort="Bartorelli, Antonio L" uniqKey="Bartorelli A" first="Antonio L." last="Bartorelli">Antonio L. Bartorelli</name>
</region>
</country>
<country name="Belgique">
<noRegion>
<name sortKey="Baux, Ana C" sort="Baux, Ana C" uniqKey="Baux A" first="Ana C." last="Baux">Ana C. Baux</name>
</noRegion>
<name sortKey="Legrand, Victor" sort="Legrand, Victor" uniqKey="Legrand V" first="Victor" last="Legrand">Victor Legrand</name>
<name sortKey="Nyakern, Maria" sort="Nyakern, Maria" uniqKey="Nyakern M" first="Maria" last="Nyakern">Maria Nyakern</name>
<name sortKey="Stoll, Hans Peter" sort="Stoll, Hans Peter" uniqKey="Stoll H" first="Hans-Peter" last="Stoll">Hans-Peter Stoll</name>
</country>
<country name="Canada">
<noRegion>
<name sortKey="Dzavik, Vladimir" sort="Dzavik, Vladimir" uniqKey="Dzavik V" first="Vladimir" last="Dzavik">Vladimir Dzavik</name>
</noRegion>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Ellis, Stepehen" sort="Ellis, Stepehen" uniqKey="Ellis S" first="Stepehen" last="Ellis">Stepehen Ellis</name>
</noRegion>
<name sortKey="Holmes, David" sort="Holmes, David" uniqKey="Holmes D" first="David" last="Holmes">David Holmes</name>
</country>
<country name="République populaire de Chine">
<noRegion>
<name sortKey="Gao, Runlin" sort="Gao, Runlin" uniqKey="Gao R" first="Runlin" last="Gao">Runlin Gao</name>
</noRegion>
</country>
<country name="Corée du Sud">
<noRegion>
<name sortKey="Jeong, Myung H" sort="Jeong, Myung H" uniqKey="Jeong M" first="Myung H." last="Jeong">Myung H. Jeong</name>
</noRegion>
</country>
<country name="Allemagne">
<noRegion>
<name sortKey="Neumann, Franz Josef" sort="Neumann, Franz Josef" uniqKey="Neumann F" first="Franz-Josef" last="Neumann">Franz-Josef Neumann</name>
</noRegion>
</country>
<country name="France">
<region name="Île-de-France">
<name sortKey="Spaulding, Christian" sort="Spaulding, Christian" uniqKey="Spaulding C" first="Christian" last="Spaulding">Christian Spaulding</name>
</region>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Worthley, Stephen" sort="Worthley, Stephen" uniqKey="Worthley S" first="Stephen" last="Worthley">Stephen Worthley</name>
</noRegion>
</country>
<country name="Suisse">
<noRegion>
<name sortKey="Urban, Philip" sort="Urban, Philip" uniqKey="Urban P" first="Philip" last="Urban">Philip Urban</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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