Demosthenes G Katritsis1, Socrates Korovesis, Efthalia Tzanalaridou, Eleftherios Giazitzoglou, Theodoros Zografos, Bernhard Meier.
Abstract
BACKGROUND: Preliminary results of a randomized trial have suggested that total lesion coverage with drug-eluting stents (DES) is not necessary in the presence of diffuse disease of nonuniform severity. In the present study, we report long-term results of this trial.
METHODS: Consecutive, consenting patients with a long (>20 mm) coronary lesion of nonuniform severity and indication for percutaneous coronary intervention were randomized to full stent coverage of the atherosclerotic lesion with multiple, overlapping (full DES group, n = 90) or spot stenting of the hemodynamically significant parts of the lesion only (defined as diameter stenosis > 50%) (spot DES group, n = 89).
RESULTS: At a follow-up of 2-7 years, 30 patients with full DES (33.3%) and 12 patients (13.5%) with spot DES had a major adverse cardiac event (MACE) (P = 0.015). Cox proportional hazard model showed that the risk for MACE was almost 65% lower among patients who were subjected to spot DES compared to those who underwent full DES (HR = 0.35, 95% CI = 0.18-0.68, P = 0.002). This association remained significant even after controlling for age, sex, and lesion length, and the type of stent used (HR = 0.41, 95% CI = 0.20-0.81, P = 0.011).
CONCLUSIONS: In the presence of diffuse disease of nonuniform severity, selective stenting of only the significantly stenosed parts of the lesion confers better long-term results compared to total lesion coverage with DES. ©2011, Wiley Periodicals, Inc.
RCT Entities:
BACKGROUND: Preliminary results of a randomized trial have suggested that total lesion coverage with drug-eluting stents (DES) is not necessary in the presence of diffuse disease of nonuniform severity. In the present study, we report long-term results of this trial.
METHODS: Consecutive, consenting patients with a long (>20 mm) coronary lesion of nonuniform severity and indication for percutaneous coronary intervention were randomized to full stent coverage of the atherosclerotic lesion with multiple, overlapping (full DES group, n = 90) or spot stenting of the hemodynamically significant parts of the lesion only (defined as diameter stenosis > 50%) (spot DES group, n = 89).
RESULTS: At a follow-up of 2-7 years, 30 patients with full DES (33.3%) and 12 patients (13.5%) with spot DES had a major adverse cardiac event (MACE) (P = 0.015). Cox proportional hazard model showed that the risk for MACE was almost 65% lower among patients who were subjected to spot DES compared to those who underwent full DES (HR = 0.35, 95% CI = 0.18-0.68, P = 0.002). This association remained significant even after controlling for age, sex, and lesion length, and the type of stent used (HR = 0.41, 95% CI = 0.20-0.81, P = 0.011).
CONCLUSIONS: In the presence of diffuse disease of nonuniform severity, selective stenting of only the significantly stenosed parts of the lesion confers better long-term results compared to total lesion coverage with DES. ©2011, Wiley Periodicals, Inc.
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Year: 2011
PMID： 22004601 DOI： 10.1111/j.1540-8183.2011.00662.x
Source DB: PubMed Journal: J Interv Cardiol ISSN： 0896-4327 Impact factor: 2.279