This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by De Felice, F. Articles by Violini, R. Search for Related Content PubMed Articles by De Felice, F. Articles by Violini, R. Related Collections Related Article

3-Year Clinical Outcome of Patients With Chronic Total Occlusion Treated With Drug-Eluting Stents

UO Cardiologia Interventistica Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy

^_* Reprint requests and correspondence: Dr. Francesco De Felice, UO Cardiologia Interventistica, Azienda Ospedaliera S. Camillo Forlanini, C.ne Gianicolense n 87, 00152 Rome, Italy (Email: f.defelice{at}lycos.com).

Objectives: The aim of this study was to evaluate whether percutaneous coronary intervention (PCI) with drug-eluting stent (DES) reduces major adverse cardiac events (MACE) in patients with chronic coronary total occlusions (CTO) compared with bare-metal stent (BMS) during 3-year follow-up.

Background: The long-term prognosis of patients with CTO treated with PCI and DES implantation is poorly investigated.

Methods: We compared the 3-year clinical outcome of 124 patients with CTO after successful PCI with DES implantation with that of 159 patients with CTO previously treated with BMS. MACE were defined as death, myocardial infarction, and target lesion revascularization (repeat PCI or coronary artery bypass surgery) and were considered as combined primary end point.

Results: After 3 years, the composite end point was significantly lower in the DES than in the BMS group: 18% versus 28%, respectively, (p < 0.05). The difference was due to the reduction of target lesion revascularization with DES compared with BMS—8% versus 21%, respectively, (p < 0.004). The Cox proportional hazards model identified: DES versus BMS (adjusted hazard ratio [HR]: 0.338, 95% confidence interval [CI]: 0.19 to 0.60, p = 0.0001), lesion length (HR: 1.033, 95% CI: 1.008 to 1.058, p = 0.012), and final minimal lumen diameter (HR: 0.456, 95% CI: 0.232 to 0.898, p = 0.023) as independent predictors of MACE at 3-year follow-up.

Conclusions: After 3 years, DES were superior to BMS in reducing MACE in patients with CTO and should be considered the preferred treatment strategy.

Key Words: bare-metal stent • chronic total occlusion • drug-eluting stent

Abbreviations and Acronyms   BMS = bare-metal stent(s)   CTO = chronic coronary total occlusion(s)   DES = drug-eluting stent(s)   MACE = major adverse cardiac events   PCI = percutaneous coronary intervention   PES = paclitaxel-eluting stent(s)   SES = sirolimus-eluting stent(s)   TIMI = Thrombolysis In Myocardial Infarction   TLR = target lesion revascularization   TVR = target vessel revascularization

Related Article

Gone But Not Forgotten: The Case for Drug-Eluting Stents in Percutaneous Revascularization of the Chronic Coronary Total Occlusion

James E. Tcheng and David A. Zidar
J. Am. Coll. Cardiol. Intv. 2009 2: 1266-1268. [Full Text] [PDF]

This article has been cited by other articles:

				J. E. Tcheng and D. A. Zidar Gone But Not Forgotten: The Case for Drug-Eluting Stents in Percutaneous Revascularization of the Chronic Coronary Total Occlusion J. Am. Coll. Cardiol. Intv., December 1, 2009; 2(12): 1266 - 1268. [Full Text] [PDF]