Author + information
- Received April 23, 2009
- Revision received July 14, 2009
- Accepted September 4, 2009
- Published online December 1, 2009.
- Francesco De Felice, MD⁎ (, )
- Rosario Fiorilli, MD,
- Antonio Parma, MD,
- Marco Nazzaro, MD,
- Carmine Musto, MD,
- Fernando Sbraga, MD,
- Giorgia Caferri, MD and
- Roberto Violini, MD
- ↵⁎Reprint requests and correspondence:
Dr. Francesco De Felice, UO Cardiologia Interventistica, Azienda Ospedaliera S. Camillo Forlanini, C.ne Gianicolense n 87, 00152 Rome, Italy
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.
- Received April 23, 2009.
- Revision received July 14, 2009.
- Accepted September 4, 2009.
- American College of Cardiology Foundation