EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2013
Impact of ad hoc percutaneous coronary intervention with drug-eluting stents in angina patients.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Kim Young-Hak, Park Duk-Woo, Ahn Jung-Min, Park Gyung-Min, Cho Yong-Rak, Lee Jong-Young, Kim Won-Jang, Yun Sung-Cheol, Kang Soo-Jin, Lee Seung-Whan, Lee Cheol Whan, Park Seong-Wook, Park Seung-Jung, IRIS-DES registry
Аннотация
AIMS: To evaluate the impact of ad hoc percutaneous coronary intervention (PCI) which combines coronary angioplasty and PCI in the same procedure in the era of drug-eluting stents (DES).
METHODS AND RESULTS: From the IRIS-DES registry, 4,738 angina patients treated using PCI with DES were enrolled. The 18-month outcomes were compared between ad hoc and non-ad hoc groups after adjustment using inverse-probability-of-treatment weighting. Ad hoc PCI was performed in 3,562 (75.2%) patients. The ad hoc PCI group had less extensive coronary disease and received fewer stents. The incidence of major adverse cardiac or cerebrovascular events, consisting of death, myocardial infarction (MI), stroke, and repeat revascularisation, did not differ between the ad hoc and the non-ad hoc groups (8.3% vs. 7.6%; adjusted hazard ratio [aHR] of ad hoc PCI, 1.22; 95% confidence interval [CI]: 0.91 to 1.63; p=0.18). The individual endpoints of death (2.0% vs. 1.9%; aHR, 1.57; 95% CI: 0.86- 2.88; p=0.14), MI (0.8% vs. 1.0%; aHR, 0.62; 95% CI: 0.29 - 1.33; p=0.22), stroke (1.0% vs. 0.9%; aHR, 1.25; 95% CI: 0.58-2.69; p=0.57), and repeat revascularisation (4.4% vs. 4.0%; aHR, 1.23; 95% CI: 0.86-1.77; p=0.25) also did not differ between the groups.
CONCLUSIONS: Ad hoc PCI using DES appears to be feasible for angina patients at a relatively low risk of procedure. This approach may reasonably be performed with evaluation of objective ischaemia using non-invasive or invasive tests.
METHODS AND RESULTS: From the IRIS-DES registry, 4,738 angina patients treated using PCI with DES were enrolled. The 18-month outcomes were compared between ad hoc and non-ad hoc groups after adjustment using inverse-probability-of-treatment weighting. Ad hoc PCI was performed in 3,562 (75.2%) patients. The ad hoc PCI group had less extensive coronary disease and received fewer stents. The incidence of major adverse cardiac or cerebrovascular events, consisting of death, myocardial infarction (MI), stroke, and repeat revascularisation, did not differ between the ad hoc and the non-ad hoc groups (8.3% vs. 7.6%; adjusted hazard ratio [aHR] of ad hoc PCI, 1.22; 95% confidence interval [CI]: 0.91 to 1.63; p=0.18). The individual endpoints of death (2.0% vs. 1.9%; aHR, 1.57; 95% CI: 0.86- 2.88; p=0.14), MI (0.8% vs. 1.0%; aHR, 0.62; 95% CI: 0.29 - 1.33; p=0.22), stroke (1.0% vs. 0.9%; aHR, 1.25; 95% CI: 0.58-2.69; p=0.57), and repeat revascularisation (4.4% vs. 4.0%; aHR, 1.23; 95% CI: 0.86-1.77; p=0.25) also did not differ between the groups.
CONCLUSIONS: Ad hoc PCI using DES appears to be feasible for angina patients at a relatively low risk of procedure. This approach may reasonably be performed with evaluation of objective ischaemia using non-invasive or invasive tests.
Предметные рубрики MeSH
AgedAngina PectorisChi-Square DistributionCoronary Artery DiseaseDrug-Eluting StentsFeasibility StudiesFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionPercutaneous Coronary InterventionProportional Hazards ModelsProsthesis DesignRegistriesRepublic of KoreaRetrospective StudiesRisk FactorsStrokeTime FactorsTreatment Outcome