Background: Limited data are available on the long-term outcomes of drug-eluting stents (DES) vs bare-metal stents (BMS) in patients with left main coronary artery (LMCA) disease.
Methods: In this observational cohort of the Revascularization for Unprotected Left Coronary Artery Stenosis: parison of ercutaneous Coronary ngioplasty vs Surgical vascularization (MAIN-COMPARE) registry, we evaluated patients with unprotected LMCA stenosis who received DES or BMS between January 2000 and June 2006. The primary outcome was a composite of all-cause death or myocardial infarction (MI) at 10 years. Adjusted outcomes were compared using propensity scores and inverse probability of treatment weighting.
Results: A total of 1102 patients underwent DES (n = 784) or BMS (n = 318) during the study period. At 10 years, the adjusted rate of the primary outcome was significantly lower in DES group than in the BMS group (27.9% vs 37.0%; hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.53-0.94; = 0.02). The adjusted 10-year mortality rate was significantly lower in DES group than in the BMS group (20.6% vs 29.6%; HR, 0.65; 95% CI, 0.46-0.91; = 0.01), whereas the 10-year rate of MI was similar between the 2 groups (9.9% vs 11.0%; HR, 0.93; 95% CI, 0.54-1.59; = 0.78). DES use was associated with a significant reduction in the rate of target-lesion revascularization (10.2% vs 21.8%; HR, 0.41; 95% CI, 0.27-0.61; < 0.001).
Conclusions: In this 10-year follow-up study in patients with LMCA disease, DES use was associated with a significant reduction in the rate of the composite of death or MI, mortality, and target-lesion revascularization, when compared with BMS.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636232 | PMC |
| http://dx.doi.org/10.1016/j.cjco.2021.05.009 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Functional Mechanical Behavior and Biocompatible Characteristics of Graphene-Coated Cardiovascular Stents.
Int J Mol Sci
December 2024
Pre-Clinical Research Centre, Wrocław Medical University, Marcinkowskiego 1, 50-368 Wrocław, Poland.
Percutaneous Coronary Intervention (PCI) is a treatment method that involves reopening narrowed arteries with a balloon catheter that delivers a cylindrical, mesh-shaped implant device to the site of the stenosis. Currently, by applying a coating to a bare metal stent (BMS) surface to improve biocompatibility, the main risks after PCI, such as restenosis and thrombosis, are reduced while maintaining the basic requirements for the mechanical behavior of the stent itself. In this work, for the first time, the development and optimization process of the spatial structure of the Co-Cr stent (L-605) with a graphene-based coating using cold-wall chemical vapor deposition (CW-CVD) to ensure uniform coverage of the implant was attempted.
View Article and Find Full Text PDFOutcomes of patients with acute complicated type B aortic dissections repaired with the Zenith dissection endovascular system compared to aortic stent graft.
Vascular
January 2025
Department of Surgery, Division of Vascular and Endovascular Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Article Synopsis
- The study evaluates the safety and effectiveness of the Zenith Dissection Endovascular System (ZDES) against traditional stent grafts for repairing acute complicated Type B Aortic Dissection (AcTBAD).
- A retrospective analysis of 32 patients revealed that the ZDES group experienced fewer postoperative adverse events (12 vs. 37), demonstrating better outcomes in false lumen thrombosis at 6 months and lower 3-year mortality rates.
- Despite some patients needing secondary interventions in the ZDES cohort due to aortic growth, overall results suggest the ZDES may offer improved safety and efficacy compared to traditional methods.
Baicalin-based composite coating for achieving biological multifunctionality of vascular stents.
J Control Release
January 2025
Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu 610031, PR China. Electronic address:
Article Synopsis
- Vascular stents are crucial for treating atherosclerosis and have reduced mortality through bare metal and drug-eluting options, but concerns like restenosis and thrombus formation persist.
- Hyaluronic acid (HA) is often used to modify stent surfaces, but its effectiveness is limited due to degradation by reactive oxygen species (ROS) and enzymes, which can provoke inflammation and affect stent performance.
- The study introduces a new coating using baicalin (BCL) to protect HA from degradation, offering enhanced endothelial cell support and greater stability, positioning this method as a promising advancement in stent technology.
Endothelialization of coronary stents after intra-luminal adenoviral VEGF-A gene transfer in a preclinical porcine restenosis model - Studies with optical coherence tomography, angioscopy, multiphoton and scanning electron microscopy.
J Mol Cell Cardiol
December 2024
A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland; Heart Centre and Gene Therapy Unit, Kuopio University Hospital, Kuopio, Finland. Electronic address:
Background: Coronary stenting operations have become the main option for the treatment of coronary heart disease. Vessel recovery after stenting has emerged as a critical factor in reducing possible complications. In this study, we evaluated the feasibility, safety and efficacy of locally administered intraluminal gene therapy delivered using a specialized infusion balloon catheter.
View Article and Find Full Text PDFRisk Factors and Incidence for In-Stent Restenosis with Drug-Eluting Stent: A Systematic Review and Meta-Analysis.
Rev Cardiovasc Med
December 2024
Department of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700 Beijing, China.
Background: Despite significant reductions in in-stent restenosis (ISR) incidence with the adoption of drug-eluting stents (DES) over bare metal stents (BMS), ISR remains an unresolved issue in the DES era. The risk factors associated with DES-ISR have not been thoroughly analyzed. This meta-analysis aims to identify the key factors and quantify their impact on DES-ISR.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!