Ten-year clinical outcome of patients treated with a drugeluting stent in the proximal left anterior descending artery segment compared with patients stented in other non-left main coronary segments

TY - JOUR

T1 - Ten-year clinical outcome of patients treated with a drugeluting stent in the proximal left anterior descending artery segment compared with patients stented in other non-left main coronary segments

AU - Kjøller-Hansen, Lars

AU - Bligaard, Niels

AU - Kelbæk, Henning

AU - Christiansen, Evald H.

AU - Thuesen, Leif

AU - Hansen, Peter R.

AU - Engstrøm, Thomas

AU - Junker, Anders

AU - Abildgaard, Ulrik

AU - Lassen, Jens F.

AU - Jensen, Jan S.

AU - Jeppesen, Jørgen L.

AU - Galløe, Anders M.

PY - 2018

Y1 - 2018

N2 - Aims: The aim of the study was to determine whether patients treated with drug-eluting stents in the proximal left anterior descending artery (LAD) carried a different long-term prognosis from patients treated in other coronary artery segments. Methods and results: Ten-year clinical outcome expressed as all-cause mortality and major adverse cardiac events (MACE: Cardiac death, acute myocardial infarction, or target vessel revascularisation) was determined for 1,479 patients with a single non-left main coronary stenosis treated with a first-generation drug-eluting stent in the SORT OUT II trial. The outcome of patients treated with stents in the proximal LAD (n=365) was compared with that of patients treated in a non-proximal LAD segment (n=1,114). Follow-up was 99.3% complete. All-cause mortality was 24.9% in the proximal LAD group vs. 26.3% in the non-proximal LAD group (p=0.60). MACE occurred less frequently in the proximal LAD group, 24.6% vs. 31.0% with a hazard ratio of 0.77 (95% confidence interval [CI]: 0.61-0.97, p=0.024). After multivariate analysis which included baseline characteristics that were unevenly distributed between the groups, the hazard ratio for MACE was 0.82 (95% CI: 0.65-1.03, p=0.09). Conclusions: Patients treated with a drug-eluting stent in the proximal LAD have similar, if not better, long-term clinical outcome compared with patients stented in other coronary artery segments.

AB - Aims: The aim of the study was to determine whether patients treated with drug-eluting stents in the proximal left anterior descending artery (LAD) carried a different long-term prognosis from patients treated in other coronary artery segments. Methods and results: Ten-year clinical outcome expressed as all-cause mortality and major adverse cardiac events (MACE: Cardiac death, acute myocardial infarction, or target vessel revascularisation) was determined for 1,479 patients with a single non-left main coronary stenosis treated with a first-generation drug-eluting stent in the SORT OUT II trial. The outcome of patients treated with stents in the proximal LAD (n=365) was compared with that of patients treated in a non-proximal LAD segment (n=1,114). Follow-up was 99.3% complete. All-cause mortality was 24.9% in the proximal LAD group vs. 26.3% in the non-proximal LAD group (p=0.60). MACE occurred less frequently in the proximal LAD group, 24.6% vs. 31.0% with a hazard ratio of 0.77 (95% confidence interval [CI]: 0.61-0.97, p=0.024). After multivariate analysis which included baseline characteristics that were unevenly distributed between the groups, the hazard ratio for MACE was 0.82 (95% CI: 0.65-1.03, p=0.09). Conclusions: Patients treated with a drug-eluting stent in the proximal LAD have similar, if not better, long-term clinical outcome compared with patients stented in other coronary artery segments.

KW - Clinical trials

KW - Drug-eluting stent

KW - Stent thrombosis

U2 - 10.4244/EIJ-D-18-00396

DO - 10.4244/EIJ-D-18-00396

M3 - Journal article

C2 - 29969425

AN - SCOPUS:85054387441

SN - 1774-024X

VL - 14

SP - 764

EP - 771

JO - EuroIntervention

JF - EuroIntervention

IS - 7

ER -