Three-Year Clinical Outcome of Patients with Coronary Disease and Increased Event Risk Treated with Newer-Generation Drug-Eluting Stents: From the Randomized DUTCH PEERS Trial

Liefke C. van der Heijden, Marlies M. Kok, Marije M. Löwik, Peter W. Danse, Gillian A.J. Jessurun, Marc Hartmann, Martin G. Stoel, Gert K. van Houwelingen, Raymond W.M. Hautvast, Gerard C.M. Linssen, Carine J.M. Doggen, Clemens Von Birgelen

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

Objective: Limited data is available on the long-term outcome of patients with increased cardiovascular event risk, treated with newer-generation durable polymer drug-eluting stents (DES).

Methods: We therefore assessed 3-year follow-up data of high-risk versus low-to intermediate-risk patients of the randomized DUTCH PEERS trial (NCT01331707). In both risk groups we also compared patients treated with Resolute Integrity versus Promus Element DES. Patients were categorized as "high-risk" if they met ≥1 of the following criteria: (1) diabetes (17.9%); (2) previous myocardial infarction (21.9%); (3) previous coronary revascularization (25.8%); (4) chronic renal failure (3.5%); (5) left ventricular ejection fraction ≤30% (1.5%); and (6) age ≥75 years (17.3%).

Results: At the 3-year follow-up, the incidence of the composite endpoint target vessel failure (TVF) (13.2 vs. 7.5%; logrank p < 0.001) and 2 of its components-cardiac death (4.7 vs. 1.5%; logrank p < 0.001) and target vessel revascularization (7.3 vs. 4.7%; logrank p = 0.03)-was higher in high-risk (n = 957) versus low-to intermediate-risk patients (n = 854). Among high-risk patients, treatment with Resolute Integrity (n = 481) and Promus Element stents (n = 476) was similarly safe and efficacious (TVF: 13.3 vs. 13.1%; logrank p = 0.95; definite-or-probable stent thrombosis: 1.7 vs. 1.7%; logrank p = 1.00).

Conclusions: The newer-generation Resolute Integrity and Promus Element stents showed similar results in terms of safety and efficacy for treating high-risk patients, who had significantly higher event rates than patients with low-to-intermediate risk.

Original languageEnglish
Pages (from-to)207-217
Number of pages11
JournalCardiology
Volume137
Issue number4
DOIs
Publication statusPublished - 1 Jul 2017

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Drug-Eluting Stents
Coronary Disease
Stents
Stroke Volume
Chronic Kidney Failure
Polymers
Thrombosis
Myocardial Infarction
Safety

Keywords

  • High-risk patients
  • Newer-generation drug-eluting stent
  • Percutaneous coronary intervention
  • Promus Element everolimus-eluting stent
  • Resolute Integrity zotarolimus-eluting stent

Cite this

van der Heijden, Liefke C. ; Kok, Marlies M. ; Löwik, Marije M. ; Danse, Peter W. ; Jessurun, Gillian A.J. ; Hartmann, Marc ; Stoel, Martin G. ; van Houwelingen, Gert K. ; Hautvast, Raymond W.M. ; Linssen, Gerard C.M. ; Doggen, Carine J.M. ; Von Birgelen, Clemens. / Three-Year Clinical Outcome of Patients with Coronary Disease and Increased Event Risk Treated with Newer-Generation Drug-Eluting Stents : From the Randomized DUTCH PEERS Trial. In: Cardiology. 2017 ; Vol. 137, No. 4. pp. 207-217.
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abstract = "Objective: Limited data is available on the long-term outcome of patients with increased cardiovascular event risk, treated with newer-generation durable polymer drug-eluting stents (DES).Methods: We therefore assessed 3-year follow-up data of high-risk versus low-to intermediate-risk patients of the randomized DUTCH PEERS trial (NCT01331707). In both risk groups we also compared patients treated with Resolute Integrity versus Promus Element DES. Patients were categorized as {"}high-risk{"} if they met ≥1 of the following criteria: (1) diabetes (17.9{\%}); (2) previous myocardial infarction (21.9{\%}); (3) previous coronary revascularization (25.8{\%}); (4) chronic renal failure (3.5{\%}); (5) left ventricular ejection fraction ≤30{\%} (1.5{\%}); and (6) age ≥75 years (17.3{\%}).Results: At the 3-year follow-up, the incidence of the composite endpoint target vessel failure (TVF) (13.2 vs. 7.5{\%}; logrank p < 0.001) and 2 of its components-cardiac death (4.7 vs. 1.5{\%}; logrank p < 0.001) and target vessel revascularization (7.3 vs. 4.7{\%}; logrank p = 0.03)-was higher in high-risk (n = 957) versus low-to intermediate-risk patients (n = 854). Among high-risk patients, treatment with Resolute Integrity (n = 481) and Promus Element stents (n = 476) was similarly safe and efficacious (TVF: 13.3 vs. 13.1{\%}; logrank p = 0.95; definite-or-probable stent thrombosis: 1.7 vs. 1.7{\%}; logrank p = 1.00). Conclusions: The newer-generation Resolute Integrity and Promus Element stents showed similar results in terms of safety and efficacy for treating high-risk patients, who had significantly higher event rates than patients with low-to-intermediate risk.",
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author = "{van der Heijden}, {Liefke C.} and Kok, {Marlies M.} and L{\"o}wik, {Marije M.} and Danse, {Peter W.} and Jessurun, {Gillian A.J.} and Marc Hartmann and Stoel, {Martin G.} and {van Houwelingen}, {Gert K.} and Hautvast, {Raymond W.M.} and Linssen, {Gerard C.M.} and Doggen, {Carine J.M.} and {Von Birgelen}, Clemens",
year = "2017",
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day = "1",
doi = "10.1159/000464320",
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pages = "207--217",
journal = "Cardiology",
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van der Heijden, LC, Kok, MM, Löwik, MM, Danse, PW, Jessurun, GAJ, Hartmann, M, Stoel, MG, van Houwelingen, GK, Hautvast, RWM, Linssen, GCM, Doggen, CJM & Von Birgelen, C 2017, 'Three-Year Clinical Outcome of Patients with Coronary Disease and Increased Event Risk Treated with Newer-Generation Drug-Eluting Stents: From the Randomized DUTCH PEERS Trial', Cardiology, vol. 137, no. 4, pp. 207-217. https://doi.org/10.1159/000464320

Three-Year Clinical Outcome of Patients with Coronary Disease and Increased Event Risk Treated with Newer-Generation Drug-Eluting Stents : From the Randomized DUTCH PEERS Trial. / van der Heijden, Liefke C.; Kok, Marlies M.; Löwik, Marije M.; Danse, Peter W.; Jessurun, Gillian A.J.; Hartmann, Marc; Stoel, Martin G.; van Houwelingen, Gert K.; Hautvast, Raymond W.M.; Linssen, Gerard C.M.; Doggen, Carine J.M.; Von Birgelen, Clemens.

In: Cardiology, Vol. 137, No. 4, 01.07.2017, p. 207-217.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Three-Year Clinical Outcome of Patients with Coronary Disease and Increased Event Risk Treated with Newer-Generation Drug-Eluting Stents

T2 - From the Randomized DUTCH PEERS Trial

AU - van der Heijden, Liefke C.

AU - Kok, Marlies M.

AU - Löwik, Marije M.

AU - Danse, Peter W.

AU - Jessurun, Gillian A.J.

AU - Hartmann, Marc

AU - Stoel, Martin G.

AU - van Houwelingen, Gert K.

AU - Hautvast, Raymond W.M.

AU - Linssen, Gerard C.M.

AU - Doggen, Carine J.M.

AU - Von Birgelen, Clemens

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objective: Limited data is available on the long-term outcome of patients with increased cardiovascular event risk, treated with newer-generation durable polymer drug-eluting stents (DES).Methods: We therefore assessed 3-year follow-up data of high-risk versus low-to intermediate-risk patients of the randomized DUTCH PEERS trial (NCT01331707). In both risk groups we also compared patients treated with Resolute Integrity versus Promus Element DES. Patients were categorized as "high-risk" if they met ≥1 of the following criteria: (1) diabetes (17.9%); (2) previous myocardial infarction (21.9%); (3) previous coronary revascularization (25.8%); (4) chronic renal failure (3.5%); (5) left ventricular ejection fraction ≤30% (1.5%); and (6) age ≥75 years (17.3%).Results: At the 3-year follow-up, the incidence of the composite endpoint target vessel failure (TVF) (13.2 vs. 7.5%; logrank p < 0.001) and 2 of its components-cardiac death (4.7 vs. 1.5%; logrank p < 0.001) and target vessel revascularization (7.3 vs. 4.7%; logrank p = 0.03)-was higher in high-risk (n = 957) versus low-to intermediate-risk patients (n = 854). Among high-risk patients, treatment with Resolute Integrity (n = 481) and Promus Element stents (n = 476) was similarly safe and efficacious (TVF: 13.3 vs. 13.1%; logrank p = 0.95; definite-or-probable stent thrombosis: 1.7 vs. 1.7%; logrank p = 1.00). Conclusions: The newer-generation Resolute Integrity and Promus Element stents showed similar results in terms of safety and efficacy for treating high-risk patients, who had significantly higher event rates than patients with low-to-intermediate risk.

AB - Objective: Limited data is available on the long-term outcome of patients with increased cardiovascular event risk, treated with newer-generation durable polymer drug-eluting stents (DES).Methods: We therefore assessed 3-year follow-up data of high-risk versus low-to intermediate-risk patients of the randomized DUTCH PEERS trial (NCT01331707). In both risk groups we also compared patients treated with Resolute Integrity versus Promus Element DES. Patients were categorized as "high-risk" if they met ≥1 of the following criteria: (1) diabetes (17.9%); (2) previous myocardial infarction (21.9%); (3) previous coronary revascularization (25.8%); (4) chronic renal failure (3.5%); (5) left ventricular ejection fraction ≤30% (1.5%); and (6) age ≥75 years (17.3%).Results: At the 3-year follow-up, the incidence of the composite endpoint target vessel failure (TVF) (13.2 vs. 7.5%; logrank p < 0.001) and 2 of its components-cardiac death (4.7 vs. 1.5%; logrank p < 0.001) and target vessel revascularization (7.3 vs. 4.7%; logrank p = 0.03)-was higher in high-risk (n = 957) versus low-to intermediate-risk patients (n = 854). Among high-risk patients, treatment with Resolute Integrity (n = 481) and Promus Element stents (n = 476) was similarly safe and efficacious (TVF: 13.3 vs. 13.1%; logrank p = 0.95; definite-or-probable stent thrombosis: 1.7 vs. 1.7%; logrank p = 1.00). Conclusions: The newer-generation Resolute Integrity and Promus Element stents showed similar results in terms of safety and efficacy for treating high-risk patients, who had significantly higher event rates than patients with low-to-intermediate risk.

KW - High-risk patients

KW - Newer-generation drug-eluting stent

KW - Percutaneous coronary intervention

KW - Promus Element everolimus-eluting stent

KW - Resolute Integrity zotarolimus-eluting stent

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