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
UR - http://www.scopus.com/inward/record.url?scp=85018343038&partnerID=8YFLogxK
U2 - 10.1159/000464320
DO - 10.1159/000464320
M3 - Article
AN - SCOPUS:85018343038
VL - 137
SP - 207
EP - 217
JO - Cardiology
JF - Cardiology
SN - 0008-6312
IS - 4
ER -