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2-year patient-related versus stent-related outcomes: the SORT OUT IV (Scandinavian Organization for Randomized Trials With Clinical Outcome IV) Trial.

https://arctichealth.org/en/permalink/ahliterature120892
Source
J Am Coll Cardiol. 2012 Sep 25;60(13):1140-7
Publication Type
Article
Date
Sep-25-2012
Author
Lisette Okkels Jensen
Per Thayssen
Evald Høj Christiansen
Hans Henrik Tilsted
Michael Maeng
Knud Nørregaard Hansen
Anne Kaltoft
Henrik Steen Hansen
Hans Erik Bøtker
Lars Romer Krusell
Jan Ravkilde
Morten Madsen
Leif Thuesen
Jens Flensted Lassen
Author Affiliation
Department of Cardiology, Odense University Hospital, Odense, Denmark. okkels@dadlnet.dk
Source
J Am Coll Cardiol. 2012 Sep 25;60(13):1140-7
Date
Sep-25-2012
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary
Coronary Artery Disease - mortality - therapy
Death
Denmark
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Immunosuppressive Agents - therapeutic use
Male
Middle Aged
Myocardial Infarction - etiology
Myocardial Revascularization - statistics & numerical data
Single-Blind Method
Sirolimus - adverse effects - analogs & derivatives - therapeutic use
Thrombosis - etiology
Treatment Outcome
Abstract
There are limited head-to-head randomized data on patient-related versus stent-related outcomes for everolimus-eluting stents (EES) and sirolimus-eluting stents (SES).
In the SORT OUT IV (Scandinavian Organization for Randomized Trials With Clinical Outcome IV) trial, comparing the EES with the SES in patients with coronary artery disease, the EES was noninferior to the SES at 9 months.
The primary endpoint was a composite: cardiac death, myocardial infarction (MI), definite stent thrombosis, or target vessel revascularization. Safety and efficacy outcomes at 2 years were further assessed with specific focus on patient-related composite (all death, all MI, or any revascularization) and stent-related composite outcomes (cardiac death, target vessel MI, or symptom-driven target lesion revascularization). A total of 1,390 patients were assigned to receive the EES, and 1,384 patients were assigned to receive the SES.
At 2 years, the composite primary endpoint occurred in 8.3% in the EES group and in 8.7% in the SES group (hazard ratio [HR]: 0.94, 95% confidence interval [CI]: 0.73 to 1.22). The patient-related outcome: 15.0% in the EES group versus 15.6% in the SES group, (HR: 0.95, 95% CI: 0.78 to 1.15), and the stent-related outcome: 5.2% in the EES group versus 5.3% in the SES group (HR: 0.97, 95% CI: 0.70 to 1.35) did not differ between groups. Rate of definite stent thrombosis was lower in the EES group (0.2% vs. 0.9%, (HR: 0.23, 95% CI: 0.07 to 0.80).
At 2-year follow-up, the EES was found to be noninferior to the SES with regard to both patient-related and stent-related clinical outcomes.
PubMed ID
22958957 View in PubMed
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Cardiac symptoms before sudden cardiac death caused by coronary artery disease: a nationwide study among young Danish people.

https://arctichealth.org/en/permalink/ahliterature114837
Source
Heart. 2013 Jul;99(13):938-43
Publication Type
Article
Date
Jul-2013
Author
Reza Jabbari
Bjarke Risgaard
Anders G Holst
Jonas B Nielsen
Charlotte Glinge
Thomas Engstrøm
Henning Bundgaard
Jesper H Svendsen
Stig Haunsø
Bo Gregers Winkel
Jacob Tfelt-Hansen
Author Affiliation
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Rigshospitalet, Juliane Maries Vej 20, 2100 Copenhagen, Denmark. rezajabbari77@gmail.com
Source
Heart. 2013 Jul;99(13):938-43
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Angina Pectoris - epidemiology
Autopsy
Chi-Square Distribution
Child
Child, Preschool
Coronary Artery Disease - mortality - therapy
Death, Sudden, Cardiac - epidemiology
Denmark - epidemiology
Dyspnea - epidemiology
Female
Humans
Incidence
Infant
Male
Patient Acceptance of Health Care
Registries
Retrospective Studies
Risk factors
Time Factors
Young Adult
Abstract
The aim of this nationwide case-control study was to identify and characterise symptoms before sudden death of young persons who had died due to coronary artery disease (CAD).
We have previously investigated the incidence of sudden cardiac death (SCD) in young Danish people aged 1-35 years in Denmark during 2000-2006. We included all deaths (n=6629) and identified 314 autopsied cases of SCD, 40 of whom (13%) died from CAD. To compare symptoms before death, the CAD case group was sex- and age-matched 1:2 with a control group randomly sampled from a population of 1497 individuals who had died in accidents. We used data from the National Patient Registry on previous contacts with the healthcare system for all persons and read all available patient records, including death certificates and autopsy reports.
A total of 31 (79%) persons with CAD-SCD had cardiac symptoms such as angina pectoris (n=24, 62%) and dyspnoea during the 12 months before death, and this was significantly higher than in the control group (p
PubMed ID
23574972 View in PubMed
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Changing outcomes of coronary revascularization in British Columbia, 1995-2001.

https://arctichealth.org/en/permalink/ahliterature166205
Source
Can J Cardiol. 2006 Dec;22(14):1197-203
Publication Type
Article
Date
Dec-2006
Author
Gordon E Pate
Min Gao
Lillian Ding
Ronald G Carere
Frank O Tyers
Robert I Hayden
Author Affiliation
Interventional Cardiology Research, St Paul's Hospital, Vancouver. gordon.pate@galwayclinic.com
Source
Can J Cardiol. 2006 Dec;22(14):1197-203
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary - mortality - statistics & numerical data
British Columbia - epidemiology
Coronary Artery Bypass - mortality - statistics & numerical data
Coronary Artery Disease - mortality - therapy
Female
Humans
Male
Middle Aged
Prospective Studies
Registries
Sex Distribution
Abstract
To examine outcomes following all first coronary revascularization procedures, isolated coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) on British Columbia (BC) resident adults from 1995 to 2001.
CABG and PCI data were obtained from the BC Cardiac Registry, and mortality data were obtained from the BC Vital Statistics Agency. Analysis was performed by annual cohorts, and the rates reported are unadjusted.
An increasing percentage of revascularization procedures was performed with PCI (62% in 1995 to 73% in 2001; P
Notes
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PubMed ID
17151768 View in PubMed
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A comparative analysis of outcome after heart transplantation in patients aged 60 years and older: the University of Alberta experience.

https://arctichealth.org/en/permalink/ahliterature177387
Source
J Card Surg. 2004 Nov-Dec;19(6):559-62
Publication Type
Article
Author
Jayan Nagendran
Stephen M Wildhirt
Dennis Modry
John Mullen
Arvind Koshal
Shao Hua Wang
Author Affiliation
Department of Cardiac Surgery, University of Alberta Hospital, Edmonton, Alberta, Canada.
Source
J Card Surg. 2004 Nov-Dec;19(6):559-62
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Alberta - epidemiology
Coronary Artery Disease - mortality - therapy
Female
Follow-Up Studies
Graft Rejection - etiology - mortality
Heart Transplantation - adverse effects - mortality
Humans
Male
Middle Aged
Prospective Studies
Survival Analysis
Time Factors
Treatment Outcome
Abstract
The Registry of the International Society for Heart and Lung Transplantation (ISHLT) 2001 Annual Report indicated that the vast majority of heart transplant recipients are between 50 and 64 years of age. However, patient age beyond 60 years may have higher long-term mortality compared to younger patients. The purpose of this study was to compare short- and intermediate-term results including rates of acute rejection, transplant coronary artery disease, infections, malignancy, and mortality in cardiac transplant recipients 60 years or older with those below the age of 60 years.
We retrospectively analyzed the results of 50 patients aged 60 years and older who underwent heart transplantation at the University of Alberta from January 1990 to December 2000 and compared them with the results of 225 younger patients undergoing heart transplantation in the same time period.
The older and younger groups had similar rates for treated acute rejection episodes (20.0% vs. 12.6%), transplant coronary artery disease (4.0% vs. 1.1%), and mortality (10.5% vs. 14.3%), respectively. No differences were noted with regards to quality and quantity of infection or malignancy rates. Five-year actuarial survival between the older and younger patients was also comparable at 89.5% vs.86.9% (p > 0.05).
Heart transplantation in patients 60 years of age and older can be performed as successfully as in younger patients (
PubMed ID
15548193 View in PubMed
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Comparison of outcomes of patients = 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction).

https://arctichealth.org/en/permalink/ahliterature131661
Source
Am J Cardiol. 2011 Nov 15;108(10):1395-400
Publication Type
Article
Date
Nov-15-2011
Author
Lisbeth Antonsen
Lisette Okkels Jensen
Per Thayssen
Evald Høj Christiansen
Anders Junker
Hans-Henrik Tilsted
Christian Juhl Terkelsen
Anne Kaltoft
Michael Maeng
Knud Noerregaard Hansen
Jan Ravkilde
Jens Flensted Lassen
Morten Madsen
Henrik Toft Sørensen
Leif Thuesen
Author Affiliation
Department of Cardiology, Odense University Hospital, Odense, Denmark. dr_lissie@hotmail.com
Source
Am J Cardiol. 2011 Nov 15;108(10):1395-400
Date
Nov-15-2011
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Angina, Stable - mortality - therapy
Angina, Unstable - mortality - therapy
Angioplasty, Balloon, Coronary - statistics & numerical data - trends
Arrhythmias, Cardiac - mortality
Cohort Studies
Comorbidity
Coronary Artery Disease - mortality - therapy
Denmark - epidemiology
Female
Follow-Up Studies
Heart Failure - mortality
Humans
Male
Myocardial Infarction - mortality - therapy
Registries
Regression Analysis
Abstract
Patients = 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients = 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (= 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients = 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.
PubMed ID
21890087 View in PubMed
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Contemporary percutaneous coronary intervention versus balloon angioplasty for multivessel coronary artery disease: a comparison of the National Heart, Lung and Blood Institute Dynamic Registry and the Bypass Angioplasty Revascularization Investigation (BARI) study.

https://arctichealth.org/en/permalink/ahliterature188454
Source
Circulation. 2002 Sep 24;106(13):1627-33
Publication Type
Article
Date
Sep-24-2002
Author
V S Srinivas
Maria Mori Brooks
Katherine M Detre
Spencer B King
Alice K Jacobs
Janet Johnston
David O Williams
Author Affiliation
Department of Medicine, Division of Cardiovascular Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA.
Source
Circulation. 2002 Sep 24;106(13):1627-33
Date
Sep-24-2002
Language
English
Publication Type
Article
Keywords
Angioplasty, Balloon - adverse effects
Angioplasty, Balloon, Coronary - adverse effects
Canada - epidemiology
Clinical Trials as Topic - statistics & numerical data
Cohort Studies
Coronary Artery Bypass - adverse effects
Coronary Artery Disease - mortality - therapy
Disease-Free Survival
Female
Follow-Up Studies
Hospital Mortality
Humans
Logistic Models
Male
Middle Aged
Multicenter Studies as Topic - statistics & numerical data
Multivariate Analysis
Myocardial Revascularization - adverse effects
National Institutes of Health (U.S.)
Proportional Hazards Models
Registries
Reoperation - statistics & numerical data
Stents
Survival Rate
Treatment Outcome
United States - epidemiology
Abstract
This investigation compares the results of contemporary percutaneous coronary intervention (PCI) with standard balloon angioplasty among patients with multivessel coronary disease. Patients having balloon angioplasty in the Bypass Angioplasty Revascularization Investigation (BARI) and those within the Dynamic Registry meeting BARI eligibility criteria were studied.
Clinical features and in-hospital and 1-year outcomes of 857 BARI-eligible patients in the Dynamic Registry (contemporary PCI) were compared with the 904 randomized patients who underwent percutaneous transluminal coronary angioplasty in BARI. Compared with BARI patients, Registry patients had fewer lesions attempted (1.53 versus 2.56, P=0.001), more frequent single-vessel PCI (76% versus 33%, P
Notes
Comment In: Circulation. 2002 Sep 24;106(13):1592-412270845
PubMed ID
12270854 View in PubMed
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Outcomes of revascularization strategies for two-vessel coronary artery disease involving the proximal left anterior descending artery in an era of improved pharmacotherapy and stenting.

https://arctichealth.org/en/permalink/ahliterature158805
Source
Can J Cardiol. 2008 Feb;24(2):121-6
Publication Type
Article
Date
Feb-2008
Author
Jaroslav Hubacek
Sunil Kalla
P Diane Galbraith
Michelle M Graham
Merril L Knudtson
William A Ghali
Author Affiliation
Department of Medicine, University of Calgary, Calgary, Canada.
Source
Can J Cardiol. 2008 Feb;24(2):121-6
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Aged
Alberta - epidemiology
Angioplasty, Balloon, Coronary - mortality
Cohort Studies
Coronary Angiography
Coronary Artery Bypass - mortality
Coronary Artery Disease - mortality - therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Registries
Stents
Survival Rate
Abstract
The best therapeutic strategy for patients with double-vessel coronary artery disease and proximal left anterior descending artery involvement (2VD + pLAD) is not clear.
To compare the survival experience of a cohort of cardiac catheterization patients with 2VD + pLAD based on chosen therapeutic strategy (medical management versus percutaneous coronary intervention [PCI] versus coronary artery bypass graft surgery [CABG]).
The authors identified and studied a total of 603 patients with 2VD + pLAD from all patients who underwent diagnostic coronary angiography in Alberta between January 1997 and May 1999. The primary end point was five-year survival from index catheterization for each of the treatment groups and from time of revascularization when the two revascularization strategies were compared.
Risk-adjusted hazard ratios (HR) comparing cumulative five-year survival rates of patients treated medically, or with PCI or CABG indicated a survival benefit for patients treated with CABG (HR 0.24, 95% CI 0.11 to 0.54; P
Notes
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PubMed ID
18273485 View in PubMed
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Paclitaxel and sirolimus eluting stents versus bare metal stents: long-term risk of stent thrombosis and other outcomes. From the Western Denmark Heart Registry.

https://arctichealth.org/en/permalink/ahliterature99564
Source
EuroIntervention. 2010 Apr;5(8):898-905
Publication Type
Article
Date
Apr-2010
Author
Jensen Lisette Okkels
Tilsted Hans Henrik
Thayssen Per
Kaltoft Anne
Maeng Michael
Lassen Jens Flensted
Hansen Knud Noerregaard
Madsen Morten
Ravkilde Jan
Johnsen Søren Paaske
Sørensen Henrik Toft
Thuesen Leif
Author Affiliation
Department of Cardiology, Odense University Hospital, Denmark. okkels@dadlnet.dk
Source
EuroIntervention. 2010 Apr;5(8):898-905
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Transluminal, Percutaneous Coronary - adverse effects - instrumentation - mortality
Cardiovascular Agents - administration & dosage
Chi-Square Distribution
Coronary Artery Disease - mortality - therapy
Denmark - epidemiology
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Incidence
Kaplan-Meiers Estimate
Male
Metals
Middle Aged
Myocardial Infarction - etiology
Paclitaxel - administration & dosage
Platelet Aggregation Inhibitors - therapeutic use
Proportional Hazards Models
Prosthesis Design
Registries
Risk assessment
Risk factors
Sirolimus - administration & dosage
Stents
Thrombosis - etiology - mortality
Time Factors
Treatment Outcome
Abstract
AIMS: Stent thrombosis is a serious complication of percutaneous coronary intervention (PCI). We examined the incidence of stent thrombosis and other outcomes in patients treated with PCI and paclitaxeleluting stents (PES), sirolimus-eluting stents (SES) or bare-metal stents (BMS). METHODS AND RESULTS: All patients who underwent PES, SES or BMS implantation from January 2002 to June 2005 were identified in the population-based Western Denmark Heart Registry. All were followed for 36 months. Cox regression analysis was used to estimate relative risk (RR), controlling for covariates. A total of 12,374 patients were treated with stents: 1,298 with PES, 2,202 with SES and 8,847 with BMS. The three-year incidence of definite stent thrombosis was similar in the DES group (1.1%) and in the BMS group (0.7%) (adjusted relative risk [RR]: 1.24; 95% confidence interval [CI]: 0.85-1.81). Very late definite stent thrombosis occurred more frequently in DES-treated patients (adjusted RR: 2.89, 95% CI: 1.48- 5.65). The three-year mortality rate did not differ significantly between the two groups. Target lesion revascularisation (TLR) was lower in DES-treated patients than in BMS-treated patients (adjusted RR: 0.71, 95% CI: 0.63-0.81). CONCLUSIONS: An increased risk of very late definite stent thrombosis was observed in DES-treated patients compared with BMS-treated patients, but a similar mortality was detected. TLR continued to be lower among patients receiving DES.
PubMed ID
20542774 View in PubMed
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Paclitaxel versus sirolimus stents in diabetic and nondiabetic patients.

https://arctichealth.org/en/permalink/ahliterature146519
Source
Circ Cardiovasc Qual Outcomes. 2009 Mar;2(2):96-107
Publication Type
Article
Date
Mar-2009
Author
Maria Chiu
Dennis T Ko
Peter C Austin
Eric A Cohen
James L Velianou
Ron Goeree
Gord Blackhouse
Jack V Tu
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Canada.
Source
Circ Cardiovasc Qual Outcomes. 2009 Mar;2(2):96-107
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary - mortality
Cohort Studies
Coronary Artery Disease - mortality - therapy
Diabetic Angiopathies - mortality - therapy
Disease-Free Survival
Drug-Eluting Stents - statistics & numerical data
Female
Humans
Immunosuppressive Agents - therapeutic use
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - mortality
Ontario - epidemiology
Paclitaxel - therapeutic use
Proportional Hazards Models
Registries
Sirolimus - therapeutic use
Tubulin Modulators - therapeutic use
Abstract
Drug-eluting stents are more effective in reducing restenosis than bare-metal stents. Less certain is the relative performance of 2 widely used drug-eluting stents-sirolimus- and paclitaxel-eluting stents-in diabetic and nondiabetic patients undergoing percutaneous coronary intervention in routine clinical practice. We therefore studied the long-term effectiveness and safety of sirolimus versus paclitaxel stents overall and stratified by the absence or presence of diabetes.
We compared sirolimus and paclitaxel stents in a propensity-score matched cohort of 2054 pairs of patients (835 matched pairs of diabetic patients and 1219 matched pairs of nondiabetic patients) undergoing percutaneous coronary intervention in Ontario between December 1, 2003 and March 31, 2006. The cohort was derived from the Cardiac Care Network of Ontario percutaneous coronary intervention registry and linked to population-based administrative health databases. In the overall cohort, there was no difference in rates of target-vessel revascularization (P=0.47), myocardial infarction (P=0.71), or death (P=0.49). As compared with paclitaxel stents, the use of sirolimus stents was associated with a significantly lower 3-year rate of target-vessel revascularization in nondiabetic patients (8.3% versus 10.0%, P=0.01), but not in diabetic patients (12.7% versus 10.3%, P=0.07). Rates of all-cause mortality were similar in patients receiving sirolimus stents versus paclitaxel stents in both the diabetic (8.4% versus 9.2%, P=0.91) and nondiabetic (4.6% versus 3.0%, P=0.22) groups.
In this large observational study, patients receiving paclitaxel and sirolimus stents had similar mortality rates, but nondiabetic patients receiving sirolimus stents were significantly less likely to require repeat revascularization.
PubMed ID
20031821 View in PubMed
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Proximal coronary artery intervention: stent thrombosis, restenosis and death.

https://arctichealth.org/en/permalink/ahliterature106250
Source
Int J Cardiol. 2013 Dec 10;170(2):227-32
Publication Type
Article
Date
Dec-10-2013
Author
Fredrik Calais
Bo Lagerqvist
Jerzy Leppert
Stefan K James
Ole Fröbert
Author Affiliation
Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
Source
Int J Cardiol. 2013 Dec 10;170(2):227-32
Date
Dec-10-2013
Language
English
Publication Type
Article
Keywords
Aged
Coronary Artery Disease - mortality - therapy
Coronary Restenosis - etiology - mortality
Coronary Thrombosis - etiology - mortality
Coronary Vessels
Drug-Eluting Stents - adverse effects
Female
Follow-Up Studies
Humans
Male
Metals
Middle Aged
Percutaneous Coronary Intervention - adverse effects - methods - mortality
Proportional Hazards Models
Registries - statistics & numerical data
Stents - adverse effects
Sweden - epidemiology
Abstract
Percutaneous coronary intervention (PCI) of lesions in the proximal left anterior descending coronary artery (LAD) may confer a worse prognosis compared with the proximal right coronary artery (RCA) and left circumflex coronary artery (LCX).
From May 2005, to May 2011 we identified all PCIs for proximal, one-vessel coronary artery disease in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). We evaluated restenosis, stent thrombosis (ST) and mortality in the LAD as compared to the RCA and LCX according to stent type, bare metal (BMS) or drug-eluting stents (DES).
7840 single vessel proximal PCI procedures were identified. Mean follow-up time was 792 days. No differences in restenosis or ST were seen between the LAD and the RCA. The frequency of restenosis and ST was higher in the proximal LAD compared to the proximal LCX (restenosis: hazard ratio (HR) 2.28, confidence interval (CI) 1.56-3.34 p
PubMed ID
24211065 View in PubMed
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11 records – page 1 of 2.