Complete versus incomplete revascularization for treatment of multivessel coronary artery disease in the drug-eluting stent era
Limited data exist regarding the impact of complete revascularization (CR) versus incomplete revascularization (IR) on the long-term outcomes of patients with multivessel coronary artery disease (MVD) who underwent percutaneous coronary intervention with drug-eluting stents. We compared major advers...
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| Veröffentlicht in: | Heart and vessels 2012-09, Vol.27 (5), p.433-442 |
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| creator | Song, Young Bin Lee, Sang-Yeub Hahn, Joo-Yong Choi, Seung-Hyuk Choi, Jin-Ho Lee, Sang Hoon Hong, Kyung Pyo Park, Jeong Euy Gwon, Hyeon-Cheol |
| description | Limited data exist regarding the impact of complete revascularization (CR) versus incomplete revascularization (IR) on the long-term outcomes of patients with multivessel coronary artery disease (MVD) who underwent percutaneous coronary intervention with drug-eluting stents. We compared major adverse cardiac events [MACE: death, myocardial infarction (MI), or any revascularization] in 873 patients and in 255 pairs generated by propensity-score matching. CR was performed in 427 patients (48.9%) and IR in 446 (51.1%). While the amount of myocardium at risk by the APPROACH score was similar between two groups (56.0 ± 14.4 vs. 56.7 ± 16.1,
p
= 0.49), the SYNTAX score was lower in the CR group than in the IR group (20.7 ± 9.4 vs. 23.3 ± 10.7,
p
|
| doi_str_mv | 10.1007/s00380-011-0173-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1039885187</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1039885187</sourcerecordid><originalsourceid>FETCH-LOGICAL-c396t-df6d32c33fe1324d2f7ea6b1a45316470af6796fd2b495786e3506f2af76ae923</originalsourceid><addsrcrecordid>eNp1kU1rGzEQhkVJqV23PyCXIsgll0314ZVWx2KSNGDIpT0v8u7IWbO7cjWScXvJX48cOyUEchAD0jPPaHgJOefsijOmvyNjsmIF4zwfLYv9BzLlipeFKLU8I1NmOCsqKfSEfEbcMMZLw80nMhFcKzM35ZQ8Lvyw7SEC3UHAhLQbm5ebADuLTept6P7Z2PmROh9oDGDjAGOk3tEh9bHbASL0tPHBjzb8pTZEyKXtECxCNtL4ALQNaV1An2I3rinGgwCC_UI-OtsjfD3VGfl9c_1r8bNY3t_eLX4si0YaFYvWqVaKRkoHXIp5K5wGq1bczkvJ1Vwz65Q2yrVildfSlQJZMuWEdVpZMELOyOXRuw3-TwKM9dBhA31vR_AJa86kqaqSVzqjF2_QjU9hzL97pqRkUhyE_Eg1wSMGcPU2dENeP0P1IZ36mE6d06kP6dT73PPtZE6rAdr_HS9xZEAcAcxP4xrC69HvWZ8AnPidXQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1039330322</pqid></control><display><type>article</type><title>Complete versus incomplete revascularization for treatment of multivessel coronary artery disease in the drug-eluting stent era</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Song, Young Bin ; Lee, Sang-Yeub ; Hahn, Joo-Yong ; Choi, Seung-Hyuk ; Choi, Jin-Ho ; Lee, Sang Hoon ; Hong, Kyung Pyo ; Park, Jeong Euy ; Gwon, Hyeon-Cheol</creator><creatorcontrib>Song, Young Bin ; Lee, Sang-Yeub ; Hahn, Joo-Yong ; Choi, Seung-Hyuk ; Choi, Jin-Ho ; Lee, Sang Hoon ; Hong, Kyung Pyo ; Park, Jeong Euy ; Gwon, Hyeon-Cheol</creatorcontrib><description>Limited data exist regarding the impact of complete revascularization (CR) versus incomplete revascularization (IR) on the long-term outcomes of patients with multivessel coronary artery disease (MVD) who underwent percutaneous coronary intervention with drug-eluting stents. We compared major adverse cardiac events [MACE: death, myocardial infarction (MI), or any revascularization] in 873 patients and in 255 pairs generated by propensity-score matching. CR was performed in 427 patients (48.9%) and IR in 446 (51.1%). While the amount of myocardium at risk by the APPROACH score was similar between two groups (56.0 ± 14.4 vs. 56.7 ± 16.1,
p
= 0.49), the SYNTAX score was lower in the CR group than in the IR group (20.7 ± 9.4 vs. 23.3 ± 10.7,
p
< 0.01). MACE occurred in 203 patients (23.3%) during a median follow-up of 35 months. CR was associated with a lower incidence of MACE (HR 0.64; 95% CI 0.46–0.88;
p
< 0.01) and revascularization (HR 0.61; 95% CI 0.42–0.90;
p
= 0.01), but not of death (HR 0.87; 95% CI 0.48–1.57;
p
= 0.64) and MI (HR 0.62; 95% CI 0.23–1.67;
p
= 0.35). The incidence of periprocedural MI and stent thrombosis was similar in two groups (4.7% in the CR group vs. 3.6% in the IR group,
p
= 0.42; 1.6 vs. 1.3%,
p
= 0.72, respectively). After propensity-score matching, patients with CR had fewer MACE and revascularization than those with IR. In patients with MVD, CR strategy using drug-eluting stents could reduce repeat revascularization with similar death, MI, and stent thrombosis risk compared with IR strategy.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-011-0173-x</identifier><identifier>PMID: 21769495</identifier><identifier>CODEN: HEVEEO</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Aged ; Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Cardiovascular disease ; Coronary Angiography ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - surgery ; Coronary vessels ; Drug-Eluting Stents ; Electrocardiography ; Female ; Follow-Up Studies ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Myocardial Revascularization - methods ; Original Article ; Retrospective Studies ; Stents ; Surgical techniques ; Treatment Outcome ; Vascular Surgery</subject><ispartof>Heart and vessels, 2012-09, Vol.27 (5), p.433-442</ispartof><rights>Springer 2011</rights><rights>Springer 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-df6d32c33fe1324d2f7ea6b1a45316470af6796fd2b495786e3506f2af76ae923</citedby><cites>FETCH-LOGICAL-c396t-df6d32c33fe1324d2f7ea6b1a45316470af6796fd2b495786e3506f2af76ae923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-011-0173-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-011-0173-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21769495$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Lee, Sang-Yeub</creatorcontrib><creatorcontrib>Hahn, Joo-Yong</creatorcontrib><creatorcontrib>Choi, Seung-Hyuk</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><creatorcontrib>Lee, Sang Hoon</creatorcontrib><creatorcontrib>Hong, Kyung Pyo</creatorcontrib><creatorcontrib>Park, Jeong Euy</creatorcontrib><creatorcontrib>Gwon, Hyeon-Cheol</creatorcontrib><title>Complete versus incomplete revascularization for treatment of multivessel coronary artery disease in the drug-eluting stent era</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Limited data exist regarding the impact of complete revascularization (CR) versus incomplete revascularization (IR) on the long-term outcomes of patients with multivessel coronary artery disease (MVD) who underwent percutaneous coronary intervention with drug-eluting stents. We compared major adverse cardiac events [MACE: death, myocardial infarction (MI), or any revascularization] in 873 patients and in 255 pairs generated by propensity-score matching. CR was performed in 427 patients (48.9%) and IR in 446 (51.1%). While the amount of myocardium at risk by the APPROACH score was similar between two groups (56.0 ± 14.4 vs. 56.7 ± 16.1,
p
= 0.49), the SYNTAX score was lower in the CR group than in the IR group (20.7 ± 9.4 vs. 23.3 ± 10.7,
p
< 0.01). MACE occurred in 203 patients (23.3%) during a median follow-up of 35 months. CR was associated with a lower incidence of MACE (HR 0.64; 95% CI 0.46–0.88;
p
< 0.01) and revascularization (HR 0.61; 95% CI 0.42–0.90;
p
= 0.01), but not of death (HR 0.87; 95% CI 0.48–1.57;
p
= 0.64) and MI (HR 0.62; 95% CI 0.23–1.67;
p
= 0.35). The incidence of periprocedural MI and stent thrombosis was similar in two groups (4.7% in the CR group vs. 3.6% in the IR group,
p
= 0.42; 1.6 vs. 1.3%,
p
= 0.72, respectively). After propensity-score matching, patients with CR had fewer MACE and revascularization than those with IR. In patients with MVD, CR strategy using drug-eluting stents could reduce repeat revascularization with similar death, MI, and stent thrombosis risk compared with IR strategy.</description><subject>Aged</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary vessels</subject><subject>Drug-Eluting Stents</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myocardial Revascularization - methods</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Surgical techniques</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kU1rGzEQhkVJqV23PyCXIsgll0314ZVWx2KSNGDIpT0v8u7IWbO7cjWScXvJX48cOyUEchAD0jPPaHgJOefsijOmvyNjsmIF4zwfLYv9BzLlipeFKLU8I1NmOCsqKfSEfEbcMMZLw80nMhFcKzM35ZQ8Lvyw7SEC3UHAhLQbm5ebADuLTept6P7Z2PmROh9oDGDjAGOk3tEh9bHbASL0tPHBjzb8pTZEyKXtECxCNtL4ALQNaV1An2I3rinGgwCC_UI-OtsjfD3VGfl9c_1r8bNY3t_eLX4si0YaFYvWqVaKRkoHXIp5K5wGq1bczkvJ1Vwz65Q2yrVildfSlQJZMuWEdVpZMELOyOXRuw3-TwKM9dBhA31vR_AJa86kqaqSVzqjF2_QjU9hzL97pqRkUhyE_Eg1wSMGcPU2dENeP0P1IZ36mE6d06kP6dT73PPtZE6rAdr_HS9xZEAcAcxP4xrC69HvWZ8AnPidXQ</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Song, Young Bin</creator><creator>Lee, Sang-Yeub</creator><creator>Hahn, Joo-Yong</creator><creator>Choi, Seung-Hyuk</creator><creator>Choi, Jin-Ho</creator><creator>Lee, Sang Hoon</creator><creator>Hong, Kyung Pyo</creator><creator>Park, Jeong Euy</creator><creator>Gwon, Hyeon-Cheol</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120901</creationdate><title>Complete versus incomplete revascularization for treatment of multivessel coronary artery disease in the drug-eluting stent era</title><author>Song, Young Bin ; Lee, Sang-Yeub ; Hahn, Joo-Yong ; Choi, Seung-Hyuk ; Choi, Jin-Ho ; Lee, Sang Hoon ; Hong, Kyung Pyo ; Park, Jeong Euy ; Gwon, Hyeon-Cheol</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-df6d32c33fe1324d2f7ea6b1a45316470af6796fd2b495786e3506f2af76ae923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary vessels</topic><topic>Drug-Eluting Stents</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Myocardial Revascularization - methods</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Surgical techniques</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Lee, Sang-Yeub</creatorcontrib><creatorcontrib>Hahn, Joo-Yong</creatorcontrib><creatorcontrib>Choi, Seung-Hyuk</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><creatorcontrib>Lee, Sang Hoon</creatorcontrib><creatorcontrib>Hong, Kyung Pyo</creatorcontrib><creatorcontrib>Park, Jeong Euy</creatorcontrib><creatorcontrib>Gwon, Hyeon-Cheol</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Song, Young Bin</au><au>Lee, Sang-Yeub</au><au>Hahn, Joo-Yong</au><au>Choi, Seung-Hyuk</au><au>Choi, Jin-Ho</au><au>Lee, Sang Hoon</au><au>Hong, Kyung Pyo</au><au>Park, Jeong Euy</au><au>Gwon, Hyeon-Cheol</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complete versus incomplete revascularization for treatment of multivessel coronary artery disease in the drug-eluting stent era</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2012-09-01</date><risdate>2012</risdate><volume>27</volume><issue>5</issue><spage>433</spage><epage>442</epage><pages>433-442</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><coden>HEVEEO</coden><abstract>Limited data exist regarding the impact of complete revascularization (CR) versus incomplete revascularization (IR) on the long-term outcomes of patients with multivessel coronary artery disease (MVD) who underwent percutaneous coronary intervention with drug-eluting stents. We compared major adverse cardiac events [MACE: death, myocardial infarction (MI), or any revascularization] in 873 patients and in 255 pairs generated by propensity-score matching. CR was performed in 427 patients (48.9%) and IR in 446 (51.1%). While the amount of myocardium at risk by the APPROACH score was similar between two groups (56.0 ± 14.4 vs. 56.7 ± 16.1,
p
= 0.49), the SYNTAX score was lower in the CR group than in the IR group (20.7 ± 9.4 vs. 23.3 ± 10.7,
p
< 0.01). MACE occurred in 203 patients (23.3%) during a median follow-up of 35 months. CR was associated with a lower incidence of MACE (HR 0.64; 95% CI 0.46–0.88;
p
< 0.01) and revascularization (HR 0.61; 95% CI 0.42–0.90;
p
= 0.01), but not of death (HR 0.87; 95% CI 0.48–1.57;
p
= 0.64) and MI (HR 0.62; 95% CI 0.23–1.67;
p
= 0.35). The incidence of periprocedural MI and stent thrombosis was similar in two groups (4.7% in the CR group vs. 3.6% in the IR group,
p
= 0.42; 1.6 vs. 1.3%,
p
= 0.72, respectively). After propensity-score matching, patients with CR had fewer MACE and revascularization than those with IR. In patients with MVD, CR strategy using drug-eluting stents could reduce repeat revascularization with similar death, MI, and stent thrombosis risk compared with IR strategy.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>21769495</pmid><doi>10.1007/s00380-011-0173-x</doi><tpages>10</tpages></addata></record> |
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| subjects | Aged Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Cardiovascular disease Coronary Angiography Coronary Artery Disease - diagnosis Coronary Artery Disease - surgery Coronary vessels Drug-Eluting Stents Electrocardiography Female Follow-Up Studies Humans Male Medicine Medicine & Public Health Middle Aged Myocardial Revascularization - methods Original Article Retrospective Studies Stents Surgical techniques Treatment Outcome Vascular Surgery |
| title | Complete versus incomplete revascularization for treatment of multivessel coronary artery disease in the drug-eluting stent era |
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