Second vs. First generation drug eluting stents in multiple vessel disease and left main stenosis: Two‐year follow‐up of the observational, prospective, controlled, and multicenter ERACI IV registry
Objective To compare second generation drug eluting stents (2DES) with first generation (1DES) for the treatment of patients (pts) with multiple coronary vessel disease (MVD). Background Although 2DES improved safety and efficacy compared to 1DES, MVD remains a challenge for percutaneous coronary in...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2017-01, Vol.89 (1), p.37-46 |
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| creator | Haiek, Carlos Fernández‐Pereira, Carlos Santaera, Omar Mieres, Juan Rifourcat, Ignacio Lloberas, Juan Larribau, Miguel Pocoví, Antonio Rodriguez‐Granillo, Alfredo M. Sarmiento, Ricardo A. Antoniucci, David Rodriguez, Alfredo E. |
| description | Objective
To compare second generation drug eluting stents (2DES) with first generation (1DES) for the treatment of patients (pts) with multiple coronary vessel disease (MVD).
Background
Although 2DES improved safety and efficacy compared to 1DES, MVD remains a challenge for percutaneous coronary interventions.
Methods
ERACI IV was a prospective, observational, and controlled study in pts with MVD including left main and treated with 2DES (Firebird 2, Microport). We included 225 pts in 15 sites from Argentina. Primary endpoint was the incidence of major adverse cardiovascular events (MACCE) defined as death, myocardial infarction (MI), cerebrovascular accident (CVA) and unplanned revascularization; and to compare with 225 pts from ERACI III study (1DES). PCI strategy was planned to treat lesions ≥70% in vessels ≥ 2.00 mm, introducing a modified Syntax score (SS) where severe lesions in vessels |
| doi_str_mv | 10.1002/ccd.26468 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826663582</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4306755521</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3538-26541a2ec73d1c8a79f785fe06f42532b4e69fdc746edce6c63fa7eb66252e223</originalsourceid><addsrcrecordid>eNp1kctu1DAUhiMEojcWvAA6EhuQZqaJkzgJuyq0MFIlpFIQu8jjHA-unDj1cWY0uz4Cz8Vj9EnqucACiZVt6fN3_qM_il4n8SyJY3YuZTtjPOPls-g4yRmbFoz_eH64J1XGj6ITors4jivOqpfREeNVViRpeRz9_orS9i2saAZX2pGHJfbohNe2h9aNS0Azet0vgTz2nkD30I3G68EgrJAIDbSaUBCCCB6DykMnArXlLWn6ALdr-_jwa4PCgbLG2HV4jQNYBf4ngl0QutVuoDATGJylAaXXK5xAiOZd-ILtZGffTZYhBzq4vLmo5zD_Dg6XmrzbnEUvlDCErw7nafTt6vK2_jy9_vJpXl9cT2Wap-WU8TxLBENZpG0iS1FUqihzhTFXGctTtsiQV6qVRcaxlcglT5UocME5yxkylp5G7_beEPV-RPJNp0miMaJHO1KTlIxznublFn37D3pnRxf23FI8rvKMV3mg3u8pGXYnh6oZnO6E2zRJ3GwLbkLBza7gwL45GMdFh-1f8k-jATjfA2ttcPN_U1PXH_fKJ6GctRU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1860954695</pqid></control><display><type>article</type><title>Second vs. First generation drug eluting stents in multiple vessel disease and left main stenosis: Two‐year follow‐up of the observational, prospective, controlled, and multicenter ERACI IV registry</title><source>Wiley Online Library - AutoHoldings Journals</source><source>MEDLINE</source><creator>Haiek, Carlos ; Fernández‐Pereira, Carlos ; Santaera, Omar ; Mieres, Juan ; Rifourcat, Ignacio ; Lloberas, Juan ; Larribau, Miguel ; Pocoví, Antonio ; Rodriguez‐Granillo, Alfredo M. ; Sarmiento, Ricardo A. ; Antoniucci, David ; Rodriguez, Alfredo E.</creator><creatorcontrib>Haiek, Carlos ; Fernández‐Pereira, Carlos ; Santaera, Omar ; Mieres, Juan ; Rifourcat, Ignacio ; Lloberas, Juan ; Larribau, Miguel ; Pocoví, Antonio ; Rodriguez‐Granillo, Alfredo M. ; Sarmiento, Ricardo A. ; Antoniucci, David ; Rodriguez, Alfredo E.</creatorcontrib><description>Objective
To compare second generation drug eluting stents (2DES) with first generation (1DES) for the treatment of patients (pts) with multiple coronary vessel disease (MVD).
Background
Although 2DES improved safety and efficacy compared to 1DES, MVD remains a challenge for percutaneous coronary interventions.
Methods
ERACI IV was a prospective, observational, and controlled study in pts with MVD including left main and treated with 2DES (Firebird 2, Microport). We included 225 pts in 15 sites from Argentina. Primary endpoint was the incidence of major adverse cardiovascular events (MACCE) defined as death, myocardial infarction (MI), cerebrovascular accident (CVA) and unplanned revascularization; and to compare with 225 pts from ERACI III study (1DES). PCI strategy was planned to treat lesions ≥70% in vessels ≥ 2.00 mm, introducing a modified Syntax score (SS) where severe lesions in vessels < 2.0 mm and intermediate lesions were not scored.
Results
Baseline characteristics showed that compared to ERACI III, ERACI IV pts had higher number of diabetics (P = 0.02), previous revascularization (P = 0.007), unstable angina IIb/IIIc (P < 0.001) and three vessels/left main disease (P = 0.003). Modified SS was 22.2 ± 11. At 2 years of follow‐up ERACI IV group had significantly lower incidence of death+ MI + CVA, (P = 0.01) and MACCE (P = 0.001). MACCE rate was similar in diabetics, (5.8%) and nondiabetics (7.0%). After performing a matched propensity score, MACCE remain significantly lower in ERACI IV (P = 0.005).
Conclusion
This registry showed that 2DES in MVD has a remarkable low incidence of MACCE in unadjusted and adjusted analysis. © 2016 Wiley Periodicals, Inc.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.26468</identifier><identifier>PMID: 26947138</identifier><identifier>CODEN: CARIF2</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Argentina ; complex PCI ; coronary artery disease ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Coronary Artery Disease - therapy ; Coronary Stenosis - diagnostic imaging ; Coronary Stenosis - mortality ; Coronary Stenosis - therapy ; Disease-Free Survival ; Drug-Eluting Stents ; Female ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - etiology ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - instrumentation ; Percutaneous Coronary Intervention - mortality ; Propensity Score ; Proportional Hazards Models ; Prospective Studies ; Prosthesis Design ; Registries ; Risk Factors ; Severity of Illness Index ; stent thrombosis ; stenting technique ; Stents ; Time Factors ; Treatment Outcome</subject><ispartof>Catheterization and cardiovascular interventions, 2017-01, Vol.89 (1), p.37-46</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><rights>2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-26541a2ec73d1c8a79f785fe06f42532b4e69fdc746edce6c63fa7eb66252e223</citedby><cites>FETCH-LOGICAL-c3538-26541a2ec73d1c8a79f785fe06f42532b4e69fdc746edce6c63fa7eb66252e223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.26468$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.26468$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26947138$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haiek, Carlos</creatorcontrib><creatorcontrib>Fernández‐Pereira, Carlos</creatorcontrib><creatorcontrib>Santaera, Omar</creatorcontrib><creatorcontrib>Mieres, Juan</creatorcontrib><creatorcontrib>Rifourcat, Ignacio</creatorcontrib><creatorcontrib>Lloberas, Juan</creatorcontrib><creatorcontrib>Larribau, Miguel</creatorcontrib><creatorcontrib>Pocoví, Antonio</creatorcontrib><creatorcontrib>Rodriguez‐Granillo, Alfredo M.</creatorcontrib><creatorcontrib>Sarmiento, Ricardo A.</creatorcontrib><creatorcontrib>Antoniucci, David</creatorcontrib><creatorcontrib>Rodriguez, Alfredo E.</creatorcontrib><title>Second vs. First generation drug eluting stents in multiple vessel disease and left main stenosis: Two‐year follow‐up of the observational, prospective, controlled, and multicenter ERACI IV registry</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Objective
To compare second generation drug eluting stents (2DES) with first generation (1DES) for the treatment of patients (pts) with multiple coronary vessel disease (MVD).
Background
Although 2DES improved safety and efficacy compared to 1DES, MVD remains a challenge for percutaneous coronary interventions.
Methods
ERACI IV was a prospective, observational, and controlled study in pts with MVD including left main and treated with 2DES (Firebird 2, Microport). We included 225 pts in 15 sites from Argentina. Primary endpoint was the incidence of major adverse cardiovascular events (MACCE) defined as death, myocardial infarction (MI), cerebrovascular accident (CVA) and unplanned revascularization; and to compare with 225 pts from ERACI III study (1DES). PCI strategy was planned to treat lesions ≥70% in vessels ≥ 2.00 mm, introducing a modified Syntax score (SS) where severe lesions in vessels < 2.0 mm and intermediate lesions were not scored.
Results
Baseline characteristics showed that compared to ERACI III, ERACI IV pts had higher number of diabetics (P = 0.02), previous revascularization (P = 0.007), unstable angina IIb/IIIc (P < 0.001) and three vessels/left main disease (P = 0.003). Modified SS was 22.2 ± 11. At 2 years of follow‐up ERACI IV group had significantly lower incidence of death+ MI + CVA, (P = 0.01) and MACCE (P = 0.001). MACCE rate was similar in diabetics, (5.8%) and nondiabetics (7.0%). After performing a matched propensity score, MACCE remain significantly lower in ERACI IV (P = 0.005).
Conclusion
This registry showed that 2DES in MVD has a remarkable low incidence of MACCE in unadjusted and adjusted analysis. © 2016 Wiley Periodicals, Inc.</description><subject>Aged</subject><subject>Argentina</subject><subject>complex PCI</subject><subject>coronary artery disease</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary Stenosis - diagnostic imaging</subject><subject>Coronary Stenosis - mortality</subject><subject>Coronary Stenosis - therapy</subject><subject>Disease-Free Survival</subject><subject>Drug-Eluting Stents</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - etiology</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - instrumentation</subject><subject>Percutaneous Coronary Intervention - mortality</subject><subject>Propensity Score</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Prosthesis Design</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>stent thrombosis</subject><subject>stenting technique</subject><subject>Stents</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhiMEojcWvAA6EhuQZqaJkzgJuyq0MFIlpFIQu8jjHA-unDj1cWY0uz4Cz8Vj9EnqucACiZVt6fN3_qM_il4n8SyJY3YuZTtjPOPls-g4yRmbFoz_eH64J1XGj6ITors4jivOqpfREeNVViRpeRz9_orS9i2saAZX2pGHJfbohNe2h9aNS0Azet0vgTz2nkD30I3G68EgrJAIDbSaUBCCCB6DykMnArXlLWn6ALdr-_jwa4PCgbLG2HV4jQNYBf4ngl0QutVuoDATGJylAaXXK5xAiOZd-ILtZGffTZYhBzq4vLmo5zD_Dg6XmrzbnEUvlDCErw7nafTt6vK2_jy9_vJpXl9cT2Wap-WU8TxLBENZpG0iS1FUqihzhTFXGctTtsiQV6qVRcaxlcglT5UocME5yxkylp5G7_beEPV-RPJNp0miMaJHO1KTlIxznublFn37D3pnRxf23FI8rvKMV3mg3u8pGXYnh6oZnO6E2zRJ3GwLbkLBza7gwL45GMdFh-1f8k-jATjfA2ttcPN_U1PXH_fKJ6GctRU</recordid><startdate>201701</startdate><enddate>201701</enddate><creator>Haiek, Carlos</creator><creator>Fernández‐Pereira, Carlos</creator><creator>Santaera, Omar</creator><creator>Mieres, Juan</creator><creator>Rifourcat, Ignacio</creator><creator>Lloberas, Juan</creator><creator>Larribau, Miguel</creator><creator>Pocoví, Antonio</creator><creator>Rodriguez‐Granillo, Alfredo M.</creator><creator>Sarmiento, Ricardo A.</creator><creator>Antoniucci, David</creator><creator>Rodriguez, Alfredo E.</creator><general>Wiley Subscription Services, Inc</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>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201701</creationdate><title>Second vs. First generation drug eluting stents in multiple vessel disease and left main stenosis: Two‐year follow‐up of the observational, prospective, controlled, and multicenter ERACI IV registry</title><author>Haiek, Carlos ; Fernández‐Pereira, Carlos ; Santaera, Omar ; Mieres, Juan ; Rifourcat, Ignacio ; Lloberas, Juan ; Larribau, Miguel ; Pocoví, Antonio ; Rodriguez‐Granillo, Alfredo M. ; Sarmiento, Ricardo A. ; Antoniucci, David ; Rodriguez, Alfredo E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-26541a2ec73d1c8a79f785fe06f42532b4e69fdc746edce6c63fa7eb66252e223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Argentina</topic><topic>complex PCI</topic><topic>coronary artery disease</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - mortality</topic><topic>Coronary Artery Disease - therapy</topic><topic>Coronary Stenosis - diagnostic imaging</topic><topic>Coronary Stenosis - mortality</topic><topic>Coronary Stenosis - therapy</topic><topic>Disease-Free Survival</topic><topic>Drug-Eluting Stents</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myocardial Infarction - etiology</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Percutaneous Coronary Intervention - instrumentation</topic><topic>Percutaneous Coronary Intervention - mortality</topic><topic>Propensity Score</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Prosthesis Design</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>stent thrombosis</topic><topic>stenting technique</topic><topic>Stents</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haiek, Carlos</creatorcontrib><creatorcontrib>Fernández‐Pereira, Carlos</creatorcontrib><creatorcontrib>Santaera, Omar</creatorcontrib><creatorcontrib>Mieres, Juan</creatorcontrib><creatorcontrib>Rifourcat, Ignacio</creatorcontrib><creatorcontrib>Lloberas, Juan</creatorcontrib><creatorcontrib>Larribau, Miguel</creatorcontrib><creatorcontrib>Pocoví, Antonio</creatorcontrib><creatorcontrib>Rodriguez‐Granillo, Alfredo M.</creatorcontrib><creatorcontrib>Sarmiento, Ricardo A.</creatorcontrib><creatorcontrib>Antoniucci, David</creatorcontrib><creatorcontrib>Rodriguez, Alfredo E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haiek, Carlos</au><au>Fernández‐Pereira, Carlos</au><au>Santaera, Omar</au><au>Mieres, Juan</au><au>Rifourcat, Ignacio</au><au>Lloberas, Juan</au><au>Larribau, Miguel</au><au>Pocoví, Antonio</au><au>Rodriguez‐Granillo, Alfredo M.</au><au>Sarmiento, Ricardo A.</au><au>Antoniucci, David</au><au>Rodriguez, Alfredo E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Second vs. First generation drug eluting stents in multiple vessel disease and left main stenosis: Two‐year follow‐up of the observational, prospective, controlled, and multicenter ERACI IV registry</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2017-01</date><risdate>2017</risdate><volume>89</volume><issue>1</issue><spage>37</spage><epage>46</epage><pages>37-46</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><coden>CARIF2</coden><abstract>Objective
To compare second generation drug eluting stents (2DES) with first generation (1DES) for the treatment of patients (pts) with multiple coronary vessel disease (MVD).
Background
Although 2DES improved safety and efficacy compared to 1DES, MVD remains a challenge for percutaneous coronary interventions.
Methods
ERACI IV was a prospective, observational, and controlled study in pts with MVD including left main and treated with 2DES (Firebird 2, Microport). We included 225 pts in 15 sites from Argentina. Primary endpoint was the incidence of major adverse cardiovascular events (MACCE) defined as death, myocardial infarction (MI), cerebrovascular accident (CVA) and unplanned revascularization; and to compare with 225 pts from ERACI III study (1DES). PCI strategy was planned to treat lesions ≥70% in vessels ≥ 2.00 mm, introducing a modified Syntax score (SS) where severe lesions in vessels < 2.0 mm and intermediate lesions were not scored.
Results
Baseline characteristics showed that compared to ERACI III, ERACI IV pts had higher number of diabetics (P = 0.02), previous revascularization (P = 0.007), unstable angina IIb/IIIc (P < 0.001) and three vessels/left main disease (P = 0.003). Modified SS was 22.2 ± 11. At 2 years of follow‐up ERACI IV group had significantly lower incidence of death+ MI + CVA, (P = 0.01) and MACCE (P = 0.001). MACCE rate was similar in diabetics, (5.8%) and nondiabetics (7.0%). After performing a matched propensity score, MACCE remain significantly lower in ERACI IV (P = 0.005).
Conclusion
This registry showed that 2DES in MVD has a remarkable low incidence of MACCE in unadjusted and adjusted analysis. © 2016 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>26947138</pmid><doi>10.1002/ccd.26468</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1522-1946 |
| ispartof | Catheterization and cardiovascular interventions, 2017-01, Vol.89 (1), p.37-46 |
| issn | 1522-1946 1522-726X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1826663582 |
| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Aged Argentina complex PCI coronary artery disease Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - mortality Coronary Artery Disease - therapy Coronary Stenosis - diagnostic imaging Coronary Stenosis - mortality Coronary Stenosis - therapy Disease-Free Survival Drug-Eluting Stents Female Humans Kaplan-Meier Estimate Logistic Models Male Middle Aged Multivariate Analysis Myocardial Infarction - etiology Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - instrumentation Percutaneous Coronary Intervention - mortality Propensity Score Proportional Hazards Models Prospective Studies Prosthesis Design Registries Risk Factors Severity of Illness Index stent thrombosis stenting technique Stents Time Factors Treatment Outcome |
| title | Second vs. First generation drug eluting stents in multiple vessel disease and left main stenosis: Two‐year follow‐up of the observational, prospective, controlled, and multicenter ERACI IV registry |
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