- Email: [email protected]
TCT-433: Ostial Stenting for the Isolated Ostial Lesion of Left Anterior Descending Artery: Effectiveness of Sirolimus-eluting Stent
http://www.aievolution.com/tct0901/
TUESDAY, SEPTEMBER 22, 2009, 8:00AM - 10:00AM
TCT-432
and to determine the predictors of MACEs after either sirolimus-eluting stent (SES) or paclitaxel-eluting stent (PES) implantation in diabetic patients during 3-year follow-up. Methods: Diabetic patients with de novo coronary lesions (169 patients with 190 lesions) were randomly assigned prospectively to either SES or PES in 6 different cardiovascular centers. Results: Baseline clinical and angiographic characteristics were similar EHWZHHQWKHJURXSV7KHUDWHVRI0$&(V >Q @LQWKH6(6YV >Q @LQWKH3(6*URXSS DQGGH¿QLWHVWHQWWKURPERVLV >Q @LQ WKH6(6YV>Q @LQWKH3(6*URXSS ZHUHVLPLODUEHWZHHQWKH 2 groups during the 3-year follow-up. Multivariate logistic analysis showed that insulin treatment was the only independent predictor of MACE (odds UDWLR>25@ FRQ¿GHQFHLQWHUYDO>&,@WRS 7/5 (OR 5.19, 95% CI 1.22 to 22.09, p = 0.026), and TVR (OR 9.50, 95% CI 3.07 to 29.44, p < 0.001) during the 3-year follow-up. Conclusion: The use of either SESs or PESs was effective in reducing MACEs (death, nonfatal MI, TLR), TVR, and stent thrombosis during the 3-year follow-up. Moreover, insulin treatment was a main predictor of TLR, TVR, and MACEs during the 3-year follow-up after either SES or PES implantation.
Comparison of Zotarolimus-Eluting Stents versus Sirolimus- and Paclitaxel-Eluting Stents for the Treatment of Multivessel Coronary Artery disease Hyung Oh Choi, Duk-Woo Park, Won-Jang Kim, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Jae-Joong Kim, Seong-Wook Park, Seung-Jung Park Asan Medical Center, Seoul, Republic of Korea Objectives: Data comparing second-generation zotarolimus-eluting stents =(6 ZLWK ¿UVWJHQHUDWLRQ VLUROLPXV 6(6 DQG SDFOLWD[HOHOXWLQJ VWHQWV (PES) for treatment of multivessel coronary disease (MVD) have been limited. Methods: We performed the subgroup analysis of patients with MVD from the ZEST trial comparing ZES with SES and PES in daily clinical practice. A total of 1254 patients with MVD were treated with ZES (414 patients), SES (430 patients), and PES (410 patients). The primary end point was the composite clinical outcomes of death, myocardial infarction, and ischemia driven target vessel revascularization (TVR) at 12month after index procedure. Results: Most of baseline demographics and angiographic characteristics were similar among the 3 groups. At 12 months, the rate of primary end point in the ZES group (12.2) was similar to the SES group (10.2), but superior to the PES group (17.6) (Figure 1). This outcome difference was mainly attributable WRWKHVLJQL¿FDQWGLIIHUHQFHRI795DPRQJWKHJURXSV =(66(6 and PES 8.2%) (Figure 2). During 12 months, 5 patients (1.2%) in the PES JURXSDQG SDWLHQWVLQWKH=(6JURXSKDGGH¿QLWHRUSUREDEOHVWHQW thrombosis, but none in the SES group (overall P=0.04).
TCT-431 Stent Thromboses Occur on Antiplatelet Therapy After Paclitaxel Eluting Taxus Stent Implantation for Treatment of ST-Elevation Myocardial Infarction: A Bicentric Prospective Study Jochen Wöhrle1, Thorsten Nusser1, Annette Koch2, Andreas Rillig2, Matthias Kochs1, Werner Jung2, Vinzenz Hombach1, Ralf Birkemeyer2 1 University of Ulm, Ulm, Germany2Schwarzwald-Baar Klinikum, Villingen-Schwenningen, Germany Background: We evaluated the occurrence of ST in patients with ST elevation myocardial infarction (STEMI) treated with the Paclitaxel eluting Taxus stent. Methods: We conducted a prospective bicentric study. STEMI patients were clinically followed and occurrence of MACE and ST were documented. 0$&(ZDVGH¿QHGDVGHDWKRIHYHU\FDXVHP\RFDUGLDOLQIDUFWLRQ 67(0, and NSTEMI) at every localisation and need for re-PCI at the target lesion (PCI or CABG). ASS and clopidogrel was given for 9-12 months. Results: Between 07/2004 and 09/2007 we included 339 patients with a mean age of 62±12 years. Patients had diabetes mellitus in 20%. 22 (6.5%) patients ZHUHLQFDUGLRJHQLFVKRFNDQG KDGUHFHLYHG&357DUJHWYHVVHOZDV in 125 (36.9%) patients LAD, in 63 (18.6%) CX, in 145 (42.8%) RCA and in 6 D69*7KHUHIHUHQFHGLDPHWHUZDVPP*O\NRSURWHLQ,,E,,,D inhibitors were given in 79%. Mean stent length was 28.2±13.6mm. Patients were clinically followed for mean 781±290days (range 0-1414 days; median 768 days). There were 16 (4.7%) ST within the total follow-up period. There ZDVQRDFXWHVXEDFXWH ODWHDQG YHU\ODWHGH¿QLWH ST according to the ARC criteria. ST rate within 12 months was 2.7%. ST occurred on dual antiplatelet therapy in 8 patients (1 subacute, 4 late, 3 very late), on single ASA therapy in 4 patients (2 late, 2 very late) and on single clopidogrel therapy in 4 patients (2 late, 2 very late). Patients with ST suffered from death in two and myocardial infarction in 14 patients. All 16 patients were treated by re-PCI. MACE rate (hierarchical, ST included) was in total 16.6% (N=56/337). Events were death of 27/337 (8.0%) patients (13 cardiac, 12 nonFDUGLDFXQNQRZQ P\RFDUGLDOLQIDUFWLRQLQ DQGUH3&,&$%*LQ 8 (2.4%) patients. Myocardial infarction was due to 12 STEMI and 4 NSTEMI in the target vessel and 2 STEMI and 3 NSTEMI in non-target area. There were additional 11 (3.3%) re-PCIs in the target vessel remote of the target lesion. MACE (hierarchical, ST not included) were death of 24/319 (7.5%) patients, myocardial infarction in 7 (2.2%) and re-PCI/CABG in 8 (2.5%). Conclusion: Treatment of STEMI patients with the Taxus stent was associated with a low clinical re-intervention rate. The angiographic documented frequency of stent thrombosis within 12 months was 2.7% and for the total follow-up period 4.7%. ST occurred mainly late and very late (94%). All patients with ST were on antiplatelet therapy.
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September 21-25, 2009
TCT-433 Ostial Stenting for the Isolated Ostial Lesion of Left Anterior Descending Artery: Effectiveness of Sirolimus-eluting Stent Yasushi Fuku, Kazushige Kadota, Suguru Otsuru, Masao Imai, Daiji Hasegawa, Seiji Habara, Hiroyuki Tanaka, Shingo Hosogi, Tsuyoshi Goto, Kazuaki Mitsudo Kurashiki Central Hospital, Kurashiki City, Japan Background: For the treatment of the isolated ostial lesion of left anterior descending artery (LAD), ostial stenting using bare metal stent (BMS) has been reported to be not effective. However, there is a possibility that ostial stenting using drug-eluting stent (DES) can be another strategy in the DES era. Therefore, we compared the midterm clinical and angiographic results between sirolimus-eluting stent (SES) and BMS. Methods: In this retrospective study, 90 consecutive patients with the isolated ostial lesion of LAD underwent SES (n=45) or BMS (n=45) implantation EHWZHHQ -DQXDU\ DQG -XO\ ,VRODWHG RVWLDO OHVLRQ RI /$' ZDV GH¿QHGDVVWHQRVLVZLWKLQPPRIRVWLXPRI/$'ZLWKRXWWKHGLVWDO OHVLRQRI/07RUWKHRVWLDOOHVLRQRIOHIWFLUFXPÀH[DUWHU\ /&; Results: The patient and procedural characteristics at baseline were similar except the higher prevalance of patients with acute coronary syndrome in the BMS group. All stents were successfully implanted without adjunct
|
TCT Abstracts/POSTER
159D
P O S T E R A B S T R AC T S
The American Journal of Cardiology®
Conclusions: For patients with multivessel coronary disease, the use of ZES resulted in similar major adverse cardiac events to SES, but in fewer events than PES.
http://www.aievolution.com/tct0901/
TUESDAY, SEPTEMBER 22, 2009, 8:00AM - 10:00AM
ballooning of LCX. At 6-8 months follow-up, 1 noncardiac death occurred in the SES group and 2 noncardiac deaths occurred in the BMS group (2.2% vs. 4.4%, P=0.99). No cardiac death and acute myocardial infarction occurred. Angiographic follow-up was available in 86.7% of patients in the SES group and 84.4% of those in the BMS group. Quantitative coronary angiographic DQDO\VLVLVVKRZQLQWKHWDEOH7KHUHVWHQRVLVUDWHZDVVLJQL¿FDQWO\ORZHULQ the SES group compared with the BMS group (5.1 vs. 52.6%, P<0.001).
Underweight Normal Overweight Obesity p value n
479
All-cause death, n(%) Myocardial Infarction. n(%) Stroke, n(%)
6525 533 113 (23.6%) (8.2%) 180 15 (3.1%) (2.8%) 223 23 (4.8%) (3.4%) 1001 64 (13.4%) (15.3%)
TVR, n(%) Composite adverse cardiac and 1640 185 (38.6%) cerebrovascular events, (25.1%) n(%)
3292
479
149 (4.5%) 15 (3.1%) p<0.0001 19 70 (2.1%) p=0.064 (4.0%) 16 92 (2.8%) p=0.11 (3.3%) 84 500 (15.2%) p=0.35 (17.5%) 709 (21.5%)
113 p<0.0001 (23.6%)
Conclusion: Although the rate of TVR in patients who received SES is independent of BMI, underweight patients were more associated with adverse clinical events than normal, overweight and obese patients. TCT-435
Conclusions: The angiographic outcome of ostial stenting with SES as opposed to BMS was excellent for the isolated ostial lesion of LAD. Ostial stenting using SES could be another effective strategy for the treatment of the isolated ostial lesion of LAD. TCT-434 Impact of Body Mass Index on the Outcome of Patients Treating With Sirolimus Eluting Stents
P O S T E R A B S T R AC T S
Takafumi Yamane1, Mitsuru Abe1, Yukiko Ooe1, Futoshi Yamanaka1, Nobuhito Yagi1, Nobuaki Kokubu1, Yoichiro Kasahara1, Yu Kataoka1, Yoritaka Otsuka1, Takeshi Morimoto2, Kazuaki Mitsudo3, Takeshi Kimura4, Hiroshi Nonogi1 1 National Cardiovascular Center, Suita, Japan2Kyoto University Graduate School of Medicine, Kyoto, Japan3Kurashiki Central Hospital, Kurashiki, Japan4Kyoto University, Kyoto, Japan Background: Although obese patients who received bare-metal stents demonstrated increased incidences of target vessel revascularization (TVR) and adverse clinical events, those events in patients who received paclitaxeleluting stents were not related to body mass index (BMI). There is little information about the effect of BMI on TVR and adverse clinical events in patients who received sirolimus-eluting stents (SES). Methods and results: Design of j-CYPHER registry was multi-center prospective enrollment of consecutive patients receiving SES implantation IURP FHQWHUV LQ -DSDQ )URP $XJXVW WR 1RYHPEHU patients with 17545 lesions were implanted with SES and 10778 patients treated exclusively with SES were included in this study. Median follow up period was 718 days (interquartile range 407 to 1095 days). We used BMI categories of 18.5 or less (underweight), 18.5 to less than 25 (normal weight), 25 to less than 30 (overweight), 30 or greater (obesity) as previously reported. Major adverse cardiac and cerebrovascular events (MACCE) included allFDXVHGHDWKP\RFDUGLDOLQIDUFWLRQVWURNHDQG7953DWLHQWVLQXQGHUZHLJKW JURXS ZHUH ROGHU OHVV OLNHO\ WR KDYH K\SHUWHQVLRQ K\SHUOLSLGHPLD DQG GLDEHWHV DQG PRUH OLNHO\ WR EH IHPDOH DQG RQ KHPRGLDO\VLV WKDQ WKH RWKHU groups. The incidences of MACCE of these patients are shown in the table.
160D
Impact of Smoking on the Outcome of Patients Treated with DrugEluting Stents: One-Year Results from the Prospective Multicentre German Drug-Eluting Stent Registry (DES.DE) Mohammad A. Sherif1, Gert Richardt1, Ralph Toelg1, Mohamed AbdelWahab1, Steffen Schneider2, Jochen Senges2, Karl-Heinz Kuck3, Christoph A. Nienaber4, Ulrich Tebbe5, DES.DE Study Group 1 Herz-Kreislauf Zentrum, Segeberger Kliniken, Bad Segeberg, Germany2Klinikum der Stadt Ludwigshafen GmbH, Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany3Allgemeines Krankenhaus St Georg, Hamburg, Germany4Klinik und Poliklinik für Innere Medizin, Universitätsklinikum Rostock, Rostock, Germany5Medizinische Klinik II, Klinikum Lippe-Detmold, Detmold, Germany Background: &LJDUHWWHVPRNLQJLVVWURQJO\UHODWHGWRPRUELGLW\DQGPRUWDOLW\ IURPFDUGLRYDVFXODUFDXVHVEXWWKHHIIHFWRIVPRNLQJRQWKHFOLQLFDORXWFRPH RISDWLHQWVWUHDWHGZLWKGUXJHOXWLQJVWHQWV '(6 LVXQNQRZQ Objectives: 7RDVVHVVWKHLPSDFWRIVPRNLQJRQRXWFRPHRISDWLHQWVWUHDWHG with DES. Methods & Results: The population for this study was drawn from a total of 6384 patients who were enrolled between October 2005 and October 2006 at 98 sites in the prospective multicentre German Drug-Eluting Stent Registry (DES.DE). This analysis was based on 4660 patients who underwent VXFFHVVIXO3&,XVLQJ'(6$IWHUH[FOXVLRQRIWKHVRFDOOHGH[VPRNHUV SDWLHQWV WKH\ZHUHGLYLGHGDFFRUGLQJWRWKHLUVPRNLQJKDELWLQWR VPRNHUV SDWLHQWV DQGQRQVPRNHUV SDWLHQWV &RPSDUHGWRQRQVPRNHUVVPRNHUVZHUHSUHGRPLQDQWO\PDOHVDQGVLJQL¿FDQWO\ \RXQJHU \HDUVYV \HDUVS 2WKHUULVNIDFWRUVVXFKDVGLDEHWHV DQGK\SHUWHQVLRQZHUHOHVVLQWKHVPRNHUVJURXS7KHVPRNHUVSUHVHQWHGZLWK PRUH DFXWH FRURQDU\ V\QGURPHV DQG PRUH VHYHUH DQJLRJUDSKLF ¿QGLQJV 7KHSDWLHQWVZHUHIROORZHGXSIRUPRQWKV&RPSDUHGWRQRQVPRNHUV VPRNHUVKDGVLJQL¿FDQWO\KLJKHUPRUWDOLW\ YHUVXV >25 &, @S DQGP\RFDUGLDOLQIDUFWLRQ 0, UDWHV YHUVXV >25 &,@S 6LPLODUO\WKHVPRNHUVKDGKLJKHU UDWHVRIPDMRUDGYHUVHFDUGLDFDQGFHUHEURYDVFXODUHYHQWV 0$&&( >GH¿QHG as the composite of death (cardiac and non-cardiac), myocardial infarction and VWURNH@ YHUVXV >25 &,@S 0RUHRYHU DIWHU DGMXVWPHQW IRU EDVHOLQH FOLQLFDO DQG DQJLRJUDSKLF YDULDEOHV VPRNLQJ continued to be an independent predictor for MACCE (OR=2.34; 95% CI $OWKRXJKWKH\GLGQRWUHDFKVWDWLVWLFDOO\VLJQL¿FDQWOHYHOVUDWHV RIRYHUDOOVWHQWWKURPERVLVDFFRUGLQJWR$5&FULWHULDDQGVWURNHZHUHKLJKHU DPRQJVPRNHUV YHUVXVS DQGYVSYDOXH respectively), whereas clinically-driven target vessel revascularization (TVR) UDWHVZHUHKLJKHUDPRQJQRQVPRNHUV YV S Conclusion: 2XU UHVXOWV LQGLFDWH WKDW VPRNHUV GHVSLWH KDYLQJ D ORZHU LQFLGHQFHRINQRZQSUHGLVSRVLQJULVNIDFWRUVIRUDWKHURVFOHURVLVKDYHKLJKHU UDWHVRIPRUWDOLW\0,DQG0$&&(FRPSDUHGWRQRQVPRNHUV2QWKHRWKHU KDQGVPRNLQJKDGOHVVHIIHFWRQWKHUDWHVRI795
The American Journal of Cardiology® |
September 21-25, 2009
|
TCT Abstracts/POSTER
TUESDAY, SEPTEMBER 22, 2009, 8:00AM - 10:00AM
TCT-432
and to determine the predictors of MACEs after either sirolimus-eluting stent (SES) or paclitaxel-eluting stent (PES) implantation in diabetic patients during 3-year follow-up. Methods: Diabetic patients with de novo coronary lesions (169 patients with 190 lesions) were randomly assigned prospectively to either SES or PES in 6 different cardiovascular centers. Results: Baseline clinical and angiographic characteristics were similar EHWZHHQWKHJURXSV7KHUDWHVRI0$&(V >Q @LQWKH6(6YV >Q @LQWKH3(6*URXSS DQGGH¿QLWHVWHQWWKURPERVLV >Q @LQ WKH6(6YV>Q @LQWKH3(6*URXSS ZHUHVLPLODUEHWZHHQWKH 2 groups during the 3-year follow-up. Multivariate logistic analysis showed that insulin treatment was the only independent predictor of MACE (odds UDWLR>25@ FRQ¿GHQFHLQWHUYDO>&,@WRS 7/5 (OR 5.19, 95% CI 1.22 to 22.09, p = 0.026), and TVR (OR 9.50, 95% CI 3.07 to 29.44, p < 0.001) during the 3-year follow-up. Conclusion: The use of either SESs or PESs was effective in reducing MACEs (death, nonfatal MI, TLR), TVR, and stent thrombosis during the 3-year follow-up. Moreover, insulin treatment was a main predictor of TLR, TVR, and MACEs during the 3-year follow-up after either SES or PES implantation.
Comparison of Zotarolimus-Eluting Stents versus Sirolimus- and Paclitaxel-Eluting Stents for the Treatment of Multivessel Coronary Artery disease Hyung Oh Choi, Duk-Woo Park, Won-Jang Kim, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Jae-Joong Kim, Seong-Wook Park, Seung-Jung Park Asan Medical Center, Seoul, Republic of Korea Objectives: Data comparing second-generation zotarolimus-eluting stents =(6 ZLWK ¿UVWJHQHUDWLRQ VLUROLPXV 6(6 DQG SDFOLWD[HOHOXWLQJ VWHQWV (PES) for treatment of multivessel coronary disease (MVD) have been limited. Methods: We performed the subgroup analysis of patients with MVD from the ZEST trial comparing ZES with SES and PES in daily clinical practice. A total of 1254 patients with MVD were treated with ZES (414 patients), SES (430 patients), and PES (410 patients). The primary end point was the composite clinical outcomes of death, myocardial infarction, and ischemia driven target vessel revascularization (TVR) at 12month after index procedure. Results: Most of baseline demographics and angiographic characteristics were similar among the 3 groups. At 12 months, the rate of primary end point in the ZES group (12.2) was similar to the SES group (10.2), but superior to the PES group (17.6) (Figure 1). This outcome difference was mainly attributable WRWKHVLJQL¿FDQWGLIIHUHQFHRI795DPRQJWKHJURXSV =(66(6 and PES 8.2%) (Figure 2). During 12 months, 5 patients (1.2%) in the PES JURXSDQG SDWLHQWVLQWKH=(6JURXSKDGGH¿QLWHRUSUREDEOHVWHQW thrombosis, but none in the SES group (overall P=0.04).
TCT-431 Stent Thromboses Occur on Antiplatelet Therapy After Paclitaxel Eluting Taxus Stent Implantation for Treatment of ST-Elevation Myocardial Infarction: A Bicentric Prospective Study Jochen Wöhrle1, Thorsten Nusser1, Annette Koch2, Andreas Rillig2, Matthias Kochs1, Werner Jung2, Vinzenz Hombach1, Ralf Birkemeyer2 1 University of Ulm, Ulm, Germany2Schwarzwald-Baar Klinikum, Villingen-Schwenningen, Germany Background: We evaluated the occurrence of ST in patients with ST elevation myocardial infarction (STEMI) treated with the Paclitaxel eluting Taxus stent. Methods: We conducted a prospective bicentric study. STEMI patients were clinically followed and occurrence of MACE and ST were documented. 0$&(ZDVGH¿QHGDVGHDWKRIHYHU\FDXVHP\RFDUGLDOLQIDUFWLRQ 67(0, and NSTEMI) at every localisation and need for re-PCI at the target lesion (PCI or CABG). ASS and clopidogrel was given for 9-12 months. Results: Between 07/2004 and 09/2007 we included 339 patients with a mean age of 62±12 years. Patients had diabetes mellitus in 20%. 22 (6.5%) patients ZHUHLQFDUGLRJHQLFVKRFNDQG KDGUHFHLYHG&357DUJHWYHVVHOZDV in 125 (36.9%) patients LAD, in 63 (18.6%) CX, in 145 (42.8%) RCA and in 6 D69*7KHUHIHUHQFHGLDPHWHUZDVPP*O\NRSURWHLQ,,E,,,D inhibitors were given in 79%. Mean stent length was 28.2±13.6mm. Patients were clinically followed for mean 781±290days (range 0-1414 days; median 768 days). There were 16 (4.7%) ST within the total follow-up period. There ZDVQRDFXWHVXEDFXWH ODWHDQG YHU\ODWHGH¿QLWH ST according to the ARC criteria. ST rate within 12 months was 2.7%. ST occurred on dual antiplatelet therapy in 8 patients (1 subacute, 4 late, 3 very late), on single ASA therapy in 4 patients (2 late, 2 very late) and on single clopidogrel therapy in 4 patients (2 late, 2 very late). Patients with ST suffered from death in two and myocardial infarction in 14 patients. All 16 patients were treated by re-PCI. MACE rate (hierarchical, ST included) was in total 16.6% (N=56/337). Events were death of 27/337 (8.0%) patients (13 cardiac, 12 nonFDUGLDFXQNQRZQ P\RFDUGLDOLQIDUFWLRQLQ DQGUH3&,&$%*LQ 8 (2.4%) patients. Myocardial infarction was due to 12 STEMI and 4 NSTEMI in the target vessel and 2 STEMI and 3 NSTEMI in non-target area. There were additional 11 (3.3%) re-PCIs in the target vessel remote of the target lesion. MACE (hierarchical, ST not included) were death of 24/319 (7.5%) patients, myocardial infarction in 7 (2.2%) and re-PCI/CABG in 8 (2.5%). Conclusion: Treatment of STEMI patients with the Taxus stent was associated with a low clinical re-intervention rate. The angiographic documented frequency of stent thrombosis within 12 months was 2.7% and for the total follow-up period 4.7%. ST occurred mainly late and very late (94%). All patients with ST were on antiplatelet therapy.
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September 21-25, 2009
TCT-433 Ostial Stenting for the Isolated Ostial Lesion of Left Anterior Descending Artery: Effectiveness of Sirolimus-eluting Stent Yasushi Fuku, Kazushige Kadota, Suguru Otsuru, Masao Imai, Daiji Hasegawa, Seiji Habara, Hiroyuki Tanaka, Shingo Hosogi, Tsuyoshi Goto, Kazuaki Mitsudo Kurashiki Central Hospital, Kurashiki City, Japan Background: For the treatment of the isolated ostial lesion of left anterior descending artery (LAD), ostial stenting using bare metal stent (BMS) has been reported to be not effective. However, there is a possibility that ostial stenting using drug-eluting stent (DES) can be another strategy in the DES era. Therefore, we compared the midterm clinical and angiographic results between sirolimus-eluting stent (SES) and BMS. Methods: In this retrospective study, 90 consecutive patients with the isolated ostial lesion of LAD underwent SES (n=45) or BMS (n=45) implantation EHWZHHQ -DQXDU\ DQG -XO\ ,VRODWHG RVWLDO OHVLRQ RI /$' ZDV GH¿QHGDVVWHQRVLVZLWKLQPPRIRVWLXPRI/$'ZLWKRXWWKHGLVWDO OHVLRQRI/07RUWKHRVWLDOOHVLRQRIOHIWFLUFXPÀH[DUWHU\ /&; Results: The patient and procedural characteristics at baseline were similar except the higher prevalance of patients with acute coronary syndrome in the BMS group. All stents were successfully implanted without adjunct
|
TCT Abstracts/POSTER
159D
P O S T E R A B S T R AC T S
The American Journal of Cardiology®
Conclusions: For patients with multivessel coronary disease, the use of ZES resulted in similar major adverse cardiac events to SES, but in fewer events than PES.
http://www.aievolution.com/tct0901/
TUESDAY, SEPTEMBER 22, 2009, 8:00AM - 10:00AM
ballooning of LCX. At 6-8 months follow-up, 1 noncardiac death occurred in the SES group and 2 noncardiac deaths occurred in the BMS group (2.2% vs. 4.4%, P=0.99). No cardiac death and acute myocardial infarction occurred. Angiographic follow-up was available in 86.7% of patients in the SES group and 84.4% of those in the BMS group. Quantitative coronary angiographic DQDO\VLVLVVKRZQLQWKHWDEOH7KHUHVWHQRVLVUDWHZDVVLJQL¿FDQWO\ORZHULQ the SES group compared with the BMS group (5.1 vs. 52.6%, P<0.001).
Underweight Normal Overweight Obesity p value n
479
All-cause death, n(%) Myocardial Infarction. n(%) Stroke, n(%)
6525 533 113 (23.6%) (8.2%) 180 15 (3.1%) (2.8%) 223 23 (4.8%) (3.4%) 1001 64 (13.4%) (15.3%)
TVR, n(%) Composite adverse cardiac and 1640 185 (38.6%) cerebrovascular events, (25.1%) n(%)
3292
479
149 (4.5%) 15 (3.1%) p<0.0001 19 70 (2.1%) p=0.064 (4.0%) 16 92 (2.8%) p=0.11 (3.3%) 84 500 (15.2%) p=0.35 (17.5%) 709 (21.5%)
113 p<0.0001 (23.6%)
Conclusion: Although the rate of TVR in patients who received SES is independent of BMI, underweight patients were more associated with adverse clinical events than normal, overweight and obese patients. TCT-435
Conclusions: The angiographic outcome of ostial stenting with SES as opposed to BMS was excellent for the isolated ostial lesion of LAD. Ostial stenting using SES could be another effective strategy for the treatment of the isolated ostial lesion of LAD. TCT-434 Impact of Body Mass Index on the Outcome of Patients Treating With Sirolimus Eluting Stents
P O S T E R A B S T R AC T S
Takafumi Yamane1, Mitsuru Abe1, Yukiko Ooe1, Futoshi Yamanaka1, Nobuhito Yagi1, Nobuaki Kokubu1, Yoichiro Kasahara1, Yu Kataoka1, Yoritaka Otsuka1, Takeshi Morimoto2, Kazuaki Mitsudo3, Takeshi Kimura4, Hiroshi Nonogi1 1 National Cardiovascular Center, Suita, Japan2Kyoto University Graduate School of Medicine, Kyoto, Japan3Kurashiki Central Hospital, Kurashiki, Japan4Kyoto University, Kyoto, Japan Background: Although obese patients who received bare-metal stents demonstrated increased incidences of target vessel revascularization (TVR) and adverse clinical events, those events in patients who received paclitaxeleluting stents were not related to body mass index (BMI). There is little information about the effect of BMI on TVR and adverse clinical events in patients who received sirolimus-eluting stents (SES). Methods and results: Design of j-CYPHER registry was multi-center prospective enrollment of consecutive patients receiving SES implantation IURP FHQWHUV LQ -DSDQ )URP $XJXVW WR 1RYHPEHU patients with 17545 lesions were implanted with SES and 10778 patients treated exclusively with SES were included in this study. Median follow up period was 718 days (interquartile range 407 to 1095 days). We used BMI categories of 18.5 or less (underweight), 18.5 to less than 25 (normal weight), 25 to less than 30 (overweight), 30 or greater (obesity) as previously reported. Major adverse cardiac and cerebrovascular events (MACCE) included allFDXVHGHDWKP\RFDUGLDOLQIDUFWLRQVWURNHDQG7953DWLHQWVLQXQGHUZHLJKW JURXS ZHUH ROGHU OHVV OLNHO\ WR KDYH K\SHUWHQVLRQ K\SHUOLSLGHPLD DQG GLDEHWHV DQG PRUH OLNHO\ WR EH IHPDOH DQG RQ KHPRGLDO\VLV WKDQ WKH RWKHU groups. The incidences of MACCE of these patients are shown in the table.
160D
Impact of Smoking on the Outcome of Patients Treated with DrugEluting Stents: One-Year Results from the Prospective Multicentre German Drug-Eluting Stent Registry (DES.DE) Mohammad A. Sherif1, Gert Richardt1, Ralph Toelg1, Mohamed AbdelWahab1, Steffen Schneider2, Jochen Senges2, Karl-Heinz Kuck3, Christoph A. Nienaber4, Ulrich Tebbe5, DES.DE Study Group 1 Herz-Kreislauf Zentrum, Segeberger Kliniken, Bad Segeberg, Germany2Klinikum der Stadt Ludwigshafen GmbH, Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany3Allgemeines Krankenhaus St Georg, Hamburg, Germany4Klinik und Poliklinik für Innere Medizin, Universitätsklinikum Rostock, Rostock, Germany5Medizinische Klinik II, Klinikum Lippe-Detmold, Detmold, Germany Background: &LJDUHWWHVPRNLQJLVVWURQJO\UHODWHGWRPRUELGLW\DQGPRUWDOLW\ IURPFDUGLRYDVFXODUFDXVHVEXWWKHHIIHFWRIVPRNLQJRQWKHFOLQLFDORXWFRPH RISDWLHQWVWUHDWHGZLWKGUXJHOXWLQJVWHQWV '(6 LVXQNQRZQ Objectives: 7RDVVHVVWKHLPSDFWRIVPRNLQJRQRXWFRPHRISDWLHQWVWUHDWHG with DES. Methods & Results: The population for this study was drawn from a total of 6384 patients who were enrolled between October 2005 and October 2006 at 98 sites in the prospective multicentre German Drug-Eluting Stent Registry (DES.DE). This analysis was based on 4660 patients who underwent VXFFHVVIXO3&,XVLQJ'(6$IWHUH[FOXVLRQRIWKHVRFDOOHGH[VPRNHUV SDWLHQWV WKH\ZHUHGLYLGHGDFFRUGLQJWRWKHLUVPRNLQJKDELWLQWR VPRNHUV SDWLHQWV DQGQRQVPRNHUV SDWLHQWV &RPSDUHGWRQRQVPRNHUVVPRNHUVZHUHSUHGRPLQDQWO\PDOHVDQGVLJQL¿FDQWO\ \RXQJHU \HDUVYV \HDUVS 2WKHUULVNIDFWRUVVXFKDVGLDEHWHV DQGK\SHUWHQVLRQZHUHOHVVLQWKHVPRNHUVJURXS7KHVPRNHUVSUHVHQWHGZLWK PRUH DFXWH FRURQDU\ V\QGURPHV DQG PRUH VHYHUH DQJLRJUDSKLF ¿QGLQJV 7KHSDWLHQWVZHUHIROORZHGXSIRUPRQWKV&RPSDUHGWRQRQVPRNHUV VPRNHUVKDGVLJQL¿FDQWO\KLJKHUPRUWDOLW\ YHUVXV >25 &, @S DQGP\RFDUGLDOLQIDUFWLRQ 0, UDWHV YHUVXV >25 &,@S 6LPLODUO\WKHVPRNHUVKDGKLJKHU UDWHVRIPDMRUDGYHUVHFDUGLDFDQGFHUHEURYDVFXODUHYHQWV 0$&&( >GH¿QHG as the composite of death (cardiac and non-cardiac), myocardial infarction and VWURNH@ YHUVXV >25 &,@S 0RUHRYHU DIWHU DGMXVWPHQW IRU EDVHOLQH FOLQLFDO DQG DQJLRJUDSKLF YDULDEOHV VPRNLQJ continued to be an independent predictor for MACCE (OR=2.34; 95% CI $OWKRXJKWKH\GLGQRWUHDFKVWDWLVWLFDOO\VLJQL¿FDQWOHYHOVUDWHV RIRYHUDOOVWHQWWKURPERVLVDFFRUGLQJWR$5&FULWHULDDQGVWURNHZHUHKLJKHU DPRQJVPRNHUV YHUVXVS DQGYVSYDOXH respectively), whereas clinically-driven target vessel revascularization (TVR) UDWHVZHUHKLJKHUDPRQJQRQVPRNHUV YV S Conclusion: 2XU UHVXOWV LQGLFDWH WKDW VPRNHUV GHVSLWH KDYLQJ D ORZHU LQFLGHQFHRINQRZQSUHGLVSRVLQJULVNIDFWRUVIRUDWKHURVFOHURVLVKDYHKLJKHU UDWHVRIPRUWDOLW\0,DQG0$&&(FRPSDUHGWRQRQVPRNHUV2QWKHRWKHU KDQGVPRNLQJKDGOHVVHIIHFWRQWKHUDWHVRI795
The American Journal of Cardiology® |
September 21-25, 2009
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TCT Abstracts/POSTER