Coronary artery diseaseImpact of Three or More Versus a Single Sirolimus-Eluting Stent on Outcomes in Patients Who Undergo Percutaneous Coronary Intervention
Section snippets
Methods
We retrospectively analyzed patients who underwent PCI with SESs (Cypher, Johnson & Johnson Cordis Corp.) at the Washington Hospital Center (Washington, DC). Since approval of the SES in March 2003 by the Food and Drug Administration, 929 consecutive patients who received SESs were identified; 63 patients received ≥3 SES implantations (multi group) and 866 received a single SES implantation (single group). There were 128 diseased vessels in the multi group and 891 diseased vessels in the single
Results
Baseline clinical and angiographic characteristics are listed in Table 1, Table 2. These characteristics are well balanced between groups. In-hospital complications and 30-day and 6-month clinical outcomes are presented in Table 3. During the index hospitalization, the multi group had significantly higher rates of periprocedural non–Q-wave MI (p = 0.02) than did the single group.
At 30-day follow-up, the multi group had significantly higher rates of death, Q-wave MI, target lesion
Discussion
The present study demonstrates that patients who underwent PCI with ≥3 SES implantations had significantly higher rates of in-hospital non–Q-wave MI and of death, Q-wave MI, target lesion revascularization, target vessel revascularization, and major adverse cardiac events at follow-up than did patients with the same risk profiles who underwent PCI with a single SES implantation. In addition, the multi group had a significantly lower survival rate compared with the single group. Therefore, the
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