Clinical outcome of patients with chronic total occlusion treated with drug-eluting stents.
BACKGROUND
There is limited evidence on the medium-term prognosis of patients with chronic total occlusion successfully treated with drug-eluting stent (DES) implantation.


METHODS
We compared the medium-term outcome of 111 patients with chronic total occlusion (CTO) successfully treated with implantation of sirolimus-or paclitaxel-eluting stents versus 112 patients treated with bare metal stents.


RESULTS
During an overall follow-up period of 18 months, the composite endpoint of death, myocardial infarction or target lesion revascularization was significantly lower in the drug-eluting stent than in the bare metal stent group: 8.1% vs. 21.6%, respectively (p=0.005). The difference was due to the reduction of target lesion revascularization with DES compared to bare metal stents: 3.6% vs. 18.9%, respectively (p<0.001). The Cox proportional hazards model identified DES as an independent predictor of adverse cardiac events (adjusted hazard ratio, 0.16; 95% confidence interval 0.05 to 0.52, p=0.002).


CONCLUSIONS
During medium-term follow-up use of DES is associated with improved outcome compared to use of bare metal stents in patients with CTO.
De Felice
Francesco
F
Unità Operativa Cardiologia Interventistica, Ospedale S. Camillo Forlanini, Rome, Italy. f.defelice@lycos.com
Fiorilli
Rosario
R
Parma
Antonio
A
Menichelli
Maurizio
M
Nazzaro
Marco Stefano
MS
Pucci
Edoardo
E
Dibra
Alban
A
Musto
Carmine
C
Violini
Roberto
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000188:drug therapy / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D017239:Paclitaxel / Q000008:administration & dosage*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus