title: Clinical outcome of patients with chronic total occlusion treated with drug-eluting stents.
abstract: 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.
authors.affiliation: Unità Operativa Cardiologia Interventistica, Ospedale S. Camillo Forlanini, Rome, Italy. f.defelice@lycos.com
authors.forename: Francesco
authors.initials: F
authors.lastname: De Felice
authors.forename: Rosario
authors.initials: R
authors.lastname: Fiorilli
authors.forename: Antonio
authors.initials: A
authors.lastname: Parma
authors.forename: Maurizio
authors.initials: M
authors.lastname: Menichelli
authors.forename: Marco Stefano
authors.initials: MS
authors.lastname: Nazzaro
authors.forename: Edoardo
authors.initials: E
authors.lastname: Pucci
authors.forename: Alban
authors.initials: A
authors.lastname: Dibra
authors.forename: Carmine
authors.initials: C
authors.lastname: Musto
authors.forename: Roberto
authors.initials: R
authors.lastname: Violini
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus