title: Hybrid strategy of a bare metal stent combined with a drug-eluting stent versus exclusive drug-eluting stent implantation for multivessel percutaneous coronary intervention.
abstract: OBJECTIVE
  This study aimed to examine the strategy of hybrid percutaneous coronary intervention (PCI) -bare metal stent (BMS) and drug-eluting stent (DES)- versus exclusive DES implantation for patients undergoing multivessel PCI.
  
  
  RESULTS
  A cohort of 2,065 patients who underwent PCI (698 hybrid, 1,367 exclusive DES) were followed clinically up to one year. The primary outcome was target vessel revascularisation-major adverse cardiac events (TVR-MACE). Patients presenting with cardiogenic shock, anaemia (haematocrit <25), and bypass graft PCI were excluded. Only patients with ≥ 2 stents in two different lesions were analysed for this study. Baseline and procedural characteristics were similar. Major in-hospital complications and subacute stent thrombosis rates were similar. At one year, there was no difference in TVR-MACE (hybrid 17.2% vs. DES 14.6%, p=0.128). On multivariable analysis, hybrid PCI was not a predictor of TVR-MACE. The strongest predictors of TVR-MACE at one year were hypertension and African American race. Cumulative stent thrombosis rates at one year were similar in both groups.
  
  
  CONCLUSIONS
  Patients who undergo hybrid PCI have similar composite in-hospital and 1-year outcomes as those who undergo exclusive DES PCI. The hybrid stent approach should be considered for patients with multivessel PCI since it can lower the procedure cost without increasing adverse events.
authors.affiliation: Department of Medicine, Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Asmir I
authors.initials: AI
authors.lastname: Syed
authors.forename: Itsik
authors.initials: I
authors.lastname: Ben-Dor
authors.forename: Yanlin
authors.initials: Y
authors.lastname: Li
authors.forename: Sara D
authors.initials: SD
authors.lastname: Collins
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Kohei
authors.initials: K
authors.lastname: Wakabayashi
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Gonzalez
authors.forename: Gabriel
authors.initials: G
authors.lastname: Maluenda
authors.forename: Cedric
authors.initials: C
authors.lastname: Delhaye
authors.forename: Loic
authors.initials: L
authors.lastname: Belle
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gaglia
authors.forename: Zhenyi
authors.initials: Z
authors.lastname: Xue
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kaneshige
authors.forename: Nelson
authors.initials: N
authors.lastname: Bernardo
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kent
authors.forename: William O
authors.initials: WO
authors.lastname: Suddath
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Joseph
authors.initials: J
authors.lastname: Lindsay
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D004219:District of Columbia; D054855:Drug-Eluting Stents; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D018579:Patient Selection; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals