title: Outcomes in patients undergoing multivessel percutaneous coronary intervention using sirolimus-eluting stents: a report from the e-SELECT registry.
abstract: OBJECTIVE
  Performing percutaneous coronary intervention (PCI) to multiple coronary lesions during the same procedure has potential economic and social advantages. However comprehensive outcome data of real world practice in a large population is limited. We aimed to compare short- and long-term outcomes between patients with multivessel coronary artery disease who either underwent single- or multivessel PCI within the e-SELECT registry.
  
  
  RESULTS
  The e-SELECT registry combines data collected at 320 medical centres in 56 countries where patients received CYPHER Select® or CYPHER Select® Plus sirolimus-eluting stent (SES). Rates of myocardial infarction and major adverse cardiac event (MACE) (defined as any death, myocardial infarction or target lesion revascularisation) were compared between patients undergoing single-vessel versus multivessel PCI. A total of 15,147 patients who satisfied the inclusion criteria were included in the e-SELECT registry. Two thousand two hundred and seventy-eight (2,278) subjects (15%) underwent multivessel PCI and 12,869 (85%) had single-vessel PCI. The mean age was higher in the multivessel PCI group (63 vs. 62 years, p<0.001) and there was a higher prevalence of diabetes mellitus (32.4 vs. 30.0%, p=0.02). Lesions were more complex in the single-PCI group while pre- and post-dilatation were less common in the multivessel PCI group. Myocardial infarction within the first 30 days post PCI was more common in the multivessel PCI group (1.9 vs. 0.8%, p<0.001) and most of the infarctions were periprocedural (1.3 vs. 0.6%, p=0.001). Mortality and myocardial infarction at one-year were higher in the multivessel PCI group resulting in a significantly higher MACE (6.1 vs. 4.6%, p=0.005).
  
  
  CONCLUSIONS
  Overall procedural and one year outcomes were excellent for both single- and multivessel procedures. However despite lower lesion complexity, performing multivessel PCI was associated with higher rates of periprocedural myocardial infarction and MACE when compared to single-vessel PCI in the e-SELECT registry.
authors.affiliation: Oxford Heart Centre, Oxford, UK.
authors.forename: Florim
authors.initials: F
authors.lastname: Cuculi
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Banning
authors.forename: Alexander
authors.initials: A
authors.lastname: Abizaid
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.forename: Ana C
authors.initials: AC
authors.lastname: Baux
authors.forename: Vladimir
authors.initials: V
authors.lastname: Dzavík
authors.forename: Stepehen
authors.initials: S
authors.lastname: Ellis
authors.forename: Runlin
authors.initials: R
authors.lastname: Gao
authors.forename: David
authors.initials: D
authors.lastname: Holmes
authors.forename: Myung H
authors.initials: MH
authors.lastname: Jeong
authors.forename: Victor
authors.initials: V
authors.lastname: Legrand
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Maria
authors.initials: M
authors.lastname: Nyakern
authors.forename: Christian
authors.initials: C
authors.lastname: Spaulding
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Stoll
authors.forename: Stephen
authors.initials: S
authors.lastname: Worthley
authors.forename: Philip
authors.initials: P
authors.lastname: Urban
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D003327:Coronary Disease / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D020123:Sirolimus