title: Comparison of paclitaxel-eluting stents (Taxus) and everolimus-eluting stents (Xience) in left main coronary artery disease with 3 years follow-up (from the ESTROFA-LM registry).
abstract: Evidence regarding therapy with drug-eluting stents in the left main coronary artery (LM) is based mostly on trials performed with first-generation drug-eluting stents. The aim of this study was to evaluate long-term clinical outcomes after treatment for unprotected LM disease with paclitaxel-eluting stents (PES) and everolimus-eluting stents (EES). The ESTROFA-LM is a multicenter retrospective registry including consecutive patients with unprotected LM disease treated with PES or EES. A total of 770 patients have been included at 21 centers, 415 with treated PES and 355 with EES. Treatment with 2 stents was more frequent with PES (17% vs 10.4%, p = 0.007), whereas intravascular ultrasound was more frequently used with EES (35.2% vs 26%, p = 0.006). The 3-year death and infarction survival rates were 86.1% for PES and 87.3% for EES (p = 0.50) and for death, infarction, and target lesion revascularization were 83.6% versus 82% (p = 0.60), respectively. Definite or probable thrombosis was 1.6% for PES and 1.4% for EES (p = 0.80). The use of 2 stents, age, diabetes, and acute coronary syndromes were independent predictors of mortality. In the subgroup of distal lesions, the use of intravascular ultrasound was an independent predictor of better outcome. Comparison of propensity score-matched groups did not yield differences between the 2 stents. In conclusion, the results of this multicenter registry show comparable safety and efficacy at 3 years for PES and EES in the treatment of LM disease. The use of bifurcation stenting techniques in distal lesions was a relevant independent predictor for events. The use of intravascular ultrasound appears to have a positive impact on patients treated for LM distal disease.
authors.affiliation: Hospital M. de Valdecilla, Santander, Spain. he1thj@humv.es
authors.forename: Jose M
authors.initials: JM
authors.lastname: De la Torre Hernandez
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.forename: Angel
authors.initials: A
authors.lastname: Sanchez Recalde
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Jimenez Navarro
authors.forename: Armando
authors.initials: A
authors.lastname: Perez de Prado
authors.forename: Felipe
authors.initials: F
authors.lastname: Hernandez
authors.forename: Omar
authors.initials: O
authors.lastname: Abdul-Jawad Altisent
authors.forename: Gerard
authors.initials: G
authors.lastname: Roura
authors.forename: Tamara
authors.initials: T
authors.lastname: Garcia Camarero
authors.forename: Jaime
authors.initials: J
authors.lastname: Elizaga
authors.forename: Fernando
authors.initials: F
authors.lastname: Rivero
authors.forename: Federico
authors.initials: F
authors.lastname: Gimeno
authors.forename: Ramon
authors.initials: R
authors.lastname: Calviño
authors.forename: Jose
authors.initials: J
authors.lastname: Moreu
authors.forename: Francisco
authors.initials: F
authors.lastname: Bosa
authors.forename: Jose R
authors.initials: JR
authors.lastname: Rumoroso
authors.forename: Juan A
authors.initials: JA
authors.lastname: Bullones
authors.forename: Arsenio
authors.initials: A
authors.lastname: Gallardo
authors.forename: Jose A
authors.initials: JA
authors.lastname: Fernandez Diaz
authors.forename: Jose R
authors.initials: JR
authors.lastname: Ruiz Arroyo
authors.forename: Victor
authors.initials: V
authors.lastname: Aragon
authors.forename: Monica
authors.initials: M
authors.lastname: Masotti
mesh_terms: D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000493:pharmacokinetics; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D015994:Incidence; D008297:Male; D017239:Paclitaxel / Q000494:pharmacology*; D012042:Registries; D012189:Retrospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D007166:Immunosuppressive Agents; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus