title: Impact of ad hoc percutaneous coronary intervention with drug-eluting stents in angina patients.
abstract: OBJECTIVE
  To evaluate the impact of ad hoc percutaneous coronary intervention (PCI) which combines coronary angioplasty and PCI in the same procedure in the era of drug-eluting stents (DES).
  
  
  RESULTS
  From the IRIS-DES registry, 4,738 angina patients treated using PCI with DES were enrolled. The 18-month outcomes were compared between ad hoc and non-ad hoc groups after adjustment using inverse-probability-of-treatment weighting. Ad hoc PCI was performed in 3,562 (75.2%) patients. The ad hoc PCI group had less extensive coronary disease and received fewer stents. The incidence of major adverse cardiac or cerebrovascular events, consisting of death, myocardial infarction (MI), stroke, and repeat revascularisation, did not differ between the ad hoc and the non-ad hoc groups (8.3% vs. 7.6%; adjusted hazard ratio [aHR] of ad hoc PCI, 1.22; 95% confidence interval [CI]: 0.91 to 1.63; p=0.18). The individual endpoints of death (2.0% vs. 1.9%; aHR, 1.57; 95% CI: 0.86- 2.88; p=0.14), MI (0.8% vs. 1.0%; aHR, 0.62; 95% CI: 0.29 - 1.33; p=0.22), stroke (1.0% vs. 0.9%; aHR, 1.25; 95% CI: 0.58-2.69; p=0.57), and repeat revascularisation (4.4% vs. 4.0%; aHR, 1.23; 95% CI: 0.86-1.77; p=0.25) also did not differ between the groups.
  
  
  CONCLUSIONS
  Ad hoc PCI using DES appears to be feasible for angina patients at a relatively low risk of procedure. This approach may reasonably be performed with evaluation of objective ischaemia using non-invasive or invasive tests.
authors.affiliation: Heart Institute, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Ahn
authors.forename: Gyung-Min
authors.initials: GM
authors.lastname: Park
authors.forename: Yong-Rak
authors.initials: YR
authors.lastname: Cho
authors.forename: Jong-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Won-Jang
authors.initials: WJ
authors.lastname: Kim
authors.forename: Sung-Cheol
authors.initials: SC
authors.lastname: Yun
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kang
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome