title: Second vs. First generation drug eluting stents in multiple vessel disease and left main stenosis: Two-year follow-up of the observational, prospective, controlled, and multicenter ERACI IV registry.
abstract: OBJECTIVE
  To compare second generation drug eluting stents (2DES) with first generation (1DES) for the treatment of patients (pts) with multiple coronary vessel disease (MVD).
  
  
  BACKGROUND
  Although 2DES improved safety and efficacy compared to 1DES, MVD remains a challenge for percutaneous coronary interventions.
  
  
  METHODS
  ERACI IV was a prospective, observational, and controlled study in pts with MVD including left main and treated with 2DES (Firebird 2, Microport). We included 225 pts in 15 sites from Argentina. Primary endpoint was the incidence of major adverse cardiovascular events (MACCE) defined as death, myocardial infarction (MI), cerebrovascular accident (CVA) and unplanned revascularization; and to compare with 225 pts from ERACI III study (1DES). PCI strategy was planned to treat lesions ≥70% in vessels ≥ 2.00 mm, introducing a modified Syntax score (SS) where severe lesions in vessels < 2.0 mm and intermediate lesions were not scored.
  
  
  RESULTS
  Baseline characteristics showed that compared to ERACI III, ERACI IV pts had higher number of diabetics (P = 0.02), previous revascularization (P = 0.007), unstable angina IIb/IIIc (P < 0.001) and three vessels/left main disease (P = 0.003). Modified SS was 22.2 ± 11. At 2 years of follow-up ERACI IV group had significantly lower incidence of death+ MI + CVA, (P = 0.01) and MACCE (P = 0.001). MACCE rate was similar in diabetics, (5.8%) and nondiabetics (7.0%). After performing a matched propensity score, MACCE remain significantly lower in ERACI IV (P = 0.005).
  
  
  CONCLUSIONS
  This registry showed that 2DES in MVD has a remarkable low incidence of MACCE in unadjusted and adjusted analysis. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Interventional Cardiology Department, Sanatorio De La Trinidad, Quilmes, Buenos Aires Province, Argentina.
authors.forename: Carlos
authors.initials: C
authors.lastname: Haiek
authors.affiliation: Interventional Cardiology Department, Clinica IMA, Adrogué, Buenos Aires Province, Argentina.|Clinical Research Department, Centro De Estudios En Cardiología Intervencionista, Buenos Aires City, Argentina.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Pereira
authors.affiliation: Interventional Cardiology Department, Clínica Privada Provincial, Merlo, Buenos Aires Province, Argentina.
authors.forename: Omar
authors.initials: O
authors.lastname: Santaera
authors.affiliation: Clinical Research Department, Centro De Estudios En Cardiología Intervencionista, Buenos Aires City, Argentina.|Interventional Department, Sanatorio Las Lomas, San Isidro, Buenos Aires Province, Argentina.
authors.forename: Juan
authors.initials: J
authors.lastname: Mieres
authors.affiliation: Interventional Cardiology Department, Instituto De Diagnóstico Y Tratamiento De Afecciones Cardiovasculares, La Plata, Buenos Aires Province, Argentina.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Rifourcat
authors.affiliation: Interventional Cardiology Department, Sanatorio San Miguel, San Miguel, Buenos Aires Province, Argentina.
authors.forename: Juan
authors.initials: J
authors.lastname: Lloberas
authors.affiliation: Interventional Cardiology Department, Hospital Español, Godoy Cruz City, Mendoza Province, Argentina.
authors.forename: Miguel
authors.initials: M
authors.lastname: Larribau
authors.affiliation: Interventional Cardiology Department, Centro Medico Talar, San Isidro, Buenos Aires Province, Argentina.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pocoví
authors.affiliation: Clinical Research Department, Centro De Estudios En Cardiología Intervencionista, Buenos Aires City, Argentina.
authors.forename: Alfredo M
authors.initials: AM
authors.lastname: Rodriguez-Granillo
authors.affiliation: Interventional Cardiology Department, Hospital El Cruce, Florencio Varela, Buenos Aires Province, Argentina.
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Sarmiento
authors.affiliation: Cardiology Department, Careggi Hospital, Firenze, Italy.
authors.forename: David
authors.initials: D
authors.lastname: Antoniucci
authors.affiliation: Clinical Research Department, Centro De Estudios En Cardiología Intervencionista, Buenos Aires City, Argentina.|Cardiology Department, Sanatorio Otamendi Y Miroli, Buenos Aires City, Argentina.
authors.forename: Alfredo E
authors.initials: AE
authors.lastname: Rodriguez
mesh_terms: D000368:Aged; D001118:Argentina; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: complex PCI; coronary artery disease; stent thrombosis; stenting technique