title: Angiographic complexity of coronary artery disease according to SYNTAX score and clinical outcomes after revascularisation with newer-generation drug-eluting stents: a substudy of the BIOSCIENCE trial.
abstract: OBJECTIVE
  We sought to assess the performance of drug-eluting stents combining an ultrathin cobalt-chromium platform with a biodegradable polymer across categories of increasing SYNTAX score (SS).
  
  
  RESULTS
  Patients included in the BIOSCIENCE trial and randomly allocated to treatment with biodegradable polymer sirolimus-eluting stents (BP-SES) or durable polymer everolimus-eluting stents (DP-EES) were categorised according to SS tertiles (low <8, medium 8-15, high >15). The primary endpoint, target lesion failure (TLF), was defined as a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularisation. The patient-oriented endpoint (POCE) included death, myocardial infarction, or any repeat revascularisation. The SS was available in 2,041 out of 2,119 patients (96.3%). At two-year follow-up, patients with an SS >15 experienced higher rates of both TLF and POCE as compared to patients with medium and low SS (14.5% vs. 8.1% and vs. 5.9%, p<0.001; 22.7% vs. 14.9% and vs. 12.4%; p<0.001), respectively. Comparable rates of the composite endpoints were documented for both stent types in each category of SS.
  
  
  CONCLUSIONS
  Increasing lesion complexity as assessed by SS was associated with higher rates of TLF and POCE in a contemporary PCI population with minimal exclusion criteria. BP-SES and DP-EES showed comparable performance across the entire spectrum of CAD severity.
authors: Department of Cardiology, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland.
authors: Anna
authors: A
authors: Franzone
authors: Masanori
authors: M
authors: Taniwaki
authors: Fabio
authors: F
authors: Rigamonti
authors: Dik
authors: D
authors: Heg
authors: Raffaele
authors: R
authors: Piccolo
authors: Marco
authors: M
authors: Roffi
authors: David
authors: D
authors: Tüller
authors: Olivier
authors: O
authors: Muller
authors: Andre
authors: A
authors: Vuilliomenet
authors: Stéphane
authors: S
authors: Cook
authors: Daniel
authors: D
authors: Weilenmann
authors: Christoph
authors: C
authors: Kaiser
authors: Peiman
authors: P
authors: Jamshidi
authors: Peter
authors: P
authors: Jüni
authors: Stephan
authors: S
authors: Windecker
authors: Thomas
authors: T
authors: Pilgrim
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D020123:Sirolimus