Objectives: To correlate the permeability and clinical evolution of single and multilateral patients, bearers of obstructive atherosclerosis heart disease in the proximal third of the anterior descending coronary artery (DA), who were submitted to myocardial revascularization using the left internal mammary or underwent a drug eluting stent procedure. Method: This a case history cohort study in which two centers participated. Three hundred patients were retrospectively analyzed, whose lesions were treated at the proximal one third of the DA: in the G-1 group, 150 patients, underwent myocardial revascularization surgery and, the G-2 group, 150 patients, received drug eluting stents, 95 of them received paclitaxel and 55 received sirolimus. All major adverse cardiovascular events were registered during the period (MACE) during the period between the two procedures and the angiographic restudy. Deaths were not included in these MACE, since all patients were restudied through coronariography. There were clinical and angiographic demographic differences between the two groups: the G-1 patients showed a higher incidence of diabetes (29.3% versus 20.0%, p<0.05) and three artery atherosclerosis disease 50% versus 30.6%, p<0.05) with a lower incidence of one artery (13.3% versus 30.6%, p<0.001). Results: The permeability of the two procedures was quite high in both groups. Those patients free of MACE in G-1 RESUMOObjetivo: Correlacionar a permeabilidade e a evolução clínica de pacientes uni ou multiarteriais, portadores de doença coronária aterosclerótica obstrutiva no terço proximal da artéria coronária descendente anterior (DA), que foram submetidos a cirurgia de revascularização miocárdica utilizando a mamária interna esquerda (MIE) ou que receberam stent com eluição de fármaco (SEF). Método: Este é um estudo de coorte histórico, com a participação de dois centros. Foram analisados, retrospectivamente, 300 pacientes, nos quais foi tratada lesão no terço proximal da DA: no Grupo 1 (G-1), 150 pacientes foram submetidos a cirurgia de revascularização miocárdica e no G-2, 150 receberam SEF, 95 desses stents de paclitaxel e 55 de sirolimo. Os principais eventos cardiovasculares adversos maiores (ECAM) foram registrados no período entre ambos os procedimentos e o reestudo angiográfico. O óbito não foi incluído nesses ECAM, já que todos os pacientes foram reestudados pela coronariografia. Ocorreram diferenças demográficas clínicas e angiográficas entre os dois grupos: os pacientes do G-1 apresentavam maior incidência de diabetes (29,3% vs. 20,0%; p < 0,05) e de doença aterosclerótica triarterial (50,0% vs. 30,6%; p < 0,05), com menor incidência de uniarteriais (13,3% vs. 30,6%; p < 0,001). Resultados: A permeabilidade da DA foi bastante alta, em ambos os grupos. Os pacientes livres de ECAM no G-1 e no G-2 ficaram assim distribuídos: em 12 meses, 98% vs. 97% (NS); em 24 meses, 93% vs. 94% (NS); e em 32 meses, 89% vs. 91% (NS). Conclusão: Ambas as técnicas de revascularização miocárdica para tratar a DA apresen-

Background: To date, there are no studies evaluating the use of the titanium-nitride-oxide coated stent in patients with multivessel coronary artery disease. We have compared the performance of the Titan-2 ® stent to that of the second generation drug-eluting stents in this scenario. Methods: From 2011 to 2012, 284 patients were treated with the Titan-2 ® stent, of which 100 (35.2%) had multivessel coronary artery disease. This group was compared to 100 patients, of a group of 304 (38.9%) patients with multivessel coronary artery disease treated with second generation drug-eluting stents with durable or biodegradable polymers. The primary endpoint was the occurrence of major adverse cardiovascular events at 1 year. Results: Clinical, angiographic and procedure-related characteristics of the patients did not show differences between groups. Most patients in the Titan-2 ® group were male (70%), mean age was 68.4 ± 12.9 years and 25% were diabetic. Stable symptomatic patients were prevalent (68%), 51% had three-vessel disease and ventricular function was preserved (55.6 ± 12.7%). The incidence of major adverse cardiovascular events at 1 year in the Titan-2 ® group was 21% (vs. 17%; p = 0.59), death was observed in 3% (vs. 2%; p > 0.99) of the patients, acute myocardial infarction in 5% (vs. 4%; p > 0.99) and a new revascularization procedure in 13% (vs. 11%; p = 0.83). Definitive stent thrombosis was not observed in either group. Conclusions: The Titan-2 ® stent showed similar results to those of the second-generation drug-eluting stents, which makes it attractive for use in the complex scenario of patients with multivessel coronary artery disease.

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