Impact of previous coronary artery bypass surgery on clinical outcome after percutaneous interventions with second generation drug-eluting stents in TWENTE trial and Non-Enrolled TWENTE registry

Sen, Hanim; Lam, Ming Kai; Tandjung, Kenneth; Löwik, Marije M.; Houwelingen, K. Gert van; Stoel, Martin G.; Louwerenburg, Hans W.; Man, Frits H.A.F. de; Linssen, Gerard C.M.; Grandjean, Jan G.; Doggen, Carine J.M.; Birgelen, Clemens von

doi:10.1016/j.ijcard.2014.08.036

Cited by 8 publications

(15 citation statements)

References 29 publications

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“…Another retrospective analysis used a historical control group to show, at 1‐year follow‐up, no significant differences in target vessel revascularization between early versus newer‐generation DESs (10.2% versus 10.7%) 33. Our group previously reported a target vessel revascularization rate of 9.4% in patients with a history of CABG at 1‐year follow‐up 14. The difference in event rate from the above‐mentioned study may be best explained by dissimilarities in study population.…”

Section: Discussionmentioning

confidence: 94%

“…This difference in cardiac mortality from the aforementioned studies may be largely explained by differences in study population and treatment. In the current study, we assessed a consecutive series of patients who were treated with newer‐generation DESs for all clinical syndromes except ST‐segment–elevation MI,14, 22 whereas other studies with long‐term follow‐up exclusively examined patients with ST‐segment–elevation MI or patients with acute coronary syndromes 10, 11, 17. Furthermore, these patients had been treated with or without PCI—before the introduction of the newer‐generation DES 11, 17…”

Section: Discussionmentioning

confidence: 99%

“…The use of first‐generation DESs in graft vessel lesions was associated with improved long‐term clinical outcomes compared with bare metal stent use 19, 20, 21. Little is known about the use of second‐generation DESs in patients with previous CABG 14, 32, 33. Long‐term follow‐up data are scarce but of particular interest, as a previous study suggested the presence of a late “catch‐up” in target vessel revascularization after PCI with first‐generation DESs in SVGs 34…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown significantly higher rates of repeat target vessel revascularization,7, 13 particularly if PCI was performed in degenerated saphenous vein grafts (SVGs), which also bear an increased risk for embolizing friable debris and atherothrombotic material 2, 14, 15, 16, 17, 18. The introduction of the early drug‐eluting stents (DESs) improved clinical outcomes of PCI in bypass grafts, compared with bare metal stents 19, 20, 21.…”

Section: Introductionmentioning

confidence: 99%

“…The introduction of the early drug‐eluting stents (DESs) improved clinical outcomes of PCI in bypass grafts, compared with bare metal stents 19, 20, 21. Newer‐generation DESs showed even more favorable short‐term safety profiles 14. However, there is a lack of long‐term data on outcomes after PCI with newer‐generation DESs in patients with versus without previous CABG 15, 16…”

Section: Introductionmentioning

confidence: 99%

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Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents

Heijden

Kok

Zocca

et al. 2018

JAHA

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BackgroundPercutaneous coronary intervention (PCI) in patients with previous coronary artery bypass grafting (CABG) is associated with adverse clinical events. Although newer generation drug‐eluting stents showed favorable short‐term safety profiles, there is a lack of long‐term outcome data. We evaluated the impact of previous CABG on 5‐year clinical outcomes of patients treated with PCI using newer‐generation drug‐eluting stents.Methods and ResultsIn this patient‐level pooled analysis of the prospective TWENTE (The Real‐World Endeavor Resolute versus Xience V Drug‐Eluting Stent Study in Twente) trial and nonenrolled TWENTE registry, we assessed a consecutive series of patients who underwent PCI with newer‐generation drug‐eluting stents for non–ST‐segment–elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8%) had a history of CABG. Patients with previous CABG had significantly higher 5‐year rates of cardiac death (10.4% versus 4.3%; P<0.001) and target vessel revascularization (25.0% versus 8.1%; P<0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1‐ to 5‐year follow‐up, the rates of cardiac death (8.1% versus 3.2%; P<0.001) and target vessel revascularization (17.1% versus 5.9%; P<0.001) were significantly higher in patients with previous CABG. Among patients with a history of CABG, PCI of an obstructed vein graft was associated with a higher rate of 5‐year target vessel revascularization (P=0.003).ConclusionsAt 5‐year follow‐up after PCI with newer‐generation drug‐eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous CABG. The target vessel revascularization rate was highest in patients who underwent PCI of obstructed vein grafts.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents

Heijden

Kok

Zocca

et al. 2018

JAHA

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Bifurcation treatment with novel, highly flexible drug-eluting coronary stents in all-comers: 2-year outcome in patients of the DUTCH PEERS trial

et al. 2015

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BackgroundPercutaneous coronary intervention (PCI) in bifurcated lesions with second-generation drug-eluting stents (DES) was associated with increased myocardial infarction (MI) rates. Flexible stent designs that accommodate well to vessel tapering may be of benefit in challenging anatomies such as bifurcated target lesions, but so far data are scarce.MethodsWe analyzed the 2-year follow-up data of the DUTCH PEERS (TWENTE II) trial, which randomized 1811 all-comer patients to PCI with newer generation resolute integrity zotarolimus-eluting (Medtronic) or promus element everolimus-eluting stents (Boston Scientific). In bifurcated lesions, provisional stenting was generally performed. Target vessel failure is a composite endpoint, consisting of cardiac death, target vessel MI, or target vessel revascularization.ResultsPatients with at least one bifurcated lesion (n = 465, 25.7 %) versus patients with non-bifurcated target lesions only (n = 1346, 74.3 %) showed similar rates of clinical endpoints including target vessel failure (9.2 versus 7.9 %, p = 0.36) and definite stent thrombosis (0.4 versus 1.0 %, p = 0.38). Target vessel MI was more common in patients with bifurcated lesions (3.4 versus 1.6 %, p = 0.02); but after multivariate analysis with propensity score adjustment, bifurcation treatment was found not to be an independent predictor of target vessel MI (HR 1.40, 95 % CI 0.71–2.76; p = 0.34). Among patients with bifurcated lesions, DES type and side-branch size did not affect outcome, but periprocedural MI occurred more often after two-stent approaches (9.0 versus 2.1 %; p = 0.002).ConclusionAll-comer patients treated for bifurcated and non-bifurcated target lesions showed similar and low rates of clinical endpoints, suggesting that the DES used are efficacious and safe for treating bifurcated target lesions.

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Orbital atherectomy treatment of severely calcified native coronary lesions in patients with prior coronary artery bypass grafting: Acute and one-year outcomes from the ORBIT II trial

Lee

Anose

Martinsen

et al. 2018

Cardiovascular Revascularization Medicine

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Impact of previous coronary artery bypass surgery on clinical outcome after percutaneous interventions with second generation drug-eluting stents in TWENTE trial and Non-Enrolled TWENTE registry

Abstract: Patients with previous CABG showed a favorable safety profile after PCI with second-generation DES. Nevertheless, their TVR rate was still much higher, driven by more repeat revascularizations after PCI of degenerated vein grafts. In native coronary lesions, there was no such difference.

Cited by 8 publications

References 29 publications

Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents

Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents

Bifurcation treatment with novel, highly flexible drug-eluting coronary stents in all-comers: 2-year outcome in patients of the DUTCH PEERS trial

Orbital atherectomy treatment of severely calcified native coronary lesions in patients with prior coronary artery bypass grafting: Acute and one-year outcomes from the ORBIT II trial

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