Author + information
- Valeria Paradies1,
- Pieter Smits2,
- Georgios Vlachojannis3,
- Kees-Jan Royaards4,
- Jochem Wassing5 and
- Martin van der Ent2
The objective of this study was to define the incidence and predictors of target lesion failure (TLF) after drug-eluting stent (DES) implantation at long term follow-up.
Patient-level data from Compare trials were pooled (n= 4506 patients). Compare I and II trials were prospective, randomized controlled clinical trials comparing everolimus eluting stents (EES) to placlitaxel-eluting stents (PES) and EES to biolimus-eluting (BES), respectively. TLF was defined as cardiac death, target-vessel related MI or clinical indicated Target Lesion Revascularization (TLR). Baseline clinical, procedural and angiographic characteristics in the overall pooled population were analyzed for associations with TLF at univariate analysis. A multiple logistic regression analysis was then performed.
TLF occurred in 586 out of 3920 patients (14.9%) at 5 years follow-up. At multiple logistic regression analysis the presence of diabetes mellitus, renal failure, previous coronary artery revascularization and ostial lesions were identified as independent predictors of TLF.
|TLF at 5 years||Relative Risk [95% CI]||p-value|
|Diabetes mellitus||0.67 [0.52-0.85]||0.001|
|Renal Failure||0.50 [0.32-0.79]||0.03|
|History of PCI/CABG||0.69 [0.51-0.96]||0.02|
|Number of lesions treated||1.30 [1.07-1.58]||0.07|
|Bifurcation treatment||0.73 [0.52-1.01]||0.06|
|Ostial lesions||0.75 [0.58-0.97]||0.02|
In this large pooled analysis of patients undergoing percutaneous coronary intervention with DES, the incidence of TLF at 5 years follow-up is still relevant. Clinical as well as angiographic independent predictors can be identified.
CORONARY: PCI Outcomes