Four-Year Outcomes of Multivessel Percutaneous Coronary Intervention With Xience V Everolimus-Eluting Stents

Michael S. Lee, Richard Shlofmitz, Ehtisham Mahmud, Kyung Woo Park, Seung-Woon Rha, Anna Gaborro, Jin Wang, Weiying Zhao, Krishnankutty Sudhir

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: We evaluated the long-term outcomes of multivessel compared with single-vessel percutaneous coronary intervention (PCI) with Xience V everolimus-eluting stents in real-world patients. BACKGROUND: Treatment options for multivessel disease include PCI, coronary artery bypass grafting, and medical therapy. Patients with multivessel disease are at a higher risk for ischemic complications than those with single-vessel disease. METHODS: The XIENCE V USA study was a condition-of-approval, single-arm, prospective study in unselected real-world patients. Patients who underwent multivessel PCI (n = 655) were compared with those who underwent single-vessel PCI (n = 4079). Major clinical outcomes, including mortality, stent thrombosis, and target-lesion failure (TLF), were evaluated at 4 years. RESULTS: At 4 years, mortality was similar in both groups (11.1% in multivessel patients vs 9.8% in single-vessel patients; P=.31). The multivessel PCI group had higher rates of Academic Research Consortium (ARC)-defined TLF (24.3% vs 16.4% in single-vessel patients; P<.001) and ARC-defined definite and probable stent thrombosis (2.43% vs 1.11% in single-vessel patients; P=.02). The independent predictors of ARC-defined TLF at 4 years on multivariable analysis were prior myocardial infarction, number of treated vessels, total stent length, and sex. CONCLUSION: Despite significant differences in baseline characteristics, long-term mortality rates were similar in both groups. Although ischemic complications were higher in the multivessel PCI group, the overall rates were acceptable, demonstrating the safety and efficacy of Xience V everolimus-eluting stents for the treatment of multivessel disease in a real-world population.

Original languageEnglish
Pages (from-to)240-246
Number of pages7
JournalThe Journal of invasive cardiology
Volume31
Issue number9
Publication statusPublished - 2019 Sep 1

Fingerprint

Percutaneous Coronary Intervention
Stents
Mortality
Thrombosis
Research
Everolimus
Coronary Artery Bypass
Therapeutics
Myocardial Infarction
Prospective Studies
Safety
Population

Keywords

  • drug-eluting stent
  • everolimus-eluting stent
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Lee, M. S., Shlofmitz, R., Mahmud, E., Park, K. W., Rha, S-W., Gaborro, A., ... Sudhir, K. (2019). Four-Year Outcomes of Multivessel Percutaneous Coronary Intervention With Xience V Everolimus-Eluting Stents. The Journal of invasive cardiology, 31(9), 240-246.

Four-Year Outcomes of Multivessel Percutaneous Coronary Intervention With Xience V Everolimus-Eluting Stents. / Lee, Michael S.; Shlofmitz, Richard; Mahmud, Ehtisham; Park, Kyung Woo; Rha, Seung-Woon; Gaborro, Anna; Wang, Jin; Zhao, Weiying; Sudhir, Krishnankutty.

In: The Journal of invasive cardiology, Vol. 31, No. 9, 01.09.2019, p. 240-246.

Research output: Contribution to journalArticle

Lee, MS, Shlofmitz, R, Mahmud, E, Park, KW, Rha, S-W, Gaborro, A, Wang, J, Zhao, W & Sudhir, K 2019, 'Four-Year Outcomes of Multivessel Percutaneous Coronary Intervention With Xience V Everolimus-Eluting Stents', The Journal of invasive cardiology, vol. 31, no. 9, pp. 240-246.
Lee, Michael S. ; Shlofmitz, Richard ; Mahmud, Ehtisham ; Park, Kyung Woo ; Rha, Seung-Woon ; Gaborro, Anna ; Wang, Jin ; Zhao, Weiying ; Sudhir, Krishnankutty. / Four-Year Outcomes of Multivessel Percutaneous Coronary Intervention With Xience V Everolimus-Eluting Stents. In: The Journal of invasive cardiology. 2019 ; Vol. 31, No. 9. pp. 240-246.
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abstract = "OBJECTIVES: We evaluated the long-term outcomes of multivessel compared with single-vessel percutaneous coronary intervention (PCI) with Xience V everolimus-eluting stents in real-world patients. BACKGROUND: Treatment options for multivessel disease include PCI, coronary artery bypass grafting, and medical therapy. Patients with multivessel disease are at a higher risk for ischemic complications than those with single-vessel disease. METHODS: The XIENCE V USA study was a condition-of-approval, single-arm, prospective study in unselected real-world patients. Patients who underwent multivessel PCI (n = 655) were compared with those who underwent single-vessel PCI (n = 4079). Major clinical outcomes, including mortality, stent thrombosis, and target-lesion failure (TLF), were evaluated at 4 years. RESULTS: At 4 years, mortality was similar in both groups (11.1{\%} in multivessel patients vs 9.8{\%} in single-vessel patients; P=.31). The multivessel PCI group had higher rates of Academic Research Consortium (ARC)-defined TLF (24.3{\%} vs 16.4{\%} in single-vessel patients; P<.001) and ARC-defined definite and probable stent thrombosis (2.43{\%} vs 1.11{\%} in single-vessel patients; P=.02). The independent predictors of ARC-defined TLF at 4 years on multivariable analysis were prior myocardial infarction, number of treated vessels, total stent length, and sex. CONCLUSION: Despite significant differences in baseline characteristics, long-term mortality rates were similar in both groups. Although ischemic complications were higher in the multivessel PCI group, the overall rates were acceptable, demonstrating the safety and efficacy of Xience V everolimus-eluting stents for the treatment of multivessel disease in a real-world population.",
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AU - Park, Kyung Woo

AU - Rha, Seung-Woon

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N2 - OBJECTIVES: We evaluated the long-term outcomes of multivessel compared with single-vessel percutaneous coronary intervention (PCI) with Xience V everolimus-eluting stents in real-world patients. BACKGROUND: Treatment options for multivessel disease include PCI, coronary artery bypass grafting, and medical therapy. Patients with multivessel disease are at a higher risk for ischemic complications than those with single-vessel disease. METHODS: The XIENCE V USA study was a condition-of-approval, single-arm, prospective study in unselected real-world patients. Patients who underwent multivessel PCI (n = 655) were compared with those who underwent single-vessel PCI (n = 4079). Major clinical outcomes, including mortality, stent thrombosis, and target-lesion failure (TLF), were evaluated at 4 years. RESULTS: At 4 years, mortality was similar in both groups (11.1% in multivessel patients vs 9.8% in single-vessel patients; P=.31). The multivessel PCI group had higher rates of Academic Research Consortium (ARC)-defined TLF (24.3% vs 16.4% in single-vessel patients; P<.001) and ARC-defined definite and probable stent thrombosis (2.43% vs 1.11% in single-vessel patients; P=.02). The independent predictors of ARC-defined TLF at 4 years on multivariable analysis were prior myocardial infarction, number of treated vessels, total stent length, and sex. CONCLUSION: Despite significant differences in baseline characteristics, long-term mortality rates were similar in both groups. Although ischemic complications were higher in the multivessel PCI group, the overall rates were acceptable, demonstrating the safety and efficacy of Xience V everolimus-eluting stents for the treatment of multivessel disease in a real-world population.

AB - OBJECTIVES: We evaluated the long-term outcomes of multivessel compared with single-vessel percutaneous coronary intervention (PCI) with Xience V everolimus-eluting stents in real-world patients. BACKGROUND: Treatment options for multivessel disease include PCI, coronary artery bypass grafting, and medical therapy. Patients with multivessel disease are at a higher risk for ischemic complications than those with single-vessel disease. METHODS: The XIENCE V USA study was a condition-of-approval, single-arm, prospective study in unselected real-world patients. Patients who underwent multivessel PCI (n = 655) were compared with those who underwent single-vessel PCI (n = 4079). Major clinical outcomes, including mortality, stent thrombosis, and target-lesion failure (TLF), were evaluated at 4 years. RESULTS: At 4 years, mortality was similar in both groups (11.1% in multivessel patients vs 9.8% in single-vessel patients; P=.31). The multivessel PCI group had higher rates of Academic Research Consortium (ARC)-defined TLF (24.3% vs 16.4% in single-vessel patients; P<.001) and ARC-defined definite and probable stent thrombosis (2.43% vs 1.11% in single-vessel patients; P=.02). The independent predictors of ARC-defined TLF at 4 years on multivariable analysis were prior myocardial infarction, number of treated vessels, total stent length, and sex. CONCLUSION: Despite significant differences in baseline characteristics, long-term mortality rates were similar in both groups. Although ischemic complications were higher in the multivessel PCI group, the overall rates were acceptable, demonstrating the safety and efficacy of Xience V everolimus-eluting stents for the treatment of multivessel disease in a real-world population.

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