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dc.contributor.authorPiccolo, Raffaele
dc.contributor.authorBonaa, Kaare H.
dc.contributor.authorEfthimiou, Orestis
dc.contributor.authorVarenne, Olivier
dc.contributor.authorUrban, Philip
dc.contributor.authorKaiser, Christoph
dc.contributor.authorRäber, Lorenz
dc.contributor.authorde Belder, Adam
dc.contributor.authorRemkes, Wouter
dc.contributor.authorVan’T Hof, Arnoud W. J.
dc.contributor.authorStankovic, Goran
dc.contributor.authorLemos, Pedro A.
dc.contributor.authorWilsgaard, Tom
dc.contributor.authorReifart, Jörg
dc.contributor.authorRodriguez, Alfredo E.
dc.contributor.authorRibeiro, Expedito E.
dc.contributor.authorSerruys, Patrick W. J. C.
dc.contributor.authorAbizaid, Alex
dc.contributor.authorSabaté, Manel
dc.contributor.authorByrne, Robert A.
dc.contributor.authorde la Torre Hernandez, Jose M.
dc.contributor.authorWijns, William
dc.contributor.authorEsposito, Giovanni
dc.contributor.authorJüni, Peter
dc.contributor.authorWindecker, Stephan
dc.contributor.authorValgimigli, Marco
dc.date.accessioned2022-01-24T12:52:36Z
dc.date.available2022-01-24T12:52:36Z
dc.date.issued2021-10-08
dc.description.abstractBackground - New‐generation drug‐eluting stents (DES) reduce target‐vessel revascularization compared with bare‐metal stents (BMS), and recent data suggest that DES have the potential to decrease the risk of myocardial infarction and cardiovascular mortality. We evaluated the treatment effect of DES versus BMS according to the target artery (left anterior descending [LAD] and/or left main [LM] versus other territories [no‐LAD/LM]).<p> <p>Methods and Results - The Coronary Stent Trialist (CST) Collaboration gathered individual patient data of randomized trials of DES versus BMS for the treatment of coronary artery disease. The primary outcome was the composite of cardiac death or myocardial infarction. Hazard ratios (HRs) with 95% CIs were derived from a 1‐stage individual patient data meta‐analysis. We included 26 024 patients across 19 trials: 13 650 (52.4%) in the LAD/LM and 12 373 (47.6%) in the no‐LAD/LM group. At 6‐year follow‐up, there was strong evidence that the treatment effect of DES versus BMS depended on the target vessel (P‐interaction=0.024). Compared with BMS, DES reduced the risk of cardiac death or myocardial infarction to a greater extent in the LAD/LM (HR, 0.76; 95% CI, 0.68–0.85) than in the no‐LAD/LM territories (HR, 0.93; 95% CI, 0.83–1.05). This benefit was driven by a lower risk of cardiac death (HR, 0.83; 95% CI, 0.70–0.98) and myocardial infarction (HR, 0.74; 95% CI, 0.65–0.85) in patients with LAD/LM disease randomized to DES. An interaction (P=0.004) was also found for all‐cause mortality with patients with LAD/LM disease deriving benefit from DES (HR, 0.86; 95% CI, 0.76–0.97).<p> <p>Conclusions - As compared with BMS, new‐generation DES were associated with sustained reduction in the composite of cardiac death or myocardial infarction if used for the treatment of LAD or left main coronary stenoses.en_US
dc.identifier.citationPiccolo, Bonaa, Efthimiou, Varenne, Urban, Kaiser, Räber, de Belder, Remkes, Van’T Hof, Stankovic, Lemos, Wilsgaard, Reifart, Rodriguez, Ribeiro, Serruys, Abizaid, Sabaté, Byrne, de la Torre Hernandez, Wijns, Esposito, Jüni, Windecker, Valgimigli. Drug-eluting or bare-metal stents for left anterior descending or left main coronary artery revascularization. Journal of the American Heart Association (JAHA). 2021;10(20)en_US
dc.identifier.cristinIDFRIDAID 1964096
dc.identifier.doi10.1161/JAHA.120.018828
dc.identifier.issn2047-9980
dc.identifier.urihttps://hdl.handle.net/10037/23783
dc.language.isoengen_US
dc.publisherAmerican Heart Associationen_US
dc.relation.journalJournal of the American Heart Association (JAHA)
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.titleDrug-eluting or bare-metal stents for left anterior descending or left main coronary artery revascularizationen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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