Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis: The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study

Young Hak Kim; Duk Woo Park; Jung Min Ahn; Sung Cheol Yun; Hae Geun Song; Jong Young Lee; Won Jang Kim; Soo Jin Kang; Seung Whan Lee; Cheol Whan Lee; Seong Wook Park; Yangsoo Jang; Myung Ho Jeong; Hyo Soo Kim; Seung Ho Hur; Seung Woon Rha; Do Sun Lim; Sung Ho Her; Ki Bae Seung; In Whan Seong; Seung Jung Park

doi:10.1016/j.jcin.2012.05.002

Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis: The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study

Young Hak Kim, Duk Woo Park, Jung Min Ahn, Sung Cheol Yun, Hae Geun Song, Jong Young Lee, Won Jang Kim, Soo Jin Kang, Seung Whan Lee, Cheol Whan Lee, Seong Wook Park, Yangsoo Jang, Myung Ho Jeong, Hyo Soo Kim, Seung Ho Hur, Seung Woon Rha, Do Sun Lim, Sung Ho Her, Ki Bae Seung, In Whan SeongSeung Jung Park

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

73 Citations (Scopus)

Abstract

Objectives: This study sought to evaluate the safety and efficacy of second-generation drug-eluting stents (DES) for patients with unprotected left main coronary artery (ULMCA) stenosis. Background: The clinical benefit of second-generation DES for ULMCA stenosis has not been determined. Methods: The authors assessed 334 consecutive patients who received everolimus-eluting stents (EES) for ULMCA stenosis between 2009 and 2010. The 18-month incidence rates of major adverse cardiac or cerebrovascular events (MACCE), including death, myocardial infarction (MI), stroke, or ischemia-driven target vessel revascularization (TVR), were compared with those of a randomized study comparing patients who received sirolimus-eluting stents (SES) (n = 327) or coronary artery bypass grafts (CABG) (n = 272). Results: EES (8.9%) showed a comparable incidence of MACCE as SES (10.8%; adjusted hazard ratio [aHR] of EES: 0.84; 95% confidence interval [CI]: 0.51 to 1.40; p = 0.51) and CABG (6.7%, aHR of EES: 1.40; 95% CI: 0.78 to 2.54; p = 0.26). The composite incidence of death, MI, or stroke also did not differ among patients receiving EES (3.3%), SES (3.7%; aHR of EES: 0.63; 95% CI: 0.27 to 1.47; p = 0.29), and CABG (4.8%; aHR of EES: 0.67; 95% CI: 0.29 to 1.54; p = 0.34). However, the incidence of ischemia-driven TVR in the EES group (6.5%) was higher than in the CABG group (2.6%, aHR of EES: 2.77; 95% CI: 1.17 to 6.58; p = 0.02), but comparable to SES (8.2%, aHR of EES: 1.14; 95% CI: 0.64 to 2.06; p = 0.65). Angiographic restenosis rates were similar in the SES and EES groups (13.8% vs. 9.2%, p = 0.16). Conclusions: Second-generation EES had a similar 18-month risk of MACCE for ULMCA stenosis as first-generation SES or CABG. (Evaluation of Outcomes of EES Implantation for Unprotected Left Main Coronary Artery Stenosis [PRECOMBAT-2]; NCT01348022)

Original language	English
Pages (from-to)	708-717
Number of pages	10
Journal	JACC: Cardiovascular Interventions
Volume	5
Issue number	7
DOIs	https://doi.org/10.1016/j.jcin.2012.05.002
Publication status	Published - 2012 Jul

Bibliographical note

Funding Information:
This study was supported by funds from the Abbott Vascular, Santa Clara, California, Healthcare Technology R&D Project, Ministry of Health & Welfare , Republic of Korea ( A102065 ) and Cardiovascular Research Foundation. Dr. S. J. Park has received research grants from Cordis and Abbott . Dr. Y. H. Kim has received honoraria from Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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Kim, Y. H., Park, D. W., Ahn, J. M., Yun, S. C., Song, H. G., Lee, J. Y., Kim, W. J., Kang, S. J., Lee, S. W., Lee, C. W., Park, S. W., Jang, Y., Jeong, M. H., Kim, H. S., Hur, S. H., Rha, S. W., Lim, D. S., Her, S. H., Seung, K. B., ... Park, S. J. (2012). Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis: The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study. JACC: Cardiovascular Interventions, 5(7), 708-717. https://doi.org/10.1016/j.jcin.2012.05.002

Kim, Young Hak ; Park, Duk Woo ; Ahn, Jung Min et al. / Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis : The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study. In: JACC: Cardiovascular Interventions. 2012 ; Vol. 5, No. 7. pp. 708-717.

@article{5e5cb046510a4139ad3a51f0399b55b1,

title = "Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis: The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study",

abstract = "Objectives: This study sought to evaluate the safety and efficacy of second-generation drug-eluting stents (DES) for patients with unprotected left main coronary artery (ULMCA) stenosis. Background: The clinical benefit of second-generation DES for ULMCA stenosis has not been determined. Methods: The authors assessed 334 consecutive patients who received everolimus-eluting stents (EES) for ULMCA stenosis between 2009 and 2010. The 18-month incidence rates of major adverse cardiac or cerebrovascular events (MACCE), including death, myocardial infarction (MI), stroke, or ischemia-driven target vessel revascularization (TVR), were compared with those of a randomized study comparing patients who received sirolimus-eluting stents (SES) (n = 327) or coronary artery bypass grafts (CABG) (n = 272). Results: EES (8.9%) showed a comparable incidence of MACCE as SES (10.8%; adjusted hazard ratio [aHR] of EES: 0.84; 95% confidence interval [CI]: 0.51 to 1.40; p = 0.51) and CABG (6.7%, aHR of EES: 1.40; 95% CI: 0.78 to 2.54; p = 0.26). The composite incidence of death, MI, or stroke also did not differ among patients receiving EES (3.3%), SES (3.7%; aHR of EES: 0.63; 95% CI: 0.27 to 1.47; p = 0.29), and CABG (4.8%; aHR of EES: 0.67; 95% CI: 0.29 to 1.54; p = 0.34). However, the incidence of ischemia-driven TVR in the EES group (6.5%) was higher than in the CABG group (2.6%, aHR of EES: 2.77; 95% CI: 1.17 to 6.58; p = 0.02), but comparable to SES (8.2%, aHR of EES: 1.14; 95% CI: 0.64 to 2.06; p = 0.65). Angiographic restenosis rates were similar in the SES and EES groups (13.8% vs. 9.2%, p = 0.16). Conclusions: Second-generation EES had a similar 18-month risk of MACCE for ULMCA stenosis as first-generation SES or CABG. (Evaluation of Outcomes of EES Implantation for Unprotected Left Main Coronary Artery Stenosis [PRECOMBAT-2]; NCT01348022)",

author = "Kim, {Young Hak} and Park, {Duk Woo} and Ahn, {Jung Min} and Yun, {Sung Cheol} and Song, {Hae Geun} and Lee, {Jong Young} and Kim, {Won Jang} and Kang, {Soo Jin} and Lee, {Seung Whan} and Lee, {Cheol Whan} and Park, {Seong Wook} and Yangsoo Jang and Jeong, {Myung Ho} and Kim, {Hyo Soo} and Hur, {Seung Ho} and Rha, {Seung Woon} and Lim, {Do Sun} and Her, {Sung Ho} and Seung, {Ki Bae} and Seong, {In Whan} and Park, {Seung Jung}",

note = "Funding Information: This study was supported by funds from the Abbott Vascular, Santa Clara, California, Healthcare Technology R&D Project, Ministry of Health & Welfare , Republic of Korea ( A102065 ) and Cardiovascular Research Foundation. Dr. S. J. Park has received research grants from Cordis and Abbott . Dr. Y. H. Kim has received honoraria from Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. ",

year = "2012",

month = jul,

doi = "10.1016/j.jcin.2012.05.002",

language = "English",

volume = "5",

pages = "708--717",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

publisher = "Elsevier Inc.",

number = "7",

}

Kim, YH, Park, DW, Ahn, JM, Yun, SC, Song, HG, Lee, JY, Kim, WJ, Kang, SJ, Lee, SW, Lee, CW, Park, SW, Jang, Y, Jeong, MH, Kim, HS, Hur, SH, Rha, SW, Lim, DS, Her, SH, Seung, KB, Seong, IW & Park, SJ 2012, 'Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis: The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study', JACC: Cardiovascular Interventions, vol. 5, no. 7, pp. 708-717. https://doi.org/10.1016/j.jcin.2012.05.002

Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis: The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study. / Kim, Young Hak; Park, Duk Woo; Ahn, Jung Min et al.
In: JACC: Cardiovascular Interventions, Vol. 5, No. 7, 07.2012, p. 708-717.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis

T2 - The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study

AU - Kim, Young Hak

AU - Park, Duk Woo

AU - Ahn, Jung Min

AU - Yun, Sung Cheol

AU - Song, Hae Geun

AU - Lee, Jong Young

AU - Kim, Won Jang

AU - Kang, Soo Jin

AU - Lee, Seung Whan

AU - Lee, Cheol Whan

AU - Park, Seong Wook

AU - Jang, Yangsoo

AU - Jeong, Myung Ho

AU - Kim, Hyo Soo

AU - Hur, Seung Ho

AU - Rha, Seung Woon

AU - Lim, Do Sun

AU - Her, Sung Ho

AU - Seung, Ki Bae

AU - Seong, In Whan

AU - Park, Seung Jung

N1 - Funding Information: This study was supported by funds from the Abbott Vascular, Santa Clara, California, Healthcare Technology R&D Project, Ministry of Health & Welfare , Republic of Korea ( A102065 ) and Cardiovascular Research Foundation. Dr. S. J. Park has received research grants from Cordis and Abbott . Dr. Y. H. Kim has received honoraria from Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

PY - 2012/7

Y1 - 2012/7

N2 - Objectives: This study sought to evaluate the safety and efficacy of second-generation drug-eluting stents (DES) for patients with unprotected left main coronary artery (ULMCA) stenosis. Background: The clinical benefit of second-generation DES for ULMCA stenosis has not been determined. Methods: The authors assessed 334 consecutive patients who received everolimus-eluting stents (EES) for ULMCA stenosis between 2009 and 2010. The 18-month incidence rates of major adverse cardiac or cerebrovascular events (MACCE), including death, myocardial infarction (MI), stroke, or ischemia-driven target vessel revascularization (TVR), were compared with those of a randomized study comparing patients who received sirolimus-eluting stents (SES) (n = 327) or coronary artery bypass grafts (CABG) (n = 272). Results: EES (8.9%) showed a comparable incidence of MACCE as SES (10.8%; adjusted hazard ratio [aHR] of EES: 0.84; 95% confidence interval [CI]: 0.51 to 1.40; p = 0.51) and CABG (6.7%, aHR of EES: 1.40; 95% CI: 0.78 to 2.54; p = 0.26). The composite incidence of death, MI, or stroke also did not differ among patients receiving EES (3.3%), SES (3.7%; aHR of EES: 0.63; 95% CI: 0.27 to 1.47; p = 0.29), and CABG (4.8%; aHR of EES: 0.67; 95% CI: 0.29 to 1.54; p = 0.34). However, the incidence of ischemia-driven TVR in the EES group (6.5%) was higher than in the CABG group (2.6%, aHR of EES: 2.77; 95% CI: 1.17 to 6.58; p = 0.02), but comparable to SES (8.2%, aHR of EES: 1.14; 95% CI: 0.64 to 2.06; p = 0.65). Angiographic restenosis rates were similar in the SES and EES groups (13.8% vs. 9.2%, p = 0.16). Conclusions: Second-generation EES had a similar 18-month risk of MACCE for ULMCA stenosis as first-generation SES or CABG. (Evaluation of Outcomes of EES Implantation for Unprotected Left Main Coronary Artery Stenosis [PRECOMBAT-2]; NCT01348022)

AB - Objectives: This study sought to evaluate the safety and efficacy of second-generation drug-eluting stents (DES) for patients with unprotected left main coronary artery (ULMCA) stenosis. Background: The clinical benefit of second-generation DES for ULMCA stenosis has not been determined. Methods: The authors assessed 334 consecutive patients who received everolimus-eluting stents (EES) for ULMCA stenosis between 2009 and 2010. The 18-month incidence rates of major adverse cardiac or cerebrovascular events (MACCE), including death, myocardial infarction (MI), stroke, or ischemia-driven target vessel revascularization (TVR), were compared with those of a randomized study comparing patients who received sirolimus-eluting stents (SES) (n = 327) or coronary artery bypass grafts (CABG) (n = 272). Results: EES (8.9%) showed a comparable incidence of MACCE as SES (10.8%; adjusted hazard ratio [aHR] of EES: 0.84; 95% confidence interval [CI]: 0.51 to 1.40; p = 0.51) and CABG (6.7%, aHR of EES: 1.40; 95% CI: 0.78 to 2.54; p = 0.26). The composite incidence of death, MI, or stroke also did not differ among patients receiving EES (3.3%), SES (3.7%; aHR of EES: 0.63; 95% CI: 0.27 to 1.47; p = 0.29), and CABG (4.8%; aHR of EES: 0.67; 95% CI: 0.29 to 1.54; p = 0.34). However, the incidence of ischemia-driven TVR in the EES group (6.5%) was higher than in the CABG group (2.6%, aHR of EES: 2.77; 95% CI: 1.17 to 6.58; p = 0.02), but comparable to SES (8.2%, aHR of EES: 1.14; 95% CI: 0.64 to 2.06; p = 0.65). Angiographic restenosis rates were similar in the SES and EES groups (13.8% vs. 9.2%, p = 0.16). Conclusions: Second-generation EES had a similar 18-month risk of MACCE for ULMCA stenosis as first-generation SES or CABG. (Evaluation of Outcomes of EES Implantation for Unprotected Left Main Coronary Artery Stenosis [PRECOMBAT-2]; NCT01348022)

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Kim YH, Park DW, Ahn JM, Yun SC, Song HG, Lee JY et al. Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis: The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study. JACC: Cardiovascular Interventions. 2012 Jul;5(7):708-717. doi: 10.1016/j.jcin.2012.05.002

Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis: The PRECOMBAT-2 (premier of randomized comparison of bypass surgery versus angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease) study

Abstract

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