Angiographic complexity of coronary artery disease according to SYNTAX score and clinical outcomes after revascularisation with newer-generation drug-eluting stents: a substudy of the BIOSCIENCE trial.

Franzone, Anna; Taniwaki, Masanori; Rigamonti, Fabio; Heg, Dik; Piccolo, Raffaele; Roffi, Marco; Tüller, David; Muller, Olivier; Vuilliomenet, Andre; Cook, Stéphane; Weilenmann, Daniel; Kaiser, Christoph; Jamshidi, Peiman; Jüni, Peter; Windecker, Stephan; Pilgrim, Thomas (2016). Angiographic complexity of coronary artery disease according to SYNTAX score and clinical outcomes after revascularisation with newer-generation drug-eluting stents: a substudy of the BIOSCIENCE trial. EuroIntervention, 12(5), e595-604. Europa Digital & Publishing 10.4244/EIJV12I5A99

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AIMS We sought to assess the performance of drug-eluting stents combining an ultrathin cobalt-chromium platform with a biodegradable polymer across categories of increasing SYNTAX score (SS). METHODS AND RESULTS Patients included in the BIOSCIENCE trial and randomly allocated to treatment with biodegradable polymer sirolimus-eluting stents (BP-SES) or durable polymer everolimus-eluting stents (DP-EES) were categorised according to SS tertiles (low <8, medium 8-15, high >15). The primary endpoint, target lesion failure (TLF), was defined as a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularisation. The patient-oriented endpoint (POCE) included death, myocardial infarction, or any repeat revascularisation. The SS was available in 2,041 out of 2,119 patients (96.3%). At two-year follow-up, patients with an SS >15 experienced higher rates of both TLF and POCE as compared to patients with medium and low SS (14.5% vs. 8.1% and vs. 5.9%, p<0.001; 22.7% vs. 14.9% and vs. 12.4%; p<0.001), respectively. Comparable rates of the composite endpoints were documented for both stent types in each category of SS. CONCLUSIONS Increasing lesion complexity as assessed by SS was associated with higher rates of TLF and POCE in a contemporary PCI population with minimal exclusion criteria. BP-SES and DP-EES showed comparable performance across the entire spectrum of CAD severity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Franzone, Anna; Taniwaki, Masanori; Heg, Dierik Hans; Piccolo, Raffaele; Windecker, Stephan and Pilgrim, Thomas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

20 Sep 2016 15:29

Last Modified:

21 Jun 2017 11:57

Publisher DOI:

10.4244/EIJV12I5A99

PubMed ID:

27497359

Additional Information:

Franzone and Taniwaki contributed equally to this work.

BORIS DOI:

10.7892/boris.88594

URI:

https://boris.unibe.ch/id/eprint/88594

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