First generation versus second generation drug‐eluting stents for the treatment of bifurcations: 5‐year follow‐up of the <scp>LEADERS</scp> all‐comers randomized trial

Grundeken, Maik J.; Wykrzykowska, Joanna J.; Ishibashi, Yutaka; Garg, Scot; Vries, Ton de; García‐García, Héctor M.; Onuma, Yoshinobu; Winter, Robbert J. de; Buszman, Paweł; Linke, Axel; Ischinger, Thomas; Klauß, Volker; Eberli, Franz R.; Corti, Roberto; Wijns, William; Morice, Marie‐Claude; Mario, Carlo Di; Meier, Bernhard; Jüni, Peter; Yazdani, Ashkan; Copt, Samuel; Windecker, Stephan; Serruys, Patrick W.

doi:10.1002/ccd.26344

Cited by 50 publications

(42 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subgroup analysis of LEADERS trial indicated Definite/probable ST rate was numerically lower in the second DES group (3.1 vs. 5.9%, P = 0.15). Very late definite/probable ST rates also tended to be lower with second DES (0.4 vs. 3.1%, P = 0.057) . Although our analysis did not show significant difference between SS and DS approach, either in 1st or second DES subgroup, there is indeed a trend toward increased early definite ST in first DES (0.80%, 15/1,877) vs. second DES (0.23%, 2/860) during subgroup analysis.…”

Section: Discussioncontrasting

confidence: 48%

Definite stent thrombosis after drug‐eluting stent implantation in coronary bifurcation lesions: A meta‐analysis of 3,107 patients from 14 randomized trials

Zhou

Chen

Huang

et al. 2017

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 48%

Definite stent thrombosis after drug‐eluting stent implantation in coronary bifurcation lesions: A meta‐analysis of 3,107 patients from 14 randomized trials

Zhou

Chen

Huang

et al. 2017

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…The present results also compare favorably with patients treated with tubular BES in bifurcation segments in the all-comers LEADERS trial, using an identical polymer and drug concept as in AXXESS, and where clearly higher rates of cardiac death (9.3%), TLR (12%) and definite/probable ST (3.1%) were reported at 5 years [20]. Similarly, AXXESS in the present experience proved to be as safe and efficacious as later-generation thin-strut everolimus-eluting stents in the PLATINUM study treating non-bifurcation lesions, with similar rates of cardiac death (3.1%), TLR (5.7%) and definite/ /probable ST (0.8%) at 5 years [21].…”

Section: Discussionmentioning

confidence: 58%

Long-term outcomes after percutaneous revascularization of complex coronary bifurcation lesions using a dedicated self-expanding biolimus-eluting stent system

et al. 2018

View full text Add to dashboard Cite

Background: To evaluate long-term clinical outcomes after treatment of complex bifurcation lesions with the AXXESS dedicated self-expanding biolimus A9-eluting bifurcation stent. Methods: Between 2004 and 2013, 123 patients with complex bifurcation lesions were treated in a single-center with the AXXESS stent in the proximal main vessel (MV) and additional drug-eluting stents in branches when required. Median follow-up was 5 years. Primary endpoint was the rate of major adverse cardiac events (MACE) . Secondary endpoints included MACE components (cardiac death, non-periprocedural clinical myocardial infarction [MI], target lesion revascularization [TLR]and definite/probable stent thrombosis [ST]) as well as all-cause death, target vessel revascularization (TVR) and non-TVR. Results: During follow-up, 11 (8.9%) patients experienced a MACE, of whom 2 (1.6%) suffered cardiac death, 2 (1.6%) had a non-periprocedural clinical MI requiring TLR, and 7 (5.7%) underwent elective TLR. No definite/probable ST was observed. All-cause death occurred in 9 (7.3%) patients, . Patients treated for left main (LM) bifurcation lesions were more likely to experience MACE than non-LM bifurcation lesions (25% vs. 6.5%, p = 0.04). Conclusions: Percutaneous revascularization of complex bifurcation lesions with the AXXESS stent is safe and provides excellent long-term results, especially in non-LM lesions. (Cardiol J 2018; 25, 4: 470-478)

show abstract

“…Unfortunately, only 34% of the PCI patients in the dedicated randomized PCI versus CABG trials were treated with 2 nd generation DES . This is an important limitation since newer generation DES proved successful in reducing issues of delayed healing, late and very late stent thrombotic events, and late restenosis . The latter resulted in new dedicated randomized trials such as the NOBLE, EXCEL, and SYNTAX, investigating the difference in outcome of PCI versus CABG in patients with left main coronary artery disease specifically .…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcome in patients treated with first‐ versus second‐generation drug‐eluting stents for the treatment of unprotected left main coronary artery stenosis

Zandvoort

Bommel

Masdjedi

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objective and background The study aim is to provide long‐term clinical outcome after percutaneous coronary intervention (PCI) for unprotected left main coronary arteries (ULMCA) stenosis with the first‐generation (1st‐gen) drug‐eluting stents (DES) in comparison to 2nd‐gen DES, since this is largely unknown. Methods Between May 2002, and December 2014, a consecutive series of 656 all‐comer patients underwent a PCI for ULMCA stenosis at the Erasmus Medical Center. A total of 235 patients were treated with 1st‐gen DES, while a total of 421 patients were treated with 2nd‐gen DES. Results Overall, the population consisted of 73% males and 58% presented with an acute coronary syndrome. Median follow‐up time was 1,361 days (range from 0 to 5,031). At 5 years, the cumulative incidence of major adverse clinical events (the primary composite endpoint of all‐cause death, any myocardial infarction or target lesion revascularization; MACE) did not differ between 1st‐ and 2nd‐gen DES (36.8 vs. 38.6%, respectively, Log Rank p = .79, adjusted hazard ratio [HR] = 1.28 [95% confidence interval (CI) 0.94–1.74]). No difference was found in the individual endpoints of all‐cause mortality (29.5 vs. 29% respectively, p = .88, adjusted HR = 1.19 [95% CI, 0.84–1.68]), target vessel myocardial infarction (5.0 vs. 8.4%, p = 0.17, adjusted HR = 1.75 [95% CI, 0.78–3.96]) and target lesion revascularization (8.1 vs. 9.8%, p = .94, adjusted HR = 1.16 [95% CI, 0.59–2.29]) between the 1st‐ and 2nd‐gen DES cohorts, respectively. Conclusions In this large cohort of consecutive patients treated for ULMCA stenosis, no significant differences were found in the safety and efficacy of 1st versus 2nd‐gen DES at 5 years follow‐up.

show abstract

First generation versus second generation drug‐eluting stents for the treatment of bifurcations: 5‐year follow‐up of the LEADERS all‐comers randomized trial

Cited by 50 publications

References 31 publications

Definite stent thrombosis after drug‐eluting stent implantation in coronary bifurcation lesions: A meta‐analysis of 3,107 patients from 14 randomized trials

Definite stent thrombosis after drug‐eluting stent implantation in coronary bifurcation lesions: A meta‐analysis of 3,107 patients from 14 randomized trials

Long-term outcomes after percutaneous revascularization of complex coronary bifurcation lesions using a dedicated self-expanding biolimus-eluting stent system

Long‐term outcome in patients treated with first‐ versus second‐generation drug‐eluting stents for the treatment of unprotected left main coronary artery stenosis

Contact Info

Product

Resources

About