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JACC Cardiovasc Interv ; 2(8): 718-27, 2009 Aug.
Article de Anglais | MEDLINE | ID: mdl-19695539

RÉSUMÉ

OBJECTIVES: The multicenter AUTAX (Austrian Multivessel TAXUS-Stent) registry investigated the 2-year clinical/angiographic outcomes of patients with multivessel coronary artery disease after implantation of TAXUS Express stents (Boston Scientific, Natick, Massachusetts), in a "real-world" setting. BACKGROUND: The AUTAX registry included patients with 2- or 3-vessel disease, with/without previous percutaneous coronary intervention (PCI) and concomitant surgery. METHODS: Patients (n = 441, 64 +/- 12 years, 78% men) (n = 1,080 lesions) with possible complete revascularization by PCI were prospectively included. Median clinical follow-up was 753 (quartiles 728 to 775) days after PCI in 95.7%, with control angiography of 78% at 6 months. The primary end point was the composite of major adverse cardiac (nonfatal acute myocardial infarction [AMI], all-cause mortality, target lesion revascularization [TLR]) and cerebrovascular events (MACCE). Potential risk factor effects on 2-year MACCE were evaluated using Cox regression. RESULTS: Complete revascularization was successful in 90.5%, with left main PCI of 6.8%. Rates of acute, subacute, and late stent thrombosis were 0.7%, 0.5%, and 0.5%. Two-year follow-up identified AMI (1.4%), death (3.6%), stroke (0.2%), and TLR (13.1%), for a composite MACCE of 18.3%. The binary restenosis rate was 10.8%. The median of cumulative SYNTAX score was 23.0 (range 12.0 to 56.5). The SYNTAX score did not predict TLR or MACCE, due to lack of scoring of restenotic or bypass stenoses (29.8%). Age (hazard ratio [HR]: 1.03, p = 0.019) and acute coronary syndrome (HR: 2.1, p = 0.001) were significant predictors of 2-year MACCE. Incomplete revascularization predicted death or AMI (HR: 3.84, p = 0.002). CONCLUSIONS: With the aim of complete revascularization, TAXUS stent implantations can be safe for patients with multivessel disease. The AUTAX registry including patients with post-PCI lesions provides additional information to the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) study. (Austrian Multivessel TAXUS-Stent Registry; NCT00738686).


Sujet(s)
Angioplastie coronaire par ballonnet/instrumentation , Pontage aortocoronarien , Maladie des artères coronaires/thérapie , Endoprothèses à élution de substances , Sujet âgé , Angioplastie coronaire par ballonnet/effets indésirables , Angioplastie coronaire par ballonnet/mortalité , Autriche , Coronarographie , Pontage aortocoronarien/effets indésirables , Pontage aortocoronarien/mortalité , Maladie des artères coronaires/imagerie diagnostique , Maladie des artères coronaires/mortalité , Maladie des artères coronaires/chirurgie , Resténose coronaire/étiologie , Femelle , Humains , Estimation de Kaplan-Meier , Mâle , Adulte d'âge moyen , Infarctus du myocarde/étiologie , Odds ratio , Antiagrégants plaquettaires/usage thérapeutique , Modèles des risques proportionnels , Études prospectives , Conception de prothèse , Enregistrements , Appréciation des risques , Facteurs de risque , Indice de gravité de la maladie , Accident vasculaire cérébral/étiologie , Thrombose/étiologie , Facteurs temps , Résultat thérapeutique
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