دورية أكاديمية

Outcomes after percutaneous coronary intervention in contemporary Australian practice: insights from a large multicentre registry.

التفاصيل البيبلوغرافية
العنوان: Outcomes after percutaneous coronary intervention in contemporary Australian practice: insights from a large multicentre registry.
المؤلفون: Ajani, Andrew E., Reid, Christopher M., Duffy, Stephen J., Andrianopoulos, Nick, Lefkovits, Jeffrey, Black, Alexander, New, Gishel, Lew, Robert, Shaw, James A., Yan, Bryan P., Gurvitch, Ronen, AI-Fiadh, Ali, Brennan, Angela L., Clark, David J., Al-Fiadh, Ali
المصدر: Medical Journal of Australia; 10/20/2008, Vol. 189 Issue 8, p423-428, 6p
مصطلحات موضوعية: CORONARY disease, SURGICAL stents, HEALTH care intervention (Social services), RETROSPECTIVE studies, DATA analysis, PATIENTS, MYOCARDIAL infarction treatment, TREATMENT of acute coronary syndrome, TICLOPIDINE, RESEARCH, TRANSLUMINAL angioplasty, DRUG-eluting stents, RESEARCH methodology, ACQUISITION of data, ACUTE coronary syndrome, MYOCARDIAL infarction, EVALUATION research, MEDICAL cooperation, TREATMENT effectiveness, HOSPITAL mortality, COMPARATIVE studies, MYOCARDIAL revascularization, PLATELET aggregation inhibitors, COMORBIDITY
مصطلحات جغرافية: AUSTRALIA, VICTORIA
مستخلص: Objective: To examine short- and medium-term outcomes of percutaneous coronary interventions (PCIs), with a focus on comparing drug-eluting stents (DESs) with bare-metal stents (BMSs).Design, Setting and Participants: Retrospective analysis of data from the Melbourne Interventional Group (MIG) registry, a large multicentre Australian registry. The study cohort consisted of 6364 consecutive patients undergoing 7167 PCIs between April 2004 and August 2007.Main Outcome Measures: Clinical events including death, myocardial infarction (MI), target lesion revascularisation (TLR), target vessel revascularisation (TVR) and major adverse cardiac events (MACE) (a composite of death, MI and TVR), at 30 days and at 12 months.Results: The cohort was predominantly male (74%), with a mean age of 64.7 years (SD, 12.0 years). DESs were used in 3482 (51.4%) of PCIs. In the overall cohort, rates of clinical events were low at 30 days: mortality (1.9%), MI (2.4%), TLR (2.0%), TVR (2.4%) and MACE (5.7%). At 12 months, event rates were: mortality (5.2%), MI (6.0%), TLR (5.8%), TVR (8.2%) and MACE (16.2%). Patients receiving DESs had similar mortality rates to those receiving BMSs (4.0% v 6.0%; P = 0.62 [propensity score-adjusted]); late thrombosis rates were also similar in the two groups (0.8% v 1.1%; P = 0.38). The proportion of patients receiving DESs fell significantly over time, from 54.9% in the first 24 months to 44.7% in the last 15 months of the study period (P < 0.01). Independent predictors of 12-month mortality included diabetes, renal failure, ST-segment-elevation MI and cardiogenic shock.Conclusion: Our clinical event rates were comparable with international registry outcomes. Rates of mortality and stent thrombosis were no higher in patients with DESs than those with BMSs. Although DESs were used in about half the procedures (preferentially for higher-risk lesions), recent trends suggest their use is in decline. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Supplemental Index
الوصف
تدمد:0025729X
DOI:10.5694/j.1326-5377.2008.tb02113.x