TY - JOUR
T1 - The DELTA 2 Registry
T2 - A Multicenter Registry Evaluating Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents in Patients With Obstructive Left Main Coronary Artery Disease
AU - on behalf of the
AU - DELTA 2 Investigators
AU - Chieffo, Alaide
AU - Tanaka, Akihito
AU - Giustino, Gennaro
AU - Briede, Ieva
AU - Sawaya, Fadi J.
AU - Daemen, Joost
AU - Kawamoto, Hiroyoshi
AU - Meliga, Emanuele
AU - D'Ascenzo, Fabrizio
AU - Cerrato, Enrico
AU - Stefanini, Giulio G.
AU - Capodanno, Davide
AU - Mangiameli, Andrea
AU - Templin, Christian
AU - Erglis, Andrejs
AU - Morice, Marie Claude
AU - Mehran, Roxana
AU - Van Mieghem, Nicolas M.
AU - Nakamura, Sunao
AU - De Benedictis, Mauro
AU - Pavani, Marco
AU - Varbella, Ferdinando
AU - Pisaniello, Marco
AU - Sharma, Samin K.
AU - Tamburino, Corrado
AU - Tchetche, Didier
AU - Colombo, Antonio
N1 - Publisher Copyright:
© 2017 American College of Cardiology Foundation
PY - 2017/12/11
Y1 - 2017/12/11
N2 - Objectives The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a “real world” population. Background PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. Methods All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry. The results were compared with those from the historical DELTA 1 (Drug Eluting Stent for Left Main Coronary Artery) CABG cohort using propensity score stratification. The primary endpoint was the composite of death, myocardial infarction (MI), or stroke at the median time of follow-up. Results A total of 3,986 patients were included. The mean age was 69.6 ± 10.9 years, diabetes was present in 30.8%, and 21% of the patients presented with acute MI. The distal left main coronary artery was involved in 84.6% of the lesions. At a median of 501 days (≈17 months) of follow-up, the occurrence of the primary endpoint of death, MI, or cerebrovascular accident was lower in the PCI DELTA 2 group compared with the historical DELTA 1 CABG cohort (10.3% vs. 11.6%; adjusted hazard ratio: 0.73; 95% confidence interval: 0.55 to 0.98; p = 0.03). Of note, an advantage of PCI was observed with respect to cerebrovascular accident (0.8% vs. 2.0%; adjusted hazard ratio: 0.37; 95% confidence interval: 0.16 to 0.86; p = 0.02), while an advantage of CABG was observed with respect to target vessel revascularization (14.2% vs. 2.9%; adjusted hazard ratio: 3.32; 95% confidence interval: 2.12 to 5.18; p < 0.0001). Conclusions After a median follow-up period of 17 months, PCI with new-generation drug-eluting stents was associated with an overall low rate of the composite endpoint of death, MI, or cerebrovascular accident.
AB - Objectives The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a “real world” population. Background PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. Methods All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry. The results were compared with those from the historical DELTA 1 (Drug Eluting Stent for Left Main Coronary Artery) CABG cohort using propensity score stratification. The primary endpoint was the composite of death, myocardial infarction (MI), or stroke at the median time of follow-up. Results A total of 3,986 patients were included. The mean age was 69.6 ± 10.9 years, diabetes was present in 30.8%, and 21% of the patients presented with acute MI. The distal left main coronary artery was involved in 84.6% of the lesions. At a median of 501 days (≈17 months) of follow-up, the occurrence of the primary endpoint of death, MI, or cerebrovascular accident was lower in the PCI DELTA 2 group compared with the historical DELTA 1 CABG cohort (10.3% vs. 11.6%; adjusted hazard ratio: 0.73; 95% confidence interval: 0.55 to 0.98; p = 0.03). Of note, an advantage of PCI was observed with respect to cerebrovascular accident (0.8% vs. 2.0%; adjusted hazard ratio: 0.37; 95% confidence interval: 0.16 to 0.86; p = 0.02), while an advantage of CABG was observed with respect to target vessel revascularization (14.2% vs. 2.9%; adjusted hazard ratio: 3.32; 95% confidence interval: 2.12 to 5.18; p < 0.0001). Conclusions After a median follow-up period of 17 months, PCI with new-generation drug-eluting stents was associated with an overall low rate of the composite endpoint of death, MI, or cerebrovascular accident.
KW - drug-eluting stents
KW - left main coronary artery
UR - http://www.scopus.com/inward/record.url?scp=85038119094&partnerID=8YFLogxK
U2 - 10.1016/j.jcin.2017.08.050
DO - 10.1016/j.jcin.2017.08.050
M3 - Article
C2 - 29217002
AN - SCOPUS:85038119094
SN - 1936-8798
VL - 10
SP - 2401
EP - 2410
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 23
ER -