Four-year outcomes of multivessel percutaneous coronary intervention with Xience v everolimus-eluting stents

Michael S. Lee, Richard Shlofmitz, Ehtisham Mahmud, Kyung Woo Park, Seung Woon Rha, Anna Gaborro, Jin Wang, Weiying Zhao, Krishnankutty Sudhir

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1 Citation (Scopus)

Abstract

Objectives. We evaluated the long-term outcomes of multivessel compared with single-vessel percutaneous coronary intervention (PCI) with Xience V everolimus-eluting stents in real-world patients. Background. Treatment options for multivessel disease include PCI, coronary artery bypass grafting, and medical therapy. Patients with multivessel disease are at a higher risk for ischemic complications than those with single-vessel disease. Methods. The XIENCE V USA study was a condition-of-approval, single-arm, prospective study in unselected real-world patients. Patients who underwent multivessel PCI (n = 655) were compared with those who underwent single-vessel PCI (n = 4079). Major clinical outcomes, including mortality, stent thrombosis, and target-lesion failure (TLF), were evaluated at 4 years. Results. At 4 years, mortality was similar in both groups (11.1% in multivessel patients vs 9.8% in single-vessel patients; P=.31). The multivessel PCI group had higher rates of Academic Research Consortium (ARC)-defined TLF (24.3% vs 16.4% in single-vessel patients; P<.001) and ARC-defined definite and probable stent thrombosis (2.43% vs 1.11% in single-vessel patients; P=.02). The independent predictors of ARC-defined TLF at 4 years on multivariable analysis were prior myocardial infarction, number of treated vessels, total stent length, and sex. Conclusion. Despite significant differences in baseline characteristics, long-term mortality rates were similar in both groups. Although ischemic complications were higher in the multivessel PCI group, the overall rates were acceptable, demonstrating the safety and efficacy of Xience V everolimus-eluting stents for the treatment of multivessel disease in a real-world population.

Original languageEnglish
Pages (from-to)240-246
Number of pages7
JournalJournal of Invasive Cardiology
Volume31
Issue number9
Publication statusPublished - 2019

Bibliographical note

Funding Information:
Funding: The XIENCE V USA study was a condition-of approval postmarket study whose operational expenses were funded by the sponsor (Abbott Vascular). The sponsor, principal investigator, and co-principal investigators actively collaborated with the Food and Drug Administration to design, conduct, and analyze the study. James Hermiller, MD, and Mitchell Krucoff, MD, were the principal investigators for the XIENCE V USA study, but did not review this paper. Abbott Vascular provided the statistical analysis of this study. The corresponding author had full access to the data, and all authors contributed to the preparation of the manuscript.

Publisher Copyright:
© 2019 HMP Communications. All rights reserved.

Keywords

  • Drug-eluting stent
  • Everolimus-eluting stent
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • General Medicine

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