Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 2, Number 3, June 2011, pages 97-105

Extended Outcomes of Complex Coronary Disease in the Drug Eluting Stent Era

Figure 1. Survival at one-year. Crude and adjusted Kaplan-Meier plot for one-year survival for crude DES era (orange), adjusted DES era (red), crude BMS era (green), and adjusted BMS era (blue).

Figure 2. Target lesion revascularization at one-year. Adjusted target lesion revascularization (TLR) time-to-event plot. DES era (red), BMS era (blue).

Figure 3. Target vessel revascularization at one-year. Adjusted target vessel revascularization (TVR) time-to-event plot. DES era (red), BMS era (blue).

**Table 1.** Patient Charateristics
Characteristics	BMS-era (n = 6,093)	DES-era (n = 5,651)	P-value
Age (%, yrs)
< 50	19.5	18	0.02
50 - 59	29	28.4
60 - 69	24.6	25.9
70 - 79	20.1	19.6
> 80	6.8	8.1
Sex (%)
Women	33	31.2	0.04
Men	67	68.8
BSA (%)
> 1.8	79.4	81.5	0.03
> 1.6 - < 1.8	15.3	14.4
< 1.6	5.3	4.1
Comorbidities (%)
COPD	9.3	11.2	< 0.01
Diabetes	19.7	20.9	0.11
Peripheral Vascular Disease	9.4	9.1	0.58
Renal Failure
Dialysis	1.9	1.9	0.73
Creatinine	0.7	0.6
Cancer	0.2	2.1	< 0.01
Cardiac History (%)
Prior MI
none	53.4	50.9	< 0.00
< 7 days	38.7	42.4
8 - 365	6	5
> 1 year	1.9	1.7
CHF (%)
On Admission	3.5	3.6	0.36
Prior to Admission	1.2	1.4

Table 1. Patient Charateristics

Characteristics

BMS-era (n = 6,093)

DES-era (n = 5,651)

P-value

Age (%, yrs)

< 50

19.5

0.02

50 - 59

28.4

60 - 69

24.6

25.9

70 - 79

20.1

19.6

> 80

6.8

8.1

Sex (%)

Women

31.2

0.04

Men

68.8

BSA (%)

> 1.8

79.4

81.5

0.03

> 1.6 - < 1.8

15.3

14.4

< 1.6

5.3

4.1

Comorbidities (%)

COPD

9.3

11.2

< 0.01

Diabetes

19.7

20.9

0.11

Peripheral Vascular Disease

9.4

9.1

0.58

Renal Failure

Dialysis

1.9

0.73

Creatinine

0.7

0.6

Cancer

0.2

2.1

< 0.01

Cardiac History (%)

Prior MI

none

53.4

50.9

< 0.00

< 7 days

38.7

42.4

8 - 365

> 1 year

1.9

1.7

CHF (%)

On Admission

3.5

3.6

0.36

Prior to Admission

1.2

1.4

**Table 2.** Additional Patient Characteristics
Characteristics	BMS-era	DES-era	P-value
Anatomy and Function
Diseased Vessel (%)
CX	18.8	17.8	0.02
RCA	39.4	37.8
LAD	41.8	44.4
Proximal LAD	20.1	21.7	< 0.01
Lesion Type (%)
A	15.3	11.4	< 0.00
B1	42.3	36
B2	28.2	33.4
C	14.2	19.2
Ejection Fraction
< 40	4.8	5.3	0.11
≥ 40	95.2	94.7
Procedural Priority and Process
Priority (%)
Elective	17.4	22.4	< 0.01
Urgent	58.9	48.5
Emergent	23.7	29.1
Process (%)
POBA	7.6	4.3	< 0.01
BMS	92.4	14
DES	-	81.7
> 2 Stents	29.6	22.3	< 0.01
In Hospital Outcomes (%)
Death	0.8	0.9	0.78
Emergency CABG	0.1	0.0	0.31

Table 2. Additional Patient Characteristics

Characteristics

BMS-era

DES-era

P-value

Anatomy and Function

Diseased Vessel (%)

18.8

17.8

0.02

RCA

39.4

37.8

LAD

41.8

44.4

Proximal LAD

20.1

21.7

< 0.01

Lesion Type (%)

15.3

11.4

< 0.00

42.3

28.2

33.4

14.2

19.2

Ejection Fraction

< 40

4.8

5.3

0.11

≥ 40

95.2

94.7

Procedural Priority and Process

Priority (%)

Elective

17.4

22.4

< 0.01

Urgent

58.9

48.5

Emergent

23.7

29.1

Process (%)

POBA

7.6

4.3

< 0.01

BMS

92.4

DES

81.7

> 2 Stents

29.6

22.3

< 0.01

In Hospital Outcomes (%)

Death

0.8

0.9

0.78

Emergency CABG

0.1

0.0

0.31

**Table 3.** Outcomes
Outcome	Crude	Unadjusted Hazard Ratio (95% CI)	Adjusted Hazard Ratio (95% CI)
Survival	2.8	3.2	1.13 (0.92 - 1.39)	0.96 (0.77 - 1.20)
Target Lesion Revascularization	8.3	3.4	0.40 (0.34 - 0.47)	0.38 (0.31 - 0.45)
Target Vessel Revascularization	10.1	4.7	0.45 (0.39 - 0.52)	0.43 (0.37 - 0.50)

Table 3. Outcomes

Outcome

Crude

Unadjusted Hazard Ratio (95% CI)

Adjusted Hazard Ratio (95% CI)

BMS-era (%)

DES-era (%)

Survival

2.8

3.2

1.13 (0.92 - 1.39)

0.96 (0.77 - 1.20)

Target Lesion Revascularization

8.3

3.4

0.40 (0.34 - 0.47)

0.38 (0.31 - 0.45)

Target Vessel Revascularization

10.1

4.7

0.45 (0.39 - 0.52)

0.43 (0.37 - 0.50)

**Table 4.** Outcome in Sub-Groups at Risk for Re-Stenosis
Outcome	DES-era : BMS-era (N : N)	Adjusted Hazard Ratio (95% CI)
Sex
Female	1762 : 2007	1.03 (0.74 - 1.44)	0.35 (0.26 - 0.47)	0.42 (0.32 - 0.54)
Male	3889 : 4085	0.92 (0.67 - 1.26)	0.39 (0.31 - 0.48)	0.43 (0.36 - 0.52)
Diabetes
Yes	1181 : 1200	1.14 (0.74 - 1.75)	0.28 (0.20 - 0.40)	0.33 (0.24 - 0.44)
No	4470 : 4892	0.89 (0.68 - 1.17)	0.41 (0.33 - 0.50)	0.46 (0.39 - 0.55)
BSA
< 1.8	1034 : 1211	0.71 (0.49 - 1.04)	0.30 (0.20 - 0.44)	0.37 (0.26 - 0.51)
> 1.8	4408 : 4686	1.19 (0.89 - 1.58)	0.39 (0.32 - 0.48)	0.44 (0.37 - 0.53)
ACC Lesion Type
B2 or C	2908 : 2488	1.01 (0.75 - 1.34)	0.43 (0.34 - 0.54)	0.47 (0.38 - 0.57)
A or B1	2743 : 3604	0.88 (0.61 - 1.27)	0.32 (0.24 - 0.42)	0.39 (0.31 - 0.49)
Number of Stents
> 2	1330 : 1672	0.85 (0.55 - 1.31)	0.43 (0.32 - 0.58)	0.45 (0.35 - 0.60)
< 2	4321 : 4420	1.00 (0.77 - 1.31)	0.36 (0.29 - 0.44)	0.42 (0.35 - 0.51)

Table 4. Outcome in Sub-Groups at Risk for Re-Stenosis

Outcome

DES-era : BMS-era (N : N)

Adjusted Hazard Ratio (95% CI)

Survival

Target Lesion Revasc

Target Vessel Revasc

Sex

Female

1762 : 2007

1.03 (0.74 - 1.44)

0.35 (0.26 - 0.47)

0.42 (0.32 - 0.54)

Male

3889 : 4085

0.92 (0.67 - 1.26)

0.39 (0.31 - 0.48)

0.43 (0.36 - 0.52)

Diabetes

Yes

1181 : 1200

1.14 (0.74 - 1.75)

0.28 (0.20 - 0.40)

0.33 (0.24 - 0.44)

4470 : 4892

0.89 (0.68 - 1.17)

0.41 (0.33 - 0.50)

0.46 (0.39 - 0.55)

BSA

< 1.8

1034 : 1211

0.71 (0.49 - 1.04)

0.30 (0.20 - 0.44)

0.37 (0.26 - 0.51)

> 1.8

4408 : 4686

1.19 (0.89 - 1.58)

0.39 (0.32 - 0.48)

0.44 (0.37 - 0.53)

ACC Lesion Type

B2 or C

2908 : 2488

1.01 (0.75 - 1.34)

0.43 (0.34 - 0.54)

0.47 (0.38 - 0.57)

A or B1

2743 : 3604

0.88 (0.61 - 1.27)

0.32 (0.24 - 0.42)

0.39 (0.31 - 0.49)

Number of Stents

> 2

1330 : 1672

0.85 (0.55 - 1.31)

0.43 (0.32 - 0.58)

0.45 (0.35 - 0.60)

< 2

4321 : 4420

1.00 (0.77 - 1.31)

0.36 (0.29 - 0.44)

0.42 (0.35 - 0.51)

**Table 5.** Outcome in Propensity Matched Patients
	Survival	Target Lesion Revascularization	Target Vessel Revascularization
Adjusted Hazard Ratio (95% CI)	1.0 (0.83 - 1.28)	0.4 (0.32 - 0.46)	0.44 (0.38 - 0.51)

Table 5. Outcome in Propensity Matched Patients

Survival

Target Lesion Revascularization

Target Vessel Revascularization

Adjusted Hazard Ratio (95% CI)

1.0 (0.83 - 1.28)

0.4 (0.32 - 0.46)

0.44 (0.38 - 0.51)