Target and non-target vessel related events at 10 years post percutaneous coronary intervention

J J Coughlan, Alp Aytekin, Erion Xhepa, Salvatore Cassese, Michael Joner, Tobias Koch, Jens Wiebe, Tobias Lenz, Tobias Rheude, Constanza Pellegrini, Senta Gewalt, Tareq Ibrahim, Karl-Ludwig Laugwitz, Heribert Schunkert, Adnan Kastrati, Sebastian Kufner, J J Coughlan, Alp Aytekin, Erion Xhepa, Salvatore Cassese, Michael Joner, Tobias Koch, Jens Wiebe, Tobias Lenz, Tobias Rheude, Constanza Pellegrini, Senta Gewalt, Tareq Ibrahim, Karl-Ludwig Laugwitz, Heribert Schunkert, Adnan Kastrati, Sebastian Kufner

Abstract

Aims: To define the incidence of events related to the stented vessel (target vessel related events: TVRE) and events related to non-stented vessels (non-target vessel related events: NTVRE) through to 10-year follow-up in patients post-PCI with newer generation drug eluting stents (DES).

Methods and results: The current study is a post-hoc analysis of patient level data from two randomised controlled trials in Germany. Patients older than 18 years with ischemic symptoms or evidence of myocardial ischemia in the presence of ≥ 50% de novo stenosis located in the native coronary vessels were considered eligible. The endpoints of interest were TVRE (a composite of first target vessel myocardial infarction or target vessel revascularization) and NTVRE (a composite of first non-target vessel MI or non-target vessel revascularization) through to 10 years post PCI. We included 4953 patients in this analysis. Through to 10-years post-PCI, TVRE occurred in 1238 of 4953 patients (cumulative incidence: 25.8%) and NTVRE occurred in 1442 of 4953 patients (cumulative incidence: 30.3%). The majority of TVRE and NTVRE were revascularization events. From 0 to 1 years, the cumulative incidence of TVRE was 15.9% and of NTVRE was 12.3%. From 1 to 10 years, the cumulative incidences of TVRE and NTVRE were 11.2% and 22.4%, respectively.

Conclusion: At 10-year post-PCI with new generation drug eluting stents, events related to remote vessel disease progression account for a higher proportion of events than events related to the stented vessel.

Trial registration: ISAR TEST 4 ClinicalTrials.gov Identifier: NCT00598676. ISAR TEST 5 ClinicalTrials.gov Identifier: NCT00598533.

Keywords: Atherosclerotic coronary artery disease; Cardiovascular outcomes; Drug eluting stents; Percutaneous coronary intervention; Target vessel.

Conflict of interest statement

MJ reports speaker fees from Biotronik, personal fees from Orbus Neich, grants and personal fees from Boston Scientific, grants and personal fees from Edwards, personal fees from AstraZeneca, personal fees from Recor, grants from AMGEN, not related to the current work, HS reports honoraria from AstraZeneca, Bayer Vital, MSD SHARP&DOHME, Novartis, Servier, Sanofi-Aventis, Boehringer Ingelheim, Daiichi Sankyo, Amgen, Pfizer and consulting fees from AstraZeneca, Amgen, MSD SHARP&DOHME, not related to the current work, SK reports speaker fees from AstraZeneca and speaker fees and consultant fees from Bristol Myers Squibb, not related to the current work; the other authors report no conflict of interest.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Cumulative incidence of target vessel and non-target vessel related events through to 10 years post PCI
Fig. 2
Fig. 2
Landmark analysis of target vessel and non-target vessel related events from 0–1 and 1–10 years post PCI

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Source: PubMed

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