Impact of Stable Versus Unstable Coronary Artery Disease on 1-Year Outcome in Elective Patients Undergoing Multivessel Revascularization With Sirolimus-Eluting Stents
A Subanalysis of the ARTS II Trial
Marco Valgimigli, MD, PhD*,
Keith Dawkins, MD, FRCP, FACC ,
Carlos Macaya, MD, FACC ,
Bernard de Bruyne, MD, PhD ,
Emmanuel Teiger, MD, PhD||,
Jean Fajadet, MD¶,
Richardt Gert, MD#,
Stefano De Servi, MD**,
Angelo Ramondo, MD,
Kristel Wittebols, MSc,
Hans-Peter Stoll, MD,
Tessa A.M. Rademaker, MSc and
Patrick W. Serruys, MD, PhD, FACC*,*
* Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
Wessex Cardiac Unit, Southampton University Hospital, Southampton, United Kingdom
Hospital Clinico San Carlos, Madrid, Spain
Onze Lieve Vrouw Ziekenhuis, Aalst, Belgium
|| CHU Henri Mondor, Paris, France
¶ Clinique Pasteur, Toulouse, France
# Segerberger Kliniken, Bad Segeberg, Germany
** Ospedale Civile di Legnano, Legnano, Italy
Azienda Ospedaliera Padova, Padova, Italy
Cordis Corporation, a Johnson & Johnson company, Miami Lakes, Florida
Cardialysis B.V., Rotterdam, the Netherlands
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Figure 1 Kaplan-Meier Curves
(A) Major adverse cardiac and cerebrovascular event-free survival; (B) death/cerebrovascular accident/myocardial infarction-free survival; and (C) freedom from repeat revascularization in the ARTS II study stratified into unstable (bold lines) and stable angina (thin lines).
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Figure 2 HRs and 95% CIs of Factors in the Multivariable Model by Anginal Status
There was no observed interaction between the identified outcome predictors in the model and anginal status at presentation, irrespective of the periprocedural applied definition of myocardial infarction (MI). (A) Results based on non–Q-wave MI defined as any creatine kinase (CK) or CK-myocardial band elevation  3 times the upper limit of normal are shown, with an overall p value of 0.66 for testing interaction. (B) Results based on non–Q-wave MI defined as any CK or CK-myocardial band elevation beyond the upper limit of normal are shown, with an overall p value of 0.58 for testing interaction. Blue = stable angina; red = unstable angina. ACE = angiotensin-converting enzyme; CI = confidence interval; DS = diameter stenosis; HR = hazard ratio; LCX = left circumflex artery.
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Figure 3 Kaplan-Meier Curves Out to 1 Year in Both Study Arms
(A) Major adverse cardiac and cerebrovascular event-free survival; (B) death/cerebrovascular accident/myocardial infarction-free survival; and (C) freedom from repeat revascularization. Black = sirolimus-eluting stent in the ARTS II study; red = coronary artery bypass grafting in the ARTS I study; blue = bare-metal stent in the ARTS I study. Bold lines = unstable angina; thin lines = stable angina.
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