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Coronary Artery Disease: HELP
Articles by Henrik Toft Sørensen
Based on 18 articles published since 2010
(Why 18 articles?)
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Between 2010 and 2020, Henrik T. Sørensen wrote the following 18 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Clinical Trial Comparison of outcomes in patients with versus without diabetes mellitus after revascularization with everolimus- and sirolimus-eluting stents (from the SORT OUT IV trial). 2012

Jensen, Lisette Okkels / Thayssen, Per / Junker, Anders / Maeng, Michael / Tilsted, Hans-Henrik / Kaltoft, Anne / Hansen, Knud Nørregaard / Christiansen, Evald Høj / Kristensen, Steen Dalby / Ravkilde, Jan / Madsen, Morten / Sørensen, Henrik Toft / Thuesen, Leif / Lassen, Jens Flensted. ·Department of Cardiology, Odense University Hospital, Odense, Denmark. okkels@dadlnet.dk ·Am J Cardiol · Pubmed #22959714.

ABSTRACT: Diabetes is associated with increased risk of major adverse cardiac events (MACEs) after percutaneous coronary intervention. The purpose of this substudy of the SORT OUT IV trial was to compare clinical outcomes in patients with and without diabetes mellitus treated with everolimus-eluting stents (EESs) or sirolimus-eluting stents (SESs). In total 2,774 patients (390 with diabetes, 14.1%) were randomized to stent implantation with EESs (n = 1,390, diabetes in 14.0%) or SESs (n = 1,384, diabetes in 14.2%). Randomization was stratified by presence/absence of diabetes. The primary end point was MACEs, a composite of cardiac death, myocardial infarction, definite stent thrombosis, or target vessel revascularization within 18 months. MACEs were higher in diabetic than in nondiabetic patients (13.1% vs 6.4%, hazard ratio [HR] 2.08, 95% confidence interval [CI] 1.51 to 2.86). In diabetic patients, MACEs were seen in 10.3% of those treated with EESs and in 15.8% of those treated with SESs (HR 0.63, 95% CI 0.36 to 1.11). In nondiabetic patients, MACEs occurred in 6.6% of EES-treated and in 6.3% SES-treated patients (HR 1.06, 95% CI 0.77 to 1.46). In diabetics, cardiac death occurred in 3.1% of EES-treated and in 4.6% of SES-treated patients (HR 0.67, 95% CI 0.24 to 1.89), myocardial infarction occurred in 0.5% of EES-treated and in 3.6% of SES-treated patients (HR 0.14, 95% CI 0.02 to 1.16), and clinically driven target lesion revascularization was needed in 3.1% of EES-treated and in 7.7% of SES-treated patients (HR 0.40, 95% CI 0.15 to 1.02). No interaction between diabetes status and type of drug-eluting stent was found for the end points. In conclusion, patients with diabetes have higher MACE rates than nondiabetics. No significant differences in safety or efficacy outcomes after EES or SES implantation were present in nondiabetic or diabetic patients.

2 Article Diabetes Mellitus Is Associated With Increased Risk of Ischemic Stroke in Patients With and Without Coronary Artery Disease. 2019

Olesen, Kevin K W / Madsen, Morten / Gyldenkerne, Christine / Thrane, Pernille G / Würtz, Morten / Thim, Troels / Jensen, Lisette O / Eikelboom, John / Bøtker, Hans Erik / Sørensen, Henrik T / Maeng, Michael. ·From the Department of Cardiology (K.K.W.O., C.G., P.G.T., T.T., H.E.B., M. Maeng), Aarhus University Hospital, Denmark. · Department of Clinical Epidemiology (K.K.W.O., M. Madsen, H.T.S.), Aarhus University Hospital, Denmark. · Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark (M.W.). · Department of Cardiology, Odense University Hospital, Denmark (L.O.J.). · Population Health Research Institute, Hamilton Health Sciences and McMaster University, Ontario, Canada (J.E.). ·Stroke · Pubmed #31690249.

ABSTRACT: Background and Purpose- Diabetes mellitus (DM) and non-DM patients without coronary artery disease (CAD) have a similar low risk of myocardial infarction after coronary angiography. The risk of ischemic stroke in DM patients dependent on CAD status is less explored. We examined whether DM patients without CAD have a risk of ischemic stroke similar to that in patients with neither DM nor CAD. Methods- We conducted a cohort study of patients who underwent coronary angiography between 2004 and 2012 in Western Denmark. Patients diagnosed with previous ischemic stroke or transient ischemic attack were excluded. Patients were stratified according to the presence of DM and CAD. Follow-up started 30 days after coronary angiography. We computed event rates and adjusted incidence rate ratios using patients without DM or CAD as reference. We examined the trend between CAD extent and ischemic stroke in patients with DM. Results- A total of 81 909 patients were included. Median follow-up was 3.8 years. Patients with both DM and CAD were at the highest risk of ischemic stroke (1.32 events per 100 person-years; adjusted incidence rate ratio, 2.00 [95% CI, 1.72-2.32]). Patients with CAD alone (0.77 events per 100 person-years; adjusted incidence rate ratio, 1.27 [95% CI, 1.12-1.44]) or DM alone (0.95 events per 100 person-years; adjusted incidence rate ratio, 1.74 [95% CI, 1.42-2.15]) were at intermediate risk, whereas patients with neither DM nor CAD (0.52 events per 100 person-years) were at the lowest risk. Among patients with DM, extent of CAD was further predictive of risk (

3 Article Risk stratification by assessment of coronary artery disease using coronary computed tomography angiography in diabetes and non-diabetes patients: a study from the Western Denmark Cardiac Computed Tomography Registry. 2019

Olesen, Kevin K W / Riis, Anders H / Nielsen, Lene H / Steffensen, Flemming H / Nørgaard, Bjarne L / Jensen, Jesper M / Poulsen, Per L / Thim, Troels / Bøtker, Hans Erik / Sørensen, Henrik T / Maeng, Michael. ·Department of Cardiology, Aarhus University Hospital, Palle Juel Jensens Boulevard 99, Aarhus, Denmark. · Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, Aarhus, Denmark. · Department of Cardiology, Lillebaelt Hospital, Beriderbakken 4, Vejle, Denmark. · Departments of Endocrinology and Internal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark. ·Eur Heart J Cardiovasc Imaging · Pubmed #31220229.

ABSTRACT: AIMS: We examined whether severity of coronary artery disease (CAD) measured by coronary computed tomography angiography can be used to predict rates of myocardial infarction (MI) and death in patients with and without diabetes. METHODS AND RESULTS: A cohort study of consecutive patients (n = 48 731) registered in the Western Denmark Cardiac Computed Tomography Registry from 2008 to 2016. Patients were stratified by diabetes status and CAD severity (no, non-obstructive, or obstructive). Endpoints were MI and death. Event rates per 1000 person-years, unadjusted and adjusted incidence rate ratios were computed. Median follow-up was 3.6 years. Among non-diabetes patients, MI event rates per 1000 person-years were 1.4 for no CAD, 4.1 for non-obstructive CAD, and 9.1 for obstructive CAD. Among diabetes patients, the corresponding rates were 2.1 for no CAD, 4.8 for non-obstructive CAD, and 12.6 for obstructive CAD. Non-diabetes and diabetes patients without CAD had similar low rates of MI [adjusted incidence rate ratio 1.40, 95% confidence interval (CI): 0.71-2.78]. Among diabetes patients, the adjusted risk of MI increased with severity of CAD (no CAD: reference; non-obstructive CAD: adjusted incidence rate ratio 1.71, 95% CI: 0.79-3.68; obstructive CAD: adjusted incidence rate ratio 4.42, 95% CI: 2.14-9.17). Diabetes patients had higher death rates than non-diabetes patients, irrespective of CAD severity. CONCLUSION: In patients without CAD, diabetes patients have a low risk of MI similar to non-diabetes patients. Further, MI rates increase with CAD severity in both diabetes and non-diabetes patients; with diabetes patients with obstructive CAD having the highest risk of MI.

4 Article Association between anti-diabetes treatments and cardiovascular risk in diabetes patients with and without coronary artery disease. 2019

Gyldenkerne, Christine / Olesen, Kevin Kris Warnakula / Madsen, Morten / Thim, Troels / Jensen, Lisette Okkels / Raungaard, Bent / Sørensen, Henrik Toft / Bøtker, Hans Erik / Maeng, Michael. ·1 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. · 2 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. · 3 Department of Cardiology, Odense University Hospital, Odense, Denmark. · 4 Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. ·Diab Vasc Dis Res · Pubmed #30939916.

ABSTRACT: OBJECTIVE: We examined the risk of myocardial infarction associated with glucose-lowering therapy among diabetes patients with and without obstructive coronary artery disease. METHODS: A cohort of patients with type 1 or type 2 diabetes (n = 12,030), who underwent coronary angiography from 2004 to 2012, were stratified by presence of obstructive (any stenosis ⩾50%) coronary artery disease and by type of diabetes treatment: diet, non-insulin treatment and insulin (±oral anti-diabetics). The primary endpoint was myocardial infarction. Adjusted hazard ratios were calculated using diet-treated patients without coronary artery disease as reference. RESULTS: In patients without coronary artery disease, risk of myocardial infarction was similar in patients treated with non-insulin medication (adjusted hazard ratio 0.70, 95% confidence interval 0.27-1.81) and insulin (adjusted hazard ratio 0.76, 95% confidence interval 0.27-2.08) as compared to diet only. In patients with coronary artery disease, the risk of myocardial infarction was higher than in the reference group and an incremental risk was observed being lowest in patients treated with diet (adjusted hazard ratio 3.79, 95% confidence interval 1.61-8.88), followed by non-insulin medication (adjusted hazard ratio 5.42, 95% confidence interval 2.40-12.22), and highest in insulin-treated patients (adjusted hazard ratio 7.91, 95% confidence interval 3.51-17.82). CONCLUSION: The presence of obstructive coronary artery disease defines the risk of myocardial infarction in diabetes patients. Glucose-lowering therapy, in particular insulin, was associated with risk of myocardial infarction only in the presence of coronary artery disease.

5 Article Coronary artery disease and risk of adverse cardiac events and stroke. 2017

Olesen, Kevin Kris Warnakula / Madsen, Morten / Lip, Gregory Y H / Egholm, Gro / Thim, Troels / Jensen, Lisette Okkels / Raungaard, Bent / Nielsen, Jens Cosedis / Bøtker, Hans Erik / Sørensen, Henrik Toft / Maeng, Michael. ·Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. · Institute of Cardiovascular Sciences, City Hospital, University of Birmingham, Birmingham, United Kingdom. · Department of Cardiology, Odense University Hospital, Odense, Denmark. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. ·Eur J Clin Invest · Pubmed #28804899.

ABSTRACT: BACKGROUND: Patients with acute myocardial infarction are at increased risk of ischaemic stroke. Previous myocardial infarction is an important part of risk assessment for ischaemic stroke. However, there is a lack of information regarding the association between the severity and extent of coronary artery disease and long-term risk of ischaemic stroke. MATERIALS AND METHODS: A cohort study of coronary angiographies performed in western Denmark from 1 January 2003 to 31 December 2012. Patients were stratified according to the number of vessels affected by obstructive coronary artery disease (lumen narrowing ≥50%) at the time of angiography: zero-, one-, two- or three-vessel disease and diffuse vessel disease. We followed patients for a maximum of 7 years. Endpoints were all-cause death, cardiac death, myocardial infarction and ischaemic stroke. Cumulative risks and crude and adjusted rate ratios were estimated. RESULTS: The study population included 78 195 patients. Of these, 32 061 (41·0%) had zero-vessel disease, 6205 (7·9%) had diffuse vessel disease, 20 202 (25·8%) had one-vessel disease, 10 675 (13·7%) had two-vessel disease, and 9038 (11·6%) had three-vessel disease. Median follow-up was 3·6 years (interquartile range 1·7-6·0 years). Increasing severity of obstructive coronary artery disease was associated with an increasing risk of all-cause death, cardiac death, myocardial infarction (MI) and ischaemic stroke during follow-up. CONCLUSIONS: The presence and extent of coronary artery disease was associated with an incremental risk of not only death, cardiac death, myocardial infarction, but also ischaemic stroke over a 7-year period.

6 Article Patients With Diabetes Without Significant Angiographic Coronary Artery Disease Have the Same Risk of Myocardial Infarction as Patients Without Diabetes in a Real-World Population Receiving Appropriate Prophylactic Treatment. 2017

Olesen, Kevin K W / Madsen, Morten / Egholm, Gro / Thim, Troels / Jensen, Lisette O / Raungaard, Bent / Bøtker, Hans E / Sørensen, Henrik T / Maeng, Michael. ·Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Cardiology, Odense University Hospital, Odense, Denmark. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark michael.maeng@ki.au.dk. ·Diabetes Care · Pubmed #28596210.

ABSTRACT: OBJECTIVE: The risk of myocardial infarction (MI) in patients with diabetes is greater than for patients without diabetes. Consequently, prophylactic treatment is recommended for patients with diabetes and risk factors for ischemic heart disease. We aimed to estimate the risk of adverse cardiac events in patients with and without diabetes with and without coronary artery disease (CAD) after coronary angiography (CAG). RESEARCH DESIGN AND METHODS: A population-based cohort of patients registered in the Western Denmark Heart Registry who underwent CAG between 1 January 2003 and 31 December 2012 was stratified according to the presence or absence of obstructive CAD and diabetes. End points were death, cardiac death, and MI. Unadjusted and adjusted rate ratios (RRs) were calculated by using patients without diabetes and without CAD as the reference group. RESULTS: We included 93,866 patients of whom 12,544 (13.4%) had diabetes at the time of CAG. Median follow-up was 4.1 years. Patients with and without diabetes without obstructive CAD had the same adjusted risk of death (RR 1.03 [95% CI 0.92-1.15]), cardiac death (RR 1.21 [95% CI 0.90-1.64]), and MI (RR 0.88 [95% CI 0.65-1.17]). Patients with diabetes without CAD were more often treated with statins (75.3% vs. 46.0%) and aspirin (65.7% vs. 52.7%) than patients without diabetes and CAD. CONCLUSIONS: In a real-world population, patients with diabetes with high rates of statin and aspirin treatment had the same risk of cardiovascular events as patients without diabetes in the absence of angiographically significant CAD.

7 Article Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography: a Danish multicentre cohort study. 2017

Nielsen, Lene H / Bøtker, Hans Erik / Sørensen, Henrik T / Schmidt, Morten / Pedersen, Lars / Sand, Niels Peter / Jensen, Jesper M / Steffensen, Flemming H / Tilsted, Hans Henrik / Bøttcher, Morten / Diederichsen, Axel / Lambrechtsen, Jess / Kristensen, Lone D / Øvrehus, Kristian A / Mickley, Hans / Munkholm, Henrik / Gøtzsche, Ole / Husain, Majed / Knudsen, Lars L / Nørgaard, Bjarne L. ·Department of Cardiology, Lillebaelt Hospital-Vejle, Kabbeltoft 25, DK-7100 Vejle, Denmark. · Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Cardiology, Hospital of South West Jutland, Esbjerg, Denmark. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · Department of Cardiology, Regional Hospital Herning, Herning, Denmark. · Department of Cardiology, Odense University Hospital, Denmark. · Department of Cardiology, Svendborg Hospital, Denmark. · Department of Cardiology, Regional Hospital Silkeborg, Silkeborg, Denmark. ·Eur Heart J · Pubmed #27941018.

ABSTRACT: Aims: To examine the 3.5 year prognosis of stable coronary artery disease (CAD) as assessed by coronary computed tomography angiography (CCTA) in real-world clinical practice, overall and within subgroups of patients according to age, sex, and comorbidity. Methods and results: This cohort study included 16,949 patients (median age 57 years; 57% women) with new-onset symptoms suggestive of CAD, who underwent CCTA between January 2008 and December 2012. The endpoint was a composite of late coronary revascularization procedure >90 days after CCTA, myocardial infarction, and all-cause death. The Kaplan-Meier estimator was used to compute 91 day to 3.5 year risk according to the CAD severity. Comparisons between patients with and without CAD were based on Cox-regression adjusted for age, sex, comorbidity, cardiovascular risk factors, concomitant cardiac medications, and post-CCTA treatment within 90 days. The composite endpoint occurred in 486 patients. Risk of the composite endpoint was 1.5% for patients without CAD, 6.8% for obstructive CAD, and 15% for three-vessel/left main disease. Compared with patients without CAD, higher relative risk of the composite endpoint was observed for non-obstructive CAD [hazard ratio (HR): 1.28; 95% confidence interval (CI): 1.01-1.63], obstructive one-vessel CAD (HR: 1.83; 95% CI: 1.37-2.44), two-vessel CAD (HR: 2.97; 95% CI: 2.09-4.22), and three-vessel/left main CAD (HR: 4.41; 95% CI :2.90-6.69). The results were consistent in strata of age, sex, and comorbidity. Conclusion: Coronary artery disease determined by CCTA in real-world practice predicts the 3.5 year composite risk of late revascularization, myocardial infarction, and all-cause death across different groups of age, sex, or comorbidity burden.

8 Article Risk Associated With Surgery Within 12 Months After Coronary Drug-Eluting Stent Implantation. 2016

Egholm, Gro / Kristensen, Steen Dalby / Thim, Troels / Olesen, Kevin K W / Madsen, Morten / Jensen, Svend E / Jensen, Lisette O / Sørensen, Henrik T / Bøtker, Hans E / Maeng, Michael. ·Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: grochi@rm.dk. · Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · Department of Cardiology, Odense University Hospital, Odense, Denmark. ·J Am Coll Cardiol · Pubmed #27978946.

ABSTRACT: BACKGROUND: Guidelines recommend postponing surgery for at least 6 months after treatment with a drug-eluting stent by percutaneous coronary intervention (DES-PCI). OBJECTIVES: The goal of this study was to evaluate the surgical risk associated with DES-PCI compared with that in nonstented patients without ischemic heart disease (IHD). METHODS: Between 2005 and 2012, a total of 22,590 patients underwent DES-PCI in western Denmark. By record-linking the Western Denmark Heart Registry and the Danish National Patient Register, we evaluated 4,303 DES-PCI-treated patients with a surgical procedure and compared them with a control group of patients without previous IHD undergoing similar surgical procedures (n = 20,232). Events of interest were myocardial infarction (MI), cardiac death, and all-cause mortality within 30 days after surgery. RESULTS: Surgery in DES-PCI-treated patients was associated with an increased risk of MI (1.6% vs. 0.2%; odds ratio [OR]: 4.82; 95% confidence interval [CI]: 3.25 to 7.16) and cardiac death (1.0% vs. 0.2%; OR: 5.87; 95% CI: 3.60 to 9.58) but not all-cause mortality (3.1% vs. 2.7%; OR: 1.12; 95% CI: 0.91 to 1.38). When stratified for time from PCI to surgery, only surgery within the first month was associated with a significant increased risk of events. CONCLUSIONS: Patients requiring surgery within 12 months after DES-PCI had an increased risk of MI and cardiac death compared with patients without IHD. The increased risk was only present within the first month after DES-PCI, suggesting that surgery might be undertaken earlier than currently recommended.

9 Article Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. 2016

Mäkikallio, Timo / Holm, Niels R / Lindsay, Mitchell / Spence, Mark S / Erglis, Andrejs / Menown, Ian B A / Trovik, Thor / Eskola, Markku / Romppanen, Hannu / Kellerth, Thomas / Ravkilde, Jan / Jensen, Lisette O / Kalinauskas, Gintaras / Linder, Rikard B A / Pentikainen, Markku / Hervold, Anders / Banning, Adrian / Zaman, Azfar / Cotton, Jamen / Eriksen, Erlend / Margus, Sulev / Sørensen, Henrik T / Nielsen, Per H / Niemelä, Matti / Kervinen, Kari / Lassen, Jens F / Maeng, Michael / Oldroyd, Keith / Berg, Geoff / Walsh, Simon J / Hanratty, Colm G / Kumsars, Indulis / Stradins, Peteris / Steigen, Terje K / Fröbert, Ole / Graham, Alastair N J / Endresen, Petter C / Corbascio, Matthias / Kajander, Olli / Trivedi, Uday / Hartikainen, Juha / Anttila, Vesa / Hildick-Smith, David / Thuesen, Leif / Christiansen, Evald H / Anonymous3940886. ·Department of Cardiology, Oulu University Hospital, Oulu, Finland. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiology, Golden Jubilee National Hospital, Clydebank, Scotland. · Belfast Heart Centre, Belfast Trust, Belfast, Northern Ireland. · Latvia Centre of Cardiology, Paul Stradins Clinical Hospital, Riga, Latvia. · Craigavon Cardiac Centre, Craigavon, Northern Ireland. · Department of Cardiology, University of Northern Norway, Tromsø, Norway. · Heart Hospital, Tampere University Hospital, Tampere, Finland. · Heart Center, Kuopio University Hospital, Kuopio, Finland. · Department of Cardiology, Örebro University Hospital, Örebro, Sweden. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · Department of Cardiology, Odense University Hospital, Odense, Denmark. · Department of Cardiology, Vilnius University Hospital, Vilnius, Lithuania. · Department of Cardiology, Danderyd Hospital, Stockholm, Sweden. · Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland. · Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. · Oxford Heart Centre, Oxford, UK. · Department of Cardiology, Freeman Hospital and Institute of Cellular Medicine, Newcastle, UK. · Heart and Lung Centre, New Cross Hospital, Wolverhampton, UK. · Department of Cardiology, Haukeland University Hospital, Bergen, Norway. · Department of Cardiology, East Tallinn Hospital, Tallinn, Estonia. · Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Health Research and Policy (Epidemiology), Stanford University, Stanford, CA, USA. · Department of Cardiac Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiovascular Surgery, University of Northern Norway, Tromsø, Norway. · Department of Cardiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden. · Sussex Cardiac Centre, Brighton and Sussex University Hospital, Brighton, UK. · Department of Cardiac Surgery, Oulu University Hospital, Finland. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. Electronic address: evald.christiansen@dadlnet.dk. ·Lancet · Pubmed #27810312.

ABSTRACT: BACKGROUND: Coronary artery bypass grafting (CABG) is the standard treatment for revascularisation in patients with left main coronary artery disease, but use of percutaneous coronary intervention (PCI) for this indication is increasing. We aimed to compare PCI and CABG for treatment of left main coronary artery disease. METHODS: In this prospective, randomised, open-label, non-inferiority trial, patients with left main coronary artery disease were enrolled in 36 centres in northern Europe and randomised 1:1 to treatment with PCI or CABG. Eligible patients had stable angina pectoris, unstable angina pectoris, or non-ST-elevation myocardial infarction. Exclusion criteria were ST-elevation myocardial infarction within 24 h, being considered too high risk for CABG or PCI, or expected survival of less than 1 year. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE), a composite of all-cause mortality, non-procedural myocardial infarction, any repeat coronary revascularisation, and stroke. Non-inferiority of PCI to CABG required the lower end of the 95% CI not to exceed a hazard ratio (HR) of 1·35 after up to 5 years of follow-up. The intention-to-treat principle was used in the analysis if not specified otherwise. This trial is registered with ClinicalTrials.gov identifier, number NCT01496651. FINDINGS: Between Dec 9, 2008, and Jan 21, 2015, 1201 patients were randomly assigned, 598 to PCI and 603 to CABG, and 592 in each group entered analysis by intention to treat. Kaplan-Meier 5 year estimates of MACCE were 29% for PCI (121 events) and 19% for CABG (81 events), HR 1·48 (95% CI 1·11-1·96), exceeding the limit for non-inferiority, and CABG was significantly better than PCI (p=0·0066). As-treated estimates were 28% versus 19% (1·55, 1·18-2·04, p=0·0015). Comparing PCI with CABG, 5 year estimates were 12% versus 9% (1·07, 0·67-1·72, p=0·77) for all-cause mortality, 7% versus 2% (2·88, 1·40-5·90, p=0·0040) for non-procedural myocardial infarction, 16% versus 10% (1·50, 1·04-2·17, p=0·032) for any revascularisation, and 5% versus 2% (2·25, 0·93-5·48, p=0·073) for stroke. INTERPRETATION: The findings of this study suggest that CABG might be better than PCI for treatment of left main stem coronary artery disease. FUNDING: Biosensors, Aarhus University Hospital, and participating sites.

10 Article Time-dependent effect of preinfarction angina pectoris and intermittent claudication on mortality following myocardial infarction: A Danish nationwide cohort study. 2015

Schmidt, Morten / Horváth-Puhó, Erzsébet / Pedersen, Lars / Sørensen, Henrik Toft / Bøtker, Hans Erik. ·Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark; Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgårdsvej 100, 8200 Aarhus N, Denmark. Electronic address: morten.schmidt@clin.au.dk. · Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark. · Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgårdsvej 100, 8200 Aarhus N, Denmark. ·Int J Cardiol · Pubmed #25846654.

ABSTRACT: BACKGROUND: As proxies for local and remote ischemic preconditioning, we examined whether preinfarction angina pectoris and intermittent claudication influenced mortality following myocardial infarction. METHODS: Using medical registries, we conducted a nationwide population-based cohort study of all first-time myocardial infarction patients in Denmark during 2004-2012 (n=70,458). We computed all-cause and coronary mortality rate ratios (MRRs). We categorized time between angina/claudication presentation and subsequent myocardial infarction as 0-14, 15-30, 31-90, and > 90 days. We adjusted for age, sex, coronary intervention, comorbidities, and medication use. RESULTS: Among all myocardial infarction patients, 18.4% had prior angina and 3.8% had prior intermittent claudication. Compared to patients without prior angina, the adjusted 30-day coronary MRR was 0.85 (95% confidence interval (CI): 0.80-0.92) for stable and 0.68 (95% CI: 0.58-0.79) for unstable angina patients. The mortality reduction increased when angina presented close to myocardial infarction and was higher for unstable than for stable angina. Thus, the 30-day coronary MRR was 0.72 (95% CI: 0.51-1.02) for stable angina and 0.35 (95% CI: 0.17-0.73) for unstable angina presenting within 14 days before MI. The results were robust for all-cause mortality and in numerous subgroups, including women, diabetics, patients treated with PCI, and patients treated with and without cardioprotective drugs. Preinfarction intermittent claudication was associated with higher short- and long-term mortality compared to patients without intermittent claudication. CONCLUSIONS: Preinfarction angina reduced 30-day mortality, particularly when unstable angina closely preceded MI. Preinfarction intermittent claudication was associated with increased short- and long-term mortality.

11 Article Long-term outcome of sirolimus-eluting and zotarolimus-eluting coronary stent implantation in patients with and without diabetes mellitus (a Danish organization for randomized trials on clinical outcome III substudy). 2015

Olesen, Kevin K W / Tilsted, Hans-Henrik / Jensen, Lisette O / Kaltoft, Anne / Krusell, Lars R / Ravkilde, Jan / Christiansen, Evald H / Madsen, Morten / Thayssen, Per / Sørensen, Henrik T / Lassen, Jens F / Maeng, Michael. ·Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Cardiology, Aarhus University Hospital, Aalborg Hospital, Aalborg, Denmark. · Department of Cardiology, Odense University Hospital, Odense, Denmark. · Department of Clinical Epidemiology, Aalborg University Hospital, Aarhus, Denmark. · Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: michael.maeng@ki.au.dk. ·Am J Cardiol · Pubmed #25499925.

ABSTRACT: We compared 5-year clinical outcomes in diabetic and nondiabetic patients treated with Endeavor zotarolimus-eluting stents (ZESs; Endeavor Sprint, Medtronic, Santa Rosa, California) or Cypher sirolimus-eluting stents (SESs; Cordis, Johnson & Johnson, Warren, New Jersey) coronary implantation. We randomized 2,332 patients to either ZESs (n = 1,162, n = 169 diabetic patients) or SESs (n = 1,170, n = 168 diabetic patients) stratified according to presence or absence of diabetes mellitus. End points included major adverse cardiac event (MACE), a composite of cardiac death, myocardial infarction, target vessel revascularization (TVR), and definite stent thrombosis. Among diabetic patients, MACE occurred more frequently in patients treated with ZESs than SESs (48 [28.4%] vs 31 [18.5%]; odds ratio [OR] 1.75, 95% confidence interval [CI] 1.05 to 2.93, p = 0.032) because of a higher rate of TVR (32 [18.9%] vs 14 [8.3%]; OR 2.57, 95% CI 1.32 to 5.02, p = 0.006). Among nondiabetic patients, ZES and SES had similar MACE rates at 5-year follow-up but SES was associated with a significantly higher risk of definite stent thrombosis (10 [1.0%] vs 23 [2.3%]; OR 0.43, 95% CI 0.20 to 0.91, p = 0.028). Moreover, during the last 4 years, ZES had fewer MACE, TVR, and stent thrombosis events among nondiabetic patients. In conclusion, SES remains superior to ZES in patients with diabetes throughout the 5-year follow-up, however, among nondiabetic patients, SES demonstrated a highly dynamic performance with favorable initial results followed by a late catch-up that included an overall higher risk of stent thrombosis.

12 Article Differential clinical outcomes after 1 year versus 5 years in a randomised comparison of zotarolimus-eluting and sirolimus-eluting coronary stents (the SORT OUT III study): a multicentre, open-label, randomised superiority trial. 2014

Maeng, Michael / Tilsted, Hans Henrik / Jensen, Lisette Okkels / Krusell, Lars Romer / Kaltoft, Anne / Kelbæk, Henning / Villadsen, Anton B / Ravkilde, Jan / Hansen, Knud Nørregaard / Christiansen, Evald Høj / Aarøe, Jens / Jensen, Jan Skov / Kristensen, Steen Dalby / Bøtker, Hans Erik / Thuesen, Leif / Madsen, Morten / Thayssen, Per / Sørensen, Henrik Toft / Lassen, Jens Flensted. ·Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. Electronic address: michael.maeng@ki.au.dk. · Department of Cardiology, Aarhus University Hospital, Aalborg Hospital, Aalborg, Denmark. · Department of Cardiology, Odense University Hospital, Odense, Denmark. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. · Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark. · Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. ·Lancet · Pubmed #24631162.

ABSTRACT: BACKGROUND: In head-to-head comparisons of coronary drug-eluting stents, the primary endpoint is traditionally assessed after 9-12 months. However, the optimum timepoint for this assessment remains unclear. In this study, we assessed clinical outcomes at up to 5 years' follow-up in patients who received two different types of drug-eluting stents. METHODS: We undertook this multicentre, open-label, randomised superiority trial at five percutaneous coronary intervention centres in Denmark. We randomly allocated 2332 eligible adult patients (≥18 years of age) with an indication for drug-eluting stent implantation to the zotarolimus-eluting Endeavor Sprint stent (Medtronic, Santa Rosa, CA, USA) or the sirolimus-eluting Cypher Select Plus stent (Cordis, Johnson & Johnson, Warren, NJ, USA). Randomisation of participants was achieved by computer-generated block randomisation and a telephone allocation service. The primary endpoint of the SORT OUT III study was a composite of major adverse cardiac events-cardiac death, myocardial infarction, and target vessel revascularisation-at 9 months' follow-up. In this study, endpoints included the occurrence of major adverse cardiac events and definite stent thrombosis at follow-up times of up to 5 years. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00660478. FINDINGS: We randomly allocated 1162 patients to receive the zotarolimus-eluting stent and 1170 to the sirolimus-eluting stent. At 5-year follow-up, rates of major adverse cardiac events were similar in patients treated with both types of stents (zotarolimus-eluting stents 197/1162 [17.0%] vs sirolimus-eluting stents 182/1170 [15.6%]; odds ratio [OR] 1.10, 95% CI 0.88-1.37; p=0.40). This finding was indicative of the directly contrasting results for rates of major adverse cardiac events at 1-year follow up (zotarolimus 93/1162 [8.0%] vs sirolimus 46/1170 [3.9%]; OR 2.13, 95% CI 1.48-3.07; p<0.0001) compared with those at follow-up between 1 and 5 years (104 [9.0%] vs 136 [11.6%]; OR 0.78, 95% CI 0.59-1.02; p=0.071). At 1-year follow-up, definite stent thrombosis was more frequent after implantation of the zotarolimus-eluting stent (13/1162 [1.1%]) than the sirolimus-eluting stent (4/1170 [0.3%]; OR 3.34, 95% CI 1.08-10.3; p=0.036), whereas the opposite finding was recorded for between 1 and 5 years' follow-up (zotarolimus-eluting stent 1/1162 [0.1%] vs sirolimus-eluting stent 21/1170 [1.8%], OR 0.05, 95% CI 0.01-0.36; p=0.003). 26 of 88 (30%) target lesion revascularisations in the zotarolimus-eluting stent group occurred between 1 and 5 years' follow-up, whereas 54 of 70 (77%) of those in the sirolimus-eluting stent group occurred during this follow-up period. INTERPRETATION: The superiority of sirolimus-eluting stents compared with zotarolimus-eluting stents at 1-year follow-up was lost after 5 years. The traditional 1-year primary endpoint assessment therefore might be insufficient to predict 5-year clinical outcomes in patients treated with coronary drug-eluting stent implantation. FUNDING: Cordis and Medtronic.

13 Article 3-Year clinical outcomes in the randomized SORT OUT III superiority trial comparing zotarolimus- and sirolimus-eluting coronary stents. 2012

Maeng, Michael / Tilsted, Hans-Henrik / Jensen, Lisette Okkels / Kaltoft, Anne / Kelbæk, Henning / Abildgaard, Ulrik / Villadsen, Anton B / Krusell, Lars Romer / Ravkilde, Jan / Hansen, Knud Nørregaard / Christiansen, Evald Høj / Aarøe, Jens / Jensen, Jan Skov / Kristensen, Steen Dalby / Bøtker, Hans Erik / Madsen, Morten / Thayssen, Per / Sørensen, Henrik Toft / Thuesen, Leif / Lassen, Jens Flensted. ·Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. maeng@ki.au.dk ·JACC Cardiovasc Interv · Pubmed #22917452.

ABSTRACT: OBJECTIVES: This study sought to examine the 3-year clinical outcomes in patients treated with the Endeavor (Medtronic, Santa Rosa, California) zotarolimus-eluting stent (ZES) or the Cypher (Cordis, Johnson & Johnson, Warren, New Jersey) sirolimus-eluting stent (SES) in routine clinical practice. BACKGROUND: The long-term clinical outcome in patients treated with ZES in comparison with SES is unclear. METHODS: The authors randomized 2,332 patients to ZES (n = 1,162) or SES (n = 1,170) implantation. Endpoints included major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction, or target vessel revascularization; the individual endpoints of MACE; and definite stent thrombosis. RESULTS: At 3-year follow-up, the MACE rate was higher in patients treated with ZES than in patients treated with SES (148 [12.9%] vs. 116 [10.1%]; hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.04 to 1.69; p = 0.022). Target vessel revascularization was more frequent in the ZES group compared with the SES group (103 [9.1%] vs. 76 [6.7%]; HR: 1.40, 95% CI: 1.04 to 1.89; p = 0.025), whereas the occurrence of myocardial infarction (3.8% vs. 3.3%) and cardiac death (2.8% vs. 2.8%) did not differ significantly. Although the rate of definite stent thrombosis was similar at 3-year follow-up (1.1% vs. 1.4%), very late (12 to 36 months) definite stent thrombosis occurred in 0 (0%) patients in the ZES group versus 12 (1.1%) patients in the SES group (p = 0.0005). CONCLUSIONS: Although the 3-year MACE rate is higher in patients treated with ZES versus SES, our data highlight a late safety problem concerning definite stent thrombosis with the use of SES. This finding underscores the importance of long-term follow-up in head-to-head comparisons of drug-eluting stents. (Randomized Clinical Comparison of the Endeavor and the Cypher Coronary Stents in Non-selected Angina Pectoris Patients [SORT OUT III]; NCT00660478).

14 Article Randomized comparison of everolimus-eluting and sirolimus-eluting stents in patients treated with percutaneous coronary intervention: the Scandinavian Organization for Randomized Trials with Clinical Outcome IV (SORT OUT IV). 2012

Jensen, Lisette Okkels / Thayssen, Per / Hansen, Henrik Steen / Christiansen, Evald Høj / Tilsted, Hans Henrik / Krusell, Lars Romer / Villadsen, Anton Boel / Junker, Anders / Hansen, Knud Nørregaard / Kaltoft, Anne / Maeng, Michael / Pedersen, Knud Erik / Kristensen, Steen Dalby / Bøtker, Hans Erik / Ravkilde, Jan / Sanchez, Richardo / Aarøe, Jens / Madsen, Morten / Sørensen, Henrik Toft / Thuesen, Leif / Lassen, Jens Flensted / Anonymous3080717. ·Department of Cardiology, Odense University Hospital, Denmark. okkels@dadlnet.dk ·Circulation · Pubmed #22308301.

ABSTRACT: BACKGROUND: Among drug-eluting stents released to date, the sirolimus-eluting stent has demonstrated the least amount of late lumen loss, but its efficacy and safety have not been compared head-to-head with the next-generation everolimus-eluting stent. METHODS AND RESULTS: The Scandinavian Organization for Randomized Trials with Clinical Outcome IV (SORT OUT IV) trial was a randomized multicenter, single-blind, all-comer, 2-arm, noninferiority trial comparing the everolimus-eluting stent with the sirolimus-eluting stent in patients with coronary artery disease. The primary end point was a composite of safety (cardiac death, myocardial infarction, definite stent thrombosis) and efficacy (target vessel revascularization) parameters. The noninferiority criterion was a risk difference of 0.015. Intention-to-treat analyses were done at 9- and 18-month follow-ups. A total of 1390 patients were assigned to receive the everolimus-eluting stent and 1384 patients to the sirolimus-eluting stent. At the 9-month follow-up, 68 patients (4.9%) treated with the everolimus-eluting stent compared with 72 patients (5.2%) treated with the sirolimus-eluting stent experienced the primary end point (hazard ratio, 0.94; 95% confidence interval, 0.67-1.31; P for noninferiority=0.01). At the 18-month follow-up, this differential remained: 99 patients (7.2%) treated with the everolimus-eluting stent versus 105 (7.6%) treated with the sirolimus-eluting stent (hazard ratio, 0.94; 95% confidence interval, 0.71-1.23). At the 9-month follow-up, the rate of definite stent thrombosis was higher in the sirolimus-eluting group (2 patients [0.1%] versus 9 patients [0.7%]; hazard ratio, 0.22; 95% confidence interval, 0.05-1.02). At the 18-month follow-up, this difference was sustained (3 patients [0.2%] versus 12 patients [0.9%]; hazard ratio, 0.25; 95% confidence interval, 0.07-0.88). CONCLUSION: The everolimus-eluting stent was found to be noninferior to the sirolimus-eluting stent. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00552877.

15 Article Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction). 2011

Antonsen, Lisbeth / Jensen, Lisette Okkels / Thayssen, Per / Christiansen, Evald Høj / Junker, Anders / Tilsted, Hans-Henrik / Terkelsen, Christian Juhl / Kaltoft, Anne / Maeng, Michael / Hansen, Knud Noerregaard / Ravkilde, Jan / Lassen, Jens Flensted / Madsen, Morten / Sørensen, Henrik Toft / Thuesen, Leif. ·Department of Cardiology, Odense University Hospital, Odense, Denmark. dr_lissie@hotmail.com ·Am J Cardiol · Pubmed #21890087.

ABSTRACT: Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients ≥ 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.

16 Article Outcome of sirolimus-eluting versus zotarolimus-eluting coronary stent implantation in patients with and without diabetes mellitus (a SORT OUT III Substudy). 2011

Maeng, Michael / Jensen, Lisette O / Tilsted, Hans-Henrik / Kaltoft, Anne / Kelbaek, Henning / Abildgaard, Ulrik / Villadsen, Anton / Aarøe, Jens / Thayssen, Per / Krusell, Lars R / Christiansen, Evald H / Bøtker, Hans E / Kristensen, Steen D / Ravkilde, Jan / Madsen, Morten / Sørensen, Henrik T / Rasmussen, Klaus / Thuesen, Leif / Lassen, Jens F. ·Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. ·Am J Cardiol · Pubmed #21864817.

ABSTRACT: Diabetes is associated with an increased risk of major adverse cardiac events after percutaneous coronary intervention. We compared clinical outcomes in patients with and without diabetes mellitus treated with the second-generation Endeavor zotarolimus-eluting stent (ZES) or the first-generation Cypher Select+ sirolimus-eluting stent (SES). We randomized 2,332 patients to treatment with ZESs (n = 1,162, n = 169 diabetics) or SESs (n = 1,170, n = 168 diabetics) and followed them for 18 months. Randomization was stratified by presence/absence of diabetes. The primary end point was major adverse cardiac events defined as a composite of cardiac death, myocardial infarction, or target vessel revascularization. Secondary end points included these individual end points plus all-cause mortality and target lesion revascularization. In diabetic patients, use of ZES compared to SES was associated with an increased risk of major adverse cardiac events (18.3% vs 4.8%, hazard ratio 4.05, 95% confidence interval 1.86 to 8.82), myocardial infarction (4.7% vs 0.6%, hazard ratio 8.09, 95% confidence interval 1.01 to 64.7), target vessel revascularization (14.2% vs 3.0%, hazard ratio 4.99, 95% confidence interval 1.90 to 13.1), and target lesion revascularization (12.4% vs 1.2%, hazard ratio 11.0, 95% confidence interval 2.59 to 47.1). In patients without diabetes differences in absolute risk decrease were smaller but similarly favored SES. In conclusion, implantation of ZESs compared to SESs is associated with a considerable increased risk of adverse events in patients with diabetes at 18-month follow-up.

17 Article Neither long-term statin use nor atherosclerotic disease is associated with risk of colorectal cancer. 2010

Robertson, Douglas J / Riis, Anders Hammerich / Friis, Søren / Pedersen, Lars / Baron, John A / Sørensen, Henrik Toft. ·VA Medical Center, White River Junction, Vermont 05009, USA. douglas.robertson@va.gov ·Clin Gastroenterol Hepatol · Pubmed #20816860.

ABSTRACT: BACKGROUND & AIMS: Statin use has been reported to reduce risk for colorectal cancer (CRC) whereas atherosclerotic disease has been reported to increase risk, but findings have been inconsistent. We aimed to establish the association of statin use and coronary atherosclerosis with CRC. METHODS: We performed a population-based case control study of patients with a first diagnosis of CRC cancer between January 1, 1991, and December 31, 2008 (n = 9979), using the Danish National Registry of Patients. As many as 10 population controls were matched to each patient using risk set sampling (n = 99,790). Statin use before cancer diagnosis (or control index date) was determined via county prescription databases and evidence of coronary atherosclerosis using International Classification of Diseases codes. We calculated incidence rate ratios using conditional logistic regression, adjusted for multiple covariates. RESULTS: Among patients with CRC, statin use was modest (7.7%), but 23.5% of use was long term (≥5 years). Ever use of statins (≥2 prescriptions) slightly reduced CRC risk, compared with relative to never/rare use (incidence rate ratio [IRR] = 0.87, 95% confidence interval = 0.80-0.96). However, long-term use did not affect risk compared with never/rare use (IRR = 0.95, 95% 0.80-1.12). No associations were observed between atherosclerosis, myocardial infarction, or stroke, and CRC incidence. CONCLUSIONS: Although there is a weak inverse association between ever use of statins and CRC incidence, there was no trend with increasing duration of use, so statins do not appear to reduce CRC risk. We did not confirm the reported association between atherosclerosis and CRC risk.

18 Article Paclitaxel and sirolimus eluting stents versus bare metal stents: long-term risk of stent thrombosis and other outcomes. From the Western Denmark Heart Registry. 2010

Jensen, Lisette Okkels / Tilsted, Hans Henrik / Thayssen, Per / Kaltoft, Anne / Maeng, Michael / Lassen, Jens Flensted / Hansen, Knud Noerregaard / Madsen, Morten / Ravkilde, Jan / Johnsen, Søren Paaske / Sørensen, Henrik Toft / Thuesen, Leif. ·Department of Cardiology, Odense University Hospital, Denmark. okkels@dadlnet.dk ·EuroIntervention · Pubmed #20542774.

ABSTRACT: AIMS: Stent thrombosis is a serious complication of percutaneous coronary intervention (PCI). We examined the incidence of stent thrombosis and other outcomes in patients treated with PCI and paclitaxeleluting stents (PES), sirolimus-eluting stents (SES) or bare-metal stents (BMS). METHODS AND RESULTS: All patients who underwent PES, SES or BMS implantation from January 2002 to June 2005 were identified in the population-based Western Denmark Heart Registry. All were followed for 36 months. Cox regression analysis was used to estimate relative risk (RR), controlling for covariates. A total of 12,374 patients were treated with stents: 1,298 with PES, 2,202 with SES and 8,847 with BMS. The three-year incidence of definite stent thrombosis was similar in the DES group (1.1%) and in the BMS group (0.7%) (adjusted relative risk [RR]: 1.24; 95% confidence interval [CI]: 0.85-1.81). Very late definite stent thrombosis occurred more frequently in DES-treated patients (adjusted RR: 2.89, 95% CI: 1.48- 5.65). The three-year mortality rate did not differ significantly between the two groups. Target lesion revascularisation (TLR) was lower in DES-treated patients than in BMS-treated patients (adjusted RR: 0.71, 95% CI: 0.63-0.81). CONCLUSIONS: An increased risk of very late definite stent thrombosis was observed in DES-treated patients compared with BMS-treated patients, but a similar mortality was detected. TLR continued to be lower among patients receiving DES.