The DELTA 2 Registry

A Multicenter Registry Evaluating Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents in Patients With Obstructive Left Main Coronary Artery Disease

on behalf of the, DELTA 2 Investigators

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a “real world” population. Background PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. Methods All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry. The results were compared with those from the historical DELTA 1 (Drug Eluting Stent for Left Main Coronary Artery) CABG cohort using propensity score stratification. The primary endpoint was the composite of death, myocardial infarction (MI), or stroke at the median time of follow-up. Results A total of 3,986 patients were included. The mean age was 69.6 ± 10.9 years, diabetes was present in 30.8%, and 21% of the patients presented with acute MI. The distal left main coronary artery was involved in 84.6% of the lesions. At a median of 501 days (≈17 months) of follow-up, the occurrence of the primary endpoint of death, MI, or cerebrovascular accident was lower in the PCI DELTA 2 group compared with the historical DELTA 1 CABG cohort (10.3% vs. 11.6%; adjusted hazard ratio: 0.73; 95% confidence interval: 0.55 to 0.98; p = 0.03). Of note, an advantage of PCI was observed with respect to cerebrovascular accident (0.8% vs. 2.0%; adjusted hazard ratio: 0.37; 95% confidence interval: 0.16 to 0.86; p = 0.02), while an advantage of CABG was observed with respect to target vessel revascularization (14.2% vs. 2.9%; adjusted hazard ratio: 3.32; 95% confidence interval: 2.12 to 5.18; p < 0.0001). Conclusions After a median follow-up period of 17 months, PCI with new-generation drug-eluting stents was associated with an overall low rate of the composite endpoint of death, MI, or cerebrovascular accident.

Original languageEnglish
Pages (from-to)2401-2410
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume10
Issue number23
DOIs
Publication statusPublished - Dec 11 2017

Fingerprint

Drug-Eluting Stents
Percutaneous Coronary Intervention
Registries
Coronary Artery Disease
Coronary Artery Bypass
Coronary Vessels
Stroke
Myocardial Infarction
Confidence Intervals
Propensity Score
Coronary Stenosis
Population

Keywords

  • drug-eluting stents
  • left main coronary artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{d97f2c5662c64208a9fae04923e35bb8,
title = "The DELTA 2 Registry: A Multicenter Registry Evaluating Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents in Patients With Obstructive Left Main Coronary Artery Disease",
abstract = "Objectives The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a “real world” population. Background PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. Methods All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry. The results were compared with those from the historical DELTA 1 (Drug Eluting Stent for Left Main Coronary Artery) CABG cohort using propensity score stratification. The primary endpoint was the composite of death, myocardial infarction (MI), or stroke at the median time of follow-up. Results A total of 3,986 patients were included. The mean age was 69.6 ± 10.9 years, diabetes was present in 30.8{\%}, and 21{\%} of the patients presented with acute MI. The distal left main coronary artery was involved in 84.6{\%} of the lesions. At a median of 501 days (≈17 months) of follow-up, the occurrence of the primary endpoint of death, MI, or cerebrovascular accident was lower in the PCI DELTA 2 group compared with the historical DELTA 1 CABG cohort (10.3{\%} vs. 11.6{\%}; adjusted hazard ratio: 0.73; 95{\%} confidence interval: 0.55 to 0.98; p = 0.03). Of note, an advantage of PCI was observed with respect to cerebrovascular accident (0.8{\%} vs. 2.0{\%}; adjusted hazard ratio: 0.37; 95{\%} confidence interval: 0.16 to 0.86; p = 0.02), while an advantage of CABG was observed with respect to target vessel revascularization (14.2{\%} vs. 2.9{\%}; adjusted hazard ratio: 3.32; 95{\%} confidence interval: 2.12 to 5.18; p < 0.0001). Conclusions After a median follow-up period of 17 months, PCI with new-generation drug-eluting stents was associated with an overall low rate of the composite endpoint of death, MI, or cerebrovascular accident.",
keywords = "drug-eluting stents, left main coronary artery",
author = "{on behalf of the} and {DELTA 2 Investigators} and Alaide Chieffo and Akihito Tanaka and Gennaro Giustino and Ieva Briede and Sawaya, {Fadi J.} and Joost Daemen and Hiroyoshi Kawamoto and Emanuele Meliga and Fabrizio D'Ascenzo and Enrico Cerrato and Stefanini, {Giulio G.} and Davide Capodanno and Andrea Mangiameli and Christian Templin and Andrejs Erglis and Morice, {Marie Claude} and Roxana Mehran and {Van Mieghem}, {Nicolas M.} and Sunao Nakamura and {De Benedictis}, Mauro and Marco Pavani and Ferdinando Varbella and Marco Pisaniello and Sharma, {Samin K.} and Corrado Tamburino and Didier Tchetche and Antonio Colombo",
year = "2017",
month = "12",
day = "11",
doi = "10.1016/j.jcin.2017.08.050",
language = "English",
volume = "10",
pages = "2401--2410",
journal = "JACC: Cardiovascular Interventions",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "23",

}

TY - JOUR

T1 - The DELTA 2 Registry

T2 - A Multicenter Registry Evaluating Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents in Patients With Obstructive Left Main Coronary Artery Disease

AU - on behalf of the

AU - DELTA 2 Investigators

AU - Chieffo, Alaide

AU - Tanaka, Akihito

AU - Giustino, Gennaro

AU - Briede, Ieva

AU - Sawaya, Fadi J.

AU - Daemen, Joost

AU - Kawamoto, Hiroyoshi

AU - Meliga, Emanuele

AU - D'Ascenzo, Fabrizio

AU - Cerrato, Enrico

AU - Stefanini, Giulio G.

AU - Capodanno, Davide

AU - Mangiameli, Andrea

AU - Templin, Christian

AU - Erglis, Andrejs

AU - Morice, Marie Claude

AU - Mehran, Roxana

AU - Van Mieghem, Nicolas M.

AU - Nakamura, Sunao

AU - De Benedictis, Mauro

AU - Pavani, Marco

AU - Varbella, Ferdinando

AU - Pisaniello, Marco

AU - Sharma, Samin K.

AU - Tamburino, Corrado

AU - Tchetche, Didier

AU - Colombo, Antonio

PY - 2017/12/11

Y1 - 2017/12/11

N2 - Objectives The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a “real world” population. Background PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. Methods All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry. The results were compared with those from the historical DELTA 1 (Drug Eluting Stent for Left Main Coronary Artery) CABG cohort using propensity score stratification. The primary endpoint was the composite of death, myocardial infarction (MI), or stroke at the median time of follow-up. Results A total of 3,986 patients were included. The mean age was 69.6 ± 10.9 years, diabetes was present in 30.8%, and 21% of the patients presented with acute MI. The distal left main coronary artery was involved in 84.6% of the lesions. At a median of 501 days (≈17 months) of follow-up, the occurrence of the primary endpoint of death, MI, or cerebrovascular accident was lower in the PCI DELTA 2 group compared with the historical DELTA 1 CABG cohort (10.3% vs. 11.6%; adjusted hazard ratio: 0.73; 95% confidence interval: 0.55 to 0.98; p = 0.03). Of note, an advantage of PCI was observed with respect to cerebrovascular accident (0.8% vs. 2.0%; adjusted hazard ratio: 0.37; 95% confidence interval: 0.16 to 0.86; p = 0.02), while an advantage of CABG was observed with respect to target vessel revascularization (14.2% vs. 2.9%; adjusted hazard ratio: 3.32; 95% confidence interval: 2.12 to 5.18; p < 0.0001). Conclusions After a median follow-up period of 17 months, PCI with new-generation drug-eluting stents was associated with an overall low rate of the composite endpoint of death, MI, or cerebrovascular accident.

AB - Objectives The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a “real world” population. Background PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. Methods All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry. The results were compared with those from the historical DELTA 1 (Drug Eluting Stent for Left Main Coronary Artery) CABG cohort using propensity score stratification. The primary endpoint was the composite of death, myocardial infarction (MI), or stroke at the median time of follow-up. Results A total of 3,986 patients were included. The mean age was 69.6 ± 10.9 years, diabetes was present in 30.8%, and 21% of the patients presented with acute MI. The distal left main coronary artery was involved in 84.6% of the lesions. At a median of 501 days (≈17 months) of follow-up, the occurrence of the primary endpoint of death, MI, or cerebrovascular accident was lower in the PCI DELTA 2 group compared with the historical DELTA 1 CABG cohort (10.3% vs. 11.6%; adjusted hazard ratio: 0.73; 95% confidence interval: 0.55 to 0.98; p = 0.03). Of note, an advantage of PCI was observed with respect to cerebrovascular accident (0.8% vs. 2.0%; adjusted hazard ratio: 0.37; 95% confidence interval: 0.16 to 0.86; p = 0.02), while an advantage of CABG was observed with respect to target vessel revascularization (14.2% vs. 2.9%; adjusted hazard ratio: 3.32; 95% confidence interval: 2.12 to 5.18; p < 0.0001). Conclusions After a median follow-up period of 17 months, PCI with new-generation drug-eluting stents was associated with an overall low rate of the composite endpoint of death, MI, or cerebrovascular accident.

KW - drug-eluting stents

KW - left main coronary artery

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U2 - 10.1016/j.jcin.2017.08.050

DO - 10.1016/j.jcin.2017.08.050

M3 - Article

VL - 10

SP - 2401

EP - 2410

JO - JACC: Cardiovascular Interventions

JF - JACC: Cardiovascular Interventions

SN - 1936-8798

IS - 23

ER -