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2-Year results of the AUTAX (Austrian Multivessel TAXUS-Stent) registry: Beyond the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) study
JACC - Journal of the American College of Cardiology: Cardiovascular Interventions, 08/24/09
Gyöngyösi M et al. – TAXUS stent implantations with the aim of complete revascularization can be safe for pts with multivessel disease. The multicenter AUTAX (Austrian Multivessel TAXUS-Stent) registry including pts with post- percutaneous coronary intervention (PCI) lesions provides additional information to the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) study.
Methods- AUTAX registry: study of 2-yr clinical/angiographic outcomes of pts with multivessel coronary artery disease after implantation of TAXUS Express stents in a "real-world" setting
- Prospective study of 441 pts (age 64 ± 12 yrs; 78% men; 1,080 lesions) with possible complete revascularization by PCI
- Median clinical follow-up: 753 (quartiles 728-775) days after PCI in 95.7%, with control angiography of 78% at 6 mo
- Primary endpoint: composite of major adverse cardiac (nonfatal acute myocardial infarction [AMI], all-cause mortality, target lesion revascularization [TLR]) and cerebrovascular events (MACCE)
- Cox regression analysis for potential risk factor effects on 2-yr MACCE
- Complete revascularization successful in 90.5%, with left main PCI of 6.8%
- Rates of acute, subacute, and late stent thrombosis: 0.7%, 0.5%, and 0.5%
- On 2-yr follow-up: AMI (1.4%), death (3.6%), stroke (0.2%), and TLR (13.1%), for a composite MACCE of 18.3%
- Binary restenosis rate: 10.8%
- Median of cumulative SYNTAX score: 23.0 (range 12.0-56.5)
- SYNTAX score did not predict TLR or MACCE, due to lack of scoring of restenotic or bypass stenoses (29.8%)
- Significant predictors of 2-year MACCE: age and acute coronary syndrome
- Incomplete revascularization predicted death or AMI
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