TY - JOUR
T1 - Safety and efficacy of polymer-free biolimus-eluting stents versus ultrathin stents in unprotected left main or coronary bifurcation
T2 - A propensity score analysis from the RAIN and CHANCE registries
AU - D'Ascenzo, Fabrizio
AU - Gaido, Luca
AU - Bernardi, Alessandro
AU - Saglietto, Andrea
AU - Franzé, Alfonso
AU - Ielasi, Alfonso
AU - Trabattoni, Daniela
AU - Di Biasi, Maurizio
AU - Infantino, Vincenzo
AU - Rognoni, Andrea
AU - Helft, Gerard
AU - Gangor, Andrea
AU - Latini, Roberto A.
AU - De Luca, Leonardo
AU - Mitomo, Satoru
AU - Ugo, Fabrizio
AU - Smolka, Grzegorz
AU - Huczek, Zenon
AU - Cortese, Bernardo
AU - Capodanno, Davide
AU - Chieffo, Alaide
AU - Piazza, Fabio
AU - di Mario, Carlo
AU - Poli, Arnaldo
AU - D'Urbano, Maurizio
AU - Romeo, Francesco
AU - Giammaria, Massimo
AU - Varbella, Ferdinando
AU - Sheiban, Imad
AU - Escaned, Javier
AU - De Ferrari, Gaetano M.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objectives: Evaluate safety and efficacy of polymer-free biolimus-eluting stents (PF-BESs) versus ultrathin stents in unprotected left main (ULM) or bifurcation. Background: PF-BESs due to reduced length of dual antiplatelet therapy (DAPT) are increasingly used. However, there are limited data about safety and efficacy for ULM or bifurcation. Methods: We selected all-patients treated for ULM or bifurcation from two multicenter real life registries (RAIN [NCT03544294] evaluating ultrathin stents, CHANCE [NCT03622203] appraising PF-BES). After propensity score with matching, the primary endpoint was major adverse cardiac events (MACE; a composite of all-cause death, myocardial infarction, target lesion revascularization [TLR], and stent thrombosis [ST]), while its components along with target vessel revascularization (TVR) secondary endpoints. Results: Three thousand and three patients treated with ultrathin stents and 446 with PF-BESs, resulting respectively in 562 and 281 after propensity score with matching (33 and 22%, respectively, with ULM disease). After 12 (8–20) months, rates of MACE were similar (9 vs. 8%, p = 0.56) without difference in TLR and ST (3.0 vs. 1.7%, p =.19 and 1.8 vs. 1.1%, p =.42). These results were consistent for ULM group (3 vs. 1.7% and 1.8 vs. 1.1%, p =.49 and.76), for non-ULM group (2.1 vs. 3.4%, p =.56 and 1.2 vs. 1.7%, p =.78) and for two-stent strategy (8.7 vs. 4.5% and 4.3 vs. 3.2%, p =.75 and.91). Among patients treated with 1 month of DAPT in both groups, those with ultrathin stents experienced higher rates of MACE related to all-cause death (22 vs. 12%, p =.04) with higher although not significant rates of ST (3 vs. 0%, p =.45). Conclusions: PF-BES implanted on ULM or BiF offered freedom from TLR and ST comparable to ultrathin stents. PF-BESs patients assuming DAPT for 1 month experienced a lower despite not significant incidence of ST.
AB - Objectives: Evaluate safety and efficacy of polymer-free biolimus-eluting stents (PF-BESs) versus ultrathin stents in unprotected left main (ULM) or bifurcation. Background: PF-BESs due to reduced length of dual antiplatelet therapy (DAPT) are increasingly used. However, there are limited data about safety and efficacy for ULM or bifurcation. Methods: We selected all-patients treated for ULM or bifurcation from two multicenter real life registries (RAIN [NCT03544294] evaluating ultrathin stents, CHANCE [NCT03622203] appraising PF-BES). After propensity score with matching, the primary endpoint was major adverse cardiac events (MACE; a composite of all-cause death, myocardial infarction, target lesion revascularization [TLR], and stent thrombosis [ST]), while its components along with target vessel revascularization (TVR) secondary endpoints. Results: Three thousand and three patients treated with ultrathin stents and 446 with PF-BESs, resulting respectively in 562 and 281 after propensity score with matching (33 and 22%, respectively, with ULM disease). After 12 (8–20) months, rates of MACE were similar (9 vs. 8%, p = 0.56) without difference in TLR and ST (3.0 vs. 1.7%, p =.19 and 1.8 vs. 1.1%, p =.42). These results were consistent for ULM group (3 vs. 1.7% and 1.8 vs. 1.1%, p =.49 and.76), for non-ULM group (2.1 vs. 3.4%, p =.56 and 1.2 vs. 1.7%, p =.78) and for two-stent strategy (8.7 vs. 4.5% and 4.3 vs. 3.2%, p =.75 and.91). Among patients treated with 1 month of DAPT in both groups, those with ultrathin stents experienced higher rates of MACE related to all-cause death (22 vs. 12%, p =.04) with higher although not significant rates of ST (3 vs. 0%, p =.45). Conclusions: PF-BES implanted on ULM or BiF offered freedom from TLR and ST comparable to ultrathin stents. PF-BESs patients assuming DAPT for 1 month experienced a lower despite not significant incidence of ST.
KW - coronary artery disease
KW - drug eluting stent
KW - percutaneous coronary intervention
KW - percutaneous coronary intervention complex
KW - stent restenosis
KW - stent thrombosis
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U2 - 10.1002/ccd.28413
DO - 10.1002/ccd.28413
M3 - Article
AN - SCOPUS:85070774481
SN - 1522-1946
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
ER -