TY - JOUR
T1 - Comparison of bioresorbable vs durable polymer drug-eluting stents in unprotected left main (from the RAIN-CARDIOGROUP VII Study)
AU - Iannaccone, Mario
AU - Barbero, Umberto
AU - De Benedictis, Michele
AU - Imori, Yoichi
AU - Quadri, Giorgio
AU - Trabattoni, Daniela
AU - Ryan, Nicola
AU - Venuti, Giuseppe
AU - Montabone, Andrea
AU - Wojakowski, Wojciech
AU - Rognoni, Andrea
AU - Helft, Gerard
AU - Parma, Radoslaw
AU - De Luca, Leonardo
AU - Autelli, Michele
AU - Boccuzzi, Giacomo
AU - Mattesini, Alessio
AU - Templin, Christian
AU - Cerrato, Enrico
AU - Wańha, Wojciech
AU - Smolka, Grzegorz
AU - Huczek, Zenon
AU - Tomassini, Francesco
AU - Cortese, Bernardo
AU - Capodanno, Davide
AU - Chieffo, Alaide
AU - Nuñez-Gil, Ivan
AU - Gili, Sebastiano
AU - Bassignana, Antonia
AU - di Mario, Carlo
AU - Doronzo, Baldassarre
AU - Omedè, Pierluigi
AU - D'Amico, Maurizio
AU - Tedeschi, Delio
AU - Varbella, Ferdinando
AU - Luscher, Thomas
AU - Sheiban, Imad
AU - Escaned, Javier
AU - Rinaldi, Mauro
AU - D'Ascenzo, Fabrizio
N1 - Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2020/5/15
Y1 - 2020/5/15
N2 - BACKGROUND: There are limited data regarding the impact of bioresorbable polymer drug eluting stent (BP-DES) compared to durable polymer drug eluting stent (DP-DES) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations. METHODS: In the RAIN registry (ClinicalTrials NCT03544294, june 2018 retrospectively registered) patients with a ULM or bifurcation stenosis treated with PCI using ultrathin stents (struts thinner than 81 μm) were enrolled. The primary endpoint was the rate of target lesion revascularization (TLR); major adverse cardiovascular events (MACE, a composite of all-cause death, myocardial infarction, TLR and stent thrombosis) and its components, along with target vessel revascularization (TVR) were the secondary ones. A propensity score with matching analysis to compare patients treated with BP-DES versus DP-DES was also assessed. RESULTS: From 3001 enrolled patients, after propensity score analysis 1400 patients (700 for each group) were selected. Among them, 352 had ULM disease and 1048 had non-LM bifurcations. At 16 months (12-22), rates of TLR (3.7% vs 2.9%, p = 0.22) and MACE were similar (12.3% vs. 11.6%, p = 0.74) as well as for the other endpoints. Sensitivity analysis of outcomes after a two-stents strategy, showed better outcome in term of MACE (20.4% vs 10%, p = 0.03) and TVR (12% vs 4.6%, p = 0.05) and a trend towards lower TLR in patients treated with BP-DES. CONCLUSION: In patients with bifurcations or ULM treated with ultrathin stents BP-DES seems to perform similarly to DP-DES: the trends toward improved clinical outcomes in patients treated with the BP-DES might potentially be of value for speculating the stent choice in selected high-risk subgroups of patients at increased risk of ischemic events. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03544294. Retrospectively registered June 1, 2018.
AB - BACKGROUND: There are limited data regarding the impact of bioresorbable polymer drug eluting stent (BP-DES) compared to durable polymer drug eluting stent (DP-DES) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations. METHODS: In the RAIN registry (ClinicalTrials NCT03544294, june 2018 retrospectively registered) patients with a ULM or bifurcation stenosis treated with PCI using ultrathin stents (struts thinner than 81 μm) were enrolled. The primary endpoint was the rate of target lesion revascularization (TLR); major adverse cardiovascular events (MACE, a composite of all-cause death, myocardial infarction, TLR and stent thrombosis) and its components, along with target vessel revascularization (TVR) were the secondary ones. A propensity score with matching analysis to compare patients treated with BP-DES versus DP-DES was also assessed. RESULTS: From 3001 enrolled patients, after propensity score analysis 1400 patients (700 for each group) were selected. Among them, 352 had ULM disease and 1048 had non-LM bifurcations. At 16 months (12-22), rates of TLR (3.7% vs 2.9%, p = 0.22) and MACE were similar (12.3% vs. 11.6%, p = 0.74) as well as for the other endpoints. Sensitivity analysis of outcomes after a two-stents strategy, showed better outcome in term of MACE (20.4% vs 10%, p = 0.03) and TVR (12% vs 4.6%, p = 0.05) and a trend towards lower TLR in patients treated with BP-DES. CONCLUSION: In patients with bifurcations or ULM treated with ultrathin stents BP-DES seems to perform similarly to DP-DES: the trends toward improved clinical outcomes in patients treated with the BP-DES might potentially be of value for speculating the stent choice in selected high-risk subgroups of patients at increased risk of ischemic events. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03544294. Retrospectively registered June 1, 2018.
KW - Coronary bifurcation
KW - Drug eluting stents
KW - Left main
KW - Percutaneous coronary intervention
KW - Struts thickness
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U2 - 10.1186/s12872-020-01420-5
DO - 10.1186/s12872-020-01420-5
M3 - Article
C2 - 32414330
AN - SCOPUS:85084787393
VL - 20
SP - 225
JO - BMC Cardiovascular Disorders
JF - BMC Cardiovascular Disorders
SN - 1471-2261
IS - 1
ER -