Comparison of mid-term clinical outcomes after treatment of ostial right coronary artery lesions with early and new generation drug-eluting stents: Insights from an international multicenter registry

S Mitomo, RJ Jabbour, Yusuke Watanabe, A Mangieri, M Ancona, D Regazzoli, Akihito Tanaka, A Nakajima, Toru Naganuma, F Giannini, A Latib, Sunao Nakamura, A Colombo

Research output: Contribution to journalArticle

Abstract

Background There are only a limited number of studies comparing clinical outcomes after treatment of right coronary artery (RCA) aorto-ostial (AO) lesions with early (E-) and new (N-) generation drug-eluting stents (DES). Methods From January 2005 to December 2013, 334 de novo RCA AO lesions treated with DES (E-:142 lesions, N-:192 lesions) at 2 high-volume centers (Italy and Japan) were included in this study. The primary endpoint was target lesion failure (TLF) defined as composite of cardiac mortality, target vessel myocardial infarction, and target lesion revascularization (TLR). Results Baseline and lesion characteristics were well balanced between the 2 groups. The size of the stents deployed (3.35 ± 0.37 mm vs 3.39 ± 0.33 mm, p = 0.29) and non-compliant balloons used for post-dilatation (3.55 ± 0.38 mm vs 3.62 ± 0.47 mm, p = 0.21) were similar between the two groups. The median follow-up period was 1432 (IQR: 703-2197) days in total population. The cumulative rate of TLF at 3 years was significantly higher in E-DES group when compared with N-DES group (37.7% vs 14.2%, p < 0.001), which was mainly driven by TLR (38.0% vs 11.0%, p < 0.001). Multivariable analysis revealed that N-DES [HR 0.22 (0.13–0.38), p < 0.001], stent underexpansion [HR 10.59 (6.23–17.97), p < 0.001], excessive aortic stent protrusion [HR 3.12 (1.87–5.23), p < 0.001], and proximal stent overlap [HR 1.74 (1.03–2.95), p = 0.03] were independent predictors of TLF. Conclusion For the treatment of RCA AO lesions, N-DES were associated with a lower incidence of TLF at 3 years when compared with E-DES. N-DES use and suboptimal implantation characteristics were independent predictors of TLF. © 2017 Elsevier B.V.
Original languageEnglish
Pages (from-to)53-58
Number of pages6
JournalInternational Journal of Cardiology
Volume254
Issue number3
DOIs
Publication statusPublished - 2018

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Drug-Eluting Stents
Registries
Coronary Vessels
Stents
Italy
Dilatation
Japan
Myocardial Infarction
Mortality
Incidence

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Comparison of mid-term clinical outcomes after treatment of ostial right coronary artery lesions with early and new generation drug-eluting stents: Insights from an international multicenter registry. / Mitomo, S; Jabbour, RJ; Watanabe, Yusuke; Mangieri, A; Ancona, M; Regazzoli, D; Tanaka, Akihito; Nakajima, A; Naganuma, Toru; Giannini, F; Latib, A; Nakamura, Sunao; Colombo, A.

In: International Journal of Cardiology, Vol. 254, No. 3, 2018, p. 53-58.

Research output: Contribution to journalArticle

Mitomo, S, Jabbour, RJ, Watanabe, Y, Mangieri, A, Ancona, M, Regazzoli, D, Tanaka, A, Nakajima, A, Naganuma, T, Giannini, F, Latib, A, Nakamura, S & Colombo, A 2018, 'Comparison of mid-term clinical outcomes after treatment of ostial right coronary artery lesions with early and new generation drug-eluting stents: Insights from an international multicenter registry', International Journal of Cardiology, vol. 254, no. 3, pp. 53-58. https://doi.org/10.1016/j.ijcard.2017.10.066
Mitomo, S ; Jabbour, RJ ; Watanabe, Yusuke ; Mangieri, A ; Ancona, M ; Regazzoli, D ; Tanaka, Akihito ; Nakajima, A ; Naganuma, Toru ; Giannini, F ; Latib, A ; Nakamura, Sunao ; Colombo, A. / Comparison of mid-term clinical outcomes after treatment of ostial right coronary artery lesions with early and new generation drug-eluting stents: Insights from an international multicenter registry. In: International Journal of Cardiology. 2018 ; Vol. 254, No. 3. pp. 53-58.
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abstract = "Background There are only a limited number of studies comparing clinical outcomes after treatment of right coronary artery (RCA) aorto-ostial (AO) lesions with early (E-) and new (N-) generation drug-eluting stents (DES). Methods From January 2005 to December 2013, 334 de novo RCA AO lesions treated with DES (E-:142 lesions, N-:192 lesions) at 2 high-volume centers (Italy and Japan) were included in this study. The primary endpoint was target lesion failure (TLF) defined as composite of cardiac mortality, target vessel myocardial infarction, and target lesion revascularization (TLR). Results Baseline and lesion characteristics were well balanced between the 2 groups. The size of the stents deployed (3.35 ± 0.37 mm vs 3.39 ± 0.33 mm, p = 0.29) and non-compliant balloons used for post-dilatation (3.55 ± 0.38 mm vs 3.62 ± 0.47 mm, p = 0.21) were similar between the two groups. The median follow-up period was 1432 (IQR: 703-2197) days in total population. The cumulative rate of TLF at 3 years was significantly higher in E-DES group when compared with N-DES group (37.7{\%} vs 14.2{\%}, p < 0.001), which was mainly driven by TLR (38.0{\%} vs 11.0{\%}, p < 0.001). Multivariable analysis revealed that N-DES [HR 0.22 (0.13–0.38), p < 0.001], stent underexpansion [HR 10.59 (6.23–17.97), p < 0.001], excessive aortic stent protrusion [HR 3.12 (1.87–5.23), p < 0.001], and proximal stent overlap [HR 1.74 (1.03–2.95), p = 0.03] were independent predictors of TLF. Conclusion For the treatment of RCA AO lesions, N-DES were associated with a lower incidence of TLF at 3 years when compared with E-DES. N-DES use and suboptimal implantation characteristics were independent predictors of TLF. {\circledC} 2017 Elsevier B.V.",
author = "S Mitomo and RJ Jabbour and Yusuke Watanabe and A Mangieri and M Ancona and D Regazzoli and Akihito Tanaka and A Nakajima and Toru Naganuma and F Giannini and A Latib and Sunao Nakamura and A Colombo",
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T1 - Comparison of mid-term clinical outcomes after treatment of ostial right coronary artery lesions with early and new generation drug-eluting stents: Insights from an international multicenter registry

AU - Mitomo, S

AU - Jabbour, RJ

AU - Watanabe, Yusuke

AU - Mangieri, A

AU - Ancona, M

AU - Regazzoli, D

AU - Tanaka, Akihito

AU - Nakajima, A

AU - Naganuma, Toru

AU - Giannini, F

AU - Latib, A

AU - Nakamura, Sunao

AU - Colombo, A

PY - 2018

Y1 - 2018

N2 - Background There are only a limited number of studies comparing clinical outcomes after treatment of right coronary artery (RCA) aorto-ostial (AO) lesions with early (E-) and new (N-) generation drug-eluting stents (DES). Methods From January 2005 to December 2013, 334 de novo RCA AO lesions treated with DES (E-:142 lesions, N-:192 lesions) at 2 high-volume centers (Italy and Japan) were included in this study. The primary endpoint was target lesion failure (TLF) defined as composite of cardiac mortality, target vessel myocardial infarction, and target lesion revascularization (TLR). Results Baseline and lesion characteristics were well balanced between the 2 groups. The size of the stents deployed (3.35 ± 0.37 mm vs 3.39 ± 0.33 mm, p = 0.29) and non-compliant balloons used for post-dilatation (3.55 ± 0.38 mm vs 3.62 ± 0.47 mm, p = 0.21) were similar between the two groups. The median follow-up period was 1432 (IQR: 703-2197) days in total population. The cumulative rate of TLF at 3 years was significantly higher in E-DES group when compared with N-DES group (37.7% vs 14.2%, p < 0.001), which was mainly driven by TLR (38.0% vs 11.0%, p < 0.001). Multivariable analysis revealed that N-DES [HR 0.22 (0.13–0.38), p < 0.001], stent underexpansion [HR 10.59 (6.23–17.97), p < 0.001], excessive aortic stent protrusion [HR 3.12 (1.87–5.23), p < 0.001], and proximal stent overlap [HR 1.74 (1.03–2.95), p = 0.03] were independent predictors of TLF. Conclusion For the treatment of RCA AO lesions, N-DES were associated with a lower incidence of TLF at 3 years when compared with E-DES. N-DES use and suboptimal implantation characteristics were independent predictors of TLF. © 2017 Elsevier B.V.

AB - Background There are only a limited number of studies comparing clinical outcomes after treatment of right coronary artery (RCA) aorto-ostial (AO) lesions with early (E-) and new (N-) generation drug-eluting stents (DES). Methods From January 2005 to December 2013, 334 de novo RCA AO lesions treated with DES (E-:142 lesions, N-:192 lesions) at 2 high-volume centers (Italy and Japan) were included in this study. The primary endpoint was target lesion failure (TLF) defined as composite of cardiac mortality, target vessel myocardial infarction, and target lesion revascularization (TLR). Results Baseline and lesion characteristics were well balanced between the 2 groups. The size of the stents deployed (3.35 ± 0.37 mm vs 3.39 ± 0.33 mm, p = 0.29) and non-compliant balloons used for post-dilatation (3.55 ± 0.38 mm vs 3.62 ± 0.47 mm, p = 0.21) were similar between the two groups. The median follow-up period was 1432 (IQR: 703-2197) days in total population. The cumulative rate of TLF at 3 years was significantly higher in E-DES group when compared with N-DES group (37.7% vs 14.2%, p < 0.001), which was mainly driven by TLR (38.0% vs 11.0%, p < 0.001). Multivariable analysis revealed that N-DES [HR 0.22 (0.13–0.38), p < 0.001], stent underexpansion [HR 10.59 (6.23–17.97), p < 0.001], excessive aortic stent protrusion [HR 3.12 (1.87–5.23), p < 0.001], and proximal stent overlap [HR 1.74 (1.03–2.95), p = 0.03] were independent predictors of TLF. Conclusion For the treatment of RCA AO lesions, N-DES were associated with a lower incidence of TLF at 3 years when compared with E-DES. N-DES use and suboptimal implantation characteristics were independent predictors of TLF. © 2017 Elsevier B.V.

U2 - 10.1016/j.ijcard.2017.10.066

DO - 10.1016/j.ijcard.2017.10.066

M3 - Article

VL - 254

SP - 53

EP - 58

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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ER -