Objectives: To evaluate the independent clinical impact of stent structural features in a large cohort of patients undergoing unprotected left main (ULM) or coronary bifurcation percutaneous coronary intervention (PCI) with a range of very thin strut stents. Background: Clinical impact of structural features of contemporary stents remains to be defined. Methods: All consecutive patients enrolled in the veRy thin stents for patients with left mAIn or bifurcatioN in real life (RAIN) registry were included. The following stent structural features were studied: antiproliferative drugs (everolimus vs. sirolimus vs. zotarolimus), strut material (platinum-chromium vs. cobalt-chromium), polymer (bioresorbable vs. durable), number of crowns (<8 vs. ≥8) and number of connectors (<3 vs. ≥3). For small diameter stents (≤2.5 mm), struct thickness (74 vs. 80/81 μm) was also tested. Target lesion failure (TLF), a composite of target lesion revascularization and stent thrombosis, was the primary endpoint. Multivariate analysis was performed with Cox regression models. Results: Out of 2,707 patients, 110 (4.1%) experienced a TLF event after 16 months (12–18). After adjustment for confounders, an increased number of connectors (adjusted hazard ratio [adj-HR] 0.62, 95% confidence interval (CI) 0.39–0.99, p =.04) reduced risk of TLF, driven by stents with ≥2.5 mm diameter (HR 0.54, 95% CI 0.32–0.93, p =.02). This independent relationship was lost for stents with diameter <2.5 mm, where only strut thickness appeared to impact. Conversely, no independent relationship of polymer type, number of crowns, and the specific limus-family eluted drug with outcomes was observed. Conclusions: Among a range of contemporary very thin stent models, an increased number of connectors improved device-related outcomes in this investigated high-risk procedural setting.
Impact of structural features of very thin stents implanted in unprotected left main or coronary bifurcations on clinical outcomes / Iannaccone, Mario; D'Ascenzo, Fabrizio; Gallone, Guglielmo; Mitomo, Satoru; Parma, Radoslaw; Trabattoni, Daniela; Ryan, Nicola; Muscoli, Saverio; Venuti, Giuseppe; Montabone, Andrea; De Lio, Francesca; Zaccaro, Lorenzo; Quadri, Giorgio; De Filippo, Ovidio; Wojakowski, Wojciech; Rognoni, Andrea; Helft, Gerard; Gallo, Diego; De Luca, Leonardo; Figini, Filippo; Imori, Yoichi; Conrotto, Federico; Boccuzzi, Giacomo; Mattesini, Alessio; Wanha, Wojciech; Smolka, Grzegorz; Huczek, Zenon; Rolfo, Cristina; Pennone, Mauro; Cortese, Bernardo; Capodanno, Davide; Chieffo, Alaide; Nunez-Gil, Ivan; Morbiducci, Umberto; D'Amico, Maurizio; Varbella, Ferdinando; Romeo, Francesco; Sheiban, Imad; Escaned, Javier; Garbo, Roberto; Moretti, Claudio; di Mario, Carlo; De Ferrari, Gaetano Maria. - In: CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. - ISSN 1522-1946. - 96:1(2020), pp. 1-9.
|Titolo:||Impact of structural features of very thin stents implanted in unprotected left main or coronary bifurcations on clinical outcomes|
|Data di pubblicazione:||2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1002/ccd.28667|
|Appare nelle tipologie:||1.1 Articolo in rivista|
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