Impact of Final Kissing Balloon and of Imaging on Patients Treated on Unprotected Left Main Coronary Artery With Thin-Strut Stents (From the RAIN-CARDIOGROUP VII Study).

Autor: D'Ascenzo F; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy. Electronic address: fabrizio.dascenzo@gmail.com., Omedè P; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy., De Filippo O; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy., Cerrato E; Department of Cardiology, Infermi Hospital, Rivoli, Italy., Autelli M; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy., Trabattoni D; Department of Cardiovascular Sciences, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Ryan N; Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain., Venuti G; Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy., Muscoli S; Department of Cardiovascular Disease, Tor Vergata University of Rome, Rome, Italy., Montabone A; Department of Cardiology, S.G. Bosco Hospital, Torino, Italy., Wojakowski W; Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland., Rognoni A; Coronary Care Unit and Catheterization Laboratory, A.O.U. Maggiore della Carità, Novara, Italy., Helft G; Sorbonne Université, Institut de Cardiologie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France., Gallo D; Department of Mechanical and Aerospace Engineering, PolitoBIOMed Lab, Politecnico di Torino, Torino, Italy., Parma R; Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland., De Luca L; Division of Cardiology, S. Giovanni Evangelista Hospital, Tivoli, Italy., Figini F; Pederzoli Hospital, Peschiera del Garda, Italy., Mitomo S; Unit of Cardiovascular Interventions, IRCCS San Raffaele Hospital, Milan, Italy., Boccuzzi G; Department of Cardiology, S.G. Bosco Hospital, Torino, Italy., Mattesini A; Division of Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy., Wańha W; Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland., Smolka G; Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland., Huczek Z; Medical University of Warsaw, Warsaw, Poland., Cortese B; Interventional Cardiology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy., Sheiban I; Pederzoli Hospital, Peschiera del Garda, Italy., Escaned J; Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain., Biolè C; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy., Conrotto F; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy., Templin C; Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland., Quadri G; Department of Cardiology, Infermi Hospital, Rivoli, Italy., Rolfo C; Unità Funzionale Interaziendale di Emodinamica, Ospedale degli Infermi di Rivoli e AOU San Luigi Gonzaga di Orbassano, Turin, Italy., Capodanno D; Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy., Chieffo A; Unit of Cardiovascular Interventions, IRCCS San Raffaele Hospital, Milan, Italy., Nuñez-Gil I; Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain., Morbiducci U; Department of Mechanical and Aerospace Engineering, PolitoBIOMed Lab, Politecnico di Torino, Torino, Italy., Iannaccone M; SS Annunziata Hospital, Cuneo, Italy., Gili S; Department of Cardiovascular Sciences, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Mario CD; Division of Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy., Moretti C; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy., D'Amico M; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy., Varbella F; Department of Cardiology, Infermi Hospital, Rivoli, Italy., Romeo F; Department of Cardiovascular Disease, Tor Vergata University of Rome, Rome, Italy., Lüscher TF; Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2019 May 15; Vol. 123 (10), pp. 1610-1619. Date of Electronic Publication: 2019 Feb 23.
DOI: 10.1016/j.amjcard.2019.02.013
Abstrakt: Few data are available about the impact on outcomes of procedural strategies for percutaneous coronary intervention with thin-struts stents on unprotected left main (ULM): 792 patients with an ULM stenosis treated with percutaneous coronary intervention with thin-strut stents were enrolled in the present multicenter registry. Target lesion revascularization (TLR) was the primary end point. MACE (a composite of all-cause death, myocardial infarction, TLR, and stent thrombosis) and its single components, along with target vessel revascularization were the secondary end points. Subgroup analyses were performed according to complex versus noncomplex bifurcation lesions. After 16 months, 5.5% of patients experienced a TLR. At multivariate analysis, provisional stenting (odds ratio [OR] 0.46: 0.85 to 0.23, p = 0.006), use of imaging (OR 0.45: 0.23 to 0.98, p = 0.003) and final kissing balloon (FKB) (OR 0.41: 0.83 to 0.21, p = 0.001) reduced risk of TLR. FKB reduced risk of overall TLR only for 2 stents-strategy (6.2% vs 32.4%, p <0.05), but not for provisional strategy (3.8% vs 3.7%, p = 0.67). Intracoronary imaging reduced risk of overall TLR both for provisional (2.2% vs 5.4%) and for 2-stents strategy (7.3% vs 14.1% p <0.05 for both, all confidence interval 95%). In conclusion, TLR for ULM patients treated with thin-strut stents is infrequent. Provisional stenting was noninferior compared with 2-stents apart from complex lesions. Benefit from intracoronary imaging is consistent for different strategies, whereas that from FKB persists only for 2-stents.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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