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.
Safety and efficacy of polymer-free biolimus-eluting stents versus ultrathin stents in unprotected left main or coronary bifurcation: A propensity score analysis from the RAIN and CHANCE registries / D'Ascenzo, Fabrizio; Gaido, Luca; Bernardi, Alessandro; Saglietto, Andrea; Franze, Alfonso; Ielasi, Alfonso; Trabattoni, Daniela; Di Biasi, Maurizio; Infantino, Vincenzo; Rognoni, Andrea; Helft, Gerard; Gangor, Andrea; Latini Roberto, A.; De Luca, Leonardo; Mitomo, Satoru; Ugo, Fabrizio; Smolka, Grzegorz; Huczek, Zenon; Cortese, Bernardo; Capodanno, Davide; Chieffo, A; Piazza, Fabio; di Mario, Carlo; Poli, Arnaldo; D'Urbano, Maurizio; Romeo, Francesco; Giammaria, Massimo; Varbella, Ferdinando; Sheiban, Imad; Escaned, Javier; De Ferrari Gaetano, M.. - In: CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. - ISSN 1522-1946. - 95:3(2020), pp. 522-529. [10.1002/ccd.28413]
Safety and efficacy of polymer-free biolimus-eluting stents versus ultrathin stents in unprotected left main or coronary bifurcation: A propensity score analysis from the RAIN and CHANCE registries
CHIEFFO A;
2020-01-01
Abstract
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
