Impact of coronary calcification on outcomes after ABSORB scaffold implantation: insights from the GABI-R registry.
Absorbable Implants
/ adverse effects
Coronary Artery Disease
/ diagnosis
Coronary Vessels
/ diagnostic imaging
Drug-Eluting Stents
Female
Humans
Long Term Adverse Effects
/ diagnosis
Male
Middle Aged
Myocardial Infarction
/ diagnosis
Percutaneous Coronary Intervention
/ adverse effects
Postoperative Complications
/ diagnosis
Registries
Severity of Illness Index
Tissue Scaffolds
/ adverse effects
Vascular Calcification
/ diagnosis
Vascular Patency
Journal
Coronary artery disease
ISSN: 1473-5830
Titre abrégé: Coron Artery Dis
Pays: England
ID NLM: 9011445
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
pubmed:
10
4
2020
medline:
9
10
2021
entrez:
10
4
2020
Statut:
ppublish
Résumé
To investigate the outcomes after bioresorbable scaffold (BRS) implantation in calcified coronary lesions. In calcified coronary lesions, durable metallic drug-eluting stent (DES) implantation is associated with worse clinical outcomes compared to noncalcified lesions. Although not recommended, BRSs were frequently implanted in calcified lesions in clinical practice. Their outcome is not well investigated. Between November 2013 and January 2016, 3326 patients were enrolled in the German-Austrian ABSORB ReglstRy (GABI-R). Lesion calcification severity was classified into no (n = 1144), mild (n = 1306), and moderate-to-severe (n = 690) calcification. Patients with calcification were older (none: 59.1 ± 11.2 vs. mild: 61.6 ± 10.9 vs. moderate to severe: 62.4 ± 10.5 years, P < 0.001), had more diabetes (19.1 vs. 20.8 vs. 23.9%, P = 0.015), and more often had previous myocardial infarction (MI) (19.3 vs. 23.1 vs. 25.4%, P = 0.002). Despite a higher rate of postdilatations (P < 0.001), lesions with calcification had more residual stenosis (2.05 ± 9.36% vs. 3.11 ± 9.36% vs. 3.89 ± 9.39%, P < 0.001). Consequently, procedural success was achieved in 97.7 vs. 96.2 vs. 93.6% of cases in none, mild, and moderate-to-severe calcification (P < 0.001). At 24 months, cardiac death (0.3 vs. 0.7 vs. 1.6%, P = 0.009) was higher with increasing calcification. However, no significant between-group difference was observed in the incidence of target vessel MI, target vessel revascularization, or target lesion failure. The rate of probable scaffold thrombosis was significantly higher with increasing calcification. In GABI-R, ABSORB scaffolds in calcified lesions required more postdilation, led to more residual stenosis, but did not portend increased target lesion revascularization over 2 years. Nevertheless, coronary calcification severity emerged as a cardiovascular risk marker and was predictive of cardiovascular mortality. Clinicaltrial.gov NCT02066623.
Identifiants
pubmed: 32271247
doi: 10.1097/MCA.0000000000000870
pii: 00019501-202011000-00002
doi:
Banques de données
ClinicalTrials.gov
['NCT02066623']
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
578-585Références
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