Daily risk of adverse outcomes in patients undergoing complex lesions revascularization: A subgroup analysis from the RAIN-CARDIOGROUP VII study (veRy thin stents for patients with left mAIn or bifurcatioN in real life).
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Biolè Carloalberto, Huczek Zenon, Nuñez-Gil Ivan, Boccuzzi Giacomo, Autelli Michele, Montefusco Antonio, Trabattoni Daniela, Ryan Nicola, Venuti Giuseppe, Imori Yoichi, Takano Hitoshi, Matsuda Junya, Shimizu Wataru, Muscoli Saverio, Montabone Andrea, Wojakowski Wojciech, Rognoni Andrea, Helft Gerard, Gallo Diego, Parma Radoslaw, De Luca Leonardo, Figini Filippo, Mitomo Satoru, Pennone Mauro, Mattesini Alessio, Templin Christian, Quadri Giorgio, Wańha Wojciech, Cerrato Enrico, Smolka Grzegorz, Protasiewicz Marcin, Kuliczkowski Wiktor, Rolfo Cristina, Cortese Bernardo, Capodanno Davide, Chieffo Alaide, Morbiducci Umberto, Iannaccone Mario, Gili Sebastiano, di Mario Carlo, D'Amico Maurizio, Romeo Francesco, Lüscher Thomas F, Sheiban Imad, Escaned Javier, Varbella Ferdinando, D'Ascenzo Fabrizio
Аннотация
METHODS: All consecutive patients presenting with a critical lesion of ULM or bifurcation treated with very thin struts stents, enrolled in the RAIN-Cardiogroup VII study, were analyzed. The daily risk of major acute cardiovascular events (MACE), target lesion revascularization (TLR) and stent thrombosis (ST) and their temporal distribution in the first year of follow-up was the primary endpoint. Differences among subgroups (ULM, patient presentation, kind of stent polymer) were the secondary endpoint.
RESULTS: 2745 patients were included, mean age 68 ± 11 years, 33.3% diabetics, 54.5% had an acute coronary syndrome (ACS); 88.5% of treated lesions were bifurcations, 27.2% ULM. Average daily risk was 0.022% for MACE, 0.005% for TLR and 0.004% for ST, in the first year. Bimodal distribution of adverse events, especially TLR, with an early peak in the first 50 days and a late one after 150 days, was observed. Patients with ULM presented a significantly higher daily risk of events, and ACS patients presented higher MACE risk. No difference emerged according to the type of stent polymer.
CONCLUSIONS: The daily risk of adverse events in the first year after complex PCI in our study is acceptably low. PCI on ULM carries a higher risk of complications.