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. Issue 3 (5th August 2019)

• Record Type: Journal Article
• Authors: D'Ascenzo, Fabrizio; Gaido, Luca; Bernardi, Alessandro; Saglietto, Andrea; Franzé, 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, Alaide; Piazza, Fabio; di Mario, Carlo; Poli, Arnaldo; D'Urbano, Maurizio; Romeo, Francesco; Giammaria, Massimo; Varbella, Ferdinando; Sheiban, Imad; Escaned, Javier; De Ferrari, Gaetano M.;
• Is Part Of: Catheterization and cardiovascular interventions. Volume 95:Issue 3(2020)
• Page Start: 522
• Page End: 529
• Publication Date: 2019-08-05
• Subjects: coronary artery disease -- drug eluting stent -- percutaneous coronary intervention -- percutaneous coronary intervention complex -- stent restenosis -- stent thrombosis; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.28413
• Languages: English
• ISSNs: 1522-1946

Abstract

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.