Impact of stent thickness on clinical outcomes in small vessel and bifurcation lesions: a RAIN-CARDIOGROUP VII sub-study. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Franchin, Luca; Piroli, Francesco; D'Ascenzo, Fabrizio; Nuñez-Gil, Ivan; Wojakowski, Wojciech; Imori, Yoichi; Trabattoni, Daniela; Huczek, Zenon; Venuti, Giuseppe; Muscoli, Saverio; Montabone, Andrea; Rognoni, Andrea; Parma, Radoslaw; Figini, Filippo; Mitomo, Satoru; Quadri, Giorgio; Wańha, Wojciech; Cortese, Bernardo; De Filippo, Ovidio; Ryan, Nicola; Varbella, Ferdinando; Sheiban, Imad; Helft, Gerard; De Ferrari, Gaetano M.
• Is Part Of: Journal of cardiovascular medicine. Volume 22:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: bifurcation lesion -- clinical research -- drug-eluting stent -- small vessels; Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000001037
• Languages: English
• ISSNs: 1558-2027

Abstract

Abstract : Background: The clinical impact of stent strut thickness in coronary bifurcation lesions in small vessels has not been assessed in a real-world population. Methods: All 506 patients enrolled in the RAIN study, undergoing PCI in a vessel with a diameter 2.5 mm or less were retrospectively evaluated and divided into two groups according to stent strut thickness: 74 μm ( n = 206) versus 81 μm ( n = 300); 87.1% of the lesions involved bifurcations. TLF [defined as a composite of myocardial infarction (MI) and target lesion revascularization (TLR)] was the primary endpoint, with MACE (a composite of death, MI and TLR), its components and stent thrombosis the secondary endpoint. Results: After 16 (14–18) months, a lower incidence of TLF (4.3 vs. 9.8%, P = 0.026) and ST (1.0 vs. 3.0%, P = 0.042) was seen in the 74 μm group, whereas MACE occurred in 60 of 506 patients, with no statistical difference between the two groups (9.7 vs. 13.3%, P = 0.070). At multivariate analysis, chronic renal failure increased the risk of TLF while thinner strut was an independent protective factor (hazard ratio 0.51, CI 0.17–0.85, P = 0.005). Conclusion: In this real-world population, patients being treated for small vessels lesions with thinner strut stents had lower rates of TLF, MI and ST.