One‐year clinical outcomes in patients with chronic kidney disease treated with COMBO stents: From the COMBO collaboration. Issue 6 (16th September 2020)

• Record Type: Journal Article
• Authors: Chandrasekhar, Jaya; Kalkman, Deborah N.; Sartori, Samantha; Baber, Usman; Blum, Moritz; Aquino, Melissa B.; Woudstra, Pier; Beijk, Marcel A.; Tijssen, Jan G.; Koch, Karel T.; Dangas, George D.; Colombo, Antonio; de Winter, Robbert J.; Mehran, Roxana
• Is Part Of: Catheterization and cardiovascular interventions. Volume 98:Issue 6(2021)
• Page Start: 1095
• Page End: 1101
• Publication Date: 2020-09-16
• Subjects: chronic kidney disease -- COMBO PCI -- dual therapy stent -- endothelial progenitor cell capture; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29270
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Background: Chronic kidney disease (CKD) patients undergoing percutaneous coronary intervention (PCI) experience greater ischemic events including clinically driven target lesion revascularization (CD‐TLR). Whether the COMBO biodegradable‐polymer sirolimus‐eluting stent promotes better outcomes in these patients by virtue of endothelial progenitor cell capture technology is unknown. Objective: We examined one‐year outcomes by CKD status from the COMBO collaboration. Methods: The COMBO collaboration was a patient‐level pooled dataset from the REMEDEE and MASCOT registries (3, 614 patients) of all‐comers undergoing attempted COMBO stent PCI. The primary endpoint was one‐year target lesion failure (TLF), composite of cardiac death, target‐vessel myocardial infarction (TV‐MI) or CD‐TLR. Secondary endpoints included stent thrombosis (ST). Results: The study included 6.4% ( n = 231) CKD and 93.6% ( n = 3, 361) non‐CKD patients. CKD patients were older and included more women with greater prevalence of several comorbidities but similar rate of acute coronary syndrome (50.6% vs. 54.5%, p = .26). CKD patients underwent radial PCI less often (56.1% vs. 70.3%, p < .001) and received clopidogrel (78.6% vs. 68.3%) more often ( p = .004). One‐year TLF occurred in 7.9% CKD vs. 3.7% non‐CKD patients, p = .001. CKD patients also demonstrated greater incidence of cardiac death (6.2% vs. 1.2%, p < .0001), TV‐MI (2.7% vs. 1.1%, p = .04) but similar CD‐TLR (2.7% vs 2.2%, p = .61) and definite/probable ST (1.4% vs. 0.8%, p = .42), compared to non‐CKD patients. Conclusions: CKD patients treated with COMBO stents had significantly greater incidence of one‐year TLF compared to non‐CKD patients driven by cardiac death and to a lesser extent TV‐MI but not CD‐TLR. They had similar rates of definite/probable ST.