In:
Catheterization and Cardiovascular Interventions, Wiley, Vol. 96, No. 1 ( 2020-07), p. 1-9
Abstract:
To evaluate the independent clinical impact of stent structural features in a large cohort of patients undergoing unprotected left main (ULM) or coronary bifurcation percutaneous coronary intervention (PCI) with a range of very thin strut stents. Background Clinical impact of structural features of contemporary stents remains to be defined. Methods All consecutive patients enrolled in the veRy thin stents for patients with left mAIn or bifurcatioN in real life (RAIN) registry were included. The following stent structural features were studied: antiproliferative drugs (everolimus vs. sirolimus vs. zotarolimus), strut material (platinum‐chromium vs. cobalt‐chromium), polymer (bioresorbable vs. durable), number of crowns ( 〈 8 vs. ≥8) and number of connectors ( 〈 3 vs. ≥3). For small diameter stents (≤2.5 mm), struct thickness (74 vs. 80/81 μm) was also tested. Target lesion failure (TLF), a composite of target lesion revascularization and stent thrombosis, was the primary endpoint. Multivariate analysis was performed with Cox regression models. Results Out of 2,707 patients, 110 (4.1%) experienced a TLF event after 16 months (12–18). After adjustment for confounders, an increased number of connectors (adjusted hazard ratio [adj‐HR] 0.62, 95% confidence interval (CI) 0.39–0.99, p = .04) reduced risk of TLF, driven by stents with ≥2.5 mm diameter (HR 0.54, 95% CI 0.32–0.93, p = .02). This independent relationship was lost for stents with diameter 〈 2.5 mm, where only strut thickness appeared to impact. Conversely, no independent relationship of polymer type, number of crowns, and the specific limus‐family eluted drug with outcomes was observed. Conclusions Among a range of contemporary very thin stent models, an increased number of connectors improved device‐related outcomes in this investigated high‐risk procedural setting.
Type of Medium:
Online Resource
ISSN:
1522-1946
,
1522-726X
Language:
English
Publisher:
Wiley
Publication Date:
2020
detail.hit.zdb_id:
2001555-0
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