Implantation of 2.0-mm zotarolimus drug-eluting stents for very small vessel coronary artery disease resulted in a 2-year MACE rate of 20.1%, mostly driven by target lesion revascularization.
Observational (n=134)
Implantation of 2.0-mm zotarolimus drug-eluting stents is feasible for very small vessel coronary artery disease, though patients with chronic kidney disease or calcified lesions face a significantly higher risk of major adverse cardiovascular events at 2 years.
BACKGROUND: Percutaneous coronary interventions (PCI) in very small vessel lesions represent an intriguing aspect of coronary artery disease (CAD). Uncertainty still exists in stent implantation in very small caliber vessels. This study aimed to evaluate the long-term outcomes of patients treated with 2.0-mm drug-eluting stent (DES). METHOD: This retrospective observational study included 134 patients undergoing PCI with 2.0-mm zotarolimus DES from December 2016 to May 2020. The primary endpoint was major adverse cardiovascular events (MACE) at 2-year follow-up, which was composed of all-cause mortality, target vessel myocardial infarction, and ischemia-driven target lesion revascularization. Multiple logistic regression analysis was used to identify the independent predictors of MACE, and odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULT: The lesions were diffuse (mean length 20.9 ± 5.51 mm) and belong to type B2/C lesions (90.3%). On follow-up, the MACE rate was 20.1% and mostly driven by late lumen loss demanding revascularization (11.9%). In multivariable analysis, chronic kidney disease (CKD) (OR: 4.291, 95% CI: 1.574-11.704, p = 0.004) and calcified lesions (OR: 3.688, 95% CI: 1.311-10.371, p = 0.013) were the independent predictors of subsequent cardiovascular events, whereas statin was associated with better outcomes (OR: 0.335, 95% CI: 0.119-0.949, p = 0.040). CONCLUSION: 2.0-mm DES is a feasible option for treating very small vessel CAD in complex lesions. Patients with CKD and calcified lesions carry the hazard of worse outcomes, and careful consideration should be taken before stenting in this high-risk population.
Liu et al. (Thu,) conducted a observational in very small vessel coronary artery disease (n=134). 2.0-mm zotarolimus drug-eluting stent (DES) was evaluated on Major adverse cardiovascular events (MACE) composed of all-cause mortality, target vessel myocardial infarction, and ischemia-driven target lesion revascularization. Implantation of 2.0-mm zotarolimus drug-eluting stents for very small vessel coronary artery disease resulted in a 2-year MACE rate of 20.1%, mostly driven by target lesion revascularization.
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