Why the study?
Does the addition of a drug-eluting stent to coronary rotational atherectomy reduce long-term MACE and TVR compared to non-DES strategies?
Does the addition of a drug-eluting stent to coronary rotational atherectomy reduce long-term MACE and TVR compared to non-DES strategies?
Coronary rotational atherectomy combined with drug-eluting stents provides reasonable very long-term clinical outcomes, significantly reducing target vessel revascularization compared to non-DES strategies.
RA + DES may lower long-term TVR after rotational atherectomy; leaves open MACE benefit and requires randomized confirmation.
We assessed the very long-term follow-up of a large cohort of unselected patients treated with coronary rotational atherectomy (RA). All 143 patients who underwent RA at our institution from 2000 to 2013 and with complete baseline and follow-up information were analyzed in a retrospective manner. Major adverse cardiac events (MACE) were defined as the composite of target vessel revascularization (TVR), acute myocardial infarction, and all-cause mortality. The mean follow-up was 8.2 years. The 10-year cumulative incidence of MACE for all patients was 57.9% (standard error [SE]: 5.0%). When comparing patients who received a drug-eluting stent (DES; n = 68) versus patients who did not (balloon only, bare-metal stent, or none of the aforementioned; n = 75), the RA + DES demonstrated very long-term MACE of 49.2% (SE: 7.5%) versus 62.7% (SE: 6.1%), P = .160 with TVR as the most discriminating factor, 10.7% (SE: 4.0%) versus 29.2% (SE: 6.0%), P = .016. Our results point to RA having reasonable long-term clinical results, especially in combined treatment with DES. To date, our study has the longest follow-up after RA.
No takes yet. Share an insight, caveat, or question.
Tohamy et al. (2016) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: