Key result
Drug-eluting stent implantation following rotational atherectomy was associated with a significantly lower risk of major adverse cardiac events compared to bare-metal stents (adjusted HR 0.62).
Why the study?
Does drug-eluting stent implantation reduce major adverse cardiac events compared to bare metal stents in patients with heavily calcified coronary lesions undergoing rotational atherectomy?
Cohort (n=406)
No
Does drug-eluting stent implantation reduce major adverse cardiac events compared to bare metal stents in patients with heavily calcified coronary lesions undergoing rotational atherectomy?
Hazard Ratio: 0.62 (95% CI 0.44–0.88)
Absolute Event Rate: 10.7% vs 12.7%
p-value: p=0.0081
In patients with heavily calcified coronary lesions undergoing rotational atherectomy, drug-eluting stents significantly reduce long-term major adverse cardiac events compared to bare metal stents.
May support DES preference after rotational atherectomy in calcified lesions; leaves open randomized confirmation.
Few studies have investigated the clinical outcomes of rotational atherectomy (RA) prior to and during the drugeluting stent (DES) era. The goal of this study was to assess the long-term outcome after RA followed by DES and bare metal stent (BMS) implantation in complex calcified coronary lesions and to compare the outcomes among various DESs.This was a single center retrospective observational study. Consecutive 406 patients who underwent elective RA followed by BMS or DES implantation at our institution from 2001 to 2011 were included. This study compared the long-term outcomes after treatment with RA among BMS and 3 different DESs (sirolimus-eluting stent, paclitaxel-eluting stent, and everolimus-eluting stent) implantation.The mean follow-up period was 4.6 years. Patients with DES were older and exhibited more vessel disease, longer lesion length, and smaller vessel size. Patients with BMS had a significantly higher rate of target lesion revascularization, restenosis, and larger late lumen loss than those with DES. Composite events including mortality, ACS, and target vessel revascularization were significantly higher in the BMS-RA group than in the DES-RA group. After adjustment, BMS remained an independent predictor of MACE and ACS plus death in patients treated with RA. However, there were no significant differences in late lumen loss, restenosis rate, and MACE among the 3 DES.The combination of DES-RA has a favorable effect in both the angiographic and clinical outcomes compared with BMS-RA. However, no significant differences in late loss and events rates were observed among the 3 DES groups.
No takes yet. Share an insight, caveat, or question.
Tamura et al. (2016) conducted a cohort in Complex calcified coronary lesions (n=406). Drug-eluting stents (DES) following rotational atherectomy vs. Bare metal stents (BMS) following rotational atherectomy was evaluated on Major adverse cardiac events (MACE), a composite of all-cause death, nonfatal ACS, and target vessel revascularization (HR 0.62, 95% CI 0.44-0.88, p=0.0081). Drug-eluting stent implantation following rotational atherectomy was associated with a significantly lower risk of major adverse cardiac events compared to bare-metal stents (adjusted HR 0.62).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: