Key result
The presence of an uncrossable lesion, compared to an undilatable lesion, independently predicted 1-year mortality (HR 3.43) in patients undergoing rotational atherectomy.
Why the study?
What are the predictors of poor outcome after percutaneous coronary intervention using rotational atherectomy in an all-comers population?
Observational (n=207)
No
What are the predictors of poor outcome after percutaneous coronary intervention using rotational atherectomy in an all-comers population?
In patients undergoing rotational atherectomy, uncrossable lesions and low LVEF predict worse 1-year outcomes, whereas achieving a residual SYNTAX score ≤8 is associated with improved survival.
Novel predictors may refine post-RA risk stratification; leaves open prospective validation before practice change.
INTRODUCTION: Most established risk factors after rotational atherectomy (RA) of heavily fibro-calcified lesions are associated with patients' general risk and clinical related factors and are not specific for either coronary and culprit lesion anatomy or the RA procedure. AIM: To assess novel predictors of poor outcome after percutaneous coronary intervention using RA in an all-comers population. MATERIAL AND METHODS: A total of 207 consecutive patients after RA were included in a single-center observational study. Primary endpoints were 1-year mortality and 1-year major adverse cardiac events (MACE). Secondary endpoints were angiographic and procedural success and in-hospital complications. RESULTS: = 0.04) were independent predictors of 1-year MACE. CONCLUSIONS: The presence of a novel factor, uncrossable lesion, as compared to undilatable lesion, is associated with poor outcome, and low residual SYNTAX score ≤ 8 is associated with favorable outcome in 1-year follow-up after the RA procedure and can help in risk stratification of patients undergoing complex coronary intervention with RA.
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Kübler et al. (2018) conducted an observational in Heavily calcified coronary lesions requiring rotational atherectomy (n=207). Uncrossable lesion vs. Undilatable lesion was evaluated on 1-year all-cause mortality (HR 3.43, 95% CI 1.34-8.80, p=0.01). The presence of an uncrossable lesion, compared to an undilatable lesion, independently predicted 1-year mortality (HR 3.43) in patients undergoing rotational atherectomy.
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