Salvatore Geraci1, Hiroyoshi Kawamoto2, Giuseppe Caramanno1, Neil Ruparelia2, Davide Capodanno3, Salvatore Brugaletta4, Tommaso Gori5, Holger Nef6, Manel Sabate4, Julinda Mehilli7, Maciej Lesiak8, Christoph Naber9, Carlo Di Mario10, Piera Capranzano3, Jens Wiebe6, Aleksander Araszkiewicz8, Stelios Pyxaras9, Alessio Mattesini10, Thomas Münzel5, Corrado Tamburino3, Antonio Colombo2, Azeem Latib11. 1. San Giovanni di Dio Hospital, Agrigento, Italy. 2. EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy. 3. Ferrarotto Hospital, University of Catania, Catania, Italy. 4. Department of Cardiology, Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain. 5. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany. 6. Department of Cardiology, University of Giessen, Giessen, Germany. 7. Department of Cardiology, Klinikum Großhadern, Ludwig-Maximilian Universität, Munich, Germany. 8. Department of Cardiology, University of Medical Sciences, Poznan, Poland. 9. Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany. 10. National Institute of Health Research Cardiovascular BRU, Royal Brompton Hospital & Imperial College, London, United Kingdom. 11. EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy. Electronic address: info@emocolumbus.it.
Abstract
OBJECTIVES: The authors sought to investigate 1-year outcomes in patients treated with bioresorbable everolimus-eluting vascular scaffolds (BVS) for "long coronary lesions." BACKGROUND: The present substudy derived from the GHOST-EU registry included 1,722 lesions in 1,468 consecutive patients, enrolled between November 2011 and September 2014 at 11 European centers. METHODS: The lesions were divided into 3 groups according to continuous BVS length: 1) shorter than 30 mm; 2) between 30 and 60 mm; and 3) longer than 60 mm. Primary device-oriented endpoint (target lesion failure [TLF]) was defined as a combination of cardiovascular death, target vessel myocardial infarction, or clinically driven target lesion revascularization. RESULTS: Patients with lesions ≥60 mm had more comorbidities and more complex lesion characteristics, including chronic total occlusions (37%), bifurcation lesions (40.3%), higher Syntax score (16.4 ± 7.8), and higher number of scaffolds implanted per lesion (3.3 ± 0.9 mm). The main target vessel was the left anterior coronary artery in all groups. Median follow-up was 384 (interquartile range: 359 to 459) days. One-year follow-up was completed in 70.3% of patients. TLF at 1 year was significantly higher in group C (group A 4.8%, group B 4.5%, group C 14.3%; overall p = 0.001), whereas there were no significant differences between groups A and B. Finally, a numerically higher (but not statistically significant) number of scaffold thromboses were observed in group C when compared with shorter lesions (group A 2.1%, group B 1.1%, group C 3.8%; overall p = 0.29). CONCLUSIONS: In a real-world setting, treatment of long coronary lesions with BVS ≥60 mm was associated with a higher TLF rate, driven by myocardial infarction and clinically driven target lesion revascularization.
OBJECTIVES: The authors sought to investigate 1-year outcomes in patients treated with bioresorbable everolimus-eluting vascular scaffolds (BVS) for "long coronary lesions." BACKGROUND: The present substudy derived from the GHOST-EU registry included 1,722 lesions in 1,468 consecutive patients, enrolled between November 2011 and September 2014 at 11 European centers. METHODS: The lesions were divided into 3 groups according to continuous BVS length: 1) shorter than 30 mm; 2) between 30 and 60 mm; and 3) longer than 60 mm. Primary device-oriented endpoint (target lesion failure [TLF]) was defined as a combination of cardiovascular death, target vessel myocardial infarction, or clinically driven target lesion revascularization. RESULTS:Patients with lesions ≥60 mm had more comorbidities and more complex lesion characteristics, including chronic total occlusions (37%), bifurcation lesions (40.3%), higher Syntax score (16.4 ± 7.8), and higher number of scaffolds implanted per lesion (3.3 ± 0.9 mm). The main target vessel was the left anterior coronary artery in all groups. Median follow-up was 384 (interquartile range: 359 to 459) days. One-year follow-up was completed in 70.3% of patients. TLF at 1 year was significantly higher in group C (group A 4.8%, group B 4.5%, group C 14.3%; overall p = 0.001), whereas there were no significant differences between groups A and B. Finally, a numerically higher (but not statistically significant) number of scaffold thromboses were observed in group C when compared with shorter lesions (group A 2.1%, group B 1.1%, group C 3.8%; overall p = 0.29). CONCLUSIONS: In a real-world setting, treatment of long coronary lesions with BVS ≥60 mm was associated with a higher TLF rate, driven by myocardial infarction and clinically driven target lesion revascularization.
Authors: B Everaert; J J Wykrzykowska; J Koolen; P van der Harst; P den Heijer; J P Henriques; R van der Schaaf; B de Smet; S H Hofma; R Diletti; A Weevers; J Hoorntje; P Smits; R J van Geuns Journal: Neth Heart J Date: 2017-07 Impact factor: 2.380
Authors: Mateusz P Jeżewski; Michał J Kubisa; Ceren Eyileten; Salvatore De Rosa; Günter Christ; Maciej Lesiak; Ciro Indolfi; Aurel Toma; Jolanta M Siller-Matula; Marek Postuła Journal: J Clin Med Date: 2019-12-07 Impact factor: 4.241