Jens Wiebe1, Petra Hoppmann2, Roisin Colleran1, Sebastian Kufner1, Michael Valeskini1, Salvatore Cassese1, Simon Schneider2, Michael Joner1, Heribert Schunkert3, Karl-Ludwig Laugwitz4, Adnan Kastrati3, Robert A Byrne5. 1. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. 2. 1. Med. Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany. 3. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. 4. 1. Med. Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. 5. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. Electronic address: byrne@dhm.mhn.de.
Abstract
OBJECTIVES: The aim of this study was to report clinical outcomes in patients treated in routine practice 2 years after everolimus-eluting bioresorbable stent (BRS) implantation. BACKGROUND: Long-term results in patients undergoing BRS implantation in routine clinical practice are sparse, and existing evidence from randomized trials considers mostly selected patients. METHODS: The ISAR-ABSORB registry enrolled consecutive patients undergoing BRS implantation in routine clinical practice at 2 high-volume centers in Germany. Angiographic follow-up was scheduled after 6 to 8 months and clinical follow-up to 24 months. The primary endpoint was the composite of death, myocardial infarction, or target lesion revascularization, and secondary endpoints included individual components of the primary endpoint and definite stent thrombosis. Event rates were calculated using the Kaplan-Meier method. RESULTS: A total of 419 patients were included. The mean age was 66.6 ± 10.9 years, 31.5% had diabetes, and 39.0% presented with acute coronary syndrome. Forty-nine percent of lesions were considered complex (American College of Cardiology/American Heart Association type B2 or C), and 13.1% were bifurcation lesions. The mean reference vessel diameter was 2.89 ± 0.46 mm. At 2 years, the primary endpoint had occurred in 21.6% of patients: death in 6.3%, myocardial infarction in 3.9%, target lesion revascularization in 16.0%, and definite stent thrombosis in 3.8%. CONCLUSIONS: Long-term follow-up of patients treated with BRS in routine practice showed higher event rates than expected. Future studies are required to determine the impact of changes in implantation technique and to define the optimal duration of dual antiplatelet therapy in these patients.
OBJECTIVES: The aim of this study was to report clinical outcomes in patients treated in routine practice 2 years after everolimus-eluting bioresorbable stent (BRS) implantation. BACKGROUND: Long-term results in patients undergoing BRS implantation in routine clinical practice are sparse, and existing evidence from randomized trials considers mostly selected patients. METHODS: The ISAR-ABSORB registry enrolled consecutive patients undergoing BRS implantation in routine clinical practice at 2 high-volume centers in Germany. Angiographic follow-up was scheduled after 6 to 8 months and clinical follow-up to 24 months. The primary endpoint was the composite of death, myocardial infarction, or target lesion revascularization, and secondary endpoints included individual components of the primary endpoint and definite stent thrombosis. Event rates were calculated using the Kaplan-Meier method. RESULTS: A total of 419 patients were included. The mean age was 66.6 ± 10.9 years, 31.5% had diabetes, and 39.0% presented with acute coronary syndrome. Forty-nine percent of lesions were considered complex (American College of Cardiology/American Heart Association type B2 or C), and 13.1% were bifurcation lesions. The mean reference vessel diameter was 2.89 ± 0.46 mm. At 2 years, the primary endpoint had occurred in 21.6% of patients: death in 6.3%, myocardial infarction in 3.9%, target lesion revascularization in 16.0%, and definite stent thrombosis in 3.8%. CONCLUSIONS: Long-term follow-up of patients treated with BRS in routine practice showed higher event rates than expected. Future studies are required to determine the impact of changes in implantation technique and to define the optimal duration of dual antiplatelet therapy in these patients.
Authors: Jung Min Ahn; Duk Woo Park; Sung Jin Hong; Young Keun Ahn; Joo Yong Hahn; Won Jang Kim; Soon Jun Hong; Chang Wook Nam; Do Yoon Kang; Seung Yul Lee; Woo Jung Chun; Jung Ho Heo; Deok Kyu Cho; Jin Won Kim; Sung Ho Her; Sang Wook Kim; Sang Yong Yoo; Myeong Ki Hong; Seung Jea Tahk; Kee Sik Kim; Moo Hyun Kim; Yangsoo Jang; Seung Jung Park Journal: Korean Circ J Date: 2017-11-06 Impact factor: 3.243