Clinical outcomes of first- and second-generation drug-eluting stents in patients undergoing rotational atherectomy for heavily calcified coronary lesions

Wenjie Tian, Michael Mahmoudi, Thibault Lhermusier, Lakshmana K. Pendyala, Sarkis Kiramijyan, Minha Saar, Hideaki Ota, Fang Chen, Rebecca Torguson, William O. Suddath, Lowell F. Satler, Augusto D. Pichard, Ron Waksman

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: There is paucity of data regarding the clinical outcome of second generation drug- eluting stents (DES) post rotational atherectomy (RA) for heavily calcified coronary lesions (HCCL). Methodology: The study cohort comprised 99 (116 lesions) consecutive patients who underwent RA for HCCL at our institution and received either a first generation DES (40 patients, 53 lesions) or a second generation DES (59 patients, 63 lesions). The analyzed clinical parameters were the 12-month rates of death (all cause and cardiac), Q-wave MI, target lesion revascularization (TLR), definite stent thrombosis (ST) and major adverse cardiac events (MACE) defined as the composite of death, Q-wave MI, or TLR. Results: The two groups were well matched for their baseline characteristics except for a lower left ventricular ejection fraction in the second generation DES group (46.0 ± 23.0% vs. 55.0 ± 9.0%; p = 0.02). The group receiving second generation DES had more type C lesions (81.0% vs. 58.8%; p = 0.01), shorter stent length (19.9 ± 6.1 mm vs. 22.7 ± 7.3 mm; p = 0.04) and was more likely to undergo stent postdilatation (52.4% vs. 23.1%; p = 0.001). The 1-year analyzed clinical parameters were similar in the two groups: all cause death (8.5% vs. 10.3%; p = 1.0), cardiac death (8.5% vs. 2.5%; p = 0.40), Q-wave MI (0% vs. 0%), TLR (3.6% vs. 2.7%; p = 1.0), ST (0% vs. 0%), and MACE (11.9% vs. 12.8%; p = 1.0). The 1-year MACE-free survival rate was also similar in the two cohorts. Conclusion: The use of second generation DES, following RA for HCCL, is associated with similar short and long-term clinical outcomes to first generation DES.

Original languageEnglish
Pages (from-to)147-150
Number of pages4
JournalCardiovascular Revascularization Medicine
Volume16
Issue number3
DOIs
Publication statusPublished - 01-04-2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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