1. Comparison of One-Year Outcomes in Patients >75 Versus ≤75 Years With Coronary Artery Disease Treated With COMBO Stents (From The MASCOT Registry)
- Author
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Petr Hájek, Roxana Mehran, Bryan P. Yan, Samantha Sartori, Zdeněk Coufal, Robert Gerber, Paula Tejedor, Borislav Atzev, Usman Baber, Deborah N. Kalkman, Martin Mates, Andrés Iñiguez, Tiong Kiam Ong, Muhammad Munawar, Robbert J. de Winter, George Dangas, Hazem M. Warda, Petr Kala, Martin Hudec, Houng Bang Liew, Antonio Colombo, Melissa Aquino, Michael S. Lee, Peter den Heijer, Jaya Chandrasekhar, Borislav Borisov, Jarosław Wójcik, Ahmed Khashaba, Alexandr Schee, Mascot investigators, Cardiology, ACS - Heart failure & arrhythmias, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
Male ,Target lesion ,medicine.medical_specialty ,Polymers ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Global Health ,Prosthesis Design ,Coronary artery disease ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Postoperative Complications ,0302 clinical medicine ,Internal medicine ,Absorbable Implants ,Clinical endpoint ,Humans ,Medicine ,Prospective Studies ,Registries ,030212 general & internal medicine ,Myocardial infarction ,Aged ,Aged, 80 and over ,business.industry ,Proportional hazards model ,Incidence ,Hazard ratio ,Stent ,Drug-Eluting Stents ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Cohort study - Abstract
Older patients who undergo coronary interventions are at greater risk of ischemic events and less likely to tolerate prolonged dual antiplatelet therapy (DAPT) due to bleeding risk. The COMBO biodegradable polymer sirolimus-eluting stent promotes rapid endothelialization through endothelial progenitor cell capture technology which may be advantageous in elderly patients. We compared 1-year clinical outcomes and DAPT cessation events in patients >75 versus ≤75 years from the MASCOT registry. MASCOT was a prospective, multicenter cohort study of all-comers undergoing attempted COMBO stenting. The primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, myocardial infarction (MI) not clearly attributed to a nontarget vessel or clinically driven target lesion revascularization. Bleeding was adjudicated using the Bleeding Academic Research Consortium criteria. Adjusted outcomes were analyzed using Cox regression methods. The study included 18% (n = 479) patients >75 years and 72% (n = 2,135) patients ≤75 years. One-year TLF occurred in 4.6% patients >75 years versus 3.1% patients ≤75years of age, p = 0.10; adj hazard ratio 1.36, 95% confidence intervals 0.77 to 2.38, p = 0.29. There were no significant differences in cardiac death (1.7% vs 1.3%, p = 0.55), MI (2.1% vs 1.2%, p = 0.14), target lesion revascularization (1.7% vs 1.4%, p = 0.60) and definite stent thrombosis (0.8% vs 0.4%, p = 0.19). Major Bleeding Academic Research Consortium 3,5 bleeding (3.1% vs 1.5%, p = 0.01) and DAPT cessation rates (32.4% vs 23.0%, p 75 years treated with COMBO stents had similar TLF but significantly greater incidence of bleeding than younger patients and DAPT cessation in one-third of patients over 1 year.
- Published
- 2020