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Impact of coronary calcification on outcomes after ABSORB scaffold implantation: insights from the GABI-R registry.
- Source :
-
Coronary artery disease [Coron Artery Dis] 2020 Nov; Vol. 31 (7), pp. 578-585. - Publication Year :
- 2020
-
Abstract
- Objective: To investigate the outcomes after bioresorbable scaffold (BRS) implantation in calcified coronary lesions. In calcified coronary lesions, durable metallic drug-eluting stent (DES) implantation is associated with worse clinical outcomes compared to noncalcified lesions. Although not recommended, BRSs were frequently implanted in calcified lesions in clinical practice. Their outcome is not well investigated.<br />Methods: Between November 2013 and January 2016, 3326 patients were enrolled in the German-Austrian ABSORB ReglstRy (GABI-R). Lesion calcification severity was classified into no (n = 1144), mild (n = 1306), and moderate-to-severe (n = 690) calcification.<br />Results: Patients with calcification were older (none: 59.1 ± 11.2 vs. mild: 61.6 ± 10.9 vs. moderate to severe: 62.4 ± 10.5 years, P < 0.001), had more diabetes (19.1 vs. 20.8 vs. 23.9%, P = 0.015), and more often had previous myocardial infarction (MI) (19.3 vs. 23.1 vs. 25.4%, P = 0.002). Despite a higher rate of postdilatations (P < 0.001), lesions with calcification had more residual stenosis (2.05 ± 9.36% vs. 3.11 ± 9.36% vs. 3.89 ± 9.39%, P < 0.001). Consequently, procedural success was achieved in 97.7 vs. 96.2 vs. 93.6% of cases in none, mild, and moderate-to-severe calcification (P < 0.001). At 24 months, cardiac death (0.3 vs. 0.7 vs. 1.6%, P = 0.009) was higher with increasing calcification. However, no significant between-group difference was observed in the incidence of target vessel MI, target vessel revascularization, or target lesion failure. The rate of probable scaffold thrombosis was significantly higher with increasing calcification.<br />Conclusion: In GABI-R, ABSORB scaffolds in calcified lesions required more postdilation, led to more residual stenosis, but did not portend increased target lesion revascularization over 2 years. Nevertheless, coronary calcification severity emerged as a cardiovascular risk marker and was predictive of cardiovascular mortality. Clinicaltrial.gov NCT02066623.
- Subjects :
- Absorbable Implants adverse effects
Drug-Eluting Stents
Female
Humans
Long Term Adverse Effects diagnosis
Long Term Adverse Effects etiology
Male
Middle Aged
Registries
Severity of Illness Index
Tissue Scaffolds adverse effects
Vascular Patency
Coronary Artery Disease diagnosis
Coronary Artery Disease physiopathology
Coronary Artery Disease surgery
Coronary Vessels diagnostic imaging
Coronary Vessels pathology
Myocardial Infarction diagnosis
Myocardial Infarction etiology
Percutaneous Coronary Intervention adverse effects
Percutaneous Coronary Intervention instrumentation
Percutaneous Coronary Intervention methods
Postoperative Complications diagnosis
Postoperative Complications etiology
Vascular Calcification diagnosis
Vascular Calcification surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5830
- Volume :
- 31
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Coronary artery disease
- Publication Type :
- Academic Journal
- Accession number :
- 32271247
- Full Text :
- https://doi.org/10.1097/MCA.0000000000000870