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Comparison of One-Year Outcomes in Patients >75 Versus ≤75 Years With Coronary Artery Disease Treated With COMBO Stents (From The MASCOT Registry)
- Source :
- American journal of cardiology, 127, 1-8. Elsevier Inc.
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
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.
- 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
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 127
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....01e512422ab972f89b1728f1efe9bf9d