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One‐year clinical outcomes in patients with chronic kidney disease treated with COMBO stents: From the COMBO collaboration

Authors :
Usman Baber
Moritz Blum
Jan G.P. Tijssen
Samantha Sartori
Karel T. Koch
Deborah N. Kalkman
Roxana Mehran
Melissa Aquino
Robbert J. de Winter
Antonio Colombo
Pier Woudstra
Jaya Chandrasekhar
Marcel A.M. Beijk
George Dangas
Icahn School of Medicine at Mount Sinai [New York] (MSSM)
San Raffaele Scientific Institute
Vita-Salute San Raffaele University and Center for Translational Genomics and Bioinformatics
Cardiology
ACS - Atherosclerosis & ischemic syndromes
ACS - Heart failure & arrhythmias
ACS - Pulmonary hypertension & thrombosis
Source :
Catheterization and Cardiovascular Interventions, Catheterization and Cardiovascular Interventions, Wiley, 2020, ⟨10.1002/ccd.29270⟩, Catheterization and cardiovascular interventions, 98(6), 1095-1101. Wiley-Liss Inc.
Publication Year :
2020
Publisher :
HAL CCSD, 2020.

Abstract

International audience; Background: Chronic kidney disease (CKD) patients undergoing percutaneous coronary intervention (PCI) experience greater ischemic events including clinically driven target lesion revascularization (CD-TLR). Whether the COMBO biodegradable-polymer sirolimus-eluting stent promotes better outcomes in these patients by virtue of endothelial progenitor cell capture technology is unknown.Objective: We examined one-year outcomes by CKD status from the COMBO collaboration.Methods: The COMBO collaboration was a patient-level pooled dataset from the REMEDEE and MASCOT registries (3,614 patients) of all-comers undergoing attempted COMBO stent PCI. The primary endpoint was one-year target lesion failure (TLF), composite of cardiac death, target-vessel myocardial infarction (TV-MI) or CD-TLR. Secondary endpoints included stent thrombosis (ST).Results: The study included 6.4% (n = 231) CKD and 93.6% (n = 3,361) non-CKD patients. CKD patients were older and included more women with greater prevalence of several comorbidities but similar rate of acute coronary syndrome (50.6% vs. 54.5%, p = .26). CKD patients underwent radial PCI less often (56.1% vs. 70.3%, p < .001) and received clopidogrel (78.6% vs. 68.3%) more often (p = .004). One-year TLF occurred in 7.9% CKD vs. 3.7% non-CKD patients, p = .001. CKD patients also demonstrated greater incidence of cardiac death (6.2% vs. 1.2%, p < .0001), TV-MI (2.7% vs. 1.1%, p = .04) but similar CD-TLR (2.7% vs 2.2%, p = .61) and definite/probable ST (1.4% vs. 0.8%, p = .42), compared to non-CKD patients.Conclusions: CKD patients treated with COMBO stents had significantly greater incidence of one-year TLF compared to non-CKD patients driven by cardiac death and to a lesser extent TV-MI but not CD-TLR. They had similar rates of definite/probable ST.

Details

Language :
English
ISSN :
15221946 and 1522726X
Database :
OpenAIRE
Journal :
Catheterization and Cardiovascular Interventions, Catheterization and Cardiovascular Interventions, Wiley, 2020, ⟨10.1002/ccd.29270⟩, Catheterization and cardiovascular interventions, 98(6), 1095-1101. Wiley-Liss Inc.
Accession number :
edsair.doi.dedup.....b5965accfe22c8ae8820ec5a2e3712c3
Full Text :
https://doi.org/10.1002/ccd.29270⟩