Comparison of bioresorbable vs durable polymer drug-eluting stents in unprotected left main (from the RAIN-CARDIOGROUP VII Study)

Media type: E-Article
Title: Comparison of bioresorbable vs durable polymer drug-eluting stents in unprotected left main (from the RAIN-CARDIOGROUP VII Study)
Contributor: Iannaccone, Mario; Barbero, Umberto; De Benedictis, Michele; Imori, Yoichi; Quadri, Giorgio; Trabattoni, Daniela; Ryan, Nicola; Venuti, Giuseppe; Montabone, Andrea; Wojakowski, Wojciech; Rognoni, Andrea; Helft, Gerard; Parma, Radoslaw; De Luca, Leonardo; Autelli, Michele; Boccuzzi, Giacomo; Mattesini, Alessio; Templin, Christian; Cerrato, Enrico; Wańha, Wojciech; Smolka, Grzegorz; Huczek, Zenon; Tomassini, Francesco; Cortese, Bernardo; [...]
Published: Springer Science and Business Media LLC, 2020
Published in: BMC Cardiovascular Disorders, 20 (2020) 1
Language: English
DOI: 10.1186/s12872-020-01420-5
ISSN: 1471-2261
Keywords: Cardiology and Cardiovascular Medicine
Origination:
Footnote:
Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>There are limited data regarding the impact of bioresorbable polymer drug eluting stent (BP-DES) compared to durable polymer drug eluting stent (DP-DES) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>In the RAIN registry (ClinicalTrials NCT03544294, june 2018 retrospectively registered) patients with a ULM or bifurcation stenosis treated with PCI using ultrathin stents (struts thinner than 81 μm) were enrolled. The primary endpoint was the rate of target lesion revascularization (TLR); major adverse cardiovascular events (MACE, a composite of all-cause death, myocardial infarction, TLR and stent thrombosis) and its components, along with target vessel revascularization (TVR) were the secondary ones. A propensity score with matching analysis to compare patients treated with BP-DES versus DP-DES was also assessed.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>From 3001 enrolled patients, after propensity score analysis 1400 patients (700 for each group) were selected. Among them, 352 had ULM disease and 1048 had non-LM bifurcations. At 16 months (12–22), rates of TLR (3.7% vs 2.9%, <jats:italic>p</jats:italic> = 0.22) and MACE were similar (12.3% vs. 11.6%, <jats:italic>p</jats:italic> = 0.74) as well as for the other endpoints. Sensitivity analysis of outcomes after a two-stents strategy, showed better outcome in term of MACE (20.4% vs 10%, <jats:italic>p</jats:italic> = 0.03) and TVR (12% vs 4.6%, <jats:italic>p</jats:italic> = 0.05) and a trend towards lower TLR in patients treated with BP-DES.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In patients with bifurcations or ULM treated with ultrathin stents BP-DES seems to perform similarly to DP-DES: the trends toward improved clinical outcomes in patients treated with the BP-DES might potentially be of value for speculating the stent choice in selected high-risk subgroups of patients at increased risk of ischemic events.</jats:p> </jats:sec><jats:sec> <jats:title>Trial registration</jats:title> <jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT03544294?cond=RAIN&draw=2&rank=1">NCT03544294</jats:ext-link>. Retrospectively registered June 1, 2018.</jats:p> </jats:sec>
Access State: Open Access

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