Two-Year Clinical Outcomes of Newer-Generation Drug-Eluting Stent Implantation Following Rotational Atherectomy for Heavily Calcified Lesions
- 1 January 2015
- journal article
- clinical trial
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 79 (9), 1938-1943
- https://doi.org/10.1253/circj.cj-15-0233
Abstract
Background:Clinical outcomes of implantation of the newer-generation drug-eluting stent (DES) following rotational atherectomy for heavily calcified lesions remain unclear in the real-world setting.Methods and Results:We enrolled 252 consecutive patients (273 lesions) treated with newer-generation DES following rotational atherectomy. The primary endpoint was the cumulative 2-year incidence of major adverse cardiovascular events (MACE), defined as cardiac death, myocardial infarction, clinically-driven target lesion revascularization, and definite stent thrombosis. Complete clinical follow-up information at 2-year was obtained for all patients. The mean age was 73.2±9.0 years and 155 patients (61.5%) were male. Cumulative 2-year incidence of MACE (cardiac death, myocardial infarction, clinically-driven target lesion revascularization and definite stent thrombosis) was 20.3% (7.0%, 2.1%, 18.1% and 2.1%, respectively). Predictors of MACE were presenting with acute coronary syndrome (hazard ratio [HR]: 3.80, 95% confidence interval [CI]: 1.29–11.2, P=0.02), hemodialysis (HR: 1.93, 95% CI: 1.04–3.56, P=0.04) and previous coronary artery bypass graft (HR: 2.26, 95% CI: 1.02–5.00, P=0.045).Conclusions:PCI for calcified lesions requiring rotational atherectomy is still challenging even in the era of newer-generation DES. (Circ J 2015; 79: 1938–1943)Keywords
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