Latvian Centre of Cardiology real-life registry

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Presentation transcript:

Latvian Centre of Cardiology real-life registry Two-year clinical outcomes after implantation of an everolimus-eluting bioresorbable scaffold Changes of platelet reactivity and clopidogrel effectivity during elective percutaneus coronary intervention: a comparison between design of drug eluting and bare metal stents I. Briede, K. Spalva, I. Narbute, D. Sondore, I. Kumsars, A. Dombrovskis, G. Latkovskis, K. Trusinskis, S. Jegere, A. Lismanis, K. Dombrovska, A. Rudzitis, K. Strenge, A. Grave, E. Sokolova, A. Erglis Paul Stradins Clinical University Hospital, Latvian Center of Cardiology, Riga, Latvia Introduction Objective and Methods Permanent caging of the vessel with metal is still perceived as a limitation of DES, in that it prevents late luminal enlargement, adaptive shear stress and late expansive remodeling1 BVS, transient scaffolding of the vessel prevents acute closure and recoil, drug elution counteracts neointimal proliferation, and complete bioresorption after two to four years, together with vessel lumen enlargement, plaque/media reduction and vasomotion restoration, finally realises the paradigm of vascular restoration therapy2 The aim of registry data was to evaluate two-year clinical and angiographic outcomes after implantation of everolimus-eluting bioresorbable scaffold (Absorb) from the Latvian centre of cardiology real-life registry From all patients included between November 2012 and December 2014 in the Latvian centre of cardiology real-life registry, 187 patients with stable angina and acute coronary syndrome were selected All patients had percutaneous coronary intervention (PCI) following bioresorbable scaffold (Absorb) implantation During two-years follow up, clinical and angiographic results were analysed; all-cause death, cardiac death, target vessel-related myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), scaffold thrombosis (ST), and cerebrovascular events Clinical two year follow-up reached 96.2% of patients Results The clinical angiographic and procedural characteristics are shown in Table1, 2 and 3, respectively. Clinical follow-up reached 96.2% (n=187) patients. Outcomes of major adverse cardiac events are shown in Table 4. Hospital ST was 0.5% (n=1) due to clopidogrel resistance, early ST in fifth day was 0.5% (n=1). All statistical analyses were performed using SPSS version 24.0 software (IBM SPSS, Corp., Armonk, NY). Continuous variables were expressed as mean and standard deviation (SD) Table 3. Procedural Characteristics Table 1. Baseline Clinical Characteristics Table 2. Angiographic Characteristics N=187 patients procedural data: n (%) Radial approach 142 (75,9) IVUS use 32 (17,1) OCT use 31 (16,6) GP-IIbIIIa inhibitors 112 (59,9) Pre-dilatation: Regular balloon Cutting balloon 173 (92,5) 86 (50,3) 87 (49,7) Mean pre-dilatation balloon diameter (mm) , mean  SD 2,92 ± 0,48 Mean pre-dilatation balloon length (mm) , mean  SD 15,80 ± 8,66 Mean scaffold length (mm) , mean  SD 20,10 ± 6,48 Mean scaffold diameter (mm) , mean  SD 3,17 ± 0,36 Post-dilatation Post-dilatation balloon diameter (mm) , mean  SD 3,46 ± 0,41 Post-dilatation balloon maximal atmospheres 17,11 ± 3,34 N=187 patients clinical characteristics: n (%) Males 147 (78,6) Mean age (years), mean  SD 56,74 ± 11,85 Arterial hypertension 151 (80,7) Dyslipidemia 129 (69,0) Diabetes mellitus 33 (17,6) Smoking 29 (15,5) Previous myocardial infarction 65 (34,8) Previous PCI 77 (41,2) CABG 5 (2,7) Previous cerebral infarction 10 (5,3) Peripheral artery disease 8 (4,3) Chronic kidney disease Chronic heart failure 73 (39,0) Asymptomatic 4 (2,1) Stable angina 148 (79,1) Unstable angina 11 (5,9) NSTEMI 6 (3,2) STEMI 18 (9,6) N=187 patients angiographic data: n (%) Multi-vessel disease 115 (61,5) Target lesion vessel: Left main (LM) Left anterior descending (LAD) Left circumflex (LCX) Right coronary artery (RCA) First diagonal brunch (D1) Marginal brunch (OM) Ramus intermedius (RIM) 2 (1,1) 93 (49,7) 27 (14,4) 47 (25,1) 6 (3,2) 7 (3,8) 4 (2,1) Target lesion localization: Ostial Proximal Middle Distal 34 (18,2) 123 (65,8) 113 (60,4) 24 (12,8) True bifurcation lesion 28 (14,9) Table 4. Clinical and angiographic major adverse cardiac events (MACE) at two year follow up Conclusions Bioresorbable scaffolds showed acceptable rates of target lesion revascularization and scaffold thrombosis at mid-term follow-up in stable angina and acute coronary syndrome patients. Clinical, lesion and procedural factors did not show significant difference between patients with and without target lesion failure References: Funding: This study was supported in part by Latvian National Research Program "Biomedicine for Public Health" (BIOMEDICINE) and by grant from corporation „Sistemu Inovacijas” Ieva Briede ieva.briede@gmail.com 1 Capodanno D., et al. Eurointervention. 2015; 10(10):1144-53. 2 Onuma Y, Serruys PW. Circulation. 2011;123:779-97.