Impact of stent thickness on clinical outcomes in small vessel and bifurcation lesions: a RAIN-CARDIOGROUP VII sub-study
Luca Franchin
(1)
,
Francesco Piroli
(1)
,
Fabrizio D’ascenzo
(1)
,
Ivan Nuñez-Gil
(2)
,
Wojciech Wojakowski
(3)
,
Yoichi Imori
(4)
,
Daniela Trabattoni
(5)
,
Zenon Huczek
(6)
,
Giuseppe Venuti
(7, 8)
,
Saverio Muscoli
(9)
,
Andrea Montabone
(10)
,
Andrea Rognoni
(11)
,
Radoslaw Parma
(3)
,
Filippo Figini
(12)
,
Satoru Mitomo
(13)
,
Giorgio Quadri
(14, 15)
,
Wojciech Wańha
(3)
,
Bernardo Cortese
(16)
,
Ovidio de Filippo
(1)
,
Nicola Ryan
(2)
,
Ferdinando Varbella
(14, 15)
,
Imad Sheiban
(12)
,
Gerard Helft
(17)
,
Gaetano de Ferrari
(1)
1
UNITO -
Università degli studi di Torino = University of Turin
2 Clínico San Carlos University Hospital
3 SUM - Medical University of Silesia
4 Nippon Medical School [Tokyo, Japon]
5 Centro Cardiologico Monzino [Milano]
6 Medical University of Warsaw - Poland
7 AOU Policlinico Vittorio-Emanuele [Catania, Italia]
8 Unict - Università degli studi di Catania = University of Catania
9 Università degli Studi di Roma Tor Vergata [Roma, Italia] = University of Rome Tor Vergata [Rome, Italy] = Université de Rome Tor Vergata [Rome, Italie]
10 OSGB - Ospedale San Giovanni Bosco [Turin, Italy]
11 University Hospital “Maggiore della Carità” [Novara, Italy]
12 CP - Clinica Pederzoli [Peschiera del Garda, Italy]
13 IRCCS Ospedale San Raffaele [Milan, Italy]
14 OIR - Ospedale "Infermi" di Rimini [Rimini, Italy]
15 SLGUH - Azienda Ospedaliero-Universitaria San Luigi Gonzaga/San Luigi Gonzaga University Hospital
16 CSC - Clinica San Carlo [Milan, Italy]
17 Institut de cardiologie [CHU Pitié-Salpêtrière]
2 Clínico San Carlos University Hospital
3 SUM - Medical University of Silesia
4 Nippon Medical School [Tokyo, Japon]
5 Centro Cardiologico Monzino [Milano]
6 Medical University of Warsaw - Poland
7 AOU Policlinico Vittorio-Emanuele [Catania, Italia]
8 Unict - Università degli studi di Catania = University of Catania
9 Università degli Studi di Roma Tor Vergata [Roma, Italia] = University of Rome Tor Vergata [Rome, Italy] = Université de Rome Tor Vergata [Rome, Italie]
10 OSGB - Ospedale San Giovanni Bosco [Turin, Italy]
11 University Hospital “Maggiore della Carità” [Novara, Italy]
12 CP - Clinica Pederzoli [Peschiera del Garda, Italy]
13 IRCCS Ospedale San Raffaele [Milan, Italy]
14 OIR - Ospedale "Infermi" di Rimini [Rimini, Italy]
15 SLGUH - Azienda Ospedaliero-Universitaria San Luigi Gonzaga/San Luigi Gonzaga University Hospital
16 CSC - Clinica San Carlo [Milan, Italy]
17 Institut de cardiologie [CHU Pitié-Salpêtrière]
Résumé
Background: The clinical impact of stent strut thickness in coronary bifurcation lesions in small vessels has not been assessed in a real-world population.
Methods: All 506 patients enrolled in the RAIN study, undergoing PCI in a vessel with a diameter 2.5 mm or less were retrospectively evaluated and divided into two groups according to stent strut thickness: 74 μm (n = 206) versus 81 μm (n = 300); 87.1% of the lesions involved bifurcations. TLF [defined as a composite of myocardial infarction (MI) and target lesion revascularization (TLR)] was the primary endpoint, with MACE (a composite of death, MI and TLR), its components and stent thrombosis the secondary endpoint.
Results: After 16 (14-18) months, a lower incidence of TLF (4.3 vs. 9.8%, P = 0.026) and ST (1.0 vs. 3.0%, P = 0.042) was seen in the 74 μm group, whereas MACE occurred in 60 of 506 patients, with no statistical difference between the two groups (9.7 vs. 13.3%, P = 0.070). At multivariate analysis, chronic renal failure increased the risk of TLF while thinner strut was an independent protective factor (hazard ratio 0.51, CI 0.17-0.85, P = 0.005).
Conclusion: In this real-world population, patients being treated for small vessels lesions with thinner strut stents had lower rates of TLF, MI and ST.