Impact of Coronary Artery Tortuosity on Outcomes Following Stenting: A Pooled Analysis From 6 Trials.
In: JACC: Cardiovascular Interventions, Jg. 14 (2021-05-10), Heft 9, S. 1009-1018
Online
academicJournal
Zugriff:
The authors sought to determine whether coronary artery tortuosity negatively affects clinical outcomes after stent implantation. Coronary artery tortuosity is a common angiographic finding and has been associated with increased rates of early and late major adverse events after balloon angioplasty. Individual patient data from 6 prospective, randomized stent trials were pooled. Outcomes at 30 days and 5 years following percutaneous coronary intervention of a single coronary lesion were analyzed according to the presence or absence of moderate/severe vessel tortuosity, as determined by an angiographic core laboratory. The primary endpoint was target vessel failure (TVF) (composite of cardiac death, target vessel–related myocardial infarction [TV-MI], or ischemia-driven target vessel revascularization [ID-TVR]). A total of 6,951 patients were included, 729 of whom (10.5%) underwent percutaneous coronary intervention in vessels with moderate/severe tortuosity. At 30 days, TVF was more frequent in patients with versus without moderate/severe tortuosity (3.8% vs. 2.4%; hazard ratio [HR]: 1.64; 95% confidence interval [CI]: 1.09 to 2.46; p = 0.02), a difference driven by a higher rate of TV-MI. At 5 years, TVF remained increased in patients with moderate/severe tortuosity (p = 0.003), driven by higher rates of TV-MI (p = 0.003) and ID-TVR (p = 0.01). Definite stent thrombosis was also greater in patients with versus without moderate/severe tortuosity (1.9% vs. 1.0%; HR: 1.86; 95% CI: 1.02 to 3.39; p = 0.04). After adjustment for baseline covariates, moderate/severe vessel tortuosity was independently associated with TV-MI and ID-TVR at 5 years (p = 0.04 for both). Stent implantation in vessels with moderate/severe coronary artery tortuosity is associated with increased rates of TVF due to greater rates of TV-MI and ID-TVR. [Display omitted] [ABSTRACT FROM AUTHOR]
Copyright of JACC: Cardiovascular Interventions is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Impact of Coronary Artery Tortuosity on Outcomes Following Stenting: A Pooled Analysis From 6 Trials.
|
---|---|
Autor/in / Beteiligte Person: | Konigstein, Maayan ; Ben-Yehuda, Ori ; Redfors, Björn ; Mintz, Gary S. ; Madhavan, Mahesh V. ; Golomb, Mordechai ; McAndrew, Thomas ; Zhang, Zixuan ; Kandzari, David E. ; Hermiller, James B. ; Leon, Martin B. ; Stone, Gregg W. |
Link: | |
Zeitschrift: | JACC: Cardiovascular Interventions, Jg. 14 (2021-05-10), Heft 9, S. 1009-1018 |
Veröffentlichung: | 2021 |
Medientyp: | academicJournal |
ISSN: | 1936-8798 (print) |
DOI: | 10.1016/j.jcin.2020.12.027 |
Sonstiges: |
|