Safety and efficacy of drug eluting stents in patients with spontaneous coronary artery dissection

Federico Conrotto, Fabrizio D'Ascenzo, Enrico Cerrato, Antonio Fernández-Ortiz, Nieves Gonzalo, Fernando Macaya, Corrado Tamburino, Marco Barbanti, Martijn van Lavieren, Jan J. Piek, Robert J. Applegate, Azeem Latib, Maria Teresa Spinnler, Raffaella Marzullo, Mario Iannaccone, Marco Pavani, Gabriele Crimi, Rossella Fattori, Alessandra Chinaglia, Patrizia PresbiteroFerdinando Varbella, Fiorenzo Gaita, Javier Escaned

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Aims Given the different pathogenesis, use of drug eluting stent (DES) in patients with Spontaneous Coronary Artery Dissection SCAD may delay the healing of the dissected vessel. Aim of our study was to compare the safety and the efficacy of DES vs. bare metal stent (BMS) in a cohort of patients who underwent stenting for SCAD. Methods and results Consecutive patients with SCAD between January 1995 and August 2014 were retrospectively identified in 12 centers and included. Major Adverse Cardiac Events (MACE) was the primary end point. A total of 238 SCAD patients were identified: of them 108 patients underwent PCI with DES or BMS. Overall 24 patients (22.2%) suffered an intra-procedural complication without any differences between the 2 groups. At median follow-up of 1201 days (Inter Quartile Range 541–2760), incidence of the primary endpoint showed a trend towards less events in the DES-treated patients (38.7% vs. 25.9% p = 0.14) mainly driven by the benefit of DES in terms of TVR (17.6% vs. 4%, p = 0.08), mortality (16.8% vs. 9.3%, p = 0.4), and MI rate (16% vs. 8.4%, p = 0.33). STEMI at presentation (HR 6.4, CI 95% 1.29–31.9, p = 0.02) but not kind of stent (HR 0.97, CI 95% 0.2–4.7, p = 0.9) emerged as independently related to prognosis at multivariable analysis. Conclusions In SCAD patients use of DES seems to be as safe as BMS with trend of better efficacy in the long term.

Original languageEnglish (US)
Pages (from-to)105-109
Number of pages5
JournalInternational Journal of Cardiology
Volume238
DOIs
StatePublished - Jul 1 2017
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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