TY - JOUR
T1 - Safety and efficacy of drug eluting stents in patients with spontaneous coronary artery dissection
AU - Conrotto, Federico
AU - D'Ascenzo, Fabrizio
AU - Cerrato, Enrico
AU - Fernández-Ortiz, Antonio
AU - Gonzalo, Nieves
AU - Macaya, Fernando
AU - Tamburino, Corrado
AU - Barbanti, Marco
AU - van Lavieren, Martijn
AU - Piek, Jan J.
AU - Applegate, Robert J.
AU - Latib, Azeem
AU - Spinnler, Maria Teresa
AU - Marzullo, Raffaella
AU - Iannaccone, Mario
AU - Pavani, Marco
AU - Crimi, Gabriele
AU - Fattori, Rossella
AU - Chinaglia, Alessandra
AU - Presbitero, Patrizia
AU - Varbella, Ferdinando
AU - Gaita, Fiorenzo
AU - Escaned, Javier
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85015093526&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85015093526&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2017.03.027
DO - 10.1016/j.ijcard.2017.03.027
M3 - Article
C2 - 28318654
AN - SCOPUS:85015093526
SN - 0167-5273
VL - 238
SP - 105
EP - 109
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -