mediate procedural outcome, incidence of target lesion failure (TLF, defined as ... nary artery lesions, chronic total occlusions, bifurcation lesions, stent ...
PCI: long-term outcome
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P4830 | BEDSIDE Italian biolimus eluting stent registry in all comers: in hospital and one year outcomes D. Regazzoli 1 , C. Godino 1 , C. Briguori 2 , D. Rutigliano 3 , L. Lucisano 4 , D. Zavalloni 5 , R. Fattori 6 , R. Sardella 4 , P. Presbitero 5 , A. Colombo 1 . 1 San Raffaele Hospital (IRCCS), Milan, Italy; 2 Clinica Mediterranea, Naples, Italy; 3 Santa Maria Hospital, Bari, Italy; 4 Umberto I Polyclinic of Rome, Rome, Italy; 5 Clinical Institute Humanitas IRCCS, Rozzano, Italy; 6 Ospedali Riuniti Marche Nord, Pesaro, Italy
Conclusions: In our study, the prevalence of conventional risk factors of CVD was higher in pts with higher NT-proBNP. Higher NT-proBNP was associated with adverse long term clinical outcomes up to 2 years. We suggest that elevated NTproBNP would have important and sensitive role in long term clinical outcomes following PCI.
P4828 | BEDSIDE Comparisons of the outcomes of the two drug eluting stents in small vessel: abluminal biolimus-eluting biodegradable polymer stent and zotarolimus-eluting permanent polymer stent Y.W. Yoon, J.H. Yoon, H.M. Chung, B.K. Hong, B.K. Lee, H.M. Kwon, E.Y. Choi. Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of Purpose: Biodegradable polymer drug-eluting stents (DES) offer potential for better prognosis in comparison with permanent polymer stents. However, benefits of biodegradable polymer DES has not been clarified as compared with permanent polymer stents in small vessel. The aim of this study was to compare efficacy and safety of abluminal biolimus-eluting biodegradable polymer stents and zotarolimus-eluting permanent polymer stents in small vessel coronary stenting. Methods: A total of 187 patients (116 men, 62.5±9.8 years) who needed small vessel stenting were prospectively randomized into abluminal biolimus-eluting biodegradable polymer stent group (Group I, n=90) or zotarolimus-eluting permanent polymer stent group (Group II, n=97). Clinical outcomes of one year were investigated in both groups and all patients underwent follow up coronary angiography (CAG). Results: There was no difference between abluminal biolimus-eluting biodegradable polymer stent group and zotarolimus –eluting permanent polymer stent group in demographic data and baseline QCA data. In follow up CAG data, late loss of group I tends to lower than that of group II, however there was no statistical significance (0.14±0.30 vs. 0.27±0.36, p=0.075). There was no in-stent restenosis and major adverse cardiac events (MACE) in both groups. Conclusions; The safety and efficacy of abluminal biolimus-eluting biodegradable polymer stent were not inferior to those of zotarolimus-eluting permanent polymer stent. Although there was no statistical significance between the two groups, late loss of abluminal biolimus-eluting biodegradable polymer stent tends to be lower than that of zotarolimus-eluting permanent polymer stent in patients with stent diameter of less than 2.75 mm.
P4829 | BENCH Ten years mortality in STEMI patients in the era of primary percutaneous coronary intervention P. Tousek 1 , J. Danova 2 , D. Mocova 1 , V. Kocka 1 , T. Budesinsky 1 , L. Lisa 1 , P. Widimsky 1 . 1 Charles University Prague, 3rd Faculty of Medicine, 3rd Clinical Dept of Internal Med.-Cardiology, Prague, Czech Republic; 2 3rd Faculty of Medicine, Epidemiology departement, Prague, Czech Republic Background: Primary percutaneous coronary intervention (pPCI) is the main reperfusion strategy in patients with acute myocardial infarction with ST elevation (STEMI) in EU during the last decade. Short- and mid-term mortality of those patients is well known. However, there is a lack of in formations about patient’s long -term prognosis. Goal: To analyze the long- term mortality and cause of death in patients after STEMI treated with pPCI. Methods and results: 950 consecutive patients (71% male gender, average age 63 + 12 years) treated with pPCI between January 2000 and December 2002 were included into the analysis. Patient’s status was obtained in cooperation with National institution for health and statistics by the end of the year 2012. There were 427 (45%) death during the follow-up, out of which 10% of death occurred up to 30 days after STEMI. There were no differences in prognosis between men and women (HR 0.909; p = 0.379). KILLIP classification at time of pPCI and age were the main independent predictors of the long-term mortality. The cardiovascular cause of death was identified in 70% of deceased patients followed by neoplasm in 15% patients. Conclusion: One third of patients following day 30 after STEMI treated with pPCI die in ten years. No sex difference in long-term mortality exists and the majority of death is caused by cardiovascular reasons.
Purpose: Drug-eluting stents constitute the current standard of care for the treatment of high-risk lesions. The prospective, multicenter NOBORI 2 trial has evaluated the performance of biolimus-A9 eluting stents (BES) in an unselected patient population. The trial suggests the good and sustained performance of this stent system in a real world scenario. Nevertheless, there is often discrepancy in terms of clinical event rates between randomized trials and everyday practice. Aim of this study is to evaluate clinical performance of BES in an unrestricted high-risk cohort of patients in seven major Italian cath labs. Methods: Unselected consecutive patients treated with BES were enrolled in an independent multicenter registry. Primary end-points of this registry were immediate procedural outcome, incidence of target lesion failure (TLF, defined as composite of cardiac death, myocardial infarction, and target lesion revascularization), ischemic-driven target lesion revascularization (TLR) and rate of definite stent thrombosis (ST) at 12-months follow-up. A subgroup analysis was also performed on off-label stent implantation (acute myocardial infarction, left main coronary artery lesions, chronic total occlusions, bifurcation lesions, stent restenosis, bypass graft lesions, left ventricle ejection fraction less than 35%, ostial lesions, diffuse disease longer than 30 mm). Results: Between February 2008 and July 2012, 1067 patients (82% male sex; mean age 66±11 years), for a total of 1590 lesions treated with BES were identified. Clinical follow-up was available in 90% of patient at 12 months, with a mean follow up of 16±9 months. In-hospital major adverse cardiovascular event (MACE) rate was 2.1%, mainly due to peri-procedural myocardial infarction (MI). At 12 months follow-up, TLF was 4.9%, with a cardiac mortality rate of 1.9%. Clinically driven TLR rate was 2.4%. Definite ST was observed in 10 patients (0.9%). In 781 lesions (49%) BES was used "off-label" (27% bifurcation lesions, 13% acute myocardial infarction, 11% chronic total occlusions, 7% left main lesions). In this high-risk population the incidence of in hospital MACE was 2.8%. At 12 months follow-up the TLF and clinically driven TLR rate were 7% and 2.9%, respectively. Eight case of definite ST occurred (1.6%). Conclusions: Extensive use of BES was associated with favorable procedural and 12-month outcomes despite the treatment of unselected high-risk patients and complex lesions. Furthermore, Biolimus eluting stent showed excellent safety and efficacy profile also in off-label indications, with a low rate of TVF, clinically driven TLR and ST.
P4831 | BEDSIDE Thrombosis, bleeding and DAPT non-adherence in the EDUCATE registry H. Dauerman 1 , R. Stoler 2 , D. Kereiakes 3 , L. Mauri 4 , D. Cutlip 5 on behalf of EDUCATE Study Group. 1 The University of Vermont, Burlington, United States of America; 2 Baylor University Medical Center, Dallas, United States of America; 3 The Christ Hospital, Heart and Vascular Center - Lindner Center for Research and Education, Cincinnati, United States of America; 4 Harvard Medical School, Brigham and Women’s Hospital, Boston, United States of America; 5 Beth Israel Deaconess Medical Center, Harvard Clinical Research Institute, Boston, United States of America Background: We determined predictors and outcomes of dual antiplatelet therapy (DAPT) non-adherence in the first year after Endeavor zotarolimus-eluting stent (E-ZES) placement in a broadly inclusive prospective multicenter registry. Methods: 2265 patients were evaluated after successful implantation of at least one E- ZES. At 12 months, event-free, compliant patients will be randomized to 12 vs 30 months of DAPT as part of the independent DAPT Study. Predictors of Any Non-Adherence (ANA) at 6 months and 1 year were analyzed by multivariable analysis; the association between ANA at 6 vs 12 months and thrombotic events was investigated. Results: Patients were 30% female, 34% diabetic, and 64% had stable coronary syndromes. Aspirin 81 mg qd and clopidogrel 75 qd was the most common DAPT. ANA occurred in 208 (9.6%) patients at 6 months and 378 patients (18.5%) at 1 year. Major bleeding (OR 9.48, p
