Tags

Type your tag names separated by a space and hit enter

Percutaneous coronary intervention using a full metal jacket with drug-eluting stents: major adverse cardiac events at one year.
Arq Bras Cardiol. 2013 Aug; 101(2):117-26.AB

Abstract

BACKGROUND

The clinical benefit of percutaneous coronary intervention (PCI) for long coronary lesions is unclear; furthermore, concerns have been raised about its safety.

OBJECTIVES

To evaluate the predictors of major adverse cardiac events (MACE) associated with PCI using a full metal jacket (FMJ), defined as overlapping drug-eluting stents (DES) measuring >60 mm in length, for very long lesions.

METHODS

We enrolled 136 consecutive patients with long coronary lesions requiring FMJ in our single-center registry. The primary endpoint included the combined occurrence of all-cause death, myocardial infarction (MI), and target vessel revascularization (TVR). Demographic, clinical, angiographic, and procedural variables were evaluated using stepwise Cox regression analysis to determine independent predictors of outcome.

RESULTS

The mean length of stent per lesion was 73.2 ± 12.3 mm and the mean reference vessel diameter was 2.9 ± 0.6 mm. Angiographic success was 96.3%. Freedom from MACE was 94.9% at 30 days and 85.3% at one year. At the one-year follow-up, the all-cause mortality rate was 3.7% (1.5% cardiac deaths), the MI rate was 3.7%, and the incidence of definite or probable stent thrombosis (ST) was 2.9%. Female gender [hazard ratio (HR), 4.40; 95% confidence interval (CI), 1.81-10.66; p = 0.001) and non-right coronary artery PCI (HR, 3.49; 95%CI, 1.42-8.59; p = 0,006) were independent predictors of MACE at one year. Freedom from adverse events at one year was higher in patients with stable angina who underwent PCI (HR, 0.33; 95%CI, 0.13-0.80; p = 0.014).

CONCLUSIONS

PCI using FMJ with DES for very long lesions was efficacious but associated with a high rate of ST at the one-year follow-up. However, the rate of cardiac mortality, nonprocedure-related MI, and MACE was relatively low. Target coronary vessel PCI, clinical presentation, and female gender are new contemporary clinical factors that appear to have adverse effects on the outcome of PCI using FMJ for long lesions.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng por

PubMed ID

23821408

Citation

Calé, Rita, et al. "Percutaneous Coronary Intervention Using a Full Metal Jacket With Drug-eluting Stents: Major Adverse Cardiac Events at One Year." Arquivos Brasileiros De Cardiologia, vol. 101, no. 2, 2013, pp. 117-26.
Calé R, Teles RC, Almeida M, et al. Percutaneous coronary intervention using a full metal jacket with drug-eluting stents: major adverse cardiac events at one year. Arq Bras Cardiol. 2013;101(2):117-26.
Calé, R., Teles, R. C., Almeida, M., Rosário, I. d., Sousa, P. J., Brito, J., Raposo, L., Gonçalves, P. d. e. . A., Gabriel, H. M., & Mendes, M. (2013). Percutaneous coronary intervention using a full metal jacket with drug-eluting stents: major adverse cardiac events at one year. Arquivos Brasileiros De Cardiologia, 101(2), 117-26. https://doi.org/10.5935/abc.20130139
Calé R, et al. Percutaneous Coronary Intervention Using a Full Metal Jacket With Drug-eluting Stents: Major Adverse Cardiac Events at One Year. Arq Bras Cardiol. 2013;101(2):117-26. PubMed PMID: 23821408.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous coronary intervention using a full metal jacket with drug-eluting stents: major adverse cardiac events at one year. AU - Calé,Rita, AU - Teles,Rui Campante, AU - Almeida,Manuel, AU - Rosário,Ingrid do, AU - Sousa,Pedro Jerónimo, AU - Brito,João, AU - Raposo,Luís, AU - Gonçalves,Pedro de Araújo, AU - Gabriel,Henrique Mesquita, AU - Mendes,Miguel, Y1 - 2013/07/02/ PY - 2012/11/03/received PY - 2013/12/14/accepted PY - 2013/7/4/entrez PY - 2013/7/4/pubmed PY - 2014/3/15/medline SP - 117 EP - 26 JF - Arquivos brasileiros de cardiologia JO - Arq. Bras. Cardiol. VL - 101 IS - 2 N2 - BACKGROUND: The clinical benefit of percutaneous coronary intervention (PCI) for long coronary lesions is unclear; furthermore, concerns have been raised about its safety. OBJECTIVES: To evaluate the predictors of major adverse cardiac events (MACE) associated with PCI using a full metal jacket (FMJ), defined as overlapping drug-eluting stents (DES) measuring >60 mm in length, for very long lesions. METHODS: We enrolled 136 consecutive patients with long coronary lesions requiring FMJ in our single-center registry. The primary endpoint included the combined occurrence of all-cause death, myocardial infarction (MI), and target vessel revascularization (TVR). Demographic, clinical, angiographic, and procedural variables were evaluated using stepwise Cox regression analysis to determine independent predictors of outcome. RESULTS: The mean length of stent per lesion was 73.2 ± 12.3 mm and the mean reference vessel diameter was 2.9 ± 0.6 mm. Angiographic success was 96.3%. Freedom from MACE was 94.9% at 30 days and 85.3% at one year. At the one-year follow-up, the all-cause mortality rate was 3.7% (1.5% cardiac deaths), the MI rate was 3.7%, and the incidence of definite or probable stent thrombosis (ST) was 2.9%. Female gender [hazard ratio (HR), 4.40; 95% confidence interval (CI), 1.81-10.66; p = 0.001) and non-right coronary artery PCI (HR, 3.49; 95%CI, 1.42-8.59; p = 0,006) were independent predictors of MACE at one year. Freedom from adverse events at one year was higher in patients with stable angina who underwent PCI (HR, 0.33; 95%CI, 0.13-0.80; p = 0.014). CONCLUSIONS: PCI using FMJ with DES for very long lesions was efficacious but associated with a high rate of ST at the one-year follow-up. However, the rate of cardiac mortality, nonprocedure-related MI, and MACE was relatively low. Target coronary vessel PCI, clinical presentation, and female gender are new contemporary clinical factors that appear to have adverse effects on the outcome of PCI using FMJ for long lesions. SN - 1678-4170 UR - https://www.unboundmedicine.com/medline/citation/23821408/Percutaneous_coronary_intervention_using_a_full_metal_jacket_with_drug_eluting_stents:_major_adverse_cardiac_events_at_one_year_ L2 - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2013005000046&lng=en&nrm=iso&tlng=en DB - PRIME DP - Unbound Medicine ER -