Abstract
Objectives: The aim of the present study was to assess the impact on clinical outcome of right coronary artery (RCA) ostial coverage with second-generation drug-eluting stents (DES).
Background: Treatment of the aorta-ostial (AO) region of the RCA with bare metal stents and first-generation DES has been associated with a higher risk of target-lesion revascularization (TLR).
Methods: Of the 1,391 patients of the prospective TWENTE trial, we identified 321 (23%) with single-vessel RCA treatment, who were categorized into stenting with AO stent coverage (AOC) versus stenting without AOC. The AO region was defined as 3 mm from the aortic orifice.ResultsThe 67 (20.9%) patients with AOC showed more severe lesion calcifications than the 254 patients without AOC (31.3% vs. 12.6%; P < 0.01). In the AOC group, there was a higher prevalence of hypercholesterolemia and family history of coronary disease (75.4% vs. 61.6%, and 68.7% vs. 53.5%, respectively; P = 0.03). During 2-year follow-up, patients in the AOC group had a higher incidence of TLR (7.5% vs. 1.6%; P = 0.02). Following adjustment for confounders, AOC independently predicted TLR with an adjusted hazard ratio of 4.1 (95% CI: 1.17–14.39; P = 0.03).
Conclusion: AO treatment of the RCA with second-generation DES is feasible, but our data suggest that stent coverage of the right AO segment remains a predictor of TLR.
| Original language | English |
|---|---|
| Pages (from-to) | 524-531 |
| Journal | Catheterization and cardiovascular interventions |
| Volume | 85 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 8 May 2015 |
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Keywords
- METIS-307075
- IR-93176
- Right coronary artery
- Aorta-ostial lesion
- Revascularization
- Ostium
- Drug-eluting stent(s)
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Clinical outcome of patients with implantation of second-generation drug-eluting stents in the right coronary ostium : Insights from 2-year follow-up of the TWENTE trial. / Lam, Ming Kai; Sen, Hanim; Tandjung, Kenneth; Löwik, Marije M.; Basalus, Mounir W.Z.; Mewes, Janne C.; Stoel, Martin G.; van Houwelingen, K. Gert; Linssen, Gerard C.M.; IJzerman, Maarten J.; Doggen, Carine J.M.; von Birgelen, Clemens.
In: Catheterization and cardiovascular interventions, Vol. 85, No. 4, 08.05.2015, p. 524-531.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Clinical outcome of patients with implantation of second-generation drug-eluting stents in the right coronary ostium
T2 - Insights from 2-year follow-up of the TWENTE trial
AU - Lam, Ming Kai
AU - Sen, Hanim
AU - Tandjung, Kenneth
AU - Löwik, Marije M.
AU - Basalus, Mounir W.Z.
AU - Mewes, Janne C.
AU - Stoel, Martin G.
AU - van Houwelingen, K. Gert
AU - Linssen, Gerard C.M.
AU - IJzerman, Maarten J.
AU - Doggen, Carine J.M.
AU - von Birgelen, Clemens
PY - 2015/5/8
Y1 - 2015/5/8
N2 - Objectives: The aim of the present study was to assess the impact on clinical outcome of right coronary artery (RCA) ostial coverage with second-generation drug-eluting stents (DES).Background: Treatment of the aorta-ostial (AO) region of the RCA with bare metal stents and first-generation DES has been associated with a higher risk of target-lesion revascularization (TLR).Methods: Of the 1,391 patients of the prospective TWENTE trial, we identified 321 (23%) with single-vessel RCA treatment, who were categorized into stenting with AO stent coverage (AOC) versus stenting without AOC. The AO region was defined as 3 mm from the aortic orifice.ResultsThe 67 (20.9%) patients with AOC showed more severe lesion calcifications than the 254 patients without AOC (31.3% vs. 12.6%; P < 0.01). In the AOC group, there was a higher prevalence of hypercholesterolemia and family history of coronary disease (75.4% vs. 61.6%, and 68.7% vs. 53.5%, respectively; P = 0.03). During 2-year follow-up, patients in the AOC group had a higher incidence of TLR (7.5% vs. 1.6%; P = 0.02). Following adjustment for confounders, AOC independently predicted TLR with an adjusted hazard ratio of 4.1 (95% CI: 1.17–14.39; P = 0.03).Conclusion: AO treatment of the RCA with second-generation DES is feasible, but our data suggest that stent coverage of the right AO segment remains a predictor of TLR.
AB - Objectives: The aim of the present study was to assess the impact on clinical outcome of right coronary artery (RCA) ostial coverage with second-generation drug-eluting stents (DES).Background: Treatment of the aorta-ostial (AO) region of the RCA with bare metal stents and first-generation DES has been associated with a higher risk of target-lesion revascularization (TLR).Methods: Of the 1,391 patients of the prospective TWENTE trial, we identified 321 (23%) with single-vessel RCA treatment, who were categorized into stenting with AO stent coverage (AOC) versus stenting without AOC. The AO region was defined as 3 mm from the aortic orifice.ResultsThe 67 (20.9%) patients with AOC showed more severe lesion calcifications than the 254 patients without AOC (31.3% vs. 12.6%; P < 0.01). In the AOC group, there was a higher prevalence of hypercholesterolemia and family history of coronary disease (75.4% vs. 61.6%, and 68.7% vs. 53.5%, respectively; P = 0.03). During 2-year follow-up, patients in the AOC group had a higher incidence of TLR (7.5% vs. 1.6%; P = 0.02). Following adjustment for confounders, AOC independently predicted TLR with an adjusted hazard ratio of 4.1 (95% CI: 1.17–14.39; P = 0.03).Conclusion: AO treatment of the RCA with second-generation DES is feasible, but our data suggest that stent coverage of the right AO segment remains a predictor of TLR.
KW - METIS-307075
KW - IR-93176
KW - Right coronary artery
KW - Aorta-ostial lesion
KW - Revascularization
KW - Ostium
KW - Drug-eluting stent(s)
U2 - 10.1002/ccd.25518
DO - 10.1002/ccd.25518
M3 - Article
VL - 85
SP - 524
EP - 531
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
SN - 1522-1946
IS - 4
ER -