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 - Right coronary artery
KW - Aorta-ostial lesion
KW - Revascularization
KW - Ostium
KW - Drug-eluting stent(s)
KW - 2024 OA procedure
U2 - 10.1002/ccd.25518
DO - 10.1002/ccd.25518
M3 - Article
SN - 1522-1946
VL - 85
SP - 524
EP - 531
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 4
ER -
