CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

INTERMACS Profiles and Outcomes Among Non–Inotrope-Dependent Outpatients With Heart Failure and Reduced Ejection Fraction The effect of complete percutaneous revascularisation with and without intravascular ultrasound guidance in the drugeluting stent era Impact of Lesion Preparation Strategies on Outcomes of Left Main PCI: The EXCEL Trial A new strategy for discontinuation of dual antiplatelet therapy: the RESET Trial (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation) Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenosis Dual-antiplatelet treatment beyond 1 year after drug-eluting stent implantation (ARCTIC-Interruption): a randomised trial Economic and Quality-of-Life Outcomes of Natriuretic Peptide–Guided Therapy for Heart Failure Sex differences in left main coronary artery stenting: Different characteristics but similar outcomes for women compared with men The Year in Cardiovascular Medicine 2020: Valvular Heart Disease: Discussing the Year in Cardiovascular Medicine for 2020 in the field of valvular heart disease is Professor Helmut Baumgartner and Dr Javier Bermejo. Mark Nicholls reports

Original Research2020 Jun 25;EIJ-D-20-00361.

JOURNAL:Eurointervention. Article Link

Impact of Coronary Lesion Complexity in Percutaneous Coronary Intervention: One-Year Outcomes From the Large, Multicentre e-Ultimaster Registry

MO Mohamed, J Polad, D Hildick-Smith et al. Keywords: complex PCI; outcome

ABSTRACT

AIMS -  The present study sought to examine the prevalence, clinical characteristics and one-year outcomes of patients undergoing percutaneous coronary intervention (PCI) to complex lesions (multivessel PCI, 3 stents, 3 lesions, bifurcation with 2 stents, total stent length >60 mm or chronic total occlusion [CTO]) in a prospective multicentre registry.

 

METHODS AND RESULTS -  Using the e-Ultimaster multicentre registry, a post hoc subgroup analysis was performed on 35,839 patients undergoing PCI, stratified by procedure complexity, and further by number and type of complex features. Overall, complex PCI patients (n=9,793, 27.3%) were older, more comorbid and were associated with an increased hazard ratio (HR) of the composite endpoint at one year (target lesion failure [TLF]: 1.41 [1.25; 1.59]), driven by an increased hazard of cardiac death (1.28 [1.05; 1.55]), target vessel myocardial infarction (1.48 [1.18; 1.86]) and clinically driven target lesion revascularisation. The hazard of complications increased with the rising number of complex features (3-6 vs 1-2 vs none) for all outcomes. All individual complex features were associated with an increased hazard of composite complications (except CTO) and definite/probable stent thrombosis.

 

CONCLUSIONS -  Overall, complex PCI is associated with an increased risk of mortality and complications at one year. The number and types of complex features have differing impacts on long-term outcomes.