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EFFICACY AND SAFETY OF PATIENTS TREATED WITH 48MM EVEROLIMUS ELUTING STENT AT 1 YEAR
1254 JACC March 21, 2017 Volume 69, Issue 11
Interventional Cardiology EFFICACY AND SAFETY OF PATIENTS TREATED WITH 48MM EVEROLIMUS ELUTING STENT AT 1 YEAR Poster Contributions Poster Hall, Hall C Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m. Session Title: Coronary Intervention: Drug Eluting Stent & Scaffolds Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices Presentation Number: 1240-136 Authors: Chong Keat Tan, Mohd Kamal Mohd Arshad, Hee Hwa Ho, Fahim H. Jafary, Jason K. K. Loh, Timothy Watson, Paul J. L. Ong, Tan Tock Seng Hospital, Singapore, Singapore
Background: Implanting a single long stent avoids stent overlap, geographical miss and allows possible cost savings. Our study reviewed procedural safety and clinical outcome at 1 year of patients with long coronary lesions (Type C) treated with 48mm Xience Xpedition everolimus drug eluting stent (EES). Methods: Patients with 48mm EES implanted during coronary angioplasty between 2013 to 2015 were followed up for 1 year. Major adverse cardiac events (MACE) includes cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and stent thrombosis (ST). All patients were given 1 year of dual antiplatelet therapy.
Results: 80 EES were implanted in 76 patients (58 males, mean age 59 years). 29 (38%) patients had diabetes mellitus, 43 (57%) hypertension, 42 (55%) hyperlipidaemia and 37 (49%) smokers. Indication was ST elevation MI in 19 (25%) patients, non-ST elevation MI in 23 (30%), unstable angina in 8 (11%) and stable angina in 26 (34%). Mean stent diameter was 2.96 +0.30 mm. Mean number of non-compliant balloon for post-dilatation was 1.4. In hospital MACE was 1.32% with 1 stent thrombosis on day 2 requiring TLR. At 1 year, MACE rate was 3 (3.95%) with 2 cardiac deaths (2.63%), 1 MI (1.32%) and 2 ST (2.63%). Conclusions: Our study showed that the 48mm EES appeared safe and effective at 1 year with low clinical events in this cohort of high risk patients. Characteristic
All patients
N Age Male Cardiovascular risk factors Diabetes mellitus Hypertension Hyperlipidaemia Smoking history End Stage Renal Failure Prior Myocardial Infarction Prior Percutaneous Coronary Intervention Prior Coronary Artery Bypass Graft Prior Stroke Presentation ST-segment Elevation MI Non-ST-segment MI Unstable angina Angina/Positive stress test/staged PCI Ejection Fraction (%) Creatinine (mg/dL) Creatinine Clearance Target lesions Left main into Left Anterior Descending Artery
76 59 +/- 9.39 58 (76%)
Left Anterior Descending Artery Left Circumflex Artery Right Coronary Artery ACC/AHA lesion characteristics Tortuosity Ostial Bifurcation Angulation Moderate >45 o, <90 o Extreme >90o Calcification Little or absent Moderate to heavy Outcome measure In hospital outcome Major Adverse Cardiovascular Events Cardiac death Myocardial Infarction Target Lesion Revascularization Possible / probable stent thrombosis 1 year outcome Major Adverse Cardiovascular Events Cardiac death Myocardial Infarction Target Lesion Revascularization Possible / probable stent thrombosis
Delivery success? Yes 74
No 2
N=78
N=2
29 (38%) 43 (57%) 42 (55%) 37 (49%) 3 (4%) 16 (21%) 15 (20%) 2 (3%) 3 (4%) 19 (25%) 23 (30%) 8 (11%) 26 (34%) 43 +/- 13.36 1.04 +/- 0.33 77 +/- 28.90 N= 80 1 (1.25%) 50 (62.5%) 8 (10%) 21 (26.25%) 1 (1.25%) 15 (18.75%) 34 (42.5%) 1 (1.25%) 0 79 (98.75%) 1 (1.25%) n=76 1 (1.32%) 0 0 1 (1.32%) 1 (1.32%) n=76 3 (3.95%) 2 (2.63%) 1 (1.32%) 1 (1.32%) 2 (2.63%)
Interventional Cardiology EFFICACY AND SAFETY OF PATIENTS TREATED WITH 48MM EVEROLIMUS ELUTING STENT AT 1 YEAR Poster Contributions Poster Hall, Hall C Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m. Session Title: Coronary Intervention: Drug Eluting Stent & Scaffolds Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices Presentation Number: 1240-136 Authors: Chong Keat Tan, Mohd Kamal Mohd Arshad, Hee Hwa Ho, Fahim H. Jafary, Jason K. K. Loh, Timothy Watson, Paul J. L. Ong, Tan Tock Seng Hospital, Singapore, Singapore
Background: Implanting a single long stent avoids stent overlap, geographical miss and allows possible cost savings. Our study reviewed procedural safety and clinical outcome at 1 year of patients with long coronary lesions (Type C) treated with 48mm Xience Xpedition everolimus drug eluting stent (EES). Methods: Patients with 48mm EES implanted during coronary angioplasty between 2013 to 2015 were followed up for 1 year. Major adverse cardiac events (MACE) includes cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and stent thrombosis (ST). All patients were given 1 year of dual antiplatelet therapy.
Results: 80 EES were implanted in 76 patients (58 males, mean age 59 years). 29 (38%) patients had diabetes mellitus, 43 (57%) hypertension, 42 (55%) hyperlipidaemia and 37 (49%) smokers. Indication was ST elevation MI in 19 (25%) patients, non-ST elevation MI in 23 (30%), unstable angina in 8 (11%) and stable angina in 26 (34%). Mean stent diameter was 2.96 +0.30 mm. Mean number of non-compliant balloon for post-dilatation was 1.4. In hospital MACE was 1.32% with 1 stent thrombosis on day 2 requiring TLR. At 1 year, MACE rate was 3 (3.95%) with 2 cardiac deaths (2.63%), 1 MI (1.32%) and 2 ST (2.63%). Conclusions: Our study showed that the 48mm EES appeared safe and effective at 1 year with low clinical events in this cohort of high risk patients. Characteristic
All patients
N Age Male Cardiovascular risk factors Diabetes mellitus Hypertension Hyperlipidaemia Smoking history End Stage Renal Failure Prior Myocardial Infarction Prior Percutaneous Coronary Intervention Prior Coronary Artery Bypass Graft Prior Stroke Presentation ST-segment Elevation MI Non-ST-segment MI Unstable angina Angina/Positive stress test/staged PCI Ejection Fraction (%) Creatinine (mg/dL) Creatinine Clearance Target lesions Left main into Left Anterior Descending Artery
76 59 +/- 9.39 58 (76%)
Left Anterior Descending Artery Left Circumflex Artery Right Coronary Artery ACC/AHA lesion characteristics Tortuosity Ostial Bifurcation Angulation Moderate >45 o, <90 o Extreme >90o Calcification Little or absent Moderate to heavy Outcome measure In hospital outcome Major Adverse Cardiovascular Events Cardiac death Myocardial Infarction Target Lesion Revascularization Possible / probable stent thrombosis 1 year outcome Major Adverse Cardiovascular Events Cardiac death Myocardial Infarction Target Lesion Revascularization Possible / probable stent thrombosis
Delivery success? Yes 74
No 2
N=78
N=2
29 (38%) 43 (57%) 42 (55%) 37 (49%) 3 (4%) 16 (21%) 15 (20%) 2 (3%) 3 (4%) 19 (25%) 23 (30%) 8 (11%) 26 (34%) 43 +/- 13.36 1.04 +/- 0.33 77 +/- 28.90 N= 80 1 (1.25%) 50 (62.5%) 8 (10%) 21 (26.25%) 1 (1.25%) 15 (18.75%) 34 (42.5%) 1 (1.25%) 0 79 (98.75%) 1 (1.25%) n=76 1 (1.32%) 0 0 1 (1.32%) 1 (1.32%) n=76 3 (3.95%) 2 (2.63%) 1 (1.32%) 1 (1.32%) 2 (2.63%)