Premium
Twelve‐month outcomes of patients unsuitable for prolonged DAPT presenting with an acute coronary syndrome and treated with polymer‐free biolimus A9 drug‐coated stents
Author(s) -
Kinnaird Tim,
Abdul Fairoz,
Hailan Ahmed,
Sheikh Azeem,
Hinton Jonathan,
Yazji Khaled,
Elangovan Senthil,
Yousef Adnan,
Gallagher Sean,
Choudhury Anirban,
Anderson Richard,
O'Kane Peter,
Smith David
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27722
Subject(s) - medicine , acute coronary syndrome , drug , surgery , cardiology , myocardial infarction , pharmacology
Prolonged dual anti‐platelet therapy (DAPT) is undesirable in certain patients. The biolimus‐A9 drug‐coated stent (BA9‐DCS) has a rapid drug‐elution profile allowing shortened DAPT. Methods The demographics, procedural data, and clinical outcomes for 505 patients presenting with an ACS to three UK centres and treated with a BA9‐DCS stent (PCI‐DCS) were collected, and compared to a consecutive ACS cohort of unselected patients treated in the same period with drug‐eluting stents (PCI‐DES). Results PCI‐DCS patients were older, more often female with hypertension, chronic kidney disease, severe LV dysfunction, and peripheral vascular disease more frequent than the PCI‐DES cohort. PCI‐DCS patients had a much higher Mehran bleed risk score (21.5 ± 7.7 vs. 15.9 ± 7.7, P < 0.0001). Baseline disease burden was greater in the PCI‐DCS cohort with more left main and three vessel disease. During PCI, more stents (1.91 ± 1.1 vs. 1.57 ± 0.94, P < 0.0001), total stent length (38.2 ± 20.8 vs. 31.4 ± 20.3, P < 0.0001) and longer stents (38.2 ± 20.8 vs. 31.4 ± 20.3 mm, P < 0.0001) were used in the PCI‐DCS cohort with rotational atherectomy also used more frequently. Physician‐recommended DAPT duration was 2.9 ± 3.9 months for PCI‐DCS patients and 11.3 ± 2.4 months for PCI‐DES patients ( P < 0.0001). At 12‐month follow‐up, definite stent thrombosis (0.6% vs. 1.1%) and TLR (3.2% vs. 2.7%) rates were similar between the two groups. After adjustment for baseline differences, there were no statistically significant differences in death and combined MACE rates at 12 months. Conclusions The outcomes of patients treated with polymer‐free BA9 drug‐coated stent who present with an ACS and who were deemed unsuitable for prolonged DAPT are encouraging. Further studies are warranted.