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Italian Multicenter Registry of Bare Metal Stent Use in Modern Percutaneous Coronary Intervention Era (AMARCORD): A multicenter observational study
Author(s) -
Giannini Francesco,
Pagnesi Matteo,
Campo Gianluca,
Donahue Michael,
Ferri Luca A.,
Briguori Carlo,
Stefanini Giulio G.,
Scardala Raffaele,
Sardella Gennaro,
De Rosa Salvatore,
Figini Filippo,
Monello Alberto,
Pastormerlo Luigi E.,
Testa Luca,
Nicolino Annamaria,
Ielasi Alfonso,
Durante Alessandro,
Leone Angelo,
Tzanis Giorgios,
Mangieri Antonio,
Ciccarelli Giovanni,
Briani Martina,
Reimers Bernhard,
Ceccacci Andrea,
Indolfi Ciro,
Sheiban Imad,
Palmieri Cataldo,
Bedogni Francesco,
Tespili Maurizio,
Latib Azeem,
Gallo Francesco,
Colombo Antonio
Publication year - 2021
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.28798
Subject(s) - medicine , percutaneous coronary intervention , mace , conventional pci , timi , myocardial infarction , cardiology , thrombolysis , stent , acute coronary syndrome
Objectives We aimed to evaluate the use of bare metal stent (BMS) implantation in current percutaneous coronary intervention (PCI) era, focusing on indications for use and clinical outcomes. Background Limited data on BMS usage in current clinical practice are available. Methods All patients who underwent PCI with at least one BMS implantation in 18 Italian centers from January 1, 2013 to December 31, 2017, were included in our registry. Rates of BMS use and reasons for BMS implantations were reported for the overall study period and for each year. Primary outcomes were mortality, bleeding (Bleeding Academic Research Consortium—BARC and Thrombolysis in Myocardial Infarction—TIMI non‐CABG definitions), and major adverse cardiac events (MACE) defined as the composite of all‐cause and cardiac death, any myocardial infarction, target vessel revascularization, or any stent thrombosis. Results Among 58,879 patients undergoing PCI in the study period, 2,117 (3.6%) patients (mean age 73 years, 69.7% males, 73.3% acute coronary syndrome) were treated with BMS implantation (2,353 treated lesions). The rate of BMS implantation progressively decreased from 10.1% (2013) to 0.3% (2017). Main reasons for BMS implantation were: ST‐elevation myocardial infarction (STEMI) (23.1%), advanced age (24.4%), and physician's perception of high‐bleeding risk (34.0%). At a mean follow‐up of 2.2 ± 1.5 years, all‐cause and cardiac mortality were 25.6 and 12.7%, respectively; MACE rate was 35.3%, any bleeding rate was 13.0% (BARC 3–5 bleeding 6.3%, TIMI non‐CABG major bleeding 6.1%). Conclusion In a large, contemporary, real‐world, multicenter registry, BMS use progressively reduced over the last 5 years. Main reasons for BMS implantation were STEMI, advanced age, and physician's perception of high‐bleeding risk. High rates of mortality and MACE were observed in this real‐world high‐risk population.