Long-term Outcomes After Stent Implantation in Very Small Vessel Coronary Artery Disease

Overview

Journal Clin Cardiol

Specialty Cardiology & Vascular Diseases

Date 2023 Feb 24

PMID 36824027

Authors

En-Shao Liu

Tse-Hsuan Yang

Ta-Hsin Tai

Cheng-Hung Chiang

Chin-Chang Cheng

Wei-Chun Huang

Guang-Yuan Mar

Feng-Yu Kuo

Affiliations

Soon will be listed here.

Abstract

Background: Percutaneous coronary interventions (PCI) in very small vessel lesions represent an intriguing aspect of coronary artery disease (CAD). Uncertainty still exists in stent implantation in very small caliber vessels. This study aimed to evaluate the long-term outcomes of patients treated with 2.0-mm drug-eluting stent (DES).

Method: This retrospective observational study included 134 patients undergoing PCI with 2.0-mm zotarolimus DES from December 2016 to May 2020. The primary endpoint was major adverse cardiovascular events (MACE) at 2-year follow-up, which was composed of all-cause mortality, target vessel myocardial infarction, and ischemia-driven target lesion revascularization. Multiple logistic regression analysis was used to identify the independent predictors of MACE, and odds ratios (OR) and 95% confidence intervals (CI) were calculated.

Result: The lesions were diffuse (mean length 20.9 ± 5.51 mm) and belong to type B2/C lesions (90.3%). On follow-up, the MACE rate was 20.1% and mostly driven by late lumen loss demanding revascularization (11.9%). In multivariable analysis, chronic kidney disease (CKD) (OR: 4.291, 95% CI: 1.574-11.704, p = 0.004) and calcified lesions (OR: 3.688, 95% CI: 1.311-10.371, p = 0.013) were the independent predictors of subsequent cardiovascular events, whereas statin was associated with better outcomes (OR: 0.335, 95% CI: 0.119-0.949, p = 0.040).

Conclusion: 2.0-mm DES is a feasible option for treating very small vessel CAD in complex lesions. Patients with CKD and calcified lesions carry the hazard of worse outcomes, and careful consideration should be taken before stenting in this high-risk population.

Citing Articles

Long-term outcomes after stent implantation in very small vessel coronary artery disease.

Liu E, Yang T, Tai T, Chiang C, Cheng C, Huang W Clin Cardiol. 2023; 46(4):431-440.

PMID: 36824027 PMC: 10106663. DOI: 10.1002/clc.24000.

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