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RESEARCH PRODUCT

Impact of overlapping on 1-year clinical outcomes in patients undergoing everolimus-eluting bioresorbable scaffolds implantation in routine clinical practice: Insights from the European multicenter GHOST-EU registry

Tommaso GoriHolger NefDavide CapodannoStelios PyxarasThomas MünzelSalvatore BrugalettaPiera CapranzanoJens WiebeGiuseppe CaramannoGiuseppe GiacchiCarlo Di MarioAzeem LatibToru NaganumaSalvatore GeraciAlessio MattesiniJulinda MehilliAleksander AraszkiewiczCorrado TamburinoAntonio ColomboMaciej LesiakManel SabatéChristoph NaberLuis Ortega-paz

subject

medicine.medical_specialtymedicine.medical_treatment030204 cardiovascular system & hematologyRevascularizationCoronary artery diseaseLesion03 medical and health sciences0302 clinical medicineInternal medicinemedicineClinical endpointRadiology Nuclear Medicine and imaging030212 general & internal medicineMyocardial infarctionEverolimusbusiness.industryfungiPercutaneous coronary interventionGeneral Medicinemedicine.diseaseThrombosisCardiologymedicine.symptomCardiology and Cardiovascular Medicinebusinessmedicine.drug

description

Background Overlapping implantation of bioresorbable scaffolds (BRSs) are frequent in long coronary lesions. Its impact on clinical outcomes is unknown. Objective: To compare the clinical outcomes of patients treated with overlapping BRS with those patients treated with no-overlap BRS. Methods: We analyzed the 1-year clinical outcomes of 1,477 patients treated with BRS in the GHOST-EU registry, according to the implantation of overlapping BRS. Primary endpoint was patient oriented composite endpoint (PoCE) of: all-cause death, any myocardial infarction (MI) and any repeated revascularization. Scaffold thrombosis, according to Academic Research Consortium definition, was also analyzed. Results: A total of 320 (21.7%) patients were treated with overlapping BRS (overlap group), whereas the remaining 1,157 (78.3%) received no-overlap BRS (no-overlap group). The overlap group had significantly higher frequency of male sex, diabetes mellitus, stable angina, B2/C lesion type, SYNTAX score ≥22, lesion length >34 mm, use of intracoronary imaging guidance, pre- and postdilatation. At 1-year, there were no differences in PoCE between the overlap versus no-overlap group (18.4% vs. 18.2%; HR 1.07, [0.80–1.44]; P = 0.636), even after adjustment (HR 1.05, [0.48–2.20]; P = 0.904). Scaffold thrombosis rate did not differ either at one-month (1.3% vs. 1.5%, P = 0.769) or at 1-year (1.9% vs. 2.1%, P = 0.823). Conclusions: In “Real-world” clinical practice, overlapping BRS does not appear to have an impact on clinical outcomes as compared to no-overlapping BRS. These preliminary data should be confirmed. © 2016 Wiley Periodicals, Inc.

https://doi.org/10.1002/ccd.26674