Outcomes and regional differences in practice in a worldwide coronary stent registry.
(2022) Heart (British Cardiac Society) — Vol. 108, n° 16, p. 1310-1318 (2022)
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Mamas, Mamas 
- Abstract
- The primary objective was to assess the performance of a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer in an all comer population. The secondary objective was to detail differences in contemporary percutaneous coronary intervention (PCI) practice worldwide. e-Ultimaster was an all-comer, prospective, global registry (NCT02188355) with independent event adjudication enrolling patients undergoing PCI with the study stent. The primary outcome measure was target lesion failure (TLF) at 1 year, defined as the composite of cardiac death, target vessel myocardial infarction and clinically driven target lesion revascularisation. Data were stratified according to 4 geographical regions. A total of 37 198 patients were enrolled (Europe 69.2%, Asia 17.8%, Africa/Middle East 6.6% and South America/Mexico 6.5%) and 1-year follow-up was available for 35 389 patients (95.1%). One-year TLF occurred in 3.2% of the patients, ranging from 2% (Africa/Middle East) to 4.1% (South America/Mexico). In patients with acute coronary syndrome, potent P2Y inhibitors were prescribed in 48% of patients at discharge, while at 1 year 72% were on any dual antiplatelet therapy. Lipid-lowering treatment was administered in 80.9% and 75.5% of patients at discharge and 1 year, respectively. Regional differences in the profile of the treated patients as well as in PCI practice were reported. In this investigation with worldwide representation, contemporary PCI using a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer was associated with low 1-year TLF across clinical presentations and continents. Suboptimal adherence to current recommendations around antiplatelet and lipid lowering treatments was detected.
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Citations
Cimci, M., Polad, J., Mamas, M., Iniguez-Romo, A., Chevalier, B., Abhaichand, R., Aminian, A., Roguin, A., Maluenda, G., Angioi, M., Cassel, G., Kuramitsu, S., Jacobs, L., Debrus, R., Malik, F., Hildick-Smith, D., Laanmets, P., & Roffi, M. (2022). Outcomes and regional differences in practice in a worldwide coronary stent registry. Heart (British Cardiac Society), 108(16), 1310-1318. https://doi.org/10.1136/heartjnl-2021-320116 (Original work published 2022)