DES Strut Thickness and Clinical Outcomes After CTO Recanalization: Insights From LATAM CTO Registry

Cardiovasc Revasc Med. 2023 Aug:53:28-35. doi: 10.1016/j.carrev.2023.03.002. Epub 2023 Mar 7.

Abstract

Background: Ultra-thin strut drug-eluting stent (UTS-DES) may improve outcomes after percutaneous coronary intervention (PCI) but have received limited study in chronic total occlusion (CTO) PCI.

Aims: To compare of 1-year incidence of major adverse cardiac events (MACE) between patients who underwent CTO PCI with ultrathin (≤ 75 μm) versus thin (>75 μm) strut DES in the LATAM CTO registry.

Methods: Patients were considered for inclusion only if successful CTO PCI was performed and when only one type of stent strut thickness (ultrathin or thin) was used. A propensity score matching (PSM) was computed to produce similar groups in relation to clinical and procedural characteristics.

Results: Between January 2015 and January 2020, 2092 patients underwent CTO PCI, of whom 1466 were included in the present analysis (475 in the ultra-thin and 991 in the thin strut DES). In unadjusted analysis the UTS-DES group had lower rate of MACE (HR: 0.63 95 % CI 0.42 to 0.94, p = 0.04) and repeat revascularizations (HR: 0.50 95 % CI 0.31 to 0.81, p = 0.02) at 1-year follow-up. After adjustment for confounding factors in a Cox regression model there was no difference in 1-year incidence of MACE between groups (HR: 1.15 95 % CI 0.41 to 2.97, p = 0.85). On PSM of 686 patients (343 in each group) the 1-year incidence of MACE (HR 0.68 95 % CI 0.37-1.23; P = 0.22) and individual components of MACE did not differ between groups.

Conclusions: One-year clinical outcomes after CTO PCI were similar with ultrathin and thin strut DES.

Keywords: Chronic total occlusion (CTO); Major adverse cardiac events (MACE), ultrathin struts DES, thin struts DES; Percutaneous coronary intervention (PCI).

MeSH terms

  • Chronic Disease
  • Coronary Occlusion* / diagnostic imaging
  • Coronary Occlusion* / etiology
  • Coronary Occlusion* / therapy
  • Drug-Eluting Stents* / adverse effects
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Registries
  • Risk Factors
  • Treatment Outcome