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Lookup NU author(s): Professor Azfar Zaman
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© 2021 Wiley Periodicals LLC.Objectives: To compare clinical outcomes in high bleeding risk (HBR) patients with and without complex percutaneous coronary intervention (PCI) treated with Resolute Onyx zotarolimus-eluting stents (ZES) after 1-month dual antiplatelet therapy (DAPT). Background: PCI with 1-month DAPT has been demonstrated to be safe in HBR patients treated with Resolute Onyx ZES. Whether these outcomes are consistent in patients with complex lesions is uncertain. Methods: Among HBR patients who were event-free 1 month after PCI with ZES and treated thereafter with single antiplatelet therapy (SAPT), the clinical outcomes between 1 month and 1 year were compared after complex PCI (3 vessels treated, ≥ 3 lesions treated, total stent length > 60 mm, bifurcation with ≥ 2 stents implanted, atherectomy, or left main, surgical bypass graft or chronic total occlusion PCI) versus noncomplex PCI. Propensity score adjustment was performed to adjust for baseline differences among complex and noncomplex patients. Results: Complex patients (N = 401, 26.6% of total) had a higher prevalence of hyperlipidemia, diabetes mellitus and previous myocardial infarction (MI). Between 1 month and 1 year, rates of MI (7.1% vs. 4.0%, p = 0.02) and cardiac death/MI (9.3% vs. 6.1%, p = 0.04) were higher among complex versus noncomplex patients, although stent thrombosis rates were similar. After adjustment for baseline characteristics, differences in outcomes were no longer significant between groups. Conclusions: Higher rates of ischemic outcomes in complex PCI patients were largely explained by baseline clinical differences, rather than lesion complexity, among HBR patients treated with 1-month DAPT following PCI with Resolute Onyx ZES.
Author(s): Kandzari DE, Kirtane AJ, Mehran R, Price MJ, Simon DI, Latib A, Kedhi E, Abizaid A, Worthley SG, Zaman A, Hudec M, Stoler R, Choi JW, Kanitkar M, Conradie A, Tam C-CF, Walton A, Gruberg L, Ando K, Lee LC, Lung T-H, Windecker S, Stone GW
Publication type: Article
Publication status: Published
Journal: Catheterization and Cardiovascular Interventions
Year: 2022
Volume: 99
Issue: 3
Pages: 583-592
Print publication date: 15/02/2022
Online publication date: 03/09/2021
Acceptance date: 23/08/2021
ISSN (print): 1522-1946
ISSN (electronic): 1522-726X
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1002/ccd.29939
DOI: 10.1002/ccd.29939
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