Abstract 17662: Drug Eluting Stents Better Than Bare Metal Stents After Rotational Atherectomy. A Propensity Score Adjusted Comparison in Revascularization, Mortality and MACE
Background: The impact of drug-eluting stents (DES) has never been assessed after rotational atherectomy (RA). We compared 1-year clinical outcome according to whether DES or bare metal stents (BMS) were implanted after RA.
Methods: Single centre registry including all consecutive cases of RA use. Clinical follow-up was obtained in all patients. A propensity score for being treated with DES was calculated using clinical, angiographic and procedural variables. Comparisons were adjusted on strata of the propensity score.
Results: After RA, 114 patients received BMS and 110 received DES. No significant difference was observed in clinical characteristics between groups. Two cases of coronary perforation occurred, 7 lesion failure, and 12 transient no-reflow. The use of GPIIb/IIIa inhibitors was similar in both groups, but compared with BMS, patients in the DES group had a longer duration of combination therapy with aspirin and clopidogrel. At 1 year, significantly lower rates of vessel revascularization (2% vs 12%, p=0.005), all-cause mortality (5% vs 14%, p=0.05) and MACE (10% vs 22%, p=0.02) were observed in the DES group vs BMS group. Adjustment on the strata of the propensity score did not significantly change these results (figure).
Conclusions: After RA, we observed a clear benefit in favour of DES implantation over BMS in terms of vessel revascularization, mortality and MACE rates. However, despite being propensity score adjusted, this comparison has limitations.
- © 2010 by American Heart Association, Inc.