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Chandrasekhar J, Kalkman DN, Sartori S, Baber U, Blum M, Aquino MB, Woudstra P, Beijk MA, Tijssen JG, Koch KT, Dangas GD, Colombo A, de Winter RJ, Mehran R. One-year clinical outcomes in patients with chronic kidney disease treated with COMBO stents: From the COMBO collaboration. Catheter Cardiovasc Interv 2020; 98:1095-1101. [PMID: 32964556 DOI: 10.1002/ccd.29270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/28/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) patients undergoing percutaneous coronary intervention (PCI) experience greater ischemic events including clinically driven target lesion revascularization (CD-TLR). Whether the COMBO biodegradable-polymer sirolimus-eluting stent promotes better outcomes in these patients by virtue of endothelial progenitor cell capture technology is unknown. OBJECTIVE We examined one-year outcomes by CKD status from the COMBO collaboration. METHODS The COMBO collaboration was a patient-level pooled dataset from the REMEDEE and MASCOT registries (3,614 patients) of all-comers undergoing attempted COMBO stent PCI. The primary endpoint was one-year target lesion failure (TLF), composite of cardiac death, target-vessel myocardial infarction (TV-MI) or CD-TLR. Secondary endpoints included stent thrombosis (ST). RESULTS The study included 6.4% (n = 231) CKD and 93.6% (n = 3,361) non-CKD patients. CKD patients were older and included more women with greater prevalence of several comorbidities but similar rate of acute coronary syndrome (50.6% vs. 54.5%, p = .26). CKD patients underwent radial PCI less often (56.1% vs. 70.3%, p < .001) and received clopidogrel (78.6% vs. 68.3%) more often (p = .004). One-year TLF occurred in 7.9% CKD vs. 3.7% non-CKD patients, p = .001. CKD patients also demonstrated greater incidence of cardiac death (6.2% vs. 1.2%, p < .0001), TV-MI (2.7% vs. 1.1%, p = .04) but similar CD-TLR (2.7% vs 2.2%, p = .61) and definite/probable ST (1.4% vs. 0.8%, p = .42), compared to non-CKD patients. CONCLUSIONS CKD patients treated with COMBO stents had significantly greater incidence of one-year TLF compared to non-CKD patients driven by cardiac death and to a lesser extent TV-MI but not CD-TLR. They had similar rates of definite/probable ST.
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Affiliation(s)
- Jaya Chandrasekhar
- Icahn School of Medicine at Mount Sinai Hospital, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, USA
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Deborah N Kalkman
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Samantha Sartori
- Icahn School of Medicine at Mount Sinai Hospital, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, USA
| | - Usman Baber
- Icahn School of Medicine at Mount Sinai Hospital, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, USA
| | - Moritz Blum
- Icahn School of Medicine at Mount Sinai Hospital, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, USA
| | - Melissa B Aquino
- Icahn School of Medicine at Mount Sinai Hospital, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, USA
| | - Pier Woudstra
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Marcel A Beijk
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Jan G Tijssen
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Karel T Koch
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - George D Dangas
- Icahn School of Medicine at Mount Sinai Hospital, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, USA
| | - Antonio Colombo
- Department of cardiology, San Raffaele Hospital, Milan, Italy
| | - Robbert J de Winter
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai Hospital, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, USA
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