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Pompei G, Campo G, Ruggiero R, Maffeo D, Sgura F, Arrotti S, Preti G, Iannaccone M, Erriquez A, Biscaglia S, Sganzerla P, Capecchi A, Pignatelli G, Dall'Ara G, Saia F, Tomassini F, Rolfo C, Varbella F, Cerrato E. Long-term outcomes of patients treated with sirolimus-eluting resorbable magnesium scaffolds: Insights from the SHERPA-MAGIC study. Int J Cardiol 2023:S0167-5273(23)00575-2. [PMID: 37085121 DOI: 10.1016/j.ijcard.2023.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/07/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND The resorbable magnesium scaffold (RMS) is a second-generation bioresorbable scaffold (BRS) that has shown conflicting results in previous studies. These findings suggest that patient selection and implantation technique may have an impact on clinical outcomes. This study aimed to investigate the safety and long-term effectiveness of RMS in a narrowly selected population. METHODS SHERPA-MAGIC is an investigator-driven, multicenter, prospective, single-arm study that enrolled patients undergoing BRS coronary implantation in 18 Italian centers. The present analysis considered the first 543 enrolled patients treated with RMS, with a minimum follow-up of 1 year. The study protocol included strict criteria for patient selection and standardization of RMS implantation. The primary outcome was the occurrence of the vessel-oriented composite endpoints (VOCE), including cardiac death, target vessel myocardial infarction, and ischemia-driven target vessel revascularization. RESULTS Overall, 635 vessels were treated. The 1-year cumulative occurrence of VOCE was 22 (3.5%, 95% CI 2.2%-5.2%), which was significantly lower than the prespecified estimation (from 5.5% to 8.5%). At the median follow-up of 3.5 [2.6-4.3] years, there were 3 (0.5%) cardiac deaths, 12 (1.9%) target vessel myocardial infarctions, and 33 (5.2%) ischemia-driven target vessel revascularizations. A total of 37 (5.8%, 95%CI 4.1%-7.9%) VOCEs were detected. Scaffold thrombosis occurred in 4 (0.6%, 95%CI 0.1%-1.6%) cases. Patient-level analysis confirmed the findings of the vessel-level analysis. CONCLUSIONS These results confirm the safety and performance of RMS technology. If confirmed in randomized controlled trials, they may rekindle interest in the use of scaffolds in daily practice.
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Affiliation(s)
- Graziella Pompei
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy.
| | | | - Diego Maffeo
- Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero Brescia, Brescia, Italy
| | - Fabio Sgura
- Cardiology Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Salvatore Arrotti
- Cardiology Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Gerlando Preti
- Interventional Cardiology Unit, AULSS2 Marca Trevigiana, Ospedale di Conegliano, Conegliano, Italy
| | - Mario Iannaccone
- Cardiology Unit, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Andrea Erriquez
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy
| | - Simone Biscaglia
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy
| | - Paolo Sganzerla
- Interventional Cardiology Unit, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano, Italy
| | | | | | | | - Francesco Saia
- Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Tomassini
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, Rivoli Infermi Hospital ASLTO3, Rivoli, Turin, Italy
| | - Cristina Rolfo
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, Rivoli Infermi Hospital ASLTO3, Rivoli, Turin, Italy
| | - Ferdinando Varbella
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, Rivoli Infermi Hospital ASLTO3, Rivoli, Turin, Italy
| | - Enrico Cerrato
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, Rivoli Infermi Hospital ASLTO3, Rivoli, Turin, Italy
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Cerrato E, Mejía-Rentería H, Franzè A, Quadri G, Belliggiano D, Biscaglia S, Lo Savio L, Spataro F, Erriquez A, Giacobbe F, Vergara-Uzcategui C, di Girolamo D, Tebaldi M, Varbella F, Campo G, Escaned J. Quantitative flow ratio as a new tool for angiography-based physiological evaluation of coronary artery disease: a review. Future Cardiol 2021; 17:1435-1452. [PMID: 33739146 DOI: 10.2217/fca-2020-0199] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The functional evaluation of coronary stenoses has obtained important clinical results in recent years, resulting in strong guideline recommendations. Nonetheless, the use of coronary wire-based functional evaluation has not yet become part of the routine in catheterization laboratories for several reasons, including the need to advance a wire into the coronary vessel to interrogate the stenosis. Angiography-derived indexes have been introduced to expand the current use of physiology to estimate the functional meaning of a stenosis on the basis of angiographic data only. The most studied and validated angiography-derived index is certainly the quantitative flow ratio. This article will summarize the basics of the quantitative flow ratio, the related validation studies and its current and future applications.
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Affiliation(s)
- Enrico Cerrato
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano & Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Hernan Mejía-Rentería
- Department of Cardiology, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos & Universidad Complutense de Madrid, Madrid, Spain
| | - Alfonso Franzè
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano & Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Giorgio Quadri
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano & Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Davide Belliggiano
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano & Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Simone Biscaglia
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy.,Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy
| | - Luca Lo Savio
- Interventional Cardiology Unit, Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Fabio Spataro
- Interventional Cardiology Unit, Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Andrea Erriquez
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy.,Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy
| | - Federico Giacobbe
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano & Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Carlos Vergara-Uzcategui
- Department of Cardiology, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos & Universidad Complutense de Madrid, Madrid, Spain
| | | | - Matteo Tebaldi
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy.,Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy
| | - Ferdinando Varbella
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano & Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy.,Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy
| | - Javier Escaned
- Department of Cardiology, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos & Universidad Complutense de Madrid, Madrid, Spain
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