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Chandrasekhar J, Baber U, Sartori S, Aquino MB, Hájek P, Atzev B, Hudec M, Kiam Ong T, Mates M, Borisov B, Warda HM, den Heijer P, Wojcik J, Iniguez A, Coufal Z, Khashaba A, Munawar M, Gerber RT, Yan BP, Tejedor P, Kala P, Bang Liew H, Lee M, Kalkman DN, Dangas GD, de Winter RJ, Colombo A, Mehran R. 1-Year COMBO stent outcomes stratified by the PARIS bleeding prediction score: From the MASCOT registry. IJC HEART & VASCULATURE 2020; 31:100605. [PMID: 32953969 PMCID: PMC7486438 DOI: 10.1016/j.ijcha.2020.100605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 01/12/2023]
Abstract
Background The COMBO stent is a biodegradable-polymer sirolimus-eluting stent with endothelial progenitor cell capture technology for faster endothelialization. Objective We analyzed COMBO stent outcomes in relation to bleeding risk using the PARIS bleeding score. Methods MASCOT was an international registry of all-comers undergoing attempted COMBO stent implantation. We stratified patients as low bleeding-risk (LBR) for PARIS score ≤ 3 and intermediate-to-high (IHBR) for score > 3 based on baseline age, body mass index, anemia, current smoking, chronic kidney disease and need for triple therapy. Primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, myocardial infarction (MI) not clearly attributed to a non-target vessel or clinically-driven target lesion revascularization (TLR). Bleeding was adjudicated using the Bleeding Academic Research Consortium (BARC) definition. Dual antiplatelet therapy (DAPT) cessation was independently adjudicated. Results The study included 56% (n = 1270) LBR and 44% (n = 1009) IHBR patients. Incidence of 1-year TLF was higher in IHBR patients (4.1% vs. 2.6%, p = 0.047) driven by cardiac death (1.7% vs. 0.7%, p = 0.029) with similar rates of MI (1.8% vs. 1.1%, p = 0.17), TLR (1.5% vs. 1.6%, p = 0.89) and definite/ probable stent thrombosis (1.2% vs. 0.6%, p = 0.16). Incidence of 1-year major BARC 3 or 5 bleeding was significantly higher in IHBR patients (2.3% vs. 0.9%, p = 0.0094), as was the incidence of DAPT cessation (29.3% vs. 22.8%, p < 0.01), driven by physician-guided discontinuation. Conclusions Patients with intermediate-to-high PARIS bleeding risk in the MASCOT registry experienced greater incidence of 1-year TLF, major bleeding and DAPT cessation than LBR patients, without significant differences in stent thrombosis.
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Affiliation(s)
- Jaya Chandrasekhar
- Icahn School of Medicine at Mount Sinai Hospital, New York, United States.,Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Usman Baber
- Icahn School of Medicine at Mount Sinai Hospital, New York, United States
| | - Samantha Sartori
- Icahn School of Medicine at Mount Sinai Hospital, New York, United States
| | - Melissa B Aquino
- Icahn School of Medicine at Mount Sinai Hospital, New York, United States
| | - Petr Hájek
- Motol University Hospital, Prague, Czech Republic
| | | | | | | | - Martin Mates
- Nemocnice na Homolce - Kardiologie, Prague, Czech Republic
| | | | - Hazem M Warda
- Alhyatt Cardiovascular Center and Tanta University Hospital, Egypt
| | | | - Jaroslaw Wojcik
- Hospital of Invasive Cardiology IKARDIA - Lublin/Nałęczów, Poland
| | | | - Zdeněk Coufal
- T. Bata Regional Hospital Zlin, Zlin, Czech Republic
| | | | | | | | - Bryan P Yan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | | | - Petr Kala
- University Hospital Brno, Brno, Czech Republic
| | | | - Michael Lee
- Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Deborah N Kalkman
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - George D Dangas
- Icahn School of Medicine at Mount Sinai Hospital, New York, United States
| | - Robbert J de Winter
- Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | | | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai Hospital, New York, United States
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Park TK, Lee JH, Song YB, Jeong JO, Hahn JY, Yang JH, Choi SH, Choi JH, Lee SH, Jeong MH, Kim HS, Oh JH, Yu CW, Rha SW, Jang Y, Yoon JH, Tahk SJ, Seung KB, Park JS, Gwon HC. Impact of non-compliant balloons on long-term clinical outcomes in coronary bifurcation lesions: results from the COBIS (COronary BIfurcation Stent) II registry. EUROINTERVENTION 2016; 12:456-64. [DOI: 10.4244/eijv12i4a79] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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