Abstract | AIMS: METHODS AND RESULTS: This analysis included all ACS patients treated with PCI in the Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment (ISAR-REACT) 5 trial. Complex PCI was defined as at least one of: multi-vessel PCI, ≥3 stents implanted, ≥3 lesions treated, and total stented length >60 mm. The primary endpoint was the composite of all-cause death, myocardial infarction (MI), or stroke at 12 months; the safety endpoint was Bleeding Academic Research Consortium types 3-5 bleeding at 12 months. Overall, 3377 patients were included in this analysis (complex PCI, n = 1429; non-complex PCI, n = 1948). The primary endpoint occurred more frequently in the complex PCI group than the non-complex PCI group [10.1% vs. 7.2%, hazard ratio (HR): 1.44, 95% confidence interval (CI) (1.14-1.82), P = 0.002], driven primarily by a higher risk of MI [HR: 1.62, (1.17-2.26), P = 0.004]. The safety endpoint was not statistically different between patients undergoing complex vs. non-complex PCI, although it was numerically higher in the complex PCI group [6.7% vs. 5.3%, HR: 1.28, (0.97-1.70), P = 0.08]. CONCLUSIONS:
Acute coronary syndrome patients undergoing complex PCI have an increased incidence of ischaemic events compared with ACS patients undergoing non-complex PCI. CLINICAL TRIAL REGISTRATION:
|
Authors | J J Coughlan, Alp Aytekin, Gjin Ndrepepa, Stefanie Schüpke, Isabell Bernlochner, Katharina Mayer, Franz Josef Neumann, Maurizio Menichelli, Gert Richardt, Jochen Wöhrle, Erion Xhepa, Sebastian Kufner, Hendrik B Sager, Michael Joner, Tareq Ibrahim, Massimiliano Fusaro, Karl Ludwig Laugwitz, Heribert Schunkert, Adnan Kastrati, Salvatore Cassese |
Journal | European heart journal. Acute cardiovascular care
(Eur Heart J Acute Cardiovasc Care)
Vol. 10
Issue 10
Pg. 1117-1124
(Dec 18 2021)
ISSN: 2048-8734 [Electronic] England |
PMID | 34468709
(Publication Type: Journal Article, Randomized Controlled Trial)
|
Copyright | Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: [email protected]. |
Chemical References |
- Prasugrel Hydrochloride
- Ticagrelor
|
Topics |
- Acute Coronary Syndrome
(surgery)
- Humans
- Percutaneous Coronary Intervention
- Prasugrel Hydrochloride
- Prospective Studies
- Ticagrelor
|