Journal Article

Long‐term outcomes after stent implantation in very small vessel coronary artery disease

Cheng, Chin‐Chang, Liu, En‐Shao, Yang, Tse‐Hsuan, Tai, Ta‐Hsin, Chiang, Cheng‐Hung, Huang, Wei‐Chun, Mar, Guang‐Yuan, Kuo, Feng‐Yu

2023

Overview

Background Percutaneous coronary interventions (PCI) in very small vessel lesions represent an intriguing aspect of coronary artery disease (CAD). Uncertainty still exists in stent implantation in very small caliber vessels. This study aimed to evaluate the long‐term outcomes of patients treated with 2.0‐mm drug‐eluting stent (DES). Method This retrospective observational study included 134 patients undergoing PCI with 2.0‐mm zotarolimus DES from December 2016 to May 2020. The primary endpoint was major adverse cardiovascular events (MACE) at 2‐year follow‐up, which was composed of all‐cause mortality, target vessel myocardial infarction, and ischemia‐driven target lesion revascularization. Multiple logistic regression analysis was used to identify the independent predictors of MACE, and odds ratios (OR) and 95% confidence intervals (CI) were calculated. Result The lesions were diffuse (mean length 20.9 ± 5.51 mm) and belong to type B2/C lesions (90.3%). On follow‐up, the MACE rate was 20.1% and mostly driven by late lumen loss demanding revascularization (11.9%). In multivariable analysis, chronic kidney disease (CKD) (OR: 4.291, 95% CI: 1.574−11.704, p = 0.004) and calcified lesions (OR: 3.688, 95% CI: 1.311−10.371, p = 0.013) were the independent predictors of subsequent cardiovascular events, whereas statin was associated with better outcomes (OR: 0.335, 95% CI: 0.119−0.949, p = 0.040). Conclusion 2.0‐mm DES is a feasible option for treating very small vessel CAD in complex lesions. Patients with CKD and calcified lesions carry the hazard of worse outcomes, and careful consideration should be taken before stenting in this high‐risk population. Long‐term outcomes and associated factors of 2.0 mm drug‐eluting stent implantation in very small vessel coronary artery disease.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc
• Subject: Angina pectoris / Aspirin / Beta blockers / Calcification / Cardiovascular disease / chronic kidney disease / Clinical Investigations / Coronary Artery Disease - diagnosis / Coronary Artery Disease - surgery / Coronary vessels / Demographics / Diabetes / Drug-Eluting Stents / drug‐eluting stent / Heart attacks / Hemoglobin / Humans / Medical imaging / Patients / percutaneous Coronary intervention / Percutaneous Coronary Intervention - adverse effects / Population / Prosthesis Design / Renal Insufficiency, Chronic / Risk Factors / Stents / Treatment Outcome / Variables / Vein & artery diseases / very small vessel coronary artery disease