Impact of coronary lesion complexity in percutaneous coronary intervention: 1-year outcomes from the large, multicenter e-ULTIMASTER registry

Abstract

Aims: The present study sought to examine the prevalence, clinical characteristics and 1-year outcomes of patients undergoing percutaneous coronary intervention (PCI) to complex lesions (multivessel PCI, =3 stents, =3 lesions, bifurcation with =2 stents, total stent length> 60mm or
chronic total occlusion (CTO)) in a prospective multicentre registry. Methods and Results: Using the e-Ultimaster multicentre registry, a post-hoc sub-group analysis was performed on 35,839 patients undergoing PCI, stratified by procedure complexity, and further by number and type of complex features. Overall, complex PCI patients (n=9,793,
27.3%) were older, more comorbid and were associated with an increased hazard ratio (HR) of composite endpoint at 1-year (target lesion failure (TLF): 1.41 [1.25; 1.59]), driven by increased hazard of cardiac death (1.28 [1.05; 1.55]), target vessel myocardial infarction (1.48 [1.18; 1.86]) and clinically driven target lesion revascularisation. The hazard of complications increased with rising number of complex features (3-6 vs. 1-2 vs. none) for all outcomes. All individual complex features were associated with an increased hazard of composite complications (except CTO) and definite/probable stent thrombosis. Conclusions: Overall, complex PCI is associated with an increased risk of mortality and complications at 1-year. The number and types of complex features have differing impacts on long-term outcomes.

Citation

Mamas. (2020). Impact of coronary lesion complexity in percutaneous coronary intervention: 1-year outcomes from the large, multicenter e-ULTIMASTER registry. https://doi.org/10.4244/EIJ-D-20-00361

• Acceptance Date: May 8, 2020
• Publication Date: Jun 25, 2020
• Journal: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
• Print ISSN: 1969-6213
• Pages: 603-612
• DOI: https://doi.org/10.4244/EIJ-D-20-00361
• Keywords: Newer generation drug-eluting stent, clinical trials, Ultimaster sirolimuseluting stent; complex PCI; coronary interventions
• Publisher URL: https://doi.org/10.4244/eij-d-20-00361