Impact of post-procedural minimal stent area on 2-year clinical outcomes in the SYNTAX II trial

Yuki Katagiri; Giovanni Luigi De Maria; Norihiro Kogame; Ply Chichareon; Kuniaki Takahashi; Chun Chin Chang; Rodrigo Modolo; Simon Walsh; Manel Sabate; Justin Davies; Maciej Lesiak; Raul Moreno; Ignacio Cruz-Gonzalez; Nick E J West; Jan J Piek; Joanna J Wykrzykowska; Vasim Farooq; Javier Escaned; Adrian P Banning; Yoshinobu Onuma; Patrick W Serruys

doi:https://doi.org/10.1002/ccd.28105

Impact of post-procedural minimal stent area on 2-year clinical outcomes in the SYNTAX II trial

Yuki Katagiri, Giovanni Luigi De Maria, Norihiro Kogame, Ply Chichareon, Kuniaki Takahashi, Chun Chin Chang, Rodrigo Modolo, Simon Walsh, Manel Sabate, Justin Davies, Maciej Lesiak, Raul Moreno, Ignacio Cruz-Gonzalez, Nick E J West, Jan J Piek, Joanna J Wykrzykowska, Vasim Farooq, Javier Escaned, Adrian P Banning, Yoshinobu OnumaPatrick W Serruys

Research output: Contribution to journal › Article › Academic › peer-review

25 Citations (Scopus)

Abstract

OBJECTIVES: To investigate the impact of minimal stent area (MSA) evaluated by post-procedural intravascular ultrasound (IVUS) on clinical outcomes after contemporary PCI in patients with three-vessel disease (TVD).

BACKGROUND: The impact of post-procedural MSA on clinical outcomes has not yet been extensively studied in patients with TVD.

METHODS: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a state-of-the-art PCI strategy on clinical outcomes in patients with TVD (454 patients with 1,559 lesions). The relationships between post-procedural MSA and lesion-level outcomes at 2 years were investigated. Clinical events adjudicated per patient by clinical event committee were assessed per lesion. Lesion-oriented composite endpoint (LOCE) was defined as the composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target lesion revascularization.

RESULTS: Eight hundred and nineteen lesions with post-procedural MSA available in 367 patients were included in the analysis. The post-procedural MSA per lesion was divided into terciles (smallest tercile: ≤5.0 mm2 , intermediate tercile: 5.0-6.7 mm2 , and largest tercile: >6.7 mm2 ). LOCE was observed in 16/288 (5.6%), 15/265 (5.7%), and 8/266 (3.0%) (P = 0.266). Target lesion revascularization (TLR) was observed in 16/288(5.6%), 12/265 (4.5%), and 4/266 (1.5%) (P = 0.042). The multivariate analysis demonstrated that smaller post-procedural MSA, as well as creatinine clearance, history of previous stroke, chronic total occlusion, and lesion SYNTAX Score was an independent predictor of TLR.

CONCLUSIONS: In the SYNTAX II trial, larger post-procedural MSA was independently associated with the lower rate of TLR at 2 years.

Original language	English
Pages (from-to)	E225-E234
Journal	Catheterization and cardiovascular interventions
Volume	93
Issue number	4
DOIs	https://doi.org/10.1002/ccd.28105
Publication status	Published - 1 Mar 2019

Access to Document

https://doi.org/10.1002/ccd.28105

Cite this

Katagiri, Y., De Maria, G. L., Kogame, N., Chichareon, P., Takahashi, K., Chang, C. C., Modolo, R., Walsh, S., Sabate, M., Davies, J., Lesiak, M., Moreno, R., Cruz-Gonzalez, I., West, N. E. J., Piek, J. J., Wykrzykowska, J. J., Farooq, V., Escaned, J., Banning, A. P., ... Serruys, P. W. (2019). Impact of post-procedural minimal stent area on 2-year clinical outcomes in the SYNTAX II trial. Catheterization and cardiovascular interventions, 93(4), E225-E234. https://doi.org/10.1002/ccd.28105

@article{eec7bf0827ea48e1b14e84fa23ac3c3f,

title = "Impact of post-procedural minimal stent area on 2-year clinical outcomes in the SYNTAX II trial",

abstract = "OBJECTIVES: To investigate the impact of minimal stent area (MSA) evaluated by post-procedural intravascular ultrasound (IVUS) on clinical outcomes after contemporary PCI in patients with three-vessel disease (TVD).BACKGROUND: The impact of post-procedural MSA on clinical outcomes has not yet been extensively studied in patients with TVD.METHODS: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a state-of-the-art PCI strategy on clinical outcomes in patients with TVD (454 patients with 1,559 lesions). The relationships between post-procedural MSA and lesion-level outcomes at 2 years were investigated. Clinical events adjudicated per patient by clinical event committee were assessed per lesion. Lesion-oriented composite endpoint (LOCE) was defined as the composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target lesion revascularization.RESULTS: Eight hundred and nineteen lesions with post-procedural MSA available in 367 patients were included in the analysis. The post-procedural MSA per lesion was divided into terciles (smallest tercile: ≤5.0 mm2 , intermediate tercile: 5.0-6.7 mm2 , and largest tercile: >6.7 mm2 ). LOCE was observed in 16/288 (5.6%), 15/265 (5.7%), and 8/266 (3.0%) (P = 0.266). Target lesion revascularization (TLR) was observed in 16/288(5.6%), 12/265 (4.5%), and 4/266 (1.5%) (P = 0.042). The multivariate analysis demonstrated that smaller post-procedural MSA, as well as creatinine clearance, history of previous stroke, chronic total occlusion, and lesion SYNTAX Score was an independent predictor of TLR.CONCLUSIONS: In the SYNTAX II trial, larger post-procedural MSA was independently associated with the lower rate of TLR at 2 years.",

author = "Yuki Katagiri and {De Maria}, {Giovanni Luigi} and Norihiro Kogame and Ply Chichareon and Kuniaki Takahashi and Chang, {Chun Chin} and Rodrigo Modolo and Simon Walsh and Manel Sabate and Justin Davies and Maciej Lesiak and Raul Moreno and Ignacio Cruz-Gonzalez and West, {Nick E J} and Piek, {Jan J} and Wykrzykowska, {Joanna J} and Vasim Farooq and Javier Escaned and Banning, {Adrian P} and Yoshinobu Onuma and Serruys, {Patrick W}",

note = "{\textcopyright} 2019 Wiley Periodicals, Inc.",

year = "2019",

month = mar,

day = "1",

doi = "https://doi.org/10.1002/ccd.28105",

language = "English",

volume = "93",

pages = "E225--E234",

journal = "Catheterization and cardiovascular interventions",

issn = "1522-1946",

publisher = "Wiley-Liss Inc.",

number = "4",

}

Katagiri, Y, De Maria, GL, Kogame, N, Chichareon, P, Takahashi, K, Chang, CC, Modolo, R, Walsh, S, Sabate, M, Davies, J, Lesiak, M, Moreno, R, Cruz-Gonzalez, I, West, NEJ, Piek, JJ , Wykrzykowska, JJ, Farooq, V, Escaned, J, Banning, AP, Onuma, Y & Serruys, PW 2019, 'Impact of post-procedural minimal stent area on 2-year clinical outcomes in the SYNTAX II trial', Catheterization and cardiovascular interventions, vol. 93, no. 4, pp. E225-E234. https://doi.org/10.1002/ccd.28105

TY - JOUR

T1 - Impact of post-procedural minimal stent area on 2-year clinical outcomes in the SYNTAX II trial

AU - Katagiri, Yuki

AU - De Maria, Giovanni Luigi

AU - Kogame, Norihiro

AU - Chichareon, Ply

AU - Takahashi, Kuniaki

AU - Chang, Chun Chin

AU - Modolo, Rodrigo

AU - Walsh, Simon

AU - Sabate, Manel

AU - Davies, Justin

AU - Lesiak, Maciej

AU - Moreno, Raul

AU - Cruz-Gonzalez, Ignacio

AU - West, Nick E J

AU - Piek, Jan J

AU - Wykrzykowska, Joanna J

AU - Farooq, Vasim

AU - Escaned, Javier

AU - Banning, Adrian P

AU - Onuma, Yoshinobu

AU - Serruys, Patrick W

PY - 2019/3/1

Y1 - 2019/3/1

N2 - OBJECTIVES: To investigate the impact of minimal stent area (MSA) evaluated by post-procedural intravascular ultrasound (IVUS) on clinical outcomes after contemporary PCI in patients with three-vessel disease (TVD).BACKGROUND: The impact of post-procedural MSA on clinical outcomes has not yet been extensively studied in patients with TVD.METHODS: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a state-of-the-art PCI strategy on clinical outcomes in patients with TVD (454 patients with 1,559 lesions). The relationships between post-procedural MSA and lesion-level outcomes at 2 years were investigated. Clinical events adjudicated per patient by clinical event committee were assessed per lesion. Lesion-oriented composite endpoint (LOCE) was defined as the composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target lesion revascularization.RESULTS: Eight hundred and nineteen lesions with post-procedural MSA available in 367 patients were included in the analysis. The post-procedural MSA per lesion was divided into terciles (smallest tercile: ≤5.0 mm2 , intermediate tercile: 5.0-6.7 mm2 , and largest tercile: >6.7 mm2 ). LOCE was observed in 16/288 (5.6%), 15/265 (5.7%), and 8/266 (3.0%) (P = 0.266). Target lesion revascularization (TLR) was observed in 16/288(5.6%), 12/265 (4.5%), and 4/266 (1.5%) (P = 0.042). The multivariate analysis demonstrated that smaller post-procedural MSA, as well as creatinine clearance, history of previous stroke, chronic total occlusion, and lesion SYNTAX Score was an independent predictor of TLR.CONCLUSIONS: In the SYNTAX II trial, larger post-procedural MSA was independently associated with the lower rate of TLR at 2 years.

AB - OBJECTIVES: To investigate the impact of minimal stent area (MSA) evaluated by post-procedural intravascular ultrasound (IVUS) on clinical outcomes after contemporary PCI in patients with three-vessel disease (TVD).BACKGROUND: The impact of post-procedural MSA on clinical outcomes has not yet been extensively studied in patients with TVD.METHODS: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a state-of-the-art PCI strategy on clinical outcomes in patients with TVD (454 patients with 1,559 lesions). The relationships between post-procedural MSA and lesion-level outcomes at 2 years were investigated. Clinical events adjudicated per patient by clinical event committee were assessed per lesion. Lesion-oriented composite endpoint (LOCE) was defined as the composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target lesion revascularization.RESULTS: Eight hundred and nineteen lesions with post-procedural MSA available in 367 patients were included in the analysis. The post-procedural MSA per lesion was divided into terciles (smallest tercile: ≤5.0 mm2 , intermediate tercile: 5.0-6.7 mm2 , and largest tercile: >6.7 mm2 ). LOCE was observed in 16/288 (5.6%), 15/265 (5.7%), and 8/266 (3.0%) (P = 0.266). Target lesion revascularization (TLR) was observed in 16/288(5.6%), 12/265 (4.5%), and 4/266 (1.5%) (P = 0.042). The multivariate analysis demonstrated that smaller post-procedural MSA, as well as creatinine clearance, history of previous stroke, chronic total occlusion, and lesion SYNTAX Score was an independent predictor of TLR.CONCLUSIONS: In the SYNTAX II trial, larger post-procedural MSA was independently associated with the lower rate of TLR at 2 years.

U2 - https://doi.org/10.1002/ccd.28105

DO - https://doi.org/10.1002/ccd.28105

M3 - Article

C2 - 30702187

SN - 1522-1946

VL - 93

SP - E225-E234

JO - Catheterization and cardiovascular interventions

JF - Catheterization and cardiovascular interventions

IS - 4

ER -