TY - JOUR
T1 - One-year clinical outcomes in patients with chronic kidney disease treated with COMBO stents: From the COMBO collaboration
AU - Chandrasekhar, Jaya
AU - Kalkman, Deborah N.
AU - Sartori, Samantha
AU - Baber, Usman
AU - Blum, Moritz
AU - Aquino, Melissa B.
AU - Woudstra, Pier
AU - Beijk, Marcel A.
AU - Tijssen, Jan G.
AU - Koch, Karel T.
AU - Dangas, George D.
AU - Colombo, Antonio
AU - de Winter, Robbert J.
AU - Mehran, Roxana
N1 - Funding Information: We thank all the research participants and the site researchers for their contributions to this study making this analysis possible Publisher Copyright: © 2020 Wiley Periodicals LLC.
PY - 2021/11/15
Y1 - 2021/11/15
N2 - Background: Chronic kidney disease (CKD) patients undergoing percutaneous coronary intervention (PCI) experience greater ischemic events including clinically driven target lesion revascularization (CD-TLR). Whether the COMBO biodegradable-polymer sirolimus-eluting stent promotes better outcomes in these patients by virtue of endothelial progenitor cell capture technology is unknown. Objective: We examined one-year outcomes by CKD status from the COMBO collaboration. Methods: The COMBO collaboration was a patient-level pooled dataset from the REMEDEE and MASCOT registries (3,614 patients) of all-comers undergoing attempted COMBO stent PCI. The primary endpoint was one-year target lesion failure (TLF), composite of cardiac death, target-vessel myocardial infarction (TV-MI) or CD-TLR. Secondary endpoints included stent thrombosis (ST). Results: The study included 6.4% (n = 231) CKD and 93.6% (n = 3,361) non-CKD patients. CKD patients were older and included more women with greater prevalence of several comorbidities but similar rate of acute coronary syndrome (50.6% vs. 54.5%, p =.26). CKD patients underwent radial PCI less often (56.1% vs. 70.3%, p <.001) and received clopidogrel (78.6% vs. 68.3%) more often (p =.004). One-year TLF occurred in 7.9% CKD vs. 3.7% non-CKD patients, p =.001. CKD patients also demonstrated greater incidence of cardiac death (6.2% vs. 1.2%, p <.0001), TV-MI (2.7% vs. 1.1%, p =.04) but similar CD-TLR (2.7% vs 2.2%, p =.61) and definite/probable ST (1.4% vs. 0.8%, p =.42), compared to non-CKD patients. Conclusions: CKD patients treated with COMBO stents had significantly greater incidence of one-year TLF compared to non-CKD patients driven by cardiac death and to a lesser extent TV-MI but not CD-TLR. They had similar rates of definite/probable ST.
AB - Background: Chronic kidney disease (CKD) patients undergoing percutaneous coronary intervention (PCI) experience greater ischemic events including clinically driven target lesion revascularization (CD-TLR). Whether the COMBO biodegradable-polymer sirolimus-eluting stent promotes better outcomes in these patients by virtue of endothelial progenitor cell capture technology is unknown. Objective: We examined one-year outcomes by CKD status from the COMBO collaboration. Methods: The COMBO collaboration was a patient-level pooled dataset from the REMEDEE and MASCOT registries (3,614 patients) of all-comers undergoing attempted COMBO stent PCI. The primary endpoint was one-year target lesion failure (TLF), composite of cardiac death, target-vessel myocardial infarction (TV-MI) or CD-TLR. Secondary endpoints included stent thrombosis (ST). Results: The study included 6.4% (n = 231) CKD and 93.6% (n = 3,361) non-CKD patients. CKD patients were older and included more women with greater prevalence of several comorbidities but similar rate of acute coronary syndrome (50.6% vs. 54.5%, p =.26). CKD patients underwent radial PCI less often (56.1% vs. 70.3%, p <.001) and received clopidogrel (78.6% vs. 68.3%) more often (p =.004). One-year TLF occurred in 7.9% CKD vs. 3.7% non-CKD patients, p =.001. CKD patients also demonstrated greater incidence of cardiac death (6.2% vs. 1.2%, p <.0001), TV-MI (2.7% vs. 1.1%, p =.04) but similar CD-TLR (2.7% vs 2.2%, p =.61) and definite/probable ST (1.4% vs. 0.8%, p =.42), compared to non-CKD patients. Conclusions: CKD patients treated with COMBO stents had significantly greater incidence of one-year TLF compared to non-CKD patients driven by cardiac death and to a lesser extent TV-MI but not CD-TLR. They had similar rates of definite/probable ST.
KW - COMBO PCI
KW - chronic kidney disease
KW - dual therapy stent
KW - endothelial progenitor cell capture
UR - http://www.scopus.com/inward/record.url?scp=85090953626&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ccd.29270
DO - https://doi.org/10.1002/ccd.29270
M3 - Article
C2 - 32964556
SN - 1522-1946
VL - 98
SP - 1095
EP - 1101
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 6
ER -