Coronary interventions

Clinical outcomes with unselected use of an ultrathin-strut sirolimus-eluting stent: a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)

EuroIntervention 2021;16:1413-1421. DOI: 10.4244/EIJ-D-20-00429

Sergio Buccheri
Sergio Buccheri1, MD; Giovanna Sarno1, MD, PhD; David Erlinge2, MD, PhD; Henrik Renlund3, PhD; Bo Lagerqvist1, MD, PhD; Per Grimfjärd4, MD; Nils Witt5, MD, PhD; Troels Yndigegn2, MD; Ole Fröbert6, MD, PhD; Jonas Persson7, MD, PhD; Felix Böhm8, MD, PhD; Stefan K. James1, MD, PhD
1. Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden; 2. Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden; 3. Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden; 4. Department of Cardiology, Västerås Hospital, Västerås, Sweden; 5. Department of Clinical Science and Education, Karolinska Institutet, Unit of Cardiology, Stockholm, Sweden; 6. Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden; 7. Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden; 8. Coronary Artery Disease Area, Heart and Vascular Theme, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden

Aims: The aim of this study was to assess the real-world clinical performance of a sirolimus-eluting ultrathin-strut drug-eluting stent (DES) (Orsiro) in a large nationwide cohort of patients undergoing percutaneous coronary intervention (PCI).

Methods and results: From the Swedish Coronary Angiography and Angioplasty Registry, the two-year outcomes of 4,561 patients implanted with Orsiro (Orsiro group) and 69,570 receiving other newer-generation DES (n-DES group) were analysed. The rate of definite stent thrombosis was low in both groups (0.67% and 0.83% for Orsiro and n-DES, respectively; adjusted hazard ratio [HR] 0.90, 95% confidence interval [CI]: 0.55-1.46, p-value 0.66). Restenosis was also infrequent (1.5% vs 2.0% with Orsiro and n-DES, adjusted HR 0.81, 95% CI: 0.63-1.03, p-value=0.09). The risk of target lesion revascularisation by PCI was lower in the Orsiro group (1.6% vs 2.3%, adjusted HR 0.75, 95% CI: 0.60-0.94, p-value=0.013). All-cause mortality and myocardial infarction did not show a statistically significant difference between the two groups (mortality of 7.5% in both groups, adjusted HR 0.99, 95% CI: 0.72-1.35, p-value=0.94; 6.0% vs 5.2% for myocardial infarction, adjusted HR 1.19, 95% CI: 1.00-1.43, p-value=0.06).

Conclusions: In a nationwide scenario, the use of a sirolimus-eluting ultrathin-strut DES portended favourable clinical outcomes.

Visual summary. Clinical outcomes with unselected use of an ultrathin-strut sirolimus-eluting stent.

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clinical researchdrug-eluting stentmiscellaneous
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