TY - JOUR
T1 - Outcomes and regional differences in practice in a worldwide coronary stent registry
AU - Cimci, Murat
AU - Polad, Jawed
AU - Mamas, Mamas
AU - Iniguez-Romo, Andres
AU - Chevalier, Bernard
AU - Abhaichand, Rajpal
AU - Aminian, Adel
AU - Roguin, Ariel
AU - Maluenda, Gabriel
AU - Angioi, Michael
AU - Cassel, Graham
AU - Kuramitsu, Shoichi
AU - Jacobs, Lotte
AU - Debrus, Roxane
AU - Malik, Fazila
AU - Hildick-Smith, David
AU - Laanmets, Peep
AU - Roffi, Marco
AU - e-ULTIMASTER investigators
A2 - Steinwender, Clemens
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/7/27
Y1 - 2022/7/27
N2 - OBJECTIVE: The primary objective was to assess the performance of a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer in an all comer population. The secondary objective was to detail differences in contemporary percutaneous coronary intervention (PCI) practice worldwide.METHODS: e-Ultimaster was an all-comer, prospective, global registry (NCT02188355) with independent event adjudication enrolling patients undergoing PCI with the study stent. The primary outcome measure was target lesion failure (TLF) at 1 year, defined as the composite of cardiac death, target vessel myocardial infarction and clinically driven target lesion revascularisation. Data were stratified according to 4 geographical regions.RESULTS: A total of 37 198 patients were enrolled (Europe 69.2%, Asia 17.8%, Africa/Middle East 6.6% and South America/Mexico 6.5%) and 1-year follow-up was available for 35 389 patients (95.1%). One-year TLF occurred in 3.2% of the patients, ranging from 2% (Africa/Middle East) to 4.1% (South America/Mexico). In patients with acute coronary syndrome, potent P2Y12 inhibitors were prescribed in 48% of patients at discharge, while at 1 year 72% were on any dual antiplatelet therapy. Lipid-lowering treatment was administered in 80.9% and 75.5% of patients at discharge and 1 year, respectively. Regional differences in the profile of the treated patients as well as in PCI practice were reported.CONCLUSIONS: In this investigation with worldwide representation, contemporary PCI using a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer was associated with low 1-year TLF across clinical presentations and continents. Suboptimal adherence to current recommendations around antiplatelet and lipid lowering treatments was detected.
AB - OBJECTIVE: The primary objective was to assess the performance of a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer in an all comer population. The secondary objective was to detail differences in contemporary percutaneous coronary intervention (PCI) practice worldwide.METHODS: e-Ultimaster was an all-comer, prospective, global registry (NCT02188355) with independent event adjudication enrolling patients undergoing PCI with the study stent. The primary outcome measure was target lesion failure (TLF) at 1 year, defined as the composite of cardiac death, target vessel myocardial infarction and clinically driven target lesion revascularisation. Data were stratified according to 4 geographical regions.RESULTS: A total of 37 198 patients were enrolled (Europe 69.2%, Asia 17.8%, Africa/Middle East 6.6% and South America/Mexico 6.5%) and 1-year follow-up was available for 35 389 patients (95.1%). One-year TLF occurred in 3.2% of the patients, ranging from 2% (Africa/Middle East) to 4.1% (South America/Mexico). In patients with acute coronary syndrome, potent P2Y12 inhibitors were prescribed in 48% of patients at discharge, while at 1 year 72% were on any dual antiplatelet therapy. Lipid-lowering treatment was administered in 80.9% and 75.5% of patients at discharge and 1 year, respectively. Regional differences in the profile of the treated patients as well as in PCI practice were reported.CONCLUSIONS: In this investigation with worldwide representation, contemporary PCI using a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer was associated with low 1-year TLF across clinical presentations and continents. Suboptimal adherence to current recommendations around antiplatelet and lipid lowering treatments was detected.
KW - Absorbable Implants
KW - Coronary Artery Disease/drug therapy
KW - Drug-Eluting Stents
KW - Humans
KW - Lipids
KW - Percutaneous Coronary Intervention/adverse effects
KW - Polymers
KW - Prospective Studies
KW - Registries
KW - Sirolimus/therapeutic use
KW - Stents
KW - Treatment Outcome
UR - https://www.scopus.com/pages/publications/85135375546
U2 - 10.1136/heartjnl-2021-320116
DO - 10.1136/heartjnl-2021-320116
M3 - Article
C2 - 35012960
SN - 1468-201X
VL - 108
SP - 1310
EP - 1318
JO - Heart
JF - Heart
IS - 16
ER -
