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Italian Multicenter Registry of Bare Metal Stent Use in Modern Percutaneous Coronary Intervention Era (AMARCORD): A multicenter observational study
- Source :
- Catheterization and Cardiovascular Interventions. 97:411-420
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- OBJECTIVES We aimed to evaluate the use of bare metal stent (BMS) implantation in current percutaneous coronary intervention (PCI) era, focusing on indications for use and clinical outcomes. BACKGROUND Limited data on BMS usage in current clinical practice are available. METHODS All patients who underwent PCI with at least one BMS implantation in 18 Italian centers from January 1, 2013 to December 31, 2017, were included in our registry. Rates of BMS use and reasons for BMS implantations were reported for the overall study period and for each year. Primary outcomes were mortality, bleeding (Bleeding Academic Research Consortium-BARC and Thrombolysis in Myocardial Infarction-TIMI non-CABG definitions), and major adverse cardiac events (MACE) defined as the composite of all-cause and cardiac death, any myocardial infarction, target vessel revascularization, or any stent thrombosis. RESULTS Among 58,879 patients undergoing PCI in the study period, 2,117 (3.6%) patients (mean age 73 years, 69.7% males, 73.3% acute coronary syndrome) were treated with BMS implantation (2,353 treated lesions). The rate of BMS implantation progressively decreased from 10.1% (2013) to 0.3% (2017). Main reasons for BMS implantation were: ST-elevation myocardial infarction (STEMI) (23.1%), advanced age (24.4%), and physician's perception of high-bleeding risk (34.0%). At a mean follow-up of 2.2 ± 1.5 years, all-cause and cardiac mortality were 25.6 and 12.7%, respectively; MACE rate was 35.3%, any bleeding rate was 13.0% (BARC 3-5 bleeding 6.3%, TIMI non-CABG major bleeding 6.1%). CONCLUSION In a large, contemporary, real-world, multicenter registry, BMS use progressively reduced over the last 5 years. Main reasons for BMS implantation were STEMI, advanced age, and physician's perception of high-bleeding risk. High rates of mortality and MACE were observed in this real-world high-risk population.
- Subjects :
- Male
Bare-metal stent
Acute coronary syndrome
medicine.medical_specialty
bare metal stent
medicine.medical_treatment
030204 cardiovascular system & hematology
NO
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
drug-eluting stent
medicine
Humans
Radiology, Nuclear Medicine and imaging
Registries
cardiovascular diseases
030212 general & internal medicine
business.industry
percutaneous coronary intervention
Percutaneous coronary intervention
Drug-Eluting Stents
General Medicine
bleeding
medicine.disease
dual antiplatelet therapy
Surgery
Treatment Outcome
Italy
Drug-eluting stent
Conventional PCI
Female
Stents
coronary artery disease
bare metal stent, bleeding, coronary artery disease, drug-eluting stent, dual antiplatelet therapy, percutaneous coronary intervention
Cardiology and Cardiovascular Medicine
business
TIMI
Mace
Subjects
Details
- ISSN :
- 1522726X and 15221946
- Volume :
- 97
- Database :
- OpenAIRE
- Journal :
- Catheterization and Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....0e2b3d590651212fc61942b2bfe7b16e