TORNA ALL’ELENCO

Clinical outcome of rotational atherectomy in complex calcified coronary lesions: Data from the multicentre international ROTATE registry in EuroIntervention

2015
ASL Città di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (13)Vedi tutti...

Boasi V

Piazza F

Boccuzzi G


et alii...

Abstract

Aims: Rotational atherectomy (RA) is widely used for treating calcified coronary lesions. The ROTATE (ROTational AThEerectomy) multicentre international registry was developed to assess the short- and long-term outcome after RA in a large real-world population. Methods and results: From April 2002 to December 2014 a total of 1,079 consecutive patients, treated with RA in ten different high volume centres worldwide, were collected in the ROTATE registry. Their mean age was 70.6±9.5 years, 65% being male, and about half with diabetes mellitus, renal impairment or a previous PCI. More than a quarter of patients (26.1 %) were treated with RA during the hospitalisation for an acute coronary syndrome, exploiting the radial approach in 28.6%. The most frequently treated coronary artery was the left anterior descending (47.1%) followed by the right coronary (24.9%); protected and unprotected left main stem lesions were respectively faced in 1.3% and 7.4%. Chronic total occlusions were 8.2% of total and 31.2% of procedures were IVUS-guided with a burr/artery ratio ? 0.6 in 32.5%. Second-generation DES were implanted in 63.1%. Serious procedural complications (perforations and no-flow/slow-flow), occurred rarely (respectively 0.6% and 1.3%). In-hospital death occurred in 0.7%, myocardial infarction in 6.9% (6.4% non-Q-wave and 0.5% Q wave) and stroke in 0.4%; the cumulative incidence of in-hospital major adverse events showed no differences between gender and clinical presentation, with a trend of being lower in those with radial access. The 1- and 3-year overall survival (Kaplan Meier estimate) was 96.1% and 87.7%. Multivariate analysis using the Cox proportional hazards model showed that age>75 (OR 1.98; CI 95% 1.23-3.17; p=0.005), diabetes (OR 1.6; CI 95% 0.99-2.59; p=0.05) and left ventricular ejection fraction <35 (OR 3.51; CI 95%: 2.08-5.93; p<0.001) were independent predictors of death at follow-up. Conclusions: ROTATE registry represents the largest internat

Keywords

rotational atherectomy; register; human; patient; Q wave; hospital; diabetes mellitus; death; population; coronary artery; follow up; acute coronary syndrome; heart infarction; proportional hazards model; heart left ventricle ejection fraction; cerebrovascular accident; multivariate analysis; perforation; Kaplan Meier method; procedures; occlusion; overall survival; gender; male;