Very Long-Term Follow-Up After Coronary Rotational Atherectomy: A Single-Center Experience

Abstract

We assessed the very long-term follow-up of a large cohort of unselected patients treated with coronary rotational atherectomy (RA). All 143 patients who underwent RA at our institution from 2000 to 2013 and with complete baseline and follow-up information were analyzed in a retrospective manner. Major adverse cardiac events (MACE) were defined as the composite of target vessel revascularization (TVR), acute myocardial infarction, and all-cause mortality. The mean follow-up was 8.2 years. The 10-year cumulative incidence of MACE for all patients was 57.9% (standard error [SE]: 5.0%). When comparing patients who received a drug-eluting stent (DES; n = 68) versus patients who did not (balloon only, bare-metal stent, or none of the aforementioned; n = 75), the RA + DES demonstrated very long-term MACE of 49.2% (SE: 7.5%) versus 62.7% (SE: 6.1%), P = .160 with TVR as the most discriminating factor, 10.7% (SE: 4.0%) versus 29.2% (SE: 6.0%), P = .016. Our results point to RA having reasonable long-term clinical results, especially in combined treatment with DES. To date, our study has the longest follow-up after RA.

�ndice de calcificaci�n coronaria en la tomograf�a computarizada para predecir la necesidad de aterectom�a rotacional

“…En este grupo, la AR arrojó buenos resultados angiográficos, no observándose diferencia significativa alguna entre ambos grupos durante el seguimiento. La incidencia a largo plazo de eventos cardiovasculares adversos mayores fue alta, pero similar a la descrita por otros grupos en pacientes con un perfil de riesgo similar 20,21 .…”