title: Clinical outcomes of first- and second-generation drug-eluting stents in patients undergoing rotational atherectomy for heavily calcified coronary lesions.
abstract: BACKGROUND
  There is paucity of data regarding the clinical outcome of second generation drug- eluting stents (DES) post rotational atherectomy (RA) for heavily calcified coronary lesions (HCCL).
  
  
  METHODS
  The study cohort comprised 99 (116 lesions) consecutive patients who underwent RA for HCCL at our institution and received either a first generation DES (40 patients, 53 lesions) or a second generation DES (59 patients, 63 lesions). The analyzed clinical parameters were the 12-month rates of death (all cause and cardiac), Q-wave MI, target lesion revascularization (TLR), definite stent thrombosis (ST) and major adverse cardiac events (MACE) defined as the composite of death, Q-wave MI, or TLR.
  
  
  RESULTS
  The two groups were well matched for their baseline characteristics except for a lower left ventricular ejection fraction in the second generation DES group (46.0±23.0% vs. 55.0±9.0%; p=0.02). The group receiving second generation DES had more type C lesions (81.0% vs. 58.8%; p=0.01), shorter stent length (19.9±6.1 mm vs. 22.7±7.3 mm; p=0.04) and was more likely to undergo stent postdilatation (52.4% vs. 23.1%; p=0.001). The 1-year analyzed clinical parameters were similar in the two groups: all cause death (8.5% vs. 10.3%; p=1.0), cardiac death (8.5% vs. 2.5%; p=0.40), Q-wave MI (0% vs. 0%), TLR (3.6% vs. 2.7%; p=1.0), ST (0% vs. 0%), and MACE (11.9% vs. 12.8%; p=1.0). The 1-year MACE-free survival rate was also similar in the two cohorts.
  
  
  CONCLUSIONS
  The use of second generation DES, following RA for HCCL, is associated with similar short and long-term clinical outcomes to first generation DES.
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Tian
authors.affiliation: University of Surrey, Guildford Road, Surrey, GU2-7XH, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Mahmoudi
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Thibault
authors.initials: T
authors.lastname: Lhermusier
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Lakshmana K
authors.initials: LK
authors.lastname: Pendyala
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Sarkis
authors.initials: S
authors.lastname: Kiramijyan
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Minha
authors.initials: M
authors.lastname: Saar
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ota
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: William O
authors.initials: WO
authors.lastname: Suddath
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA. Electronic address: ron.waksman@medstar.net.
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017225:Atherectomy, Coronary / Q000379:methods; D002114:Calcinosis; D002317:Cardiovascular Agents / Q000627:therapeutic use; D017023:Coronary Angiography / Q000379:methods; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents
keywords: Calcified coronary lesions; Drug-eluting stents; Rotational atherectomy