title: Two-Year Clinical Outcomes of Newer-Generation Drug-Eluting Stent Implantation Following Rotational Atherectomy for Heavily Calcified Lesions.
abstract: BACKGROUND
  Clinical outcomes of implantation of the newer-generation drug-eluting stent (DES) following rotational atherectomy for heavily calcified lesions remain unclear in the real-world setting.
  
  
  RESULTS
  We enrolled 252 consecutive patients (273 lesions) treated with newer-generation DES following rotational atherectomy. The primary endpoint was the cumulative 2-year incidence of major adverse cardiovascular events (MACE), defined as cardiac death, myocardial infarction, clinically-driven target lesion revascularization, and definite stent thrombosis. Complete clinical follow-up information at 2-year was obtained for all patients. The mean age was 73.2±9.0 years and 155 patients (61.5%) were male. Cumulative 2-year incidence of MACE (cardiac death, myocardial infarction, clinically-driven target lesion revascularization and definite stent thrombosis) was 20.3% (7.0%, 2.1%, 18.1% and 2.1%, respectively). Predictors of MACE were presenting with acute coronary syndrome (hazard ratio [HR]: 3.80, 95% confidence interval [CI]: 1.29-11.2, P=0.02), hemodialysis (HR: 1.93, 95% CI: 1.04-3.56, P=0.04) and previous coronary artery bypass graft (HR: 2.26, 95% CI: 1.02-5.00, P=0.045).
  
  
  CONCLUSIONS
  PCI for calcified lesions requiring rotational atherectomy is still challenging even in the era of newer-generation DES.
authors.affiliation: Division of Cardiovascular Medicine, Kokura Memorial Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Jinnouchi
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kuramitsu
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Shinozaki
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Hiromasa
authors.forename: Takashi
authors.initials: T
authors.lastname: Morinaga
authors.forename: Toru
authors.initials: T
authors.lastname: Mazaki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakakura
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Makoto
authors.initials: M
authors.lastname: Hyodo
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shirai
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017073:Atherectomy / Q000009:adverse effects*; D003643:Death; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D058226:Plaque, Atherosclerotic / Q000453:epidemiology / Q000601:surgery*; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology; D061205:Vascular Calcification / Q000453:epidemiology / Q000601:surgery*