title: In-hospital and midterm clinical outcomes of rotational atherectomy followed by stent implantation: the ROTATE multicentre registry.
abstract: OBJECTIVE
  The aim of this multicentre study was to investigate the in-hospital and midterm outcomes of rotational atherectomy (RA) followed by metallic stent implantation.
  
  
  RESULTS
  Between 2002 and 2013, 1,176 de novo lesions with calcified coronary lesions treated by RA and metallic stent implantation at nine institutions were assessed. Patients with ST-segment elevation myocardial infarction (STEMI) within 30 days, cardiogenic shock before the procedure, lesions with thrombus, and in-stent restenosis were excluded from the current analysis. In-hospital major adverse cardiac events (MACE) occurred in 8.3% of cases, mainly driven by periprocedural myocardial infarction. The incidence of MACE was 16.0% at one-year and 24.9% at two-year follow-up, both driven by target vessel revascularisation (13.5% at one year and 19.8% at two years). Multivariable analysis revealed that dialysis was an independent predictor for both in-hospital MACE (OR 2.33, 95% CI: 1.11-4.87, p=0.03) and follow-up MACE (HR 4.14, 95% CI: 2.87-5.96, p<0.001), whilst drug-eluting stent (DES) use was associated with a reduction in follow-up MACE (HR 0.42, 95% CI: 0.26-0.67, p<0.001).
  
  
  CONCLUSIONS
  RA appears to be safe and effective with acceptable in-hospital and follow-up MACE considering the severity of patient and lesion characteristics. DES implantation following RA was associated with a reduction in MACE during the follow-up period.
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.forename: Neil
authors.initials: N
authors.lastname: Ruparelia
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ielasi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.forename: Mauro
authors.initials: M
authors.lastname: Pennacchi
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.forename: Roberto
authors.initials: R
authors.lastname: Garbo
authors.forename: Emanuele
authors.initials: E
authors.lastname: Meliga
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.forename: Marco Luciano
authors.initials: ML
authors.lastname: Rossi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Presbitero
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Magri
authors.forename: Sunao
authors.initials: S
authors.lastname: Nakamura
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.forename: Giacomo G
authors.initials: GG
authors.lastname: Boccuzzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017225:Atherectomy, Coronary / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D016896:Treatment Outcome