One year clinical outcomes of contemporary PCI in patients with chronic coronary syndrome: experience from large scale e-ULTIMASTER registry
Notice bibliographique
Résumé
Abstract Background The 2019 ESC guideline on chronic coronary syndromes (CCS) provided insights on the management of patients with stable angina. Purpose To explore one-year outcomes of CCS patients undergoing percutaneous revascularisation representing daily clinical practice. Methods We investigated CCS patients enrolled in e-Ultimaster registry (NCT02188355), which is a prospective, multicentre, worldwide, all-comers registry enrolled >36, 000 patients treated with a thin strut (80μm) bioresorbable polymer sirolimus-eluting stents (Ultimaster). The primary endpoint was target lesion failure (TLF) at 1 year (defined as a composite of cardiac death, target-vessel related myocardial infarction (TV-MI) and clinically-driven target lesion revascularization (CD-TLR). An independent Clinical Event Committee adjudicated all end-point related events. Results Our analysis included in total 15540 patients presented with stable angina (n=12300, 79.2%) or silent ischemia (n=3240, 20.9%) at enrolment. The mean age of CCS patients was 65.7±10.5 years and 76.1% were male. Regarding comorbidities, 69.9% of CCS patient were hypertensive, 30.9% had diabetes, 62.2% had high cholesterol, and 7.5% had renal impairment. The percentage of current smokers was 15.7%. Among CCS patients, 28.1% reported previous MI while 35.2% had history of PCI and 7.4% of CABG. Among CCS patients, 42.4% were diagnosed with multivessel disease. The average number of lesions identified per patient was 1.8±1.0, and the number of treated lesions was 1.5±0.8. The left main artery was treated in 4.1% of CCS patients, 8.1% for chronic total occlusion, 6.1% for instent restenosis, while 14% of the patients were treated in one or more bifurcation lesions. Approximately 80% of the procedures were preformed via radial access. The rate of TLF at one year was 2.9%, with 0.95% of cardiac death, 0.8% of TV-MI and 1.5% of CD-TLR. Definite or probable stent thrombosis (ST) rate was 0.42%, and any bleeding occurred in 1.8% of the patients. 71.3% of the patients were already on dual antiplatelet therapy (DAPT) before procedure, 93.3% were on DAPT at 3 months follow up, while DAPT was continued in 64.9% of patients at 1 year. At 3 months after index PCI, 91.4% of the treated CCS patients were angina free, 7.6% reported stable angina, and 0.5% unstable angina. The similar result was observed at 1 year, with 90.9% of the patients remaining angina free, 7.5% of patients with stable angina, while only 0.6% reported unstable angina. In a stepwise regression model, we identified risk factors of TLF in CCS patients including age, body mass index, diabetes, renal failure, lesion complexity such as target vessel LM or bifurcation, and number of stents implanted. Conclusions In this large, international all-comers registry, more than 90% of CCS patients treated with PCI remain angina free at one year, with low rate of TLF and ST, adding further evidence to ongoing debate about CCS treatment strategy. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Limted study funding by Terumo
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».