Complete revascularization is associated with improved long-term outcomes in patients undergoing percutaneous coronary rotational atherectomy
DAI Qing
BAI Xin-bo
WU Han
WEI Zhong-hai
WANG Kun
WANG Lian
KANG Li-na
XU Biao
Abstract：Objective To compare the long-term outcomes of patients undergoing percutaneous coronary rotational atherectomy who achieved complete versus incomplete revascularization.Methods Patients who underwent percutaneous coronary rotational atherectomy at Nanjing Drum Tower Hospital from November 2011 to December 2018 were included.Complete revascularization was defined as successful revascularization of all coronary artery segments with a reference diameter≥2.25 mm and diameter stenosis≥70%.Cox proportional hazards models were used to evaluate the risk factors for long-term major adverse cardiovascular events(MACE)and all-cause mortality.Results A total of 209 patients were included,with 118 in the complete revascularization group and 91 in the incomplete revascularization group.The median follow-up time was 82 months.The incidence of MACE in the complete revascularization group was lower than that in the incomplete revascularization group(17.8%vs.40.7%,P<0.001).There was no significant difference in the long-term all-cause mortality between the two groups(30.5%vs.42.9%,P=0.065).The independent influencing factors for the long-term MACE risk were complete revascularization(HR=0.45,95%CI 0.26-0.79,P=0.006),baseline Syntax score(HR=1.03,95%CI 1.00-1.05,P=0.036),and diabetes(HR=1.89,95%CI 1.11-3.23,P=0.019).The independent influencing factors for the long-term all-cause mortality risk were renal insufficiency(HR=3.01,95%CI 1.61-5.64,P=0.001),age(HR=1.05,95%CI 1.02-1.08,P=0.003)and rotational atherectomy of the left anterior descending artery(HR=0.54,95%CI 0.30-0.96,P=0.036).Conclusion For patients with severe coronary artery calcification undergoing rotational atherectomy,complete revascularization is associated with a reduced risk of long-term MACE.
Keywords：Complete revascularizationCoronary artery calcificationPercutaneous coronary rotational atherectomyLong-term outcomes
Publication Date：2025-11-20
Online Publishing Date：2025-12-05(First online date of this platform, not the publication date of the document)
Pages：6( 983-988 )