Abstract

ObjectivesTo evaluate the 3-year clinical outcomes of a polymer-free sirolimus-eluting, Nano plus stent for the treatment of coronary artery disease in the NANO multicenter Registry.BackgroundThe long-term clinical data evaluating the safety and efficacy of the novel polymer-free sirolimus-eluting Nano plus stent (Lepu Medical, Beijing, China) is limited.MethodsThe NANO all-comers Registry trial was a prospective, multicenter clinical registry conducted in 26 centers in China between August 2016 and January 2017. A total of 2481 consecutive patients were exclusively treated with the Nano plus stent. The primary clinical endpoint, target lesion failure (TLF, defined as cardiac death, target vessel nonfatal myocardial infarction, and clinically driven target lesion revascularization [CD-TLR]), was analyzed at 3 years.ResultsAt 3 years, 2295 patients (92.5%) were followed. The incidence of TLF was 6.8% (168/2481). The rate of cardiac death was 3.8% (94/2481), target vessel nonfatal myocardial infarction 0.7% (18/2481), and CD-TLR 2.9% (68/2481). The rate of definite/probable stent thrombosis was 0.5% (13/2481). The risk factors of diabetes mellitus, acute myocardial infarction, age, chronic renal failure, in-stent restenosis, chronic total occlusion, and left ventricular ejection fraction < 40% were the independent predictors of 3-year TLF.ConclusionsAt three years, the rate of TLF was relatively low in patients treated with the polymer-free Nano plus stent. The polymer-free Nano plus stent showed a favorable safety and efficacy profile in real-world patients.Clinical trial registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02929030.

Highlights

  • Percutaneous coronary interventions (PCI) with drugeluting stents (DES) are currently the most common revascularization treatment strategy for coronary artery disease worldwide

  • The risk factors of diabetes mellitus, acute myocardial infarction, age, chronic renal failure, in-stent restenosis, chronic total occlusion, and left ventricular ejection fraction < 40% were the independent predictors of 3-year target lesion failure (TLF)

  • At three years, the rate of TLF was relatively low in patients treated with the polymer-free Nano plus stent

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Summary

Introduction

Percutaneous coronary interventions (PCI) with drugeluting stents (DES) are currently the most common revascularization treatment strategy for coronary artery disease worldwide. DES has dramatically improved clinical outcomes compared to the bare metal stent (BMS) [1]; current DES systems always need relatively long (> 6 months) dual antiplatelet therapy (DAPT) [2], Dai et al BMC Cardiovascular Disorders (2021) 21:537 which confined their usage on a significant proportion of patients with adherence restraints, such as those at high bleeding risk [3]. In patients at high bleeding risk, polymer-free DES was found to be superior to BMS when used with a 1-month course of DAPT [8]. The long-term clinical data evaluating the safety and efficacy of the novel polymer-free sirolimus-eluting Nano plus stent (Lepu Medical, Beijing, China) is limited

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