A Prospective, Multicenter, Real-World Registry of Coronary Lithotripsy in Calcified Coronary Arteries : The REPLICA-EPIC18 Study
Rodriguez-Leor, Oriol (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cid-Alvarez, Ana Belen (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Lopez-Benito, Maria (Hospital Universitario de León)
Gonzalo, Nieves (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos)
Vilalta, Victoria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Diarte de Miguel, Jose Antonio (Hospital Universitario Miguel Servet (Saragossa))
Fernandez López, Leticia (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Jurado-Roman, Alfonso (Hospital Universitario La Paz (Madrid))
Diego, Alejandro (Hospital Clínico Universitario (Salamanca))
Oteo, Juan Francisco (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Cuellas, Carlos (Hospital Universitario de León)
Trillo, Ramiro (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Travieso, Alejandro (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos)
Alfonso, Fernando (Hospital Universitario de la Princesa (Madrid))
Carrillo, Xavier (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vegas-Valle, José Miguel (Hospital Universitario de Cabueñes (Gijón))
Cortes-Villar, Carlos (Hospital Universitario Miguel Servet (Saragossa))
Pascual, Isaac (Hospital Universitario Central de Asturias)
Muñoz Camacho, Juan Francisco (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Flores, Xacobe (Complejo Hospitalario Universitario de A Coruña)
Vera-Vera, Silvio (Hospital Universitario La Paz (Madrid))
Moreu, Jose (Hospital Universitario de Toledo)
Barreira de Sousa, Gilles (Hospital Clínico Universitario (Salamanca))
Martí, David (Hospital Central de la Defensa Gómez Ulla)
Jimenez-Mazuecos, Jesus (Complejo Hospitalario Universitario de Albacete)
Fuertes, Monica (Hospital Universitari Joan XXIII de Tarragona)
Ocaranza, Raymundo (Hospital Universitario Lucus Augusti (Lugo))
de la Torre Hernandez, Jose Maria (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Lozano, Fernando (Hospital General Universitario de Ciudad Real)
Solana Martinez, Santiago G. (Hospital de Donostia (Sant Sebastià, País Basc))
Gomez Lara, Josep (Hospital Universitari de Bellvitge)
Perez de Prado, Armando (Hospital Universitario de León)
REPLICA-EPIC18 Investigators
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Background: Intravascular lithotripsy (IVL) has demonstrated effectiveness in the treatment of calcified lesions in selected patients with stable coronary disease. Objectives: The authors sought to assess the performance of coronary IVL in calcified coronary lesions in a real-life, all comers, setting. Methods: The REPLICA-EPIC18 study prospectively enrolled consecutive patients treated with IVL in 26 centers in Spain. An independent core laboratory performed the angiographic analysis and event adjudication. The primary effectiveness endpoint assessed procedural success (successful IVL delivery, final diameter stenosis <20%, and absence of in-hospital major adverse cardiovascular events [MACE]). The primary safety endpoint measured freedom from MACE at 30 days. A predefined substudy compared outcomes between acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) patients. Results: A total of 426 patients (456 lesions) were included, 63% of the patients presenting with ACS. IVL delivery was successful in 99% of cases. Before IVL, 49% of lesions were considered undilatable. The primary effectiveness endpoint was achieved in 66% of patients, with similar rates among CCS patients (68%) and ACS patients (65%). Likewise, there were no significant differences in angiographic success after IVL between CCS and ACS patients. The rate of MACE at 30 days (primary safety endpoint) was 3% (1% in CCS and 5% in ACS patients [P = 0. 073]). Conclusions: Coronary IVL proved to be a feasible and safe procedure in a "real-life" setting, effectively facilitating stent implantation in severely calcified lesions. Patients with ACS on admission showed similar angiographic success rates but showed a trend toward higher 30-day MACE compared with patients with CCS. (REPLICA-EPIC18 study [Registry of Coronary Lithotripsy in Spain]; NCT04298307).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Acute coronary syndrome ; Coronary artery calcification ; Intravascular lithotripsy
Published in:	JACC: Cardiovascular Interventions, Vol. 17 Núm. 6 (25 2024) , p. 756-767, ISSN 1876-7605

DOI: 10.1016/j.jcin.2023.12.018
PMID: 38385926

12 p, 907.6 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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