Rotational Atherectomy, Lithotripsy, or Laser for Calcified Coronary Stenosis: One‐Year Outcomes From the ROLLER COASTER‐EPIC22 Trial

作者：Mattia Basile, Antonio Gómez‐Menchero, Borja Rivero Santana, Ignacio J. Amat‐Santos, Santiago Jiménez‐Valero, Juan Caballero‐Borrego, Soledad Ojeda, Gema Miñana, Ariana Gonzálvez‐García, Daniel Tébar Márquez, Maria Jessica Roa‐Garrido, Santiago Jesús Camacho Freire, Raymundo Ocaranza‐Sánchez, Antonio Rueda‐Domínguez, Guillermo Galeote, Raúl Moreno, Alfonso Jurado‐Román · 发表于：Catheterization and Cardiovascular Interventions · 年份：2025 · DOI：10.1002/ccd.31529 · 被引用次数：5 · 研究领域：Coronary Interventions and Diagnostics、Cardiac Imaging and Diagnostics、Pain Management and Treatment

BACKGROUND: The ROLLER COASTR-EPIC22 was the first randomized trial to directly compare rotational atherectomy (RA), excimer laser coronary angioplasty (ELCA), and intravascular lithotripsy (IVL) for the treatment of patients with calcified coronary stenosis. AIMS: The aim of this study is to report and compare its 1-year clinical outcomes. METHODS: The ROLLER COASTR-EPIC22 trial randomized 171 patients with angiographic moderate to severe calcified coronary lesions to PCI with RA (n = 57), IVL (n = 57), or ELCA (n = 57). A pre-specified analysis of clinical events at one year from the index PCI was conducted. The clinical endpoints analyzed at one year were the rate of major adverse cardiovascular events (MACE), defined as the occurrence of cardiac death, target vessel myocardial infarction (TV-MI), target lesion revascularization (TLR), target vessel revascularization (TVR) and stent thrombosis. Furthermore, the rate of all-cause mortality, non-fatal TV-MI, TVR, TLR, and stent thrombosis were analyzed separately. Kaplan-Meier analysis was performed to assess time-to-event outcomes. The adjudication of clinical events was conducted in accordance with the intention-to-treat principle. RESULTS: The mean age was 70.9 ± 8.2 years and 77.2% of the patients were men. Clinical presentation was acute coronary syndrome in 35.7% of patients and severe angiographic calcification was observed in 82.5% of lesions by the independent core laboratory unaware to the treatment arm. All patien...