Clinical, angiographic, and procedural predictors of angiographic restenosis after sirolimus-eluting stent implantation in complex patients
An evaluation from the Rapamycin- Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) study
BACKGROUND: The factors associated with the occurrence of restenosis after sirolimus-eluting stent (SES) implantation in complex cases are currently unknown. METHODS AND RESULTS: A cohort of consecutive complex patients treated with SES implantation was selected according to the following criteria: (1) treatment of acute myocardial infarction, (2) treatment of in-stent restenosis, (3) 2.25-mm diameter SES, (4) left main coronary stenting, (5) chronic total occlusion, (6) stented segment >36 mm, and (7) bifurcation stenting. The present study population was composed of 238 patients (441 lesions) for whom 6-month angiographic follow-up data were obtained (70% of eligible patients). Significant clinical, angiographic, and procedural predictors of post-SES restenosis were evaluated. Binary in-segment restenosis was diagnosed in 7.9% of lesions (6.3% in-stent, 0.9% at the proximal edge, 0.7% at the distal edge). The following characteristics were identified as independent multivariate predictors: treatment of in-stent restenosis (OR 4.16, 95% CI 1.63 to 11.01; P<0.01), ostial location (OR 4.84, 95% CI 1.81 to 12.07; P<0.01), diabetes (OR 2.63, 95% CI 1.14 to 6.31; P=0.02), total stented length (per 10-mm increase; OR 1.42, 95% CI 1.21 to 1.68; P<0.01), reference diameter (per 1.0-mm increase; OR 0.46, 95% CI 0.24 to 0.87; P=0.03), and left anterior descending artery (OR 0.30, 95% CI 0.10 to 0.69; P<0.01). CONCLUSIONS: Angiographic restenosis after SES implantation in complex patients is an infrequent event, occurring mainly in association with lesion-based characteristics and diabetes mellitus.
|Keywords||*Stents/statistics & numerical data, Aged, Cohort Studies, Comorbidity, Coronary Angiography, Coronary Restenosis/*epidemiology/radiography, Coronary Stenosis/drug therapy/surgery, Diabetes Mellitus/epidemiology, Drug Implants, Female, Humans, Incidence, Male, Middle Aged, Netherlands/epidemiology, Research Support, Non-U.S. Gov't, Risk Factors, Sirolimus/administration & dosage/*therapeutic use|
|Note||Epub 2004 Mar 1|
|Persistent URL||dx.doi.org/10.1161/01.CIR.0000121358.26097.06, hdl.handle.net/1765/13314|
Lemos, P.A., Hoye, A., Goedhart, D., Arampatzis, C.A., Saia, F., van der Giessen, W.J., … Serruys, P.W.J.C.. (2004). Clinical, angiographic, and procedural predictors of angiographic restenosis after sirolimus-eluting stent implantation in complex patients. Circulation (Baltimore), 109(11), 1366–1370. doi:10.1161/01.CIR.0000121358.26097.06