Clinical, angiographic, and procedural predictors of angiographic restenosis after sirolimus-eluting stent implantation in complex patients

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 lesi... Mehr ...

Verfasser: Lemos Neto, P.A. (Pedro)
Hoye, A. (Angela)
Goedhart, D. (Dick)
Arampatzis, C.A. (Chourmouzios)
Saia, F. (Francesco)
Giessen, W.J. (Wim) van der
McFadden, E.P. (Eugene)
Sianos, G. (Georgios)
Smits, P.C. (Pieter)
Hofma, S.H. (Sjoerd)
Feyter, P.J. (Pim) de
Domburg, R.T. (Ron) van
Serruys, P.W.J.C. (Patrick)
Dokumenttyp: Artikel
Erscheinungsdatum: 2004
Schlagwörter: *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
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29198896
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://repub.eur.nl/pub/13314

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.