Clinical and Angiographic Outcomes After Placement of Multiple Overlapping Drug-Eluting Stents in Diffuse Coronary Lesions

Cheol Whan Lee, Kyoung Ha Park, Young Hak Kim, Myeongki Hong, Jae Joong Kim, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Multiple overlapping drug-eluting stents have increasingly been used to treat diffuse coronary disease, but the safety and efficacy of this approach remains unclear. We assayed the clinical and angiographic outcomes after placement of "full metal jacket" stents (stented length ≥60 mm) in 347 consecutive patients (352 lesions) with very long de novo coronary lesions. Mean age was 61.0 ± 10.1 years, and the mean stented length was 71.9 ± 13.7 mm. The procedural success rate was 97.7%. Major in-hospital complications (1 death, 2 cases of acute stent thrombosis) occurred in 3 patients (0.7%). Angiographic follow-up data, obtained for 230 (234 lesions) of the 328 eligible patients (70.1%), showed that the restenosis rate was 13.7%. Multivariate analysis found that the reference artery diameter (odds ratio 0.05, 95% confidence interval [CI] 0.01 to 0.33, p = 0.002) and the use of Taxus stents (odds ratio 2.88, 95% CI 1.03 to 8.04, p = 0.043) were significant predictors of restenosis. During follow-up (16.6 ± 6.9 months), 9 deaths (6 cardiac and 3 noncardiac), 1 nonfatal myocardial infarction, and 13 target lesion revascularizations occurred. The cumulative probability of survival without major adverse cardiac events (cardiac death, Q-wave myocardial infarction, and target lesion revascularization) was 95.4 ± 1.1% and 91.4 ± 2.1% at 1 and 2 years, respectively. Left ventricular dysfunction (ejection fraction <45%) was the only predictor of stent thrombosis (hazard ratio 18.24, 95% CI 1.65 to 201.19, p = 0.018) and cardiac death/Q-wave myocardial infarction (hazard ratio 5.37, 95% CI 1.28 to 22.49, p = 0.021). In conclusion, full metal jacket drug-eluting stents may be a safe and effective method to treat diffuse coronary disease and may be a useful treatment option for complex long lesions.

Original languageEnglish
Pages (from-to)918-922
Number of pages5
JournalAmerican Journal of Cardiology
Volume98
Issue number7
DOIs
Publication statusPublished - 2006 Oct 1

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Drug-Eluting Stents
Stents
Confidence Intervals
Myocardial Infarction
Coronary Disease
Thrombosis
Metals
Odds Ratio
Taxus
Left Ventricular Dysfunction
Stroke Volume
Multivariate Analysis
Arteries
Safety
Survival
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Cheol Whan ; Park, Kyoung Ha ; Kim, Young Hak ; Hong, Myeongki ; Kim, Jae Joong ; Park, Seong Wook ; Park, Seung Jung. / Clinical and Angiographic Outcomes After Placement of Multiple Overlapping Drug-Eluting Stents in Diffuse Coronary Lesions. In: American Journal of Cardiology. 2006 ; Vol. 98, No. 7. pp. 918-922.
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title = "Clinical and Angiographic Outcomes After Placement of Multiple Overlapping Drug-Eluting Stents in Diffuse Coronary Lesions",
abstract = "Multiple overlapping drug-eluting stents have increasingly been used to treat diffuse coronary disease, but the safety and efficacy of this approach remains unclear. We assayed the clinical and angiographic outcomes after placement of {"}full metal jacket{"} stents (stented length ≥60 mm) in 347 consecutive patients (352 lesions) with very long de novo coronary lesions. Mean age was 61.0 ± 10.1 years, and the mean stented length was 71.9 ± 13.7 mm. The procedural success rate was 97.7{\%}. Major in-hospital complications (1 death, 2 cases of acute stent thrombosis) occurred in 3 patients (0.7{\%}). Angiographic follow-up data, obtained for 230 (234 lesions) of the 328 eligible patients (70.1{\%}), showed that the restenosis rate was 13.7{\%}. Multivariate analysis found that the reference artery diameter (odds ratio 0.05, 95{\%} confidence interval [CI] 0.01 to 0.33, p = 0.002) and the use of Taxus stents (odds ratio 2.88, 95{\%} CI 1.03 to 8.04, p = 0.043) were significant predictors of restenosis. During follow-up (16.6 ± 6.9 months), 9 deaths (6 cardiac and 3 noncardiac), 1 nonfatal myocardial infarction, and 13 target lesion revascularizations occurred. The cumulative probability of survival without major adverse cardiac events (cardiac death, Q-wave myocardial infarction, and target lesion revascularization) was 95.4 ± 1.1{\%} and 91.4 ± 2.1{\%} at 1 and 2 years, respectively. Left ventricular dysfunction (ejection fraction <45{\%}) was the only predictor of stent thrombosis (hazard ratio 18.24, 95{\%} CI 1.65 to 201.19, p = 0.018) and cardiac death/Q-wave myocardial infarction (hazard ratio 5.37, 95{\%} CI 1.28 to 22.49, p = 0.021). In conclusion, full metal jacket drug-eluting stents may be a safe and effective method to treat diffuse coronary disease and may be a useful treatment option for complex long lesions.",
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Clinical and Angiographic Outcomes After Placement of Multiple Overlapping Drug-Eluting Stents in Diffuse Coronary Lesions. / Lee, Cheol Whan; Park, Kyoung Ha; Kim, Young Hak; Hong, Myeongki; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung.

In: American Journal of Cardiology, Vol. 98, No. 7, 01.10.2006, p. 918-922.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical and Angiographic Outcomes After Placement of Multiple Overlapping Drug-Eluting Stents in Diffuse Coronary Lesions

AU - Lee, Cheol Whan

AU - Park, Kyoung Ha

AU - Kim, Young Hak

AU - Hong, Myeongki

AU - Kim, Jae Joong

AU - Park, Seong Wook

AU - Park, Seung Jung

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N2 - Multiple overlapping drug-eluting stents have increasingly been used to treat diffuse coronary disease, but the safety and efficacy of this approach remains unclear. We assayed the clinical and angiographic outcomes after placement of "full metal jacket" stents (stented length ≥60 mm) in 347 consecutive patients (352 lesions) with very long de novo coronary lesions. Mean age was 61.0 ± 10.1 years, and the mean stented length was 71.9 ± 13.7 mm. The procedural success rate was 97.7%. Major in-hospital complications (1 death, 2 cases of acute stent thrombosis) occurred in 3 patients (0.7%). Angiographic follow-up data, obtained for 230 (234 lesions) of the 328 eligible patients (70.1%), showed that the restenosis rate was 13.7%. Multivariate analysis found that the reference artery diameter (odds ratio 0.05, 95% confidence interval [CI] 0.01 to 0.33, p = 0.002) and the use of Taxus stents (odds ratio 2.88, 95% CI 1.03 to 8.04, p = 0.043) were significant predictors of restenosis. During follow-up (16.6 ± 6.9 months), 9 deaths (6 cardiac and 3 noncardiac), 1 nonfatal myocardial infarction, and 13 target lesion revascularizations occurred. The cumulative probability of survival without major adverse cardiac events (cardiac death, Q-wave myocardial infarction, and target lesion revascularization) was 95.4 ± 1.1% and 91.4 ± 2.1% at 1 and 2 years, respectively. Left ventricular dysfunction (ejection fraction <45%) was the only predictor of stent thrombosis (hazard ratio 18.24, 95% CI 1.65 to 201.19, p = 0.018) and cardiac death/Q-wave myocardial infarction (hazard ratio 5.37, 95% CI 1.28 to 22.49, p = 0.021). In conclusion, full metal jacket drug-eluting stents may be a safe and effective method to treat diffuse coronary disease and may be a useful treatment option for complex long lesions.

AB - Multiple overlapping drug-eluting stents have increasingly been used to treat diffuse coronary disease, but the safety and efficacy of this approach remains unclear. We assayed the clinical and angiographic outcomes after placement of "full metal jacket" stents (stented length ≥60 mm) in 347 consecutive patients (352 lesions) with very long de novo coronary lesions. Mean age was 61.0 ± 10.1 years, and the mean stented length was 71.9 ± 13.7 mm. The procedural success rate was 97.7%. Major in-hospital complications (1 death, 2 cases of acute stent thrombosis) occurred in 3 patients (0.7%). Angiographic follow-up data, obtained for 230 (234 lesions) of the 328 eligible patients (70.1%), showed that the restenosis rate was 13.7%. Multivariate analysis found that the reference artery diameter (odds ratio 0.05, 95% confidence interval [CI] 0.01 to 0.33, p = 0.002) and the use of Taxus stents (odds ratio 2.88, 95% CI 1.03 to 8.04, p = 0.043) were significant predictors of restenosis. During follow-up (16.6 ± 6.9 months), 9 deaths (6 cardiac and 3 noncardiac), 1 nonfatal myocardial infarction, and 13 target lesion revascularizations occurred. The cumulative probability of survival without major adverse cardiac events (cardiac death, Q-wave myocardial infarction, and target lesion revascularization) was 95.4 ± 1.1% and 91.4 ± 2.1% at 1 and 2 years, respectively. Left ventricular dysfunction (ejection fraction <45%) was the only predictor of stent thrombosis (hazard ratio 18.24, 95% CI 1.65 to 201.19, p = 0.018) and cardiac death/Q-wave myocardial infarction (hazard ratio 5.37, 95% CI 1.28 to 22.49, p = 0.021). In conclusion, full metal jacket drug-eluting stents may be a safe and effective method to treat diffuse coronary disease and may be a useful treatment option for complex long lesions.

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