Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes

Eui Im, Seung Yul Lee, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeongki Hong

Research output: Contribution to journalArticle

Abstract

Background and aims: The impact of late drug-eluting stent (DES) malapposition detected by optical coherence tomography (OCT) on long-term clinical outcomes has not been clearly established. We evaluated long-term clinical outcomes of late stent malapposition (LSM) detected by OCT in a qualified study population. Methods: A total of 428 patients were selected from previous randomized OCT studies that evaluated the degree of strut coverage of different DESs at a 3–12-month follow-up OCT examination. These patients were assigned to one of two groups based on the presence (n = 136) or absence (n = 292) of LSM on follow-up OCT images (performed at 7.0 ± 3.4 months after DES implantation). The cumulative rates of composite events (cardiac death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis) were compared between the two groups. Results: During 73.7 ± 18.3 months of follow-up, cardiac death or (very) late stent thrombosis did not occur in either group. The cumulative rate of composite events was similar among the patients in each group (6.2% in patients with LSM vs. 11.7% in those without LSM) [hazard ratio (HR) = 0.569, 95% confidence interval (CI) = 0.257–1.257, p = 0.163]. Target vessel-related myocardial infarction occurred in 0.7% of patients with LSM vs. 1.5% of those without LSM (HR = 0.521, 95% CI = 0.058–4.670, p = 0.560). Target-vessel revascularization was performed in 5.4% of patients with LSM vs. 10.2% of those without LSM (HR = 0.574, 95% CI = 0.246–1.343, p = 0.201). Conclusions: Cardiac death or (very) late stent thrombosis did not occur in patients with OCT-detected LSM during long-term follow-up. The presence of OCT-detected LSM was not associated with adverse clinical events.

Original languageEnglish
Pages (from-to)118-123
Number of pages6
JournalAtherosclerosis
Volume288
DOIs
Publication statusPublished - 2019 Sep 1

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Drug-Eluting Stents
Stents
Optical Coherence Tomography
Thrombosis
Confidence Intervals
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Im, Eui ; Lee, Seung Yul ; Hong, Sung Jin ; Ahn, Chul Min ; Kim, Jung Sun ; Kim, Byeong Keuk ; Ko, Young Guk ; Choi, Donghoon ; Jang, Yangsoo ; Hong, Myeongki. / Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes. In: Atherosclerosis. 2019 ; Vol. 288. pp. 118-123.
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title = "Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes",
abstract = "Background and aims: The impact of late drug-eluting stent (DES) malapposition detected by optical coherence tomography (OCT) on long-term clinical outcomes has not been clearly established. We evaluated long-term clinical outcomes of late stent malapposition (LSM) detected by OCT in a qualified study population. Methods: A total of 428 patients were selected from previous randomized OCT studies that evaluated the degree of strut coverage of different DESs at a 3–12-month follow-up OCT examination. These patients were assigned to one of two groups based on the presence (n = 136) or absence (n = 292) of LSM on follow-up OCT images (performed at 7.0 ± 3.4 months after DES implantation). The cumulative rates of composite events (cardiac death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis) were compared between the two groups. Results: During 73.7 ± 18.3 months of follow-up, cardiac death or (very) late stent thrombosis did not occur in either group. The cumulative rate of composite events was similar among the patients in each group (6.2{\%} in patients with LSM vs. 11.7{\%} in those without LSM) [hazard ratio (HR) = 0.569, 95{\%} confidence interval (CI) = 0.257–1.257, p = 0.163]. Target vessel-related myocardial infarction occurred in 0.7{\%} of patients with LSM vs. 1.5{\%} of those without LSM (HR = 0.521, 95{\%} CI = 0.058–4.670, p = 0.560). Target-vessel revascularization was performed in 5.4{\%} of patients with LSM vs. 10.2{\%} of those without LSM (HR = 0.574, 95{\%} CI = 0.246–1.343, p = 0.201). Conclusions: Cardiac death or (very) late stent thrombosis did not occur in patients with OCT-detected LSM during long-term follow-up. The presence of OCT-detected LSM was not associated with adverse clinical events.",
author = "Eui Im and Lee, {Seung Yul} and Hong, {Sung Jin} and Ahn, {Chul Min} and Kim, {Jung Sun} and Kim, {Byeong Keuk} and Ko, {Young Guk} and Donghoon Choi and Yangsoo Jang and Myeongki Hong",
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Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes. / Im, Eui; Lee, Seung Yul; Hong, Sung Jin; Ahn, Chul Min; Kim, Jung Sun; Kim, Byeong Keuk; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeongki.

In: Atherosclerosis, Vol. 288, 01.09.2019, p. 118-123.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes

AU - Im, Eui

AU - Lee, Seung Yul

AU - Hong, Sung Jin

AU - Ahn, Chul Min

AU - Kim, Jung Sun

AU - Kim, Byeong Keuk

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Hong, Myeongki

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background and aims: The impact of late drug-eluting stent (DES) malapposition detected by optical coherence tomography (OCT) on long-term clinical outcomes has not been clearly established. We evaluated long-term clinical outcomes of late stent malapposition (LSM) detected by OCT in a qualified study population. Methods: A total of 428 patients were selected from previous randomized OCT studies that evaluated the degree of strut coverage of different DESs at a 3–12-month follow-up OCT examination. These patients were assigned to one of two groups based on the presence (n = 136) or absence (n = 292) of LSM on follow-up OCT images (performed at 7.0 ± 3.4 months after DES implantation). The cumulative rates of composite events (cardiac death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis) were compared between the two groups. Results: During 73.7 ± 18.3 months of follow-up, cardiac death or (very) late stent thrombosis did not occur in either group. The cumulative rate of composite events was similar among the patients in each group (6.2% in patients with LSM vs. 11.7% in those without LSM) [hazard ratio (HR) = 0.569, 95% confidence interval (CI) = 0.257–1.257, p = 0.163]. Target vessel-related myocardial infarction occurred in 0.7% of patients with LSM vs. 1.5% of those without LSM (HR = 0.521, 95% CI = 0.058–4.670, p = 0.560). Target-vessel revascularization was performed in 5.4% of patients with LSM vs. 10.2% of those without LSM (HR = 0.574, 95% CI = 0.246–1.343, p = 0.201). Conclusions: Cardiac death or (very) late stent thrombosis did not occur in patients with OCT-detected LSM during long-term follow-up. The presence of OCT-detected LSM was not associated with adverse clinical events.

AB - Background and aims: The impact of late drug-eluting stent (DES) malapposition detected by optical coherence tomography (OCT) on long-term clinical outcomes has not been clearly established. We evaluated long-term clinical outcomes of late stent malapposition (LSM) detected by OCT in a qualified study population. Methods: A total of 428 patients were selected from previous randomized OCT studies that evaluated the degree of strut coverage of different DESs at a 3–12-month follow-up OCT examination. These patients were assigned to one of two groups based on the presence (n = 136) or absence (n = 292) of LSM on follow-up OCT images (performed at 7.0 ± 3.4 months after DES implantation). The cumulative rates of composite events (cardiac death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis) were compared between the two groups. Results: During 73.7 ± 18.3 months of follow-up, cardiac death or (very) late stent thrombosis did not occur in either group. The cumulative rate of composite events was similar among the patients in each group (6.2% in patients with LSM vs. 11.7% in those without LSM) [hazard ratio (HR) = 0.569, 95% confidence interval (CI) = 0.257–1.257, p = 0.163]. Target vessel-related myocardial infarction occurred in 0.7% of patients with LSM vs. 1.5% of those without LSM (HR = 0.521, 95% CI = 0.058–4.670, p = 0.560). Target-vessel revascularization was performed in 5.4% of patients with LSM vs. 10.2% of those without LSM (HR = 0.574, 95% CI = 0.246–1.343, p = 0.201). Conclusions: Cardiac death or (very) late stent thrombosis did not occur in patients with OCT-detected LSM during long-term follow-up. The presence of OCT-detected LSM was not associated with adverse clinical events.

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