Abstract
Background: Sirolimus-eluting stents have been increasingly used for treatment of restenosis after implantation of bare metal stents (BMSs) or drug-eluting stents (DESs), but little is known regarding their long-term outcomes. Methods: We compared long-term clinical outcomes in 295 patients treated with sirolimus-eluting stents for post-BMS (n = 224) vs. post-DES (n = 71) restenosis. All follow-ups were at least 12 months, and the primary endpoint was major adverse cardiac events (MACE), defined as cardiac death, nonfatal myocardial infarction (MI) or target lesion revascularization (TLR). Results: Baseline characteristics were similar between the two groups, except that mean lesion length (28.0 ± 16.2 vs. 19.5 ± 13.6, P < 0.01) and mean stented length (35.4 ± 19.2 vs. 25.7 ± 14.7, P < 0.01) were significantly longer in the post-BMS group. Major in-hospital complications occurred in 2 patients. During a mean follow-up of 31.3 ± 11.1 months, there were 9 deaths (4 cardiac, 5 noncardiac), 3 nonfatal MIs, and 25 TLRs. Late stent thrombosis was documented in 2 patients (1 in each group). There were no between group differences in cardiac or total deaths, but there were trends toward less frequent cardiac death/MI or TLR in the post-BMS group. The cumulative probability of MACE-free survival was significantly better for the post-BMS group (95.0% ± 1.5% vs. 87.3% ± 4.0% at 1 year; 93.0% ± 1.7% vs. 81.0% ± 5.2% at 2 years; Log Rank P = 0.016). In multivariate analysis, post-DES restenosis was the only significant predictor of MACE (OR 3.29, 95%CI 1.13-9.61, P = 0.029). Conclusions: Sirolimus-eluting stents were effective for treatment of in-stent restenosis, but post-DES restenosis was associated with poorer outcomes than post-BMS restenosis.
| Original language | English |
|---|---|
| Pages (from-to) | 594-598 |
| Number of pages | 5 |
| Journal | Catheterization and Cardiovascular Interventions |
| Volume | 71 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2008 Apr 1 |
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All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
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Long-term clinical outcomes after sirolimus-eluting stent implantation for treatment of restenosis within bare-metal versus drug-eluting stents. / Cheol, Whan Lee; Kim, Sang Hyun; Suh, Jon; Park, Duk Woo; Lee, Seung Hwan; Kim, Young Hak; Hong, Myeong Ki; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung.
In: Catheterization and Cardiovascular Interventions, Vol. 71, No. 5, 01.04.2008, p. 594-598.Research output: Contribution to journal › Article
TY - JOUR
T1 - Long-term clinical outcomes after sirolimus-eluting stent implantation for treatment of restenosis within bare-metal versus drug-eluting stents
AU - Cheol, Whan Lee
AU - Kim, Sang Hyun
AU - Suh, Jon
AU - Park, Duk Woo
AU - Lee, Seung Hwan
AU - Kim, Young Hak
AU - Hong, Myeong Ki
AU - Kim, Jae Joong
AU - Park, Seong Wook
AU - Park, Seung Jung
PY - 2008/4/1
Y1 - 2008/4/1
N2 - Background: Sirolimus-eluting stents have been increasingly used for treatment of restenosis after implantation of bare metal stents (BMSs) or drug-eluting stents (DESs), but little is known regarding their long-term outcomes. Methods: We compared long-term clinical outcomes in 295 patients treated with sirolimus-eluting stents for post-BMS (n = 224) vs. post-DES (n = 71) restenosis. All follow-ups were at least 12 months, and the primary endpoint was major adverse cardiac events (MACE), defined as cardiac death, nonfatal myocardial infarction (MI) or target lesion revascularization (TLR). Results: Baseline characteristics were similar between the two groups, except that mean lesion length (28.0 ± 16.2 vs. 19.5 ± 13.6, P < 0.01) and mean stented length (35.4 ± 19.2 vs. 25.7 ± 14.7, P < 0.01) were significantly longer in the post-BMS group. Major in-hospital complications occurred in 2 patients. During a mean follow-up of 31.3 ± 11.1 months, there were 9 deaths (4 cardiac, 5 noncardiac), 3 nonfatal MIs, and 25 TLRs. Late stent thrombosis was documented in 2 patients (1 in each group). There were no between group differences in cardiac or total deaths, but there were trends toward less frequent cardiac death/MI or TLR in the post-BMS group. The cumulative probability of MACE-free survival was significantly better for the post-BMS group (95.0% ± 1.5% vs. 87.3% ± 4.0% at 1 year; 93.0% ± 1.7% vs. 81.0% ± 5.2% at 2 years; Log Rank P = 0.016). In multivariate analysis, post-DES restenosis was the only significant predictor of MACE (OR 3.29, 95%CI 1.13-9.61, P = 0.029). Conclusions: Sirolimus-eluting stents were effective for treatment of in-stent restenosis, but post-DES restenosis was associated with poorer outcomes than post-BMS restenosis.
AB - Background: Sirolimus-eluting stents have been increasingly used for treatment of restenosis after implantation of bare metal stents (BMSs) or drug-eluting stents (DESs), but little is known regarding their long-term outcomes. Methods: We compared long-term clinical outcomes in 295 patients treated with sirolimus-eluting stents for post-BMS (n = 224) vs. post-DES (n = 71) restenosis. All follow-ups were at least 12 months, and the primary endpoint was major adverse cardiac events (MACE), defined as cardiac death, nonfatal myocardial infarction (MI) or target lesion revascularization (TLR). Results: Baseline characteristics were similar between the two groups, except that mean lesion length (28.0 ± 16.2 vs. 19.5 ± 13.6, P < 0.01) and mean stented length (35.4 ± 19.2 vs. 25.7 ± 14.7, P < 0.01) were significantly longer in the post-BMS group. Major in-hospital complications occurred in 2 patients. During a mean follow-up of 31.3 ± 11.1 months, there were 9 deaths (4 cardiac, 5 noncardiac), 3 nonfatal MIs, and 25 TLRs. Late stent thrombosis was documented in 2 patients (1 in each group). There were no between group differences in cardiac or total deaths, but there were trends toward less frequent cardiac death/MI or TLR in the post-BMS group. The cumulative probability of MACE-free survival was significantly better for the post-BMS group (95.0% ± 1.5% vs. 87.3% ± 4.0% at 1 year; 93.0% ± 1.7% vs. 81.0% ± 5.2% at 2 years; Log Rank P = 0.016). In multivariate analysis, post-DES restenosis was the only significant predictor of MACE (OR 3.29, 95%CI 1.13-9.61, P = 0.029). Conclusions: Sirolimus-eluting stents were effective for treatment of in-stent restenosis, but post-DES restenosis was associated with poorer outcomes than post-BMS restenosis.
UR - http://www.scopus.com/inward/record.url?scp=42249113032&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=42249113032&partnerID=8YFLogxK
U2 - 10.1002/ccd.21399
DO - 10.1002/ccd.21399
M3 - Article
C2 - 18311841
AN - SCOPUS:42249113032
VL - 71
SP - 594
EP - 598
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
IS - 5
ER -