Long-term clinical outcomes after sirolimus-eluting stent implantation for treatment of restenosis within bare-metal versus drug-eluting stents

Whan Lee Cheol, Sang Hyun Kim, Jon Suh, Duk Woo Park, Seung Hwan Lee, Young Hak Kim, Myeong Ki Hong, Jae Joong Kim, Seong Wook Park, Seung Jung Park

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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 languageEnglish
Pages (from-to)594-598
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume71
Issue number5
DOIs
Publication statusPublished - 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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