Long-term clinical outcomes of late stent malapposition detected by optical coherence tomography after drug-eluting stent implantation

Eui Im, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong

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Abstract

Background-The relationship between late stent malapposition (LSM) and adverse cardiovascular events is controversial. Studies are needed to evaluate long-term (>5 years) clinical outcomes of LSM detected by optical coherence tomography (OCT) after drugeluting stent implantation. Methods and Results-We investigated long-term clinical outcomes of OCT-detected LSM in 351 patients who received drugeluting stents and were examined by both poststent and follow-up OCT (175±60 days after drug-eluting stent implantation) from January 2009 to December 2011. LSM was observed in 99 patients (28%). We evaluated the cumulative rate of composite events (cardiovascular death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis). During 80.1±24.5 months of follow-up, very late stent thrombosis did not occur in any patients with LSM. The cumulative 8-year rate of composite events was 7.3% in patients with LSM and 10.5% in patients without LSM (P=0.822, log-rank test). We further divided patients into the following 4 groups: patients with both late-persistent and late-acquired stent malapposition (n=23), patients with late-persistent stent malapposition alone (n=45), patients with late-acquired stent malapposition alone (n=31), and patients without LSM (n=252). The cumulative 8-year rates of composite events were similar among these 4 groups (0%, 9.6%, 9.7%, and 10.5%, respectively; P=0.468 by log-rank test). Conclusions-During long-term follow-up (>5 years), very late stent thrombosis did not occur in patients with OCT-detected LSM. The rates of adverse clinical events were similar between patients with LSM versus those without LSM. Presence of OCT-detected LSM was not associated with unfavorable clinical outcomes.

Original languageEnglish
Article numbere011817
JournalJournal of the American Heart Association
Volume8
Issue number7
DOIs
Publication statusPublished - 2019 Jan 1

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Drug-Eluting Stents
Optical Coherence Tomography
Stents
Thrombosis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{63c0fd86952d4941a55c5c12c51d937d,
title = "Long-term clinical outcomes of late stent malapposition detected by optical coherence tomography after drug-eluting stent implantation",
abstract = "Background-The relationship between late stent malapposition (LSM) and adverse cardiovascular events is controversial. Studies are needed to evaluate long-term (>5 years) clinical outcomes of LSM detected by optical coherence tomography (OCT) after drugeluting stent implantation. Methods and Results-We investigated long-term clinical outcomes of OCT-detected LSM in 351 patients who received drugeluting stents and were examined by both poststent and follow-up OCT (175±60 days after drug-eluting stent implantation) from January 2009 to December 2011. LSM was observed in 99 patients (28{\%}). We evaluated the cumulative rate of composite events (cardiovascular death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis). During 80.1±24.5 months of follow-up, very late stent thrombosis did not occur in any patients with LSM. The cumulative 8-year rate of composite events was 7.3{\%} in patients with LSM and 10.5{\%} in patients without LSM (P=0.822, log-rank test). We further divided patients into the following 4 groups: patients with both late-persistent and late-acquired stent malapposition (n=23), patients with late-persistent stent malapposition alone (n=45), patients with late-acquired stent malapposition alone (n=31), and patients without LSM (n=252). The cumulative 8-year rates of composite events were similar among these 4 groups (0{\%}, 9.6{\%}, 9.7{\%}, and 10.5{\%}, respectively; P=0.468 by log-rank test). Conclusions-During long-term follow-up (>5 years), very late stent thrombosis did not occur in patients with OCT-detected LSM. The rates of adverse clinical events were similar between patients with LSM versus those without LSM. Presence of OCT-detected LSM was not associated with unfavorable clinical outcomes.",
author = "Eui Im 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 Hong, {Myeong Ki}",
year = "2019",
month = "1",
day = "1",
doi = "10.1161/JAHA.118.011817",
language = "English",
volume = "8",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
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}

Long-term clinical outcomes of late stent malapposition detected by optical coherence tomography after drug-eluting stent implantation. / Im, Eui; Hong, Sung Jin; Ahn, Chul Min; Kim, Jung Sun; Kim, Byeong Keuk; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeong Ki.

In: Journal of the American Heart Association, Vol. 8, No. 7, e011817, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term clinical outcomes of late stent malapposition detected by optical coherence tomography after drug-eluting stent implantation

AU - Im, Eui

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, Myeong Ki

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background-The relationship between late stent malapposition (LSM) and adverse cardiovascular events is controversial. Studies are needed to evaluate long-term (>5 years) clinical outcomes of LSM detected by optical coherence tomography (OCT) after drugeluting stent implantation. Methods and Results-We investigated long-term clinical outcomes of OCT-detected LSM in 351 patients who received drugeluting stents and were examined by both poststent and follow-up OCT (175±60 days after drug-eluting stent implantation) from January 2009 to December 2011. LSM was observed in 99 patients (28%). We evaluated the cumulative rate of composite events (cardiovascular death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis). During 80.1±24.5 months of follow-up, very late stent thrombosis did not occur in any patients with LSM. The cumulative 8-year rate of composite events was 7.3% in patients with LSM and 10.5% in patients without LSM (P=0.822, log-rank test). We further divided patients into the following 4 groups: patients with both late-persistent and late-acquired stent malapposition (n=23), patients with late-persistent stent malapposition alone (n=45), patients with late-acquired stent malapposition alone (n=31), and patients without LSM (n=252). The cumulative 8-year rates of composite events were similar among these 4 groups (0%, 9.6%, 9.7%, and 10.5%, respectively; P=0.468 by log-rank test). Conclusions-During long-term follow-up (>5 years), very late stent thrombosis did not occur in patients with OCT-detected LSM. The rates of adverse clinical events were similar between patients with LSM versus those without LSM. Presence of OCT-detected LSM was not associated with unfavorable clinical outcomes.

AB - Background-The relationship between late stent malapposition (LSM) and adverse cardiovascular events is controversial. Studies are needed to evaluate long-term (>5 years) clinical outcomes of LSM detected by optical coherence tomography (OCT) after drugeluting stent implantation. Methods and Results-We investigated long-term clinical outcomes of OCT-detected LSM in 351 patients who received drugeluting stents and were examined by both poststent and follow-up OCT (175±60 days after drug-eluting stent implantation) from January 2009 to December 2011. LSM was observed in 99 patients (28%). We evaluated the cumulative rate of composite events (cardiovascular death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis). During 80.1±24.5 months of follow-up, very late stent thrombosis did not occur in any patients with LSM. The cumulative 8-year rate of composite events was 7.3% in patients with LSM and 10.5% in patients without LSM (P=0.822, log-rank test). We further divided patients into the following 4 groups: patients with both late-persistent and late-acquired stent malapposition (n=23), patients with late-persistent stent malapposition alone (n=45), patients with late-acquired stent malapposition alone (n=31), and patients without LSM (n=252). The cumulative 8-year rates of composite events were similar among these 4 groups (0%, 9.6%, 9.7%, and 10.5%, respectively; P=0.468 by log-rank test). Conclusions-During long-term follow-up (>5 years), very late stent thrombosis did not occur in patients with OCT-detected LSM. The rates of adverse clinical events were similar between patients with LSM versus those without LSM. Presence of OCT-detected LSM was not associated with unfavorable clinical outcomes.

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U2 - 10.1161/JAHA.118.011817

DO - 10.1161/JAHA.118.011817

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