Optical coherence tomography derived cut-off value of uncovered stent struts to predict adverse clinical outcomes after drug-eluting stent implantation

Hoyoun Won, Dong Ho Shin, Byeong Keuk Kim, Gary S. Mintz, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong

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Abstract

Although the presence of uncovered struts may be associated with occurrence of stent thrombosis, the impact of uncovered struts detected routinely by optical coherence tomography (OCT) on subsequent long-term clinical outcomes remains unclear. The objective of this study was to determine the cut-off value of uncovered struts that predicted adverse clinical outcomes after drug eluting stent (DES) implantation. Major safety events (MSEs, a composite occurrence of cardiovascular death, myocardial infarction, and stent thrombosis) were evaluated in 489 DES-treated patients (535 lesions) during the median 851 days after follow-upOCT.MSEs occurred in six patients (four definite stent thrombosis and two sudden cardiac death). The best cut-off value of percentage of uncovered struts for predicting MSE was 5.9 % using the maximal χ2 method: area under the receiver-operating characteristic curve = 0.779, 95 % confidence interval (CI) = 0.648-0.910, p = 0.019, a sensitivity of 83.3 %and a specificity of 70.3 %. Independent predictors for MSE were post-intervention minimal lumen diameter (odds ratio 0.019, 95 % CI = 0.001-0.513, p = 0.018) and percentage of uncovered struts >5.9 % (odds ratio 19.781, 95 %CI = 2.071-188.968, p = 0.010).Agreater percentage of uncovered struts (the cut-off value of >5.9 % uncovered struts) might be significantly associated with occurrence of MSE after DES implantation.

Original languageEnglish
Pages (from-to)1255-1263
Number of pages9
JournalInternational Journal of Cardiovascular Imaging
Volume29
Issue number6
DOIs
Publication statusPublished - 2013 Aug 1

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All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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