Results and Predictors of Angiographic Restenosis and Long-Term Adverse Cardiac Events After Drug-Eluting Stent Implantation for Aorto-Ostial Coronary Artery Disease

Duk Woo Park, Myeongki Hong, Il Woo Suh, Eui Seock Hwang, Se Whan Lee, Young Hoon Jeong, Young Hak Kim, Cheol Whan Lee, Jae Joong Kim, Seong Wook Park, Seung Jung Park

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Abstract

The correlates of angiographic and clinical outcomes after drug-eluting stent (DES) implantation for aorto-ostial lesions remain unknown. This study evaluated long-term results of DES implantation for aorto-ostial lesions and determined risk factors for restenosis and adverse cardiac events. In total, 184 consecutive patients who underwent DES implantation for aorto-ostial lesions were investigated (DES group) compared with 172 consecutive patients treated with bare metal stents before the introduction of DESs (pre-DES group). Major adverse cardiac events (MACEs) were defined as death, Q-wave myocardial infarction, and need for target lesion revascularization. The DES group had significantly higher risk clinical and procedural profiles than the pre-DES group. Procedural success rates were 99.5% in the DES group and 100% in the pre-DES group (p = 1.0). The DES group had a significantly lower incidence of in-segment restenosis (10.5% vs 26.0%, p = 0.001) and target lesion revascularization (4.3% vs 11.6%, p = 0.011). Cumulative MACE rates at 1 year were 6.5% in the DES group and 13.4% in the pre-DES group (p = 0.03). By multivariate analysis, treatment of bypass graft, treatment of in-stent restenosis, and reference vessel diameter were predictors of restenosis, and only reference vessel diameter (hazard ratio 0.20, 95% confidence interval 0.05 to 0.75, p = 0.017) inversely correlated with 1-year MACEs after DES implantation. In conclusion, DES implantation for aorto-ostial lesions is associated with a significant decrease in restenosis and MACEs compared with the pre-DES phase. Treatment of bypass graft and in-stent restenosis and reference vessel size were identified as predictors of restenosis and/or long-term MACEs after DES implantation.

Original languageEnglish
Pages (from-to)760-765
Number of pages6
JournalAmerican Journal of Cardiology
Volume99
Issue number6
DOIs
Publication statusPublished - 2007 Mar 15

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Drug-Eluting Stents
Coronary Artery Disease
Stents
Transplants

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Duk Woo ; Hong, Myeongki ; Suh, Il Woo ; Hwang, Eui Seock ; Lee, Se Whan ; Jeong, Young Hoon ; Kim, Young Hak ; Lee, Cheol Whan ; Kim, Jae Joong ; Park, Seong Wook ; Park, Seung Jung. / Results and Predictors of Angiographic Restenosis and Long-Term Adverse Cardiac Events After Drug-Eluting Stent Implantation for Aorto-Ostial Coronary Artery Disease. In: American Journal of Cardiology. 2007 ; Vol. 99, No. 6. pp. 760-765.
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title = "Results and Predictors of Angiographic Restenosis and Long-Term Adverse Cardiac Events After Drug-Eluting Stent Implantation for Aorto-Ostial Coronary Artery Disease",
abstract = "The correlates of angiographic and clinical outcomes after drug-eluting stent (DES) implantation for aorto-ostial lesions remain unknown. This study evaluated long-term results of DES implantation for aorto-ostial lesions and determined risk factors for restenosis and adverse cardiac events. In total, 184 consecutive patients who underwent DES implantation for aorto-ostial lesions were investigated (DES group) compared with 172 consecutive patients treated with bare metal stents before the introduction of DESs (pre-DES group). Major adverse cardiac events (MACEs) were defined as death, Q-wave myocardial infarction, and need for target lesion revascularization. The DES group had significantly higher risk clinical and procedural profiles than the pre-DES group. Procedural success rates were 99.5{\%} in the DES group and 100{\%} in the pre-DES group (p = 1.0). The DES group had a significantly lower incidence of in-segment restenosis (10.5{\%} vs 26.0{\%}, p = 0.001) and target lesion revascularization (4.3{\%} vs 11.6{\%}, p = 0.011). Cumulative MACE rates at 1 year were 6.5{\%} in the DES group and 13.4{\%} in the pre-DES group (p = 0.03). By multivariate analysis, treatment of bypass graft, treatment of in-stent restenosis, and reference vessel diameter were predictors of restenosis, and only reference vessel diameter (hazard ratio 0.20, 95{\%} confidence interval 0.05 to 0.75, p = 0.017) inversely correlated with 1-year MACEs after DES implantation. In conclusion, DES implantation for aorto-ostial lesions is associated with a significant decrease in restenosis and MACEs compared with the pre-DES phase. Treatment of bypass graft and in-stent restenosis and reference vessel size were identified as predictors of restenosis and/or long-term MACEs after DES implantation.",
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Results and Predictors of Angiographic Restenosis and Long-Term Adverse Cardiac Events After Drug-Eluting Stent Implantation for Aorto-Ostial Coronary Artery Disease. / Park, Duk Woo; Hong, Myeongki; Suh, Il Woo; Hwang, Eui Seock; Lee, Se Whan; Jeong, Young Hoon; Kim, Young Hak; Lee, Cheol Whan; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung.

In: American Journal of Cardiology, Vol. 99, No. 6, 15.03.2007, p. 760-765.

Research output: Contribution to journalArticle

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T1 - Results and Predictors of Angiographic Restenosis and Long-Term Adverse Cardiac Events After Drug-Eluting Stent Implantation for Aorto-Ostial Coronary Artery Disease

AU - Park, Duk Woo

AU - Hong, Myeongki

AU - Suh, Il Woo

AU - Hwang, Eui Seock

AU - Lee, Se Whan

AU - Jeong, Young Hoon

AU - Kim, Young Hak

AU - Lee, Cheol Whan

AU - Kim, Jae Joong

AU - Park, Seong Wook

AU - Park, Seung Jung

PY - 2007/3/15

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N2 - The correlates of angiographic and clinical outcomes after drug-eluting stent (DES) implantation for aorto-ostial lesions remain unknown. This study evaluated long-term results of DES implantation for aorto-ostial lesions and determined risk factors for restenosis and adverse cardiac events. In total, 184 consecutive patients who underwent DES implantation for aorto-ostial lesions were investigated (DES group) compared with 172 consecutive patients treated with bare metal stents before the introduction of DESs (pre-DES group). Major adverse cardiac events (MACEs) were defined as death, Q-wave myocardial infarction, and need for target lesion revascularization. The DES group had significantly higher risk clinical and procedural profiles than the pre-DES group. Procedural success rates were 99.5% in the DES group and 100% in the pre-DES group (p = 1.0). The DES group had a significantly lower incidence of in-segment restenosis (10.5% vs 26.0%, p = 0.001) and target lesion revascularization (4.3% vs 11.6%, p = 0.011). Cumulative MACE rates at 1 year were 6.5% in the DES group and 13.4% in the pre-DES group (p = 0.03). By multivariate analysis, treatment of bypass graft, treatment of in-stent restenosis, and reference vessel diameter were predictors of restenosis, and only reference vessel diameter (hazard ratio 0.20, 95% confidence interval 0.05 to 0.75, p = 0.017) inversely correlated with 1-year MACEs after DES implantation. In conclusion, DES implantation for aorto-ostial lesions is associated with a significant decrease in restenosis and MACEs compared with the pre-DES phase. Treatment of bypass graft and in-stent restenosis and reference vessel size were identified as predictors of restenosis and/or long-term MACEs after DES implantation.

AB - The correlates of angiographic and clinical outcomes after drug-eluting stent (DES) implantation for aorto-ostial lesions remain unknown. This study evaluated long-term results of DES implantation for aorto-ostial lesions and determined risk factors for restenosis and adverse cardiac events. In total, 184 consecutive patients who underwent DES implantation for aorto-ostial lesions were investigated (DES group) compared with 172 consecutive patients treated with bare metal stents before the introduction of DESs (pre-DES group). Major adverse cardiac events (MACEs) were defined as death, Q-wave myocardial infarction, and need for target lesion revascularization. The DES group had significantly higher risk clinical and procedural profiles than the pre-DES group. Procedural success rates were 99.5% in the DES group and 100% in the pre-DES group (p = 1.0). The DES group had a significantly lower incidence of in-segment restenosis (10.5% vs 26.0%, p = 0.001) and target lesion revascularization (4.3% vs 11.6%, p = 0.011). Cumulative MACE rates at 1 year were 6.5% in the DES group and 13.4% in the pre-DES group (p = 0.03). By multivariate analysis, treatment of bypass graft, treatment of in-stent restenosis, and reference vessel diameter were predictors of restenosis, and only reference vessel diameter (hazard ratio 0.20, 95% confidence interval 0.05 to 0.75, p = 0.017) inversely correlated with 1-year MACEs after DES implantation. In conclusion, DES implantation for aorto-ostial lesions is associated with a significant decrease in restenosis and MACEs compared with the pre-DES phase. Treatment of bypass graft and in-stent restenosis and reference vessel size were identified as predictors of restenosis and/or long-term MACEs after DES implantation.

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