Possible predictors of target lesion revascularization after drug-eluting stent implantation.
BACKGROUND
A small number of patients still need target lesion revascularization (TLR) after drug-eluting stent (DES) implantation. It is important for the management of coronary artery disease to assess the predictors of TLR after DES implantation.


RESULTS
Two hundred ninety-seven patients (325 lesions) were treated with Cypher sirolimus-eluting and/or TAXUS paclitaxel-eluting stent implantation at four centers in Japan and Brazil. Among these centers, 20 patients (24 lesions) needed clinically driven TLR. The clinical and angiographic characteristics of TLR patients were compared to those of non-TLR patients. Hemodialysis, prior myocardial infarction (MI) and prior coronary artery bypass grafting (CABG) were more frequent in TLR patients than in non-TLR patients. An ostial stenosis was more frequent in the TLR group than in the non-TLR group (41.7% vs 19.9%, p=0.012). In addition, post-procedure in-stent percentage diameter stenosis (%DS) was higher in TLR patients (21.9% vs 13.3%, p = 0.002). Stepwise logistic regression analysis indicated that all of these variables were independent predictors of TLR after DES implantation.


CONCLUSIONS
Hemodialysis, prior MI, prior CABG, ostial lesion location and high in-stent %DS may be independent predictors of TLR after DES implantation.
Yanagi
Daizaburo
D
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka.
Shirai
Kazuyuki
K
Mori
Ken
K
Ike
Amane
A
Costantini
Costantino O
CO
Costantini
Costantino R
CR
Nishikawa
Hiroaki
H
Miller
Nathan
N
Zhang
Bo
B
Tsuchiya
Yoshihiro
Y
Urata
Hidenori
H
Saku
Keijiro
K
D000368:Aged; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005544:Forecasting; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D017239:Paclitaxel / Q000008:administration & dosage*; D006435:Renal Dialysis; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000009:adverse effects
D017239:Paclitaxel; D020123:Sirolimus