[Long-term clinical efficiency of endovascular treatment using Cypher rapamycin-eluting stents in patients with coronary heart disease].
The study was undertaken to analyze the long-term results in patients with coronary heart disease (CHD) one year or more after Cypher stent implantation. It covered 1221 patients. One-, two-, and three- vessel lesions were observed in 693 (56.8%), 344 (28.2%), and 184 (15%) patients, respectively. A total of 1967 Cypher stents were implanted. The results of treatment were analyzed 1 and 2 years after intervention. The efficiency of a procedure was evaluated by the following parameters: the presence or absence of anginal symptoms, the presence and absence of complications (fatal outcome, myocardial infarction). The following morphological parameters: the rate of restenosis and that of late stent thrombosis were also assessed. The results of one- and two-year follow-ups were used to make a multivariate analysis of the clinical and morphological predictors of coronary complications (fatal outcome, myocardial infarction, recurrent angina pectoris) in the late period, as well as the predictors of restenosis and late stent thrombosis. Restenosis following 1 year of Cypher stent implantation is 3.1%. The factors that significantly increase the risk of this complication within the first year are diabetes mellitus and revascularization in the patients operated on. The one-year rate of Cypher stent thromboses is 1.6%. Patients' discontinuation of antiaggregant therapy is the sole factor that significantly increases the rate of their late thromboses in this period. Within the second year of a follow-up, the rate of late Cypher stent thromboses is 1.8%. The risk of this complication is significantly increased by factors, such as a lengthy (more than 3 mm) stented portion, renal failure, and less than 40% left ventricular ejection fraction.
Savchenko
A P
AP
Cherkavskaia
O V
OV
Rudenko
B A
BA
Bolotov
P A
PA
D001807:Blood Vessel Prosthesis; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D023921:Coronary Stenosis / Q000517:prevention & control*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000378:metabolism / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000295:instrumentation; D011859:Radiography; D012008:Recurrence; D020123:Sirolimus / Q000378:metabolism / Q000494:pharmacology*; D015607:Stents; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000295:instrumentation*
D007166:Immunosuppressive Agents; D020123:Sirolimus