Lower levels of in-stent late loss are not associated with the risk of stent thrombosis in patients receiving drug-eluting stents.
OBJECTIVE
The aim of this study was to evaluate whether there is any relationship between in-stent late loss (ISLL) and the risk of stent thrombosis (ST) in patients treated with drug eluting stents (DES). The benefit of DES in reducing binary angiographic restenosis and the need for new revascularisation procedures is due to a reduction on ISLL. It has been hypothesised, however, that neointimal hyperplasia could preclude ST, and thus a very low ISLL could increase the risk of ST.


RESULTS
We selected 26 randomised clinical trials comparing bare metal stents and DES or different DES types, and including clinical and angiographic follow-up. In order to evaluate the association between risk of ST and ISLL, meta-regression analyses were conducted, weighting for the number of patients of each study. Twenty-six studies were included, retrieving 36 subgroups for analysis and 8,971 patients treated with DES. The incidence for ST and LST was 0.81% and 0.17%. Using meta-regression techniques, neither the risk of ST nor the risk of LST were found to be significantly associated with ISLL, accounting for -0.82 and -0.002 meta-regression estimates respectively (IC 95%: -1.92 to 0.28 for ST and -0.008 to 0.003 for LST).


CONCLUSIONS
The risk of ST and LST after DES implantation is not related with ISLL values. A very low mean value of ISLL is nor associated with a higher risk of ST.
Rivero
Fernando
F
Department of Interventional Cardiology, University Hospital La Paz, Madrid, Spain.
Moreno
Raúl
R
Barreales
Laura
L
Galeote
Guillermo
G
Sánchez-Recalde
Angel
A
Calvo
Luis
L
Jimenez-Valero
Santiago
S
Villate
Alexis
A
Vanegas
Mauricio
M
López-Sendón
José-Luis
JL
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D011859:Radiography; D012307:Risk Factors