Incidence and risk factors of late target lesion revascularization after sirolimus-eluting stent implantation (3-year follow-up of the j-Cypher Registry).
It yet has not been clarified whether there is a late catch-up phenomenon in target lesion revascularization (TLR) after sirolimus-eluting stent (SES) compared to bare metal stent (BMS) implantation. In 12,824 patients enrolled in the j-Cypher Registry, incidences of early (within first year) and late (1 year to 3 years) TLR were compared between 17,050 lesions treated with SESs and 1,259 lesions treated with BMSs. Incidences of TLR in SES-treated lesions were 5.7% at 1 year, 8.1% at 2 years, and 10.0% at 3 years, whereas those in BMS-treated lesions were 14.2%, 15.5%, and 15.5%, respectively (p <0.0001, log-rank test). Incidences of late TLR were significantly higher with SESs compared to BMSs (2.6% vs 1.4% at 2 years and 4.5% vs 1.4% at 3 years, p = 0.0007, log-rank test). A multivariable logistic regression model identified 7 independent risk factors for late TLR at 3 years after SES implantation: hemodialysis, low estimated glomerular filtration rate, ostial right coronary artery, lesion length >or=30 mm, 2 stents for bifurcation, American Heart Association/American College of Cardiology type B2/C, and vessel size <2.5 mm. Of these, 5 factors were common to those for early TLR. In conclusion, a late catch-up phenomenon was observed as indicated by the increasing incidence of late TLR after SES, but not after BMS, implantation. Risk factors for late TLR were generally common to those for early TLR.
Nakagawa
Yoshihisa
Y
Division of Cardiology, Tenri Hospital, Tenri, Japan. nakagawa@tenriyorozu-hp.or.jp
Kimura
Takeshi
T
Morimoto
Takeshi
T
Nomura
Masanori
M
Saku
Keijiro
K
Haruta
Seiichi
S
Muramatsu
Toshiya
T
Nobuyoshi
Masakiyo
M
Kadota
Kazushige
K
Fujita
Hiroshi
H
Tatami
Ryozo
R
Shiode
Nobuo
N
Nishikawa
Hideo
H
Shibata
Yoshisato
Y
Miyazaki
Shunichi
S
Murata
Yoshiharu
Y
Honda
Takashi
T
Kawasaki
Tomohiro
T
Doi
Osamu
O
Hiasa
Yoshikazu
Y
Hayashi
Yasuhiko
Y
Matsuzaki
Masunori
M
Mitsudo
Kazuaki
K
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D012042:Registries; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D020123:Sirolimus