title: Predictors of early and late target lesion revascularization after drug-eluting stent implantation.
abstract: BACKGROUND
  Recent studies have suggested the existence of a late catch-up phenomenon after drug-eluting stent (DES) implantation. The aim of this study is to identify predictors of early (≤1 year) and late (>1 year) target lesion revascularization (TLR) in DESs.
  
  
  METHODS
  The COACT (CathOlic medical center percutAneous Coronary inTervention) registry was designed to evaluate the clinical outcomes after DES implantation. Data from 9,127 consecutive patients were reviewed, all of whom underwent percutaneous coronary intervention (PCI) with DES between January 2004 and December 2009, including 8,126 patients who received PCI with homogenous DES.
  
  
  RESULTS
  During a median follow-up period of 24 months (interquartile range, 11-41), the cumulative incidences of early and late TLR were 4.7% (95% confidence interval [CI], 4.2-5.1) and 3.3% (95% CI, 2.9-3.7). Independent predictors of early TLR were multivessel disease (odds ratio [OR] 1.637; 95% CI 1.241-2.158, P < 0.001) and stent diameter (OR 0.614; 95% CI 0.437-0.862, P = 0.005). Independent predictors of late TLR were stent diameter (OR 0.567; 95% CI 0.367-0.875, P = 0.010), insulin-dependent diabetes mellitus (OR 2.235; 95% CI 1.314-3.802, P = 0.003), first-generation DES (OR 5.104; 95% CI 2.744-9.492, P < 0.001), and elevated levels of high-sensitivity C-reactive protein at follow-up coronary angiography >2 mg/dL (OR 1.616; 95% CI 1.173-2.226, P = 0.003).
  
  
  CONCLUSIONS
  Although multivessel disease and stent diameter were associated with early TLR, late TLR was more associated with clinical comorbidities including insulin-dependent diabetes and procedural factors like the generation of the stent used and stent diameter. The risk factors for TLR may be markedly different at different time points during TLR.
authors.affiliation: Cardiovascular Center and Cardiology Division, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ik Jun
authors.initials: IJ
authors.lastname: Choi
authors.forename: Hun-Jun
authors.initials: HJ
authors.lastname: Park
authors.forename: Suk-Min
authors.initials: SM
authors.lastname: Seo
authors.forename: Yoon-Seok
authors.initials: YS
authors.lastname: Koh
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Kiyuk
authors.initials: K
authors.lastname: Chang
authors.forename: Wook-Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Pum-Joon
authors.initials: PJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D023903:Coronary Restenosis / Q000453:epidemiology* / Q000209:etiology; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012042:Registries; D056910:Republic of Korea; D012307:Risk Factors; D016896:Treatment Outcome