title: Incidence and predictors for late target lesion revascularization after sirolimus-eluting stent implantation.
abstract: BACKGROUND
  In long-term follow-up after drug-eluting stents (DES) implantation, late target lesion revascularization (TLR) is occasionally required. However, the incidence and predictors for late TLR with DES have not been fully investigated.
  
  
  RESULTS
  Between August 2004 and March 2005, 249 consecutive patients underwent percutaneous coronary intervention with sirolimus-eluting stents (SES) at our institution. Angiographic follow-up data were obtained in 228 patients (91.6%) with 274 lesions (91.6%) at 8 months. TLR incidence was evaluated up to 5 years. The 5-year clinical follow-up data were obtained in 222 patients (97.4%) with 264 lesions (96.4%). The incidence of early TLR before 1 year was 16.7%, and that of late TLR (1-5 years) was 8.3% (2.1% per year). Multivariate analysis indicated that significant predictors for late TLR were insulin-treated diabetes mellitus (DM) (odds ratio (OR) 10.88, P=0.001), stent fracture (OR 27.24, P=0.012), and age (OR 0.94, P=0.026). No association was observed between late TLR and lesion characteristics, including parameters measured by quantitative coronary angiography other than stent fracture, at baseline, post procedure, and follow-up.
  
  
  CONCLUSIONS
  Late TLR after SES implantation occurred in approximately 2.1% of lesions per year after the first year without attenuation up to 5 years. Significant predictors for late TLR were insulin-treated DM, stent fracture and younger age. Careful long-term follow-up after SES implantation might be recommended.
authors.affiliation: Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Hara
authors.forename: Jiro
authors.initials: J
authors.lastname: Aoki
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: Shuzou
authors.initials: S
authors.lastname: Tanimoto
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Yahagi
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakashima
authors.forename: Takuya
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Asami
authors.forename: Mika
authors.initials: M
authors.lastname: Watanabe
authors.forename: Eri
authors.initials: E
authors.lastname: Yoshida
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hara
mesh_terms: D000367:Age Factors; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000494:pharmacology*; D017023:Coronary Angiography; D003920:Diabetes Mellitus / Q000188:drug therapy; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D015994:Incidence; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure / Q000009:adverse effects; D012307:Risk Factors; D020123:Sirolimus / Q000494:pharmacology*
chemical_list: D000903:Antibiotics, Antineoplastic; D007004:Hypoglycemic Agents; D007328:Insulin; D020123:Sirolimus