title: Long-term clinical follow-up after drug-eluting stent implantation for bare metal in-stent restenosis.
abstract: OBJECTIVE
  We aimed to evaluate the long-term safety and efficacy of drug-eluting stent (DES) implantation in the treatment of diffuse bare metal stent (BMS) restenosis as compared to the treatment of de novo coronary lesions in high restenosis risk patient population.
  
  
  BACKGROUND
  To date limited long-term data are available about the treatment of BMS restenosis with DES.
  
  
  METHODS
  Five hundred and fourteen consecutive patients who underwent DES implantation between January 2003 and October 2006 at our institute were studied: 201 patients received DES for treatment of BMS restenosis and 313 patients received DES for high restenosis risk de novo lesions. Outcomes were calculated using propensity score adjustment. Mean follow-up length was 45.6 ± 21.5 months.
  
  
  RESULTS
  The rates of acute coronary syndrome, three-vessel disease, and diabetes were high in both restenosis and de novo groups: 44.8% versus 46.3%, 20.9% versus 28.7%, and 34.3% versus 38.9%, respectively. The incidence of ischemia-driven target lesion revascularization (TLR) yielded similar results in the restenosis group and de novo group at 4 years (10.4% vs 12.4%, P = 0.490). All-cause mortality was lower in the restenosis group at 4 years (7.4% vs 14.7%, P = 0.032); however, the incidence of definite and probable stent thrombosis did not differ (1.9% vs 1.6%, P = 0.708) between the 2 groups.
  
  
  CONCLUSIONS
  DESs are safe in the treatment of diffuse BMS restenosis and the rate of additional TLR is acceptable as compared to the use of DES in de novo lesions.
authors.affiliation: Semmelweis University, Heart Center, Budapest, Hungary. bberta9@gmail.com
authors.forename: Balazs
authors.initials: B
authors.lastname: Berta
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Ruzsa
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Barczi
authors.forename: David
authors.initials: D
authors.lastname: Becker
authors.forename: Laszlo
authors.initials: L
authors.lastname: Geller
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Jambrik
authors.forename: Levente
authors.initials: L
authors.lastname: Molnar
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Szabo
authors.forename: Bela
authors.initials: B
authors.lastname: Merkely
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011446:Prospective Studies; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States