Incidence and Predictors for Late Target Lesion Revascularization After Sirolimus-Eluting Stent Implantation
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概要
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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. Methods and 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. (Circ J 2013; 77: 988–994)
著者
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Tanabe Kengo
Division Of Cardiology Mitsui Memorial Hospital
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Aoki Jiro
Division Of Cardiology Mitsui Memorial Hospital
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Hashimoto Takuya
Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of
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Tanimoto Shuzou
Division Of Cardiology Mitsui Memorial Hospital
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Hara Kazuhiro
Division Of Cardiology
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Nakajima Hiroyoshi
Division Of Cardiology Department Of Medicine Mitsui Memorial Hospital
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Watanabe Mika
Division of Cardiology, Mitsui Memorial Hospital
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Hara Hironori
Division of Cardiology, Mitsui Memorial Hospital
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Nakajima Yoshifumi
Division of Cardiology, Mitsui Memorial Hospital
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Yahagi Kazuyuki
Division of Cardiology, Mitsui Memorial Hospital
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Nakashima Makoto
Division of Cardiology, Mitsui Memorial Hospital
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Asami Masahiko
Division of Cardiology, Mitsui Memorial Hospital
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Yoshida Eri
Division of Cardiology, Mitsui Memorial Hospital
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Hashimoto Takuya
Division of Cardiology, Mitsui Memorial Hospital
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