1. Do outcomes following intervention for drug-eluting stent restenosis depend on whether the restenosed stent was polymer-free or polymer-coated?
- Author
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Harada Y, Schneider S, Colleran R, Rai H, Bohner J, Kuna C, Kufner S, Giacoppo D, Schüpke S, Joner M, Ibrahim T, Laugwitz KL, Kastrati A, and Byrne RA
- Subjects
- Aged, Angioplasty, Balloon, Coronary, Cause of Death, Coronary Restenosis etiology, Coronary Restenosis mortality, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction epidemiology, Myocardial Revascularization statistics & numerical data, Retreatment statistics & numerical data, Statistics, Nonparametric, Time Factors, Treatment Outcome, Coronary Restenosis therapy, Drug-Eluting Stents adverse effects, Polymers adverse effects
- Abstract
Introduction and Objectives: Outcomes of patients undergoing percutaneous intervention for drug-eluting stent (DES) restenosis are poorer than those in patients with bare-metal stent restenosis. It is unknown if this is related to the presence of polymer coating. We sought to compare outcomes after interventions for in-stent restenosis (ISR) of polymer-free DES vs durable polymer DES., Methods: Patients enrolled in the ISAR-TEST 5 randomized trial who underwent repeat percutaneous intervention for ISR during follow-up were included. Angiographic outcomes at 6 to 8 months and clinical outcomes at 2 years were analyzed and compared between 2 groups according to whether the restenosed stent was a polymer-free or a durable polymer DES. Multivariate analysis was used to adjust for differences between groups., Results: A total of 326 patients with ISR were included: 220 with ISR in polymer-free DES and 106 with ISR in durable polymer DES. Angiographic follow-up was available for 83.4% of patients. No difference was observed in recurrent binary restenosis between the 2 groups (31.7% vs 27.0%; P=.38; P
adjusted =.29). At 2 years, the composite of death, myocardial infarction, or repeat target lesion revascularization were similar between the 2 groups (35.7% vs 34.0%; HR=1.04, 95%CI, 0.70-1.55; P=.83; Padjusted =.79). The rate of repeat target lesion revascularization was also similar in the 2 groups (29.8% vs 31.5%; HR=0.91, 95%CI, 0.60-1.39; P=.68; Padjusted =.62)., Conclusions: In patients undergoing reintervention for DES-ISR, we found no evidence of differences in outcomes according to whether the restenosed stent was a polymer-free or durable polymer DES., (Copyright © 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)- Published
- 2020
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