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Impact of sirolimus-eluting stent fracture on 4-year clinical outcomes.
- Source :
-
Circulation. Cardiovascular interventions [Circ Cardiovasc Interv] 2011 Aug; Vol. 4 (4), pp. 349-54. Date of Electronic Publication: 2011 Aug 02. - Publication Year :
- 2011
-
Abstract
- Background: Although stent fracture (SF) after sirolimus-eluting stent (SES) implantation has been recognized as one of the predisposing factors of in-stent restenosis, it remains uncertain whether SF can increase the risk of major adverse cardiac events (MACE), especially beyond 1 year after SES implantation. The aim of this study was to assess the impact of SF relative to non-SF on 4-year clinical outcomes after treatment with SES of comparable unselected lesions.<br />Methods and Results: A total of 874 lesions in 793 patients undergoing SES implantation and subsequent angiography 6 to 9 months after index procedure were analyzed. At 6- to 9-month angiographic follow-up, SF was identified in 70 of 874 lesions (8.0%). In-stent late loss was significantly higher in SF lesions versus non-SF lesions (0.42±0.59 mm versus 0.13±0.49 mm, P<0.001), resulting in a significantly higher in-stent restenosis rate (21.4% versus 4.1%, P<0.001). At 4 years, SF versus non-SF was associated with a significantly higher MACE rate (23.2% versus 12.6%, P=0.014), mainly driven by significantly higher target-lesion revascularization (18.8% versus 10.2%, P=0.029) rate. Adverse effects of SF on clinical outcomes occurred mostly within the first year (17.4% versus 6.6%, P=0.001), with similar MACE rate between 1 and 4 years (5.8% versus 5.9%, P=0.611). No significant differences between SF versus non-SF patients were observed in the cumulative frequency of very late stent thrombosis (2.9% versus 1.4%, P=0.281), death (0% versus 2.1%, P=0.252), or myocardial infarction (5.8% versus 2.9%, P=0.165).<br />Conclusions: SF of SES was associated with higher MACE rate up to 1 year, mainly driven by higher target-lesion revascularization, whereas no significant association was evident between years 1 and 4.
- Subjects :
- Aged
Drug-Eluting Stents statistics & numerical data
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Risk Factors
Sirolimus administration & dosage
Treatment Outcome
Blood Vessel Prosthesis Implantation
Coronary Restenosis epidemiology
Coronary Restenosis etiology
Postoperative Complications
Prosthesis Failure adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1941-7632
- Volume :
- 4
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Circulation. Cardiovascular interventions
- Publication Type :
- Academic Journal
- Accession number :
- 21813403
- Full Text :
- https://doi.org/10.1161/CIRCINTERVENTIONS.110.958306