Post-intervention minimal stent area as a predictor of target lesion revascularization after everolimus-eluting stent implantation for in-stent restenosis: a single-center observational study.
Coron Artery Dis
; 30(6): 432-439, 2019 09.
Article
em En
| MEDLINE
| ID: mdl-30883432
ABSTRACT
BACKGROUND:
Everolimus-eluting stent (EES) is effective for treating in-stent restenosis (ISR). However, the long-term incidence of target lesion revascularization (TLR) is unknown. Further, the role of post-intervention minimal stent area (MSA) measured by intravascular ultrasound (IVUS) in TLR is unknown in this setting. PATIENTS ANDMETHODS:
Overall, 223 ISR lesions (192 patients) that were treated with EES between 2010 and 2016 were analyzed retrospectively. Lesions were divided into two groups according to the post-intervention MSA [ ≤ 5.3 mm 72 lesions (67 patients), and > 5.3 mm 151 lesions (138 patients)]. The cut-off point was determined on the basis of receiver operating characteristic curve analysis.RESULTS:
The cumulative 5-year incidence of TLR was significantly higher in the group with MSA of 5.3 mm or less than in the group with MSA more than 5.3 mm (15.8 and 7.2%, P = 0.01). After adjusting for confounders, the excess risk of the group with MSA of 5.3 mm or less relative to the group with MSA more than 5.3 mm for TLR remained significant [hazard ratio 3.07, 95% confidence interval (CI) 1.17-8.51, P = 0.02]. Using multivariate logistic regression analysis, we identified female sex (odds ratio 2.39, 95% CI 1.06-5.49, P = 0.04) and stent size of 3.0 mm or less (odds ratio 13.43, 95% CI 6.23-32.38, P < 0.0001) as independent predictors of MSA of 5.3 mm or less.CONCLUSION:
EES implantation for ISR was associated with an acceptable rate of TLR through long-term follow-up. Postintervention MSA of 5.3 mm or less was associated independently with a higher risk for TLR.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fármacos Cardiovasculares
/
Reestenose Coronária
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Stents Farmacológicos
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Intervenção Coronária Percutânea
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Everolimo
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Coron Artery Dis
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article