Author + information
- Ron Waksman,
- Kyle Buchanan,
- M. Chadi Alraies,
- Arie Steinvil,
- Toby Rogers,
- Edward Koifman,
- Jiaxiang Gai,
- Rebecca Torguson,
- Itsik Ben-Dor,
- Augusto Pichard and
- Lowell Satler
Background: In-stent restenosis (ISR) results in a total rate of death or nonfatal myocardial infarction (MI) of 3.5%. Drug-eluting stents (DES) have decreased but not eliminated the risk of ISR, resulting in complex interventions. This study evaluated the outcomes of ISR with contemporary DES compared with that of de novo coronary artery lesions.
Methods: We performed a retrospective analysis of patients who received at least one stent at our center from 2007 to 2016. The patients were stratified based on percutaneous coronary intervention (PCI) of de novo lesions only or ISR. Procedure characteristics and clinical outcomes at 1 year were compared between groups.
Results: Our analysis included 10,758 patients who received PCI with at least 1-year follow-up. Among those, 810 (7.5%) were treated for ISR and 9,948 (92.4%) were treated for de novo lesions only. Only 44.1% of the ISR lesions were treated with DES compared with 89.7% of the de novo lesions (p<0.001). Overall, 91.6% of the ISR lesions and 92.0% of the de novo lesions were type B or C (p=0.66). The 1-year composite outcome of all-cause death, Q-wave MI, and target lesion revascularization was 15.6% in the ISR group and 9.3% in the de novo group (p<0.001).
Conclusions: ISR in the contemporary DES era is modest but remains a concern. In this study, the ISR group was treated with significantly less DES but overall lesion complexity was no different between groups. However, 1-year composite outcome was significantly worse in the ISR group compared to the de novo group.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: PCI for NSTEMI and Complex Patients With Multiple Co-Morbidities
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1154-146
- 2017 American College of Cardiology Foundation