Author + information
- Takashi Hiromasa,
- Shoichi Kuramitsu,
- Takashi Morinaga,
- Yohei Kobayashi,
- Hiroyuki Jinnouchi,
- Takenori Domei,
- Makoto Hyodo,
- Yoshimitsu Soga,
- Shinichi Shirai and
- Kenji Ando
Background: Newer-generation drug-eluting stent (DES) have shown to the improved safety and efficacy compared with first-generation DES. The treatment of in-stent restenosis (ISR) lesions is one of the unsolved issues even in the DES era and it remains unclear whether clinical outcome after newer-generation DES implantation for ISR lesion was similar to that for non-ISR lesion. Our aim was to assess the clinical outcomes after the XIENCE/PROMUS cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation for ISR lesion compared with that for non-ISR lesion.
Methods: A total of 1064 patients with 1440 lesions undergoing CoCr-EES implantation between February 2010 and May 2011 were analyzed. We assessed the 3-year cumulative incidences of major adverse cardiac events (MACE), defined as a composite of cardiac death, non-fatal myocardial infarction, definite stent thrombosis, and clinically driven target lesion revascularization (TLR) between the ISR and non-ISR groups.
Results: Of 1064 patients with 1440 lesions, 189 patients had 193 ISR lesions treated with CoCr-EES. At 3-year, the cumulative incidence of MACE was significantly higher in the ISR group than in the non-ISR group (23.4% vs. 13.4%, p<0.001), mainly driven by the higher rate of cardiac death and TLR (7.7% vs. 4.0%, p=0.03; 18.5% vs. 9.5%, p<0.001, respectively). The cumulative incidences of myocardial infarction, and stent thrombosis were not different between the ISR and non-ISR groups (1.9% vs. 1.2%, p=0.27; 1.4% vs. 0.7%, p=0.16, respectively). ISR lesion, hemodialysis, diabetes mellitus were predictors of MACE.
Conclusions: Three-year clinical outcome after CoCr-EES implantation for ISR lesions was associated with higher rate of clinically driven TLR and cardiac death compared with that for non-ISR lesions.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: PCI in Complex Patients
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1287-196
- 2017 American College of Cardiology Foundation