Circulation. 2004;109:1366-1370
Published online before print March 1, 2004, doi: 10.1161/01.CIR.0000121358.26097.06
Published online before print March 1, 2004, doi: 10.1161/01.CIR.0000121358.26097.06
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2004;109:1366-1370.)
© 2004 American Heart Association, Inc.
Clinical Investigation and Reports |
Clinical, Angiographic, and Procedural Predictors of Angiographic Restenosis After Sirolimus-Eluting Stent Implantation in Complex Patients
An Evaluation From the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) Study
From Erasmus Medical Center (P.A.L., A.H., C.A.A., F.S., W.J.v.d.G., E.M., G.S., P.C.S., S.H.H., P.J.d.F., R.T.v.D., P.W.S.), Thoraxcenter, and Cardialysis BV (D.G.), Statistical Department, Rotterdam, The Netherlands.
Correspondence to Patrick W. Serruys, MD, PhD, Department of Cardiology, Thoraxcenter, Room Bd 408, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. E-mail p.w.j.c.serruys{at}erasmusmc.nl
Received October 14, 2003; revision received December 17, 2003; accepted December 30, 2003.
Background— The factors associated with the occurrence of restenosis after sirolimus-eluting stent (SES) implantation in complex cases are currently unknown.
Methods and Results— A cohort of consecutive complex patients treated with SES implantation was selected according to the following criteria: (1) treatment of acute myocardial infarction, (2) treatment of in-stent restenosis, (3) 2.25-mm diameter SES, (4) left main coronary stenting, (5) chronic total occlusion, (6) stented segment >36 mm, and (7) bifurcation stenting. The present study population was composed of 238 patients (441 lesions) for whom 6-month angiographic follow-up data were obtained (70% of eligible patients). Significant clinical, angiographic, and procedural predictors of post-SES restenosis were evaluated. Binary in-segment restenosis was diagnosed in 7.9% of lesions (6.3% in-stent, 0.9% at the proximal edge, 0.7% at the distal edge). The following characteristics were identified as independent multivariate predictors: treatment of in-stent restenosis (OR 4.16, 95% CI 1.63 to 11.01; P<0.01), ostial location (OR 4.84, 95% CI 1.81 to 12.07; P<0.01), diabetes (OR 2.63, 95% CI 1.14 to 6.31; P=0.02), total stented length (per 10-mm increase; OR 1.42, 95% CI 1.21 to 1.68; P<0.01), reference diameter (per 1.0-mm increase; OR 0.46, 95% CI 0.24 to 0.87; P=0.03), and left anterior descending artery (OR 0.30, 95% CI 0.10 to 0.69; P<0.01).
Conclusions— Angiographic restenosis after SES implantation in complex patients is an infrequent event, occurring mainly in association with lesion-based characteristics and diabetes mellitus.
Key Words: stents • angioplasty • revascularization • restenosis
This article has been cited by other articles:
 |
|
 |
|
  T. Takagi, H. Okura, Y. Kobayashi, T. Kataoka, H. Taguchi, I. Toda, K. Tamita, A. Yamamuro, Y. Sakanoue, A. Ito, et al. A Prospective, Multicenter, Randomized Trial to Assess Efficacy of Pioglitazone on In-Stent Neointimal Suppression in Type 2 Diabetes: POPPS (Prevention of In-Stent Neointimal Proliferation by Pioglitazone Study) J. Am. Coll. Cardiol. Intv., June 1, 2009; 2(6): 524 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. K. James, U. Stenestrand, J. Lindback, J. Carlsson, F. Schersten, T. Nilsson, L. Wallentin, B. Lagerqvist, and the SCAAR Study Group Long-Term Safety and Efficacy of Drug-Eluting versus Bare-Metal Stents in Sweden N. Engl. J. Med., May 7, 2009; 360(19): 1933 - 1945. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Vaquerizo, T. Lefevre, O. Darremont, M. Silvestri, Y. Louvard, J. L. Leymarie, P. Garot, H. Routledge, F. de Marco, T. Unterseeh, et al. Unprotected Left Main Stenting in the Real World: Two-Year Outcomes of the French Left Main Taxus Registry Circulation, May 5, 2009; 119(17): 2349 - 2356. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Qiangjun Cai, K. Skelding, A. Armstrong Jr, D. Desai, G. C. Wood, and J. Blankenship Predictors of Long-Term Major Adverse Cardiac Events and Clinical Restenosis Following Elective Percutaneous Coronary Stenting Angiology, April 1, 2009; 60(2): 141 - 147. [Abstract] [PDF]
|
|
|
|
 |
|
 A. B. Baker, A. Groothuis, M. Jonas, D. S. Ettenson, T. Shazly, E. Zcharia, I. Vlodavsky, P. Seifert, and E. R. Edelman Heparanase Alters Arterial Structure, Mechanics, and Repair Following Endovascular Stenting in Mice Circ. Res., February 13, 2009; 104(3): 380 - 387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Shemin Coronary Artery Bypass Grafting Versus Stenting for Unprotected Left Main Coronary Artery Disease: Where Lies the Body of Proof? Circulation, December 2, 2008; 118(23): 2326 - 2329. [Full Text] [PDF]
|
|
|
|
|
|
B. Chevalier, C. Di Mario, F.-J. Neumann, F. Ribichini, P. Urban, J. J. Popma, P. J. Fitzgerald, D. E. Cutlip, D. O. Williams, J. Ormiston, et al. A Randomized, Controlled, Multicenter Trial to Evaluate the Safety and Efficacy of Zotarolimus- Versus Paclitaxel-Eluting Stents in De Novo Occlusive Lesions in Coronary Arteries: The ZoMaxx I Trial J. Am. Coll. Cardiol. Intv., October 1, 2008; 1(5): 524 - 532. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-W. Lee, S.-W. Park, Y.-H. Kim, S.-C. Yun, D.-W. Park, C. W. Lee, M.-K. Hong, K.-S. Rhee, J. K. Chae, J.-K. Ko, et al. A Randomized Comparison of Sirolimus- Versus Paclitaxel-Eluting Stent Implantation in Patients With Diabetes Mellitus J. Am. Coll. Cardiol., August 26, 2008; 52(9): 727 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-W. Lee, S.-W. Park, Y.-H. Kim, S.-C. Yun, D.-W. Park, C. W. Lee, M.-K. Hong, H.-S. Kim, J.-K. Ko, J.-H. Park, et al. Drug-Eluting Stenting Followed by Cilostazol Treatment Reduces Late Restenosis in Patients With Diabetes Mellitus: The DECLARE-DIABETES Trial (A Randomized Comparison of Triple Antiplatelet Therapy With Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Diabetic Patients) J. Am. Coll. Cardiol., March 25, 2008; 51(12): 1181 - 1187. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Romagnoli, G. M. Sangiorgi, J. Cosgrave, E. Guillet, and A. Colombo Drug-eluting stenting the case for post-dilation. J. Am. Coll. Cardiol. Intv., February 1, 2008; 1(1): 22 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Wilson and J. T. Willerson Myocardial Revascularization with Percutaneous Devices Card. Surg. Adult, January 1, 2008; 3(2008): 573 - 598. [Full Text]
|
|
|
|
|
|
J. Machecourt, N. Danchin, J. M. Lablanche, J. M. Fauvel, J. L. Bonnet, S. Marliere, A. Foote, J. L. Quesada, H. Eltchaninoff, G. Vanzetto, et al. Risk Factors for Stent Thrombosis After Implantation of Sirolimus-Eluting Stents in Diabetic and Nondiabetic Patients: The EVASTENT Matched-Cohort Registry J. Am. Coll. Cardiol., August 7, 2007; 50(6): 501 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Marzocchi, F. Saia, G. Piovaccari, A. Manari, E. Aurier, A. Benassi, A. Cremonesi, G. Percoco, E. Varani, P. Magnavacchi, et al. Long-Term Safety and Efficacy of Drug-Eluting Stents: Two-Year Results of the REAL (REgistro AngiopLastiche dell'Emilia Romagna) Multicenter Registry Circulation, June 26, 2007; 115(25): 3181 - 3188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Lagerqvist, S. K. James, U. Stenestrand, J. Lindback, T. Nilsson, L. Wallentin, and the SCAAR Study Group Long-Term Outcomes with Drug-Eluting Stents versus Bare-Metal Stents in Sweden N. Engl. J. Med., March 8, 2007; 356(10): 1009 - 1019. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Ashley, R. Ferrara, J. Y. King, A. Vailaya, A. Kuchinsky, X. He, B. Byers, U. Gerckens, S. Oblin, A. Tsalenko, et al. Network Analysis of Human In-Stent Restenosis Circulation, December 12, 2006; 114(24): 2644 - 2654. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. Taggart Coronary Artery Bypass Grafting is Still the Best Treatment for Multivessel and Left Main Disease, But Patients Need to Know Ann. Thorac. Surg., December 1, 2006; 82(6): 1966 - 1975. [Full Text] [PDF]
|
|
|
|
|
|
B. Scheller, C. Hehrlein, W. Bocksch, W. Rutsch, D. Haghi, U. Dietz, M. Bohm, and U. Speck Treatment of Coronary In-Stent Restenosis with a Paclitaxel-Coated Balloon Catheter N. Engl. J. Med., November 16, 2006; 355(20): 2113 - 2124. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Elezi, A. Dibra, J. Mehilli, J. Pache, R. Wessely, A. Schomig, and A. Kastrati Vessel Size and Outcome After Coronary Drug-Eluting Stent Placement: Results From a Large Cohort of Patients Treated With Sirolimus- or Paclitaxel-Eluting Stents J. Am. Coll. Cardiol., October 3, 2006; 48(7): 1304 - 1309. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Saia, G. Piovaccari, A. Manari, A. Santarelli, A. Benassi, E. Aurier, P. Sangiorgio, F. Tarantino, G. Geraci, G. Vecchi, et al. Clinical Outcomes for Sirolimus-Eluting Stents and Polymer-Coated Paclitaxel-Eluting Stents in Daily Practice: Results From a Large Multicenter Registry J. Am. Coll. Cardiol., October 3, 2006; 48(7): 1312 - 1318. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. B. Barner Status of percutaneous coronary intervention and coronary artery bypass. Eur. J. Cardiothorac. Surg., September 1, 2006; 30(3): 419 - 424. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Liistro, M. Fineschi, P. Angioli, G. Sinicropi, G. Falsini, T. Gori, K. Ducci, A. Bravi, and L. Bolognese Effectiveness and Safety of Sirolimus Stent Implantation for Coronary In-Stent Restenosis: The TRUE (Tuscany Registry of Sirolimus for Unselected In-Stent Restenosis) Registry J. Am. Coll. Cardiol., July 18, 2006; 48(2): 270 - 275. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-K. Hong, G. S. Mintz, C. W. Lee, D.-W. Park, B.-R. Choi, K.-H. Park, Y.-H. Kim, S.-S. Cheong, J.-K. Song, J.-J. Kim, et al. Intravascular ultrasound predictors of angiographic restenosis after sirolimus-eluting stent implantation Eur. Heart J., June 1, 2006; 27(11): 1305 - 1310. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Rogers and E. R. Edelman Pushing Drug-Eluting Stents Into Uncharted Territory: Simpler Than You Think--More Complex Than You Imagine Circulation, May 16, 2006; 113(19): 2262 - 2265. [Full Text] [PDF]
|
|
|
|
|
|
A. Kastrati, A. Dibra, J. Mehilli, S. Mayer, S. Pinieck, J. Pache, J. Dirschinger, and A. Schomig Predictive Factors of Restenosis After Coronary Implantation of Sirolimus- or Paclitaxel-Eluting Stents Circulation, May 16, 2006; 113(19): 2293 - 2300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Kim, M. H. Jeong, K. H. Kim, I. S. Sohn, Y. J. Hong, H. W. Park, J. H. Kim, Y. K. Ahn, J. G. Cho, J. C. Park, et al. The Clinical Results of a Platelet Glycoprotein IIb/IIIa Receptor Blocker (Abciximab: ReoPro)-Coated Stent in Acute Myocardial Infarction J. Am. Coll. Cardiol., March 7, 2006; 47(5): 933 - 938. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Beyar, L. Gruberg, D. Deleanu, A. Roguin, Y. Almagor, S. Cohen, G. Kumar, and T. Wenderow Remote-Control Percutaneous Coronary Interventions: Concept, Validation, and First-in-Humans Pilot Clinical Trial J. Am. Coll. Cardiol., January 17, 2006; 47(2): 296 - 300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Jonas, E. R. Edelman, A. Groothuis, A. B. Baker, P. Seifert, and C. Rogers Vascular Neointimal Formation and Signaling Pathway Activation in Response to Stent Injury in Insulin-Resistant and Diabetic Animals Circ. Res., September 30, 2005; 97(7): 725 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-B. Seung, Y.-H. Kim, D.-W. Park, B.-K. Lee, C. W. Lee, M.-K. Hong, P.-J. Kim, W.-S. Chung, S.-J. Tahk, S.-W. Park, et al. Effectiveness of Sirolimus-Eluting Stent Implantation for the Treatment of Ostial Left Anterior Descending Artery Stenosis With Intravascular Ultrasound Guidance J. Am. Coll. Cardiol., September 6, 2005; 46(5): 787 - 792. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Garot, T. Lefevre, M. Savage, Y. Louvard, W. R. Bamlet, J. T. Willerson, M.-C. Morice, and D. R. Holmes Jr Nine-Month Outcome of Patients Treated by Percutaneous Coronary Interventions for Bifurcation Lesions in the Recent Era: A Report From the Prevention of Restenosis With Tranilast and its Outcomes (PRESTO) Trial J. Am. Coll. Cardiol., August 16, 2005; 46(4): 606 - 612. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.-K. Koo, H.-J. Kang, T.-J. Youn, I.-H. Chae, D.-J. Choi, H.-S. Kim, D.-W. Sohn, B.-H. Oh, M.-M. Lee, Y.-B. Park, et al. Physiologic Assessment of Jailed Side Branch Lesions Using Fractional Flow Reserve J. Am. Coll. Cardiol., August 16, 2005; 46(4): 633 - 637. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Pache, A. Dibra, J. Mehilli, J. Dirschinger, A. Schomig, and A. Kastrati Drug-eluting stents compared with thin-strut bare stents for the reduction of restenosis: a prospective, randomized trial Eur. Heart J., July 1, 2005; 26(13): 1262 - 1268. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Tsagalou, A. Chieffo, I. Iakovou, L. Ge, G. M. Sangiorgi, N. Corvaja, F. Airoldi, M. Montorfano, I. Michev, and A. Colombo Multiple Overlapping Drug-Eluting Stents to Treat Diffuse Disease of the Left Anterior Descending Coronary Artery J. Am. Coll. Cardiol., May 17, 2005; 45(10): 1570 - 1573. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F.-J. Neumann, W. Desmet, E. Grube, J. Brachmann, P. Presbitero, P. Rubartelli, A. Mugge, F. Di Pede, D. Fullgraf, W. Aengevaeren, et al. Effectiveness and Safety of Sirolimus-Eluting Stents in the Treatment of Restenosis After Coronary Stent Placement Circulation, April 26, 2005; 111(16): 2107 - 2111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. W. O'Neill, S. R. Dixon, and C. L. Grines The year in interventional cardiology J. Am. Coll. Cardiol., April 5, 2005; 45(7): 1117 - 1134. [Full Text] [PDF]
|
|
|
|
 |
|
 D. P Taggart Surgery is the best intervention for severe coronary artery disease BMJ, April 2, 2005; 330(7494): 785 - 786. [Full Text] [PDF]
|
|
|
|
|
|
P. A. Lemos, N. Mercado, R. T. van Domburg, R. E. Kuntz, W. W. O'Neill, and P. W. Serruys Comparison of Late Luminal Loss Response Pattern After Sirolimus-Eluting Stent Implantation or Conventional Stenting Circulation, November 16, 2004; 110(20): 3199 - 3205. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. SoRelle Cardiovascular News Circulation, March 23, 2004; 109(11): e9028 - e9030. [Full Text]
|
|