Abstract 1953: Predictors of Target Lesion Revascularization After Implantation of Sirolimus-eluting Stent: From One-Year Clinical Outcome of The j-Cypher Registry
Introduction: Although Sirolimus-eluting stent (SES) has markedly suppress neointimal hyperplasia, in-stent restenosis still occurs and target lesion revascularization (TLR) is needed.
Hypothesis: Data are limited regarding the predictors of TLR after SES implantation in the real world practice.
Objective: To identify these predictors, one-year outcome of the j-Cypher Registry was analyzed.
Methods: Design of this registry was multi-center prospective enrollment of consecutive patients receiving SES from 41 centers. As of April 25, 2006, one-year follow-up data were available in 2103 lesions from 1912 patients underwent successful implantation of SES.
Results: Patients’ characteristics of this cohort were as follows, mean age: 68 ± 10 years, male in 72%, diabetes in 47%, multi-vessel disease in 56%, renal dysfunction (sCre > 1.2) in 15%, and hemodialysis in 4.5%. Number of stent used per lesion was 1.3 ± 0.6. Lesion location in ostial site was observed as follows, Ostial RCA in 3.1%, Ostial LAD in 4.8% and Ostial LCX in 1.4%. Bifurcation lesion was observed in 18.2%, and elective two-stent strategy was chosen in 11%. The other characteristics of lesions were as follows, in-stent restenosis in 20%, severe calcification in 8.7%, CTO in 8.0%, STEMI culprit in 3.5%, vessel size < 2.5mm in 29%, and lesion length > 30mm in 12%. At one-year follow-up, 136 lesions (6.5%) needed TLR. Using multivariate logistic regression analysis, 9 factors were identified to be independent as shown in the table⇓.
Conclusions: In addition to the known predictors such as In-stent restenosis, Diabetes, Calcification, Small vessel, and Long lesion, several other factors such as Elective two-stent strategy for bifurcation, Hemodialysis and Ostial RCA were identified to be the independent predictors of TLR.