Abstract 1954: Is In-Stent Late Loss Valid to Predict the Risk of Binary Angiographic Restenosis and Target Revascularization in the Era of Drug-Eluting Stents?
In-stent late loss (ISLL) after drug-eluting stent (DES) implantation does not follow a normal distribution. Because of that, concerns exist about the degree of association between ISLL and the rates of both binary angiographic restenosis (BAR) and target lesion revascularization (TLR). We aimed to evaluate the relationship between ISLL after DES implantation and the rates of BAR and TLR.
Methods: we selected 27 trials in which currently available DES (Cypher, Taxus, Endeavor, Janus, Xience V, Yukon) were randomly evaluated and in which data from ISLL, BAR, and TLR were provided. Out of the 27 trials, 7 were head-to-head trials comparing two different types of DES, whereas 20 randomly compared DES and conventional stents. Therefore, 34 groups of patients allocated to DES were available for analysis (8,259 patients). We evaluated the relationship between mean ISLL in each group with the rates of BAR and TLR in each trial (meta-regression), adjusting for the number of patients included in each trials, the proportion of diabetics and the mean reference vessel diameter.
Results: there was a significant association between ISLL and both the rate of BAR (BAR(%) = 13.74 + 13,37(ISLL); P = 0.008; R = 0.55) and TLR (TLR(%) = 16.85 + 9,94(ISLL); P = 0.008; R = 0.58) (see figure⇓).
Conclusion: there is a clear relationship between ISLL and both BAR and TLR with the use of the currently available DES.