Abstract 6027: Long-Term Clinical Outcome of Treating Long Diffuse (>30mm) Lesions with Sirolimus-Eluting Stent.: From Two-Year Clinical Outcome of the j-Cypher Registry
Design of the j-Cypher Registry was multi-center prospective enrollment of consecutive patients (pts) receiving Sirolimus Eluting Stent (SES) from 41 centers in Japan. By the end of March, 2007, two-year clinical follow-up data were completed in 11351 pts (14820 lesions) underwent successful implantation of SES. Among them, 1684 pts (1808 lesions) were treated with exclusive SES in the long diffuse (lesion length>30mm), de-novo native coronary lesion. The mean age was 68±10 years. 422 pts (46.5%) had diabetes (DM) (13.2% insulin treated), 326 pts (50.6%) had CRF (Ccr <60 ml/min) (5.0% hemodialysis). The mean number of stents per lesion was 2.2±0.7, and the average lesion length were 43.9±13.2mm. Target Lesion Revascularizaion (TLR) rates through 2 years were 6.4% in patients with lesion length (LL) ≤30mm, 14.0% in patients with LL >30mm. There was no significant difference in the incidence of stent thrombosis between two groups (0.7% in patients with LL less than 30mm, 0.7% in patients with LL > 30mm, p=0.9873). In the multivariate analysis, the significant negative predictors of two-year death were poor LV (EF<40%) (Relative Risk (RR) 2.6), history of heart failure (RR 3.5), hemodialysis (RR 5.0) and renal dysfunction (Ccr<60ml/min) (RR 3.6). Although the restenosis rate of SES implantation for long diffuse lesion was higher than short lesions, there was no difference in the incidence of stent thrombosis rate.