Abstract 15729: Impact of Sirolimus-Eluting Stent Fractures Without Early Cardiac Events on Long-Term Clinical Outcomes: A Multislice Computed Tomography Study
Background: Long-term outcomes of sirolimus-eluting stent (SES) fractures without early clinical events have not been fully clarified. Multislice computed tomography (MSCT) can clearly depict stent fractures. This study sought to evaluate the impact of SES fractures on long-term clinical outcomes using MSCT.
Methods: In this study, 528 patients undergoing 6- to 18-month follow-up 64-slice MSCT after SES implantation without early clinical events were followed clinically (the median follow-up interval was 4.6 years). A CT-detected stent fracture was defined as a complete gap upon visual inspection with Hounsfield Units (HU) <300 at the site of separation. The major adverse cardiac events (MACE), including cardiac death, stent thrombosis, and target lesion revascularization was compared according to the presence of stent fracture.
Results: Stent fractures were detected in 39 patients (7.4%) by follow-up MSCT. MACE was observed in 52 patients (9.8%; 2.1% per year). MACE were more common in patients with CT-detected stent fractures than those without (46% vs 7%, p<0.01). Univariate logistic regression analysis indicated a significant relationship between MACE and a stent fracture (Hazard ratio (HR): 7.65, 95% confidence interval (CI): 4.31-13.6, p<0.01), stent length (HR: 1.03, 95% CI: 1.02-1.04, p<0.01), diabetes mellitus (HR: 1.77, 95%, CI: 1.02-3.06, p=0.04), age (HR: 1.03, 95% CI: 1.00-1.07, p=0.04) and chronic total occlusion (HR: 2.54, 95% CI: 1.24-5.22, p=0.01).
In the multivariate model, a stent fracture (HR: 5.36; 95% CI: 2.74-10.5, p<0.01) and age remained a significant predictor of MACE (HR: 1.03, 95% CI: 1.00-1.07, p=0.04).
Conclusions: A SES fracture detected by MSCT without early clinical events was associated with long-term clinical adverse events.
- © 2013 by American Heart Association, Inc.