＜Editors' Choice＞ Very long-term clinical outcomes after percutaneous coronary intervention for complex vs non-complex lesions: 10-year outcomes following sirolimus-eluting stent implantation.

Autor:	Riku S; Department of Cardiology, Handa City Hospital, Handa, Japan.; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Suzuki S; Department of Cardiology, Handa City Hospital, Handa, Japan.; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Yokoi T; Department of Cardiology, Handa City Hospital, Handa, Japan., Sakaguchi T; Department of Cardiology, Handa City Hospital, Handa, Japan., Yamamoto T; Department of Cardiology, Handa City Hospital, Handa, Japan., Jinno Y; Department of Cardiology, Handa City Hospital, Handa, Japan., Tanaka A; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Ishii H; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.; Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan., Inden Y; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Murohara T; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Jazyk:	angličtina
Zdroj:	Nagoya journal of medical science [Nagoya J Med Sci] 2022 May; Vol. 84 (2), pp. 352-365.
DOI:	10.18999/nagjms.84.2.352
Abstrakt:	Few studies have reported the long-term outcomes (>10 years) following first-generation drug-eluting stent implantation. In this single-center retrospective study, we investigated the very long-term clinical outcomes after first-generation sirolimus-eluting stent (SES) implantation in patients with complex lesions. The study included 383 consecutive patients who underwent initial SES implantation between July 2004 and January 2006; 84 and 299 of these patients reported a history of percutaneous coronary intervention (PCI) for complex and noncomplex lesions, respectively. Complex PCI was defined as having at least one of the following features: left main trunk PCI, implantation of ≥3 stents, bifurcation lesions with implantation of 2 stents, total stent length >60 mm, or chronic total occlusion. The target lesion revascularization (TLR) rate was significantly higher in the complex PCI than in the noncomplex PCI group (29.4% vs 13.0%, P=0.001), and we observed a significant intergroup difference in the late TLR (>1 year) rates (21.6% vs 9.5%, P=0.008). Late TLR continued over 10 years at a rate of 2.4%/year in the complex PCI and 1.1%/year in the noncomplex PCI group. Cox regression analysis revealed that complex PCI was related to TLR both over 10 years (hazard ratio 2.29, P=0.003) and beyond 1 year (hazard ratio 2.32, P=0.01). Cardiac death was more common in the complex PCI than in the noncomplex PCI group, particularly 4 years after PCI (15.8% vs 7.5%, P=0.031). Sudden death was the major cause of cardiac death beyond 4 years in the complex PCI group. These data indicate that long-term careful follow-up is essential for patients implanted with SES, especially those treated for complex lesions. Competing Interests: The authors declare that they have no conflict of interest.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu