Characteristics of recurrent in-stent restenosis after second- and third-generation drug-eluting stent implantation
| Autor: | Takafumi Inoue, Junichiro Takaoka, Takashi Kajiya, Kazunari Kitazono, Yoshihiko Atsuchi, Mitsuru Ohishi, Hirokazu Shimono, Toshiko Ninomiya, Nobuhiko Atsuchi, Akihiro Miyamura |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Coronary Angiography Revascularization Coronary Restenosis 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Japan Restenosis Recurrence Risk Factors medicine Humans 030212 general & internal medicine Aged Retrospective Studies business.industry Stent Cholesterol LDL General Medicine Odds ratio Prognosis medicine.disease Coronary Vessels Third generation Confidence interval Drug-eluting stent Female Stents Radiology In stent restenosis Cardiology and Cardiovascular Medicine business Tomography Optical Coherence |
| Zdroj: | Coronary Artery Disease. 32:36-41 |
| ISSN: | 0954-6928 |
| Popis: | Background In second- and third-generation drug-eluting stent (DES) era, in-stent restenosis (ISR) is not commonly seen. However, a few patients still need repeat revascularizations for recurrent ISR even after second- and third-generation DES implantation. Methods From January 2012 to March 2017, 2339 lesions underwent second- and third-generation DES (Nobori, Promus Element, Resolute Integrity, Xience, Ultimaster and Synergy) implantation, of which 95 lesions (4.1%) underwent revascularization for first ISR. All lesions were divided into two groups of recurrent ISR group and non-recurrent ISR group. After successful optical coherence tomography (OCT) guided revascularization for all lesions, we investigated characteristics of recurrent ISR, and 2 years follow-up were completed. Results The mean age was 70.8 ± 11.7 years, and 73.2% were males. Among 56 DES-ISR lesions which were assessed by OCT, recurrent ISR was seen in 33.9% (N = 19) at 2 years follow-up after revascularization for first ISR. Serum low-density lipoprotein-cholesterol (LDL-C) level was higher in recurrent ISR group compared with non-recurrent ISR group (114.1 ± 53.9 mg/dl vs. 90.9 ± 27.8 mg/dl, P = 0.04) and heterogeneous tissue pattern was more frequently found in recurrent ISR group compared with non-recurrent ISR group (63.2% vs. 27.0%, P = 0.03). Multivariate analysis identified a heterogeneous tissue pattern (odds ratio 3.71; 95% confidence interval 1.09-12.59; P = 0.03) as an independent predictor of recurrent restenosis. Conclusion Recurrent ISR of second- and third-generation DES was associated with heterogeneous tissue pattern of first ISR, and high LDL-C level was associated with recurrence. |
| Databáze: | OpenAIRE |
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