Do drug elution components increase the risk of fracture of sirolimus-eluting stents?
| Autor: | Shino Kan, Hiroyuki Naruse, Hisashi Umeda, Yukio Ozaki, Tadashi Nakano, Masaya Ota, Shigeru Matsui, Masanori Okumura, Kousuke Hattori, Makoto Ishikawa, Hitoshi Hishida, Tomoko Kawai, Junichi Ishii |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Urology Coronary Artery Disease Coronary Angiography Prosthesis Design Risk Assessment Coronary Restenosis Restenosis Risk Factors Angioplasty medicine.artery Odds Ratio medicine Humans Treatment Failure Angioplasty Balloon Coronary Aged Retrospective Studies Sirolimus Chi-Square Distribution medicine.diagnostic_test business.industry Stent Cardiovascular Agents Drug-Eluting Stents General Medicine Odds ratio Middle Aged medicine.disease Confidence interval Prosthesis Failure Metals Right coronary artery Angiography Female Stents Cardiology and Cardiovascular Medicine business Chi-squared distribution |
| Zdroj: | Coronary Artery Disease. 21:298-303 |
| ISSN: | 0954-6928 |
| DOI: | 10.1097/mca.0b013e32833aa6a1 |
| Popis: | OBJECTIVES Stent fracture (SF) of sirolimus-eluting stents (SES) has emerged recently in the literature and shown to be associated with an increased risk of restenosis; however, little is known regarding SF after bare-metal stent implantation. We sought to assess whether the use of SES was associated with an increased risk of SF compared with its bare-metal platform, the Bx-velocity stent (BX-BMS). METHODS A total of 478 lesions in 416 patients undergoing SES implantation and subsequent angiography 6-9 months after the index procedure were compared with 152 lesions in 142 consecutive patients treated with BX-BMS. Stented lesions with total stent-length greater than 40 mm were excluded. RESULTS There were no significant differences in overall baseline clinical and anatomic features between the SES and BX-BMS groups, or in SF frequencies at 6-9 month follow-up (4.4% for SES and 1.3% for BX-BMS, P= 0.078). In-stent restenosis was observed more often in SF lesions versus non-SF lesions (34.8 vs. 7.7%, P< 0.001) in association with a higher 3-year adverse events rate (27.3 vs. 13.6%, P = 0.076). The risk of SF at 6-9 months was independently associated with total stent length [odds ratio (OR), 2.13; 95% confidence interval (CI), 1.18-3.83; P = 0.012], angulated lesions (OR, 4.25; 95% CI, 1.80-10.00; P = 0.001), and right coronary artery lesions (OR, 3.55; 95% CI, 1.46-8.62; P = 0.005) but not with SES use. CONCLUSION Stent implantation in right coronary artery lesions, tortuous lesions, and/or longer lesions covered with longer stents, and not SES versus BX-BMS use, may be associated with increased likelihood of SF. |
| Databáze: | OpenAIRE |
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