Document Detail


Clinical presentation of patients with in-stent restenosis in the drug-eluting stent era.
MedLine Citation:
PMID:  18688064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Drug-eluting stents (DES) represent a significant improvement in the treatment of coronary artery disease as they decrease restenosis rates by approximately 50% compared with bare-metal stents. In-stent restenosis (ISR) is perceived to be a benign phenomenon because it is a gradual process and may lead to angina pectoris. With bare-metal stents, ISR has been associated with myocardial infarction in approximately 10% to 15% of cases. Comparable data with DES are lacking. METHODS: From April 2003 to December 2005, 42 out of 889 patients (4.7%) with DES ISR were identified at our institution. We excluded 3 orthotopic heart transplant patients who had ISR. Therefore, the final analysis included 39 patients. RESULTS: The mean age was 66 +/- 10 years, 77% were male, and 33% were diabetic. A mean of 1.8 +/- 0.9 stents were implanted with a total stent length of 39 +/- 24 mm. The mean time from percutaneous coronary intervention to detection of ISR was 396 +/- 290 days. At a mean from follow up of 35 +/- 10 months, 8% were asymptomatic, 77% presented with angina pectoris, 5% with unstable angina, and 10% with non-ST-segment elevation myocardial infarction. CONCLUSIONS: In the DES era, although most patients with ISR have stable symptoms, myocardial infarction occurred in 10%, suggesting that ISR is not a benign clinical entity. DES with improved designs or drug elution systems that further decrease the incidence of ISR are needed.
Authors:
Michael S Lee; Antonio Pessegueiro; Raymond Zimmer; Daniel Jurewitz; Jonathan Tobis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  20     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-08     Completed Date:  2009-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  401-3     Citation Subset:  IM    
Affiliation:
UCLA Medical Center, Division of Cardiology, 10833 Le Conte Avenue, Room BL-394 CHS, Los Angeles, CA 90025, USA. mslee@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / etiology*
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects
Coronary Restenosis / etiology*
Drug-Eluting Stents / adverse effects*
Female
Humans
Male
Middle Aged
Myocardial Infarction / etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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