Document Detail

Impact of multiple and long sirolimus-eluting stent implantation on 3-year clinical outcomes in the j-Cypher Registry.
MedLine Citation:
PMID:  20170875     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Our aim was to study the relationships between total stent length (TSL) and long-term clinical outcomes after sirolimus-eluting stent (SES) implantation.
BACKGROUND: SES compared with bare-metal stent use for long lesion treatment is associated with reduced restenosis rates.
METHODS: Three-year follow-up data were available for 10,773 patients (14,651 lesions) that had been treated with only SES (Cypher, Cordis Corp., Warren, New Jersey) in the j-Cypher registry. Patients and lesions were divided into quartile groups: TSL per patient (Q1: 8 to 23 mm, Q2: 24 to 36 mm, Q3: 37 to 54 mm, Q4: 55 to 293 mm), and TSL per lesion (QA: 8 to 18 mm, QB: 19 to 23 mm, QC: 24 to 33 mm, QD: 34 to 150 mm).
RESULTS: In per-lesion data, longer TSL increased target lesion revascularization (TLR) rates but did not increase stent thrombosis rates (p = 0.2324). In per-patient data, the incidences of TLR remarkably increased with increasing TSL. Incidence of composite of death and myocardial infarction also increased with increasing TSL; however, after adjustment for baseline differences, there was no statistical significance. Definite stent thrombosis rate in group Q4 was significantly higher than in other groups, both unadjusted (hazard ratio: 1.770, p = 0.0081) and adjusted (hazard ratio: 1.727, p = 0.0122) for baseline differences.
CONCLUSIONS: TSL per lesion and patient had significantly impacts on TLR rates. Longer TSL per patient was associated with increased incidence of stent thrombosis through 3 years.
Shinichi Shirai; Takeshi Kimura; Masakiyo Nobuyoshi; Takeshi Morimoto; Kenji Ando; Yoshimitsu Soga; Kyohei Yamaji; Katsuhiro Kondo; Koyu Sakai; Takeshi Arita; Masahiko Goya; Masashi Iwabuchi; Hiroyoshi Yokoi; Hideyuki Nosaka; Kazuaki Mitsudo;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2011-06-02     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  180-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Confidence Intervals
Coronary Artery Disease / mortality,  prevention & control
Coronary Restenosis / mortality,  prevention & control*
Drug-Eluting Stents*
Immunosuppressive Agents / therapeutic use*
Logistic Models
Proportional Hazards Models
Risk Factors
Sirolimus / therapeutic use*
Time Factors
Treatment Outcome*
Reg. No./Substance:
0/Immunosuppressive Agents; W36ZG6FT64/Sirolimus
Comment In:
JACC Cardiovasc Interv. 2010 Feb;3(2):189-90   [PMID:  20170876 ]

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