Document Detail


Long-term vascular changes after drug-eluting stent implantation assessed by serial volumetric intravascular ultrasound analysis.
MedLine Citation:
PMID:  20451685     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Using serial volumetric intravascular ultrasonography, we evaluated the predictors of late intimal hyperplasia (IH) increases after drug-eluting stent implantation. All eligible patients who underwent 6-month angiography without visual restenosis were requested to undergo a 2-year follow-up examination. Complete serial (after stenting and early [6-month], and late [2-year] follow-up) angiographic and intravascular ultrasound data were available for 135 patients with 143 lesions: 99 sirolimus-eluting stents and 44 paclitaxel-eluting stents. The external elastic membrane, stent, lumen, and peri-stent plaque volumes (external elastic membrane minus stent) were normalized by stent length. The percentage of IH volume was calculated as IH volume/stent volume x 100. The early reduction in the minimum lumen area was greater than the late reduction in the minimum lumen area (-0.8 +/- 0.8 vs -0.2 +/- 0.5 mm(2), p <0.001). A progressive increase occurred in the percentage of IH volume: 8.1 +/- 7.1% from baseline to 6 months and 2.4 +/- 3.9% from 6 months to 2 years (p <0.001, between the early and late increases in the percentage of IH). The use of paclitaxel-eluting stents was the only independent predictor for the percentage of IH volume at 6 months (beta = 0.419, p <0.001). The use of paclitaxel-eluting stents (beta = 0.365, p <0.001, 95% confidence interval 3.7 to 9.7) and the post-stenting normalized plaque and media volume (beta = 0.195, p = 0.020, 95% confidence interval 0.1 to 1.6) were the only independent predictors for the percentage of IH volume at 2 years. However, when the percentage of IH at 6 months was forced into the model, the percentage of IH at 6 months and the post-stenting normalized plaque and media volume, not paclitaxel-eluting stent use, predicted the 2-year percentage of IH. In conclusion, although IH continued to increase beyond 6 months, the growth rate of intima and luminal loss attenuated with time.
Authors:
Soo-Jin Kang; Duk-Woo Park; Gary S Mintz; Seung-Whan Lee; Young-Hak Kim; Cheol Whan Lee; Ki-Hoon Han; Jae-Joong Kim; Seong-Wook Park; Seung-Jung Park
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-04-08
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-06-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1402-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  methods*
Chi-Square Distribution
Cohort Studies
Coronary Angiography
Coronary Restenosis / epidemiology,  pathology,  ultrasonography*
Coronary Stenosis / radiography,  therapy*
Drug-Eluting Stents*
Female
Follow-Up Studies
Graft Occlusion, Vascular / epidemiology,  pathology,  ultrasonography*
Humans
Incidence
Male
Middle Aged
Paclitaxel / administration & dosage
Probability
Registries
Risk Assessment
Severity of Illness Index
Sirolimus / administration & dosage
Time Factors
Treatment Outcome
Tunica Intima / pathology
Ultrasonography, Interventional*
Chemical
Reg. No./Substance:
33069-62-4/Paclitaxel; 53123-88-9/Sirolimus

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


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