Temporal patterns of drug‐eluting stent failure and its relationship with clinical outcomes. Issue 4 (19th July 2014)

• Record Type: Journal Article
• Authors: Lee, Cheol Whan; Ahn, Jung‐Min; Yoon, Sung‐Han; Lee, Jong‐Young; Park, Duk‐Woo; Kang, Soo‐Jin; Lee, Seung‐Whan; Kim, Young‐Hak; Park, Seong‐Wook; Park, Seung‐Jung
• Is Part Of: Catheterization and cardiovascular interventions. Volume 85:Issue 4(2015:Mar. 01)
• Page Start: 515
• Page End: 521
• Publication Date: 2014-07-19
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25595
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25595-sec-0001" sec-type="section"> <title>Objectives</title> <p>We investigated the temporal patterns of drug‐eluting stents (DES) failure and its relationship with clinical outcomes in patients with DES failure.</p> </sec> <sec id="ccd25595-sec-0002" sec-type="section"> <title>Background</title> <p>Time to DES failure is widely variable, but little information is available on the temporal patterns of DES failure and its impact on clinical outcomes.</p> </sec> <sec id="ccd25595-sec-0003" sec-type="section"> <title>Methods</title> <p>The angiographic patterns of DES failure and clinical outcomes in 633 patients with 676 lesions who presented with their first instance of DES failure were analyzed. The primary outcome was all‐cause death following treatment for DES failure.</p> </sec> <sec id="ccd25595-sec-0004" sec-type="section"> <title>Results</title> <p>DES failure occurred in a median of 10.1 months after the index procedure. We identified 548 and 85 instances of DES restenosis (86.6%) and stent thrombosis (13.4%), respectively. Patients were divided into three groups according to the interval from the index procedure to DES failure: group 1 (early DES failure: <12 months), group 2 (late: 12–36 months), and group 3 (very late: ≥36 months). Acute myocardial infarction was more common in patients who developed failure after ≥12 months than patients with earlier presentations. Focal DES failure was more common in group 1, whereas nonfocal DES failure in groups 2 and 3. During follow‐up after retreatment (median, 52.8 months), all‐cause death was significantly higher in group 3 compared with group 1 (adjusted hazard ratio, 2.97; 95%CI, 1.31–6.74; <italic>P</italic> = 0.009). Similar findings were observed in terms of the rates of death or myocardial infarction.</p> </sec> <sec id="ccd25595-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Late DES failure is more likely to progress to acute myocardial infarction, aggressive angiographic patterns, and worse outcomes following retreatment. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>