Stent Fracture After Sirolimus-Eluting Stent Implantation. (August 2015)

• Record Type: Journal Article
• Authors: Ohya, Masanobu; Kadota, Kazushige; Tada, Takeshi; Habara, Seiji; Shimada, Takenobu; Amano, Hidewo; Izawa, Yu; Hyodo, Yusuke; Miyake, Koshi; Otsuru, Suguru; Hasegawa, Daiji; Tanaka, Hiroyuki; Maruo, Takeshi; Katoh, Harumi; Fuku, Yasushi; Goto, Tsuyoshi; Mitsudo, Kazuaki
• Is Part Of: Circulation. Volume 8:Number 8(2015)
• Publication Date: 2015-08
• Subjects: Cardiovascular system -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Treatment -- Periodicals; 616.105
• DOI: 10.1161/CIRCINTERVENTIONS.115.002664
• Languages: English
• ISSNs: 1941-7640

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background—</title> <p>Stent fracture (SF) after sirolimus-eluting stent implantation is reported to be associated with target lesion revascularization (TLR) and stent thrombosis. We aimed to assess the clinical impact of SF at 8 years.</p> </sec> <sec> <title>Methods and Results—</title> <p>Between 2002 and 2005, 972 patients (1795 lesions) underwent sirolimus-eluting stent implantation and follow-up angiography within 1 year after index procedure. SF, defined as the complete separation of stent segments or stent struts at follow-up angiography, was observed in 105 lesions (5.8%). The study sample comprised 954 patients (1630 lesions), excluding 147 lesions undergoing TLR and 18 patients (18 lesions) who died or in whom stent thrombosis developed within 1 year after sirolimus-eluting stent implantation. The median follow-up duration was 9.1 years (the first and third quarters, 8.7 and 9.4 years). The primary end point was defined as any TLR. The 8-year cumulative rates of adverse events were estimated by Kaplan–Meier methods with <italic>P</italic> values from log-rank tests. Between patients with and without SF, there were no significant differences in the cumulative rates of all-cause death (23.5% versus 27.6%, <italic>P</italic>=0.35) and cardiac death (4.7% versus 9.1%, <italic>P</italic>=0.14), whereas patients with SF had significantly higher cumulative rates in myocardial infarction (10.1% versus 3.3%, <italic>P</italic>=0.001), very late stent thrombosis (6.8% versus 0.7%, <italic>P</italic><0.001), any TLR (38.1% versus 10.8%, <italic>P</italic><0.001), and clinically driven TLR (26.2% versus 6.6%, <italic>P</italic><0.001).</p> </sec> <sec> <title>Conclusions—</title> <p>SF after sirolimus-eluting stent implantation was consistently associated with higher rates of adverse cardiac events during the 8-year follow-up.</p> </sec> </abstract>