- 作者：Shinichi Shirai ; MD?/sup> ; Takeshi Kimura ; MD&dagger ; ; taketaka@kuhp.kyoto-u.ac.jp ; Masakiyo Nobuyoshi ; MD?/sup> ; Takeshi Morimoto ; MD&Dagger ; ; Kenji Ando ; MD?/sup> ; Yoshimitsu Soga ; MD?/sup> ; Kyohei Yamaji ; MD?/sup> ; Katsuhiro Kondo ; MD?/sup> ; Koyu Sakai ; MD?/sup> ; Takeshi Arita ; MD?/sup> ; Masahiko Goya ; MD?/sup> ; Masashi Iwabuchi ; MD?/sup> ; Hiroyoshi Yokoi ; MD?/sup> ; Hideyuki Nosaka ; MD?/sup> ; Kazuaki Mitsudo ; MD§ ; ; j-Cypher Registry Investigators
- 关键词：stent ; follow-up studies ; coronary artery disease ; long stent ; clinical outcomes
- 刊名：JACC: Cardiovascular Interventions
- 出版年：2010
- 出版时间：February 2010
- 年：2010
- 卷：3
- 期：2
- 页码：180-188
- 全文大小：821 K
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.