Clinical usefulness of the Driver? stent in a retrospective, collaborative, multicenter, open-label study in Japanese real-world patients with coronary artery disease and the drug-eluting stent era
文摘
The objectives of the present study were to determine predictors for target lesion revascularization (TLR) and to examine the clinical usefulness of the Driver? stent (a cobalt alloy, modular-type) in Japanese patients with coronary artery disease. Data on 631 Japanese patients including 241 with stable angina and 361 with acute coronary syndrome—who had been implanted with the Driver? stent (805 lesions) between August 2004 and February 2005—were collected retrospectively; 95.0 and 81.7% of these lesions were de novo and ACC/AHA classification B2/C type, respectively. Early angiography of 622 patients revealed 1) the preprocedural minimal lumen diameter (MLD) of 0.80?±?0.51?mm, with lesion lengths of 17.1?±?7.3?mm, and 2) the postprocedural MLD of 2.95?±?0.55?mm, with MLD gains of 2.14?±?0.68?mm. At 270?days of clinical follow-up, the incidences of major adverse cardiac events (MACE), TLR, and early stent thrombosis (ST) were 18.8, 14.7, and 0.2%, respectively; the TLR rate decreased statistically significantly to 5.3 and 5.9% when implanting the Driver? stent (3.5 and 4.0?mm) and by IVUS, respectively. Absence rate of diabetes mellitus, presence rate of AMI, presence rate of stent diameters of ?.5?mm, and presence rate of IVUS-guided PCI showed lower TLR rates, with statistically significant differences. Uni- and multivariate analyses revealed that AMI and stent diameter (?.5?mm) are significant predictors for TLR (0.048 and 0.047, respectively), indicating that physicians are recommended to consider these variables when selecting candidate real-world patients for IVUS-guided PCI.