Is there delayed restenosis in patients with coronary artery disease treated with sirolimus-eluting stent?

Abstract

BACKGROUND:

Although long-term follow-up after sirolimus-eluting stent implantation shows a sustained clinical benefit in several randomized and registered trials, little is known about the pattern of neointimal growth beyond the first 6 to 9 months. In this study, we therefore evaluated the possible delayed restenosis in patients with coronary artery disease treated with sirolimus-eluting stent.

METHODS:

A total of consecutive 333 patients with 453 lesions were enrolled in this study (among 782 consecutive patients with 1023 lesions). Lesions were subjected to follow-up by quantitative coronary angiography, and patients were divided into two groups according to the time of follow-up by quantitative coronary angiography: early group (< or =270 days, n=270 with 369 lesions) and late group (>270 days, n=63 with 84 lesions). Binary restenosis was defined as stenosis of more than 50% of the lumen diameter in the target lesion.

RESULTS:

Baseline clinical, demographic or angiographic characteristics were well balanced between the two groups. The in-stent restenosis rate was not significant between the early group and the late group (3.5 vs. 6.0%; P>0.05). The late loss and target lesion revascularization appeared higher in late group but there were no significant differences (0.15+/-0.38 mm vs. 0.24+/-0.44 mm; and 4.9 vs. 9.5%, P>0.05, respectively). Similarly, overall thrombosis rate was also same in both groups. In-segment restenosis was, however, higher in late group compared with that in early group (7.9 vs. 16.7%, P=0.013).

CONCLUSION:

In this unrestricted population, the beneficial effects of sirolimus-eluting stent implantation extend out more than 1 year in real world practice, that has been confirmed by the results of the large randomized clinical trials. The late in-segment restenosis could, however, be found, suggesting that a prolonged clinical and angiographic surveillance in this subset of patients seems to be warranted.

• Authors: Jian-Jun Li, Bo Xu, Yue-Jin Yang, Ji-Lin Chen, Shu-Bing Qiao, Wei-Hua Ma, Xue-Wen Qin, Min Yao, Hai-Bo Liu, Yong-Jian Wu, Jin-Qing Yuan, Jue Chen, Shi-Jie You, Jun Dai, Ran Xia, Run-Lin Gao
• Journal: Coronary artery disease (Coron Artery Dis) Vol. 18 Issue 4 Pg. 293-8 (Jun 2007) ISSN: 0954-6928 [Print] England
• PMID: 17496493 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Delayed-Action Preparations
• Immunosuppressive Agents
• Sirolimus

Topics

• Aged
• Aged, 80 and over
• Coronary Angiography
• Coronary Artery Disease (diagnostic imaging, drug therapy, surgery)
• Coronary Restenosis (diagnostic imaging, prevention & control)
• Delayed-Action Preparations
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Middle Aged
• Retrospective Studies
• Sirolimus (administration & dosage)
• Stents
• Treatment Outcome