[Risk factors and clinical outcome of coronary artery aneurysms developed after drug-eluting stent implantation].

Abstract

OBJECTIVE:

To evaluate risk factors and clinical outcome of coronary artery aneurysms (CAA) developed after drug-eluting stent implantation evidenced by coronary angiographic follow-up.

METHODS:

This study analyzed 4500 consecutive patient with de novo coronary artery stenosis receiving drug-eluting stent (DES) implantation from January 2004 to May 2009. Seven hundred and sixty patients with angiographic follow-ups at 6 - 8 months and 28 - 48 months after the index procedure were enrolled. CAA was defined as a localized dilatation exceeding 1.5 times the diameter of the adjacent artery. The independent risk factors and major adverse cardiac events (MACE) including cardiac death, myocardial infarction, target-vessel revascularization (TVR) and in-stent thrombosis were analyzed.

RESULTS:

CAA was detected in 70 patients with 70 lesions (9.2%, 70/760). Logistic analysis showed that lesion in an infarct-related artery (OR: 5.9, P < 0.01), lesion in the left anterior descending artery (OR: 4.5, P < 0.01), lesion with chronic total occlusion (OR: 3.4, P < 0.05), and lesion length > 33 mm (OR: 2.9, P < 0.05) were independent risk factors for CAA. Follow-up duration was (1131 ± 478) days. MACE was found in 19 patients and all received TVR. There were 11 patients with myocardial infarction and 8 patients with evidence of in-stent thrombosis. Mortality was zero during follow-up.

CONCLUSIONS:

The risk factors for the development of CAA after DES are lesions in an infarct-related artery, in the left anterior descending artery, with chronic total occlusion, and with lesion length > 33 mm. MACE is not uncommon in patients with CAA and long-ferm clinical follow-up is warranted for patients with CAA.

• Authors: Shou-jie Shan, Zhi-zhong Liu, Jun-jie Zhang, Fei Ye, Song Lin, Nai-liang Tian, Shao-liang Chen
• Journal: Zhonghua xin xue guan bing za zhi (Zhonghua Xin Xue Guan Bing Za Zhi) Vol. 41 Issue 2 Pg. 103-7 (Feb 2013) ISSN: 0253-3758 [Print] China
• PMID: 23710738 (Publication Type: English Abstract, Journal Article)

Topics

• Aged
• Coronary Aneurysm (etiology)
• Coronary Restenosis (therapy)
• Drug-Eluting Stents (adverse effects)
• Female
• Follow-Up Studies
• Humans
• Logistic Models
• Male
• Middle Aged
• Prognosis
• Risk Factors