Risk factors and clinical outcome of coronary artery aneurysms developed after drug-eluting stent implantation
10.3760/cma.j.issn.0253-3758.2013.02.005
- VernacularTitle:药物洗脱支架置入后冠状动脉瘤形成的危险因素和预后
- Author:
Shou-Jie SHAN
1
;
Zhi-Zhong LIU
;
Jun-Jie ZHANG
;
Fei YE
;
Song LIN
;
Nai-Liang TIAN
;
Shao-Liang CHEN
Author Information
1. 210006,南京医科大学附属南京第一医院心脏科
- Keywords:
Coronary aneurysm;
Drug-eluting stents;
Risk factors
- From:
Chinese Journal of Cardiology
2013;41(2):103-107
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate risk factors and clinical outcome of coronary artery aneurysms (CAA) developed after drug-eluting stent implantation evidenced by coronary angiographic followup.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 infarctrelated 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.
