Association between late incomplete stent apposition after sirolimus eluting stent implantation and clinical outcomes in patients with acute coronary syndrome
10.3760/cma.j.issn.0253-3758.2009.01.005
- VernacularTitle:急性冠状动脉综合征患者雷帕霉素洗脱支架晚期贴壁不良及其对临床预后的影响
- Author:
Rui-Yan ZHANG
1
;
Run DU
;
Zheng-Bin ZHU
;
Qi ZHANG
;
Jian HU
;
Feng-Hua DING
;
An-Kang L(U)
;
Jian-Sheng ZHANG
;
Wei-Feng SHEN
Author Information
1. 上海交通大学医学院附属瑞金医院
- Keywords:
Coronary disease;
Stents;
Ultrasonography,interventional
- From:
Chinese Journal of Cardiology
2009;37(1):30-34
- CountryChina
- Language:Chinese
-
Abstract:
Objective The impact of late incomplete stent apposition(ISA)post sirolimus eluting stent(SES)implantation in patients with acute coronary syndrome(ACS)on long-term clinical outcomes remainB controversial.The alm of the present study was to eva]uate the association between late ISA and clinical outcomes in patients with ACS compared with that with stable angina(SA).Methods From February 2005 to March 2007,54 ACS patients and 83 SA patients were enrolled in this study,late ISA was determined by meallS of threc-dimensional volumetric intravaaculair ultrasound(IVUS)analyses one year after SES implantation and clinical outcomes one year post IVUS were obtained in these patients.Results In 219 treated lesions of the 137 patients,late ISA wag documented in 25 lesions in 16 patients(20 ISA in 12 ACS patients vs.5 ISA in 4 SA patients,P＜0.001).Thoush lunlen area in reference and stented segment,neointimal hyperplasia(NIH)area and percentage of NIH in stented segment,and external elastic membrane(EEM)area in reference segment were similar between two groups,EEM area in stented segment [(15.34±5.44)mm2vs.(13.83±4.51)mm2,P=0.026],stented/reference segment EEM area ratio (1.13±0.22 vs.1.02±0.18,P＜0.001),plaque and media area[(8.43±3.93)mm2vs.(7.01±2.93)mm2,P=0.002]was significantly lager in ACS group than that in SA group.Multivariable logistic analysis showed that ACS(OR 6.477 with 95%CI from 2.297 to 18.263,P＜0.001)and stent length≥23 mm(OR 3.680 with 95% CI from 1.181 to 11.469,P=0.025)were main independent factors of occurrence of late ISA.Incidence of main adverse cardiac events(MACE)one year post IVUS Wag similar between the two groups.Conclusion Compared with patients with SA,ACS patients had larger stented segment EEM area,plaque and media areaas well as increased incidence of ISA.However,the incidence of MACE was similar in ACS and SA patients one year after IVUS.
