Yonsei Med J.  2013 Jan;54(1):41-47. 10.3349/ymj.2013.54.1.41.

Relationship between Angiographic Late Loss and 5-Year Clinical Outcome after Drug-Eluting Stent Implantation

• Yang YJ
• Shin S
• Kim BK
• Kim JS
• Shin DH
• Ko YG
• Choi D
• Jang Y
• Hong MK

• KMID: 1776916
• DOI: http://doi.org/10.3349/ymj.2013.54.1.41

Abstract

PURPOSE
Currently, insufficient data exist to evaluate the relationship between angiographic late loss (LL) and long-term clinical outcome after drug-eluting stent (DES) implantation. In this study, we hypothesized that angiographic LL between 0.3 and 0.6 mm correlate with favorable long-term clinical outcomes.
MATERIALS AND METHODS
Patients were enrolled in the present study if they had undergone both DES implantation in single coronary vessel and a subsequent follow-up angiogram (n=634). These individuals were then subdivided into three groups based on their relative angiographic LL: group I (angiographic LL <0.3 mm, n=378), group II (angiographic LL between 0.3 and 0.6 mm, n=124), and group III (angiographic LL >0.6 mm, n=134). During a 5-year follow-up period, all subjects were tracked for critical events, defined as any cause of death or myocardial infarction, which were then compared among the three groups.
RESULTS
Mean follow-up duration was 63.0+/-10.0 months. Critical events occurred in 25 subjects in group I (6.6%), 5 in group II (4.0%), and 17 in group III (12.7%), (p=0.020; group I vs. group II, p=0.293; group II vs. group III, p=0.013). In a subsequent multivariate logistic regression analysis, chronic renal failure [odds ratio (OR)=3.29, 95% confidence interval (CI): 1.48-7.31, p=0.003] and long lesion length, defined as lesion length >28 mm (OR=1.88, 95% CI: 1.02-3.46, p=0.042) were independent predictors of long-term critical events.
CONCLUSION
This retrospective analysis fails to demonstrate that post-DES implantation angiographic LL between 0.3 and 0.6 mm is protective against future critical events.

Keyword

Coronary artery disease; stents; outcome assessment

MeSH Terms

Adult
Aged
Angiography/*methods
Coronary Artery Disease/*surgery
Coronary Vessels/surgery
*Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic/complications
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Percutaneous Coronary Intervention/methods
Prosthesis Failure
Retrospective Studies
Time Factors
Treatment Outcome

Figure

• 

  Fig. 1 Using Kaplan-Meier curves, the incidence of clinical events of three groups according to angiographic late loss (<0.3 mm, between 0.3 and 0.6 mm and >0.6 mm) are shown. (A) Death or myocardial infarction free survival rate. (B) Target vessel revascularization free survival rate. (C) Stent thrombosis free survival rate.

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