Imai Masao, Kimura Takeshi, Morimoto Takeshi, Saito Naritatsu, Shiomi Hiroki, Kawaguchi Ren, Kan Hakuken, Mukawa Hiroaki, Fujita Hiroshi, Ishise Takuo, Hayashi Fujio, Nagao Kazuya, Take Shunsuke, Taniguchi Hiromasa, Sakamoto Hiroki, Yamane Takafumi, Shirota Kinya, Tamekiyo Hiromichi, Okamura Takayuki, Kishi Koichi, Miyazaki Shinichirou, Yamamoto Satoshi, Yamaji Kyohei, Kawasaki Tomohiro, Taguchi Eiji, Nakajima Hitoshi, Kosedo Ippei, Tada Takeshi, Kadota Kazushige, Mitsudo Kazuaki
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shougoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Cardiovasc Interv Ther. 2014 Jul;29(3):226-36. doi: 10.1007/s12928-014-0248-6. Epub 2014 Feb 15.
This study sought to assess clinical significance of angiographic peri-stent contrast staining (PSS) after sirolimus-eluting stent (SES) implantation in a large multicenter study with 5-year follow-up. The j-Cypher PSS substudy is a multicenter study including 5712 patients (7838 lesions) who underwent follow-up angiographic study within 12 months after SES implantation. Late acquired PSS was observed in 184 patients (3.2 %) or 194 lesions (2.5 %). Independent risk factors of PSS were chronic total occlusion and left anterior descending artery lesion, while negative risk factors were in-stent restenosis, diabetes mellitus, ≥70 years of age, and left circumflex coronary artery lesion. Cumulative incidence of definite very late stent thrombosis (VLST) at 4 years after the index follow-up angiography in lesions with PSS was significantly higher than that in lesions without PSS (5.3 versus 0.7 %, P < 0.0001). Late target-lesion revascularization (TLR) was also more frequently observed in the PSS group (13 versus 6.9 %, P = 0.01), while late TLR for restenosis excluding those TLR procedures for VLST tended to be higher in the PSS group (9.9 versus 6.3 %; P = 0.15). PSS found in 2.5 % of lesions within 12 months after SES implantation was associated with higher risk for subsequent VLST.
