Department of Cardiology, Kurashiki Central Hospital.
Circ J. 2017 Sep 25;81(10):1514-1521. doi: 10.1253/circj.CJ-17-0236. Epub 2017 Jun 13.
Stent fracture (SF) and peri-stent contrast staining (PSS) after sirolimus-eluting stent implantation are reported to be risk factors of adverse events. However, the effect of these after everolimus-eluting stent (EES) implantation on long-term outcomes remains unclear.Methods and Results:The study sample comprised 636 patients (1,081 lesions) undergoing EES implantation in 2010 and follow-up angiography within 1 year. The 5-year cumulative rates of target lesion revascularization (TLR) and major adverse cardiac events (MACE: a combination of all-cause death, myocardial infarction, and TLR) were compared between patients with and without SF or PSS. SF was observed in 2.7%, and PSS in 3.0%. The cumulative rates of MACE and TLR were significantly higher in the SF group than in the non-SF group (51.7% vs. 27.5% and 48.3% vs. 13.4%, respectively), but showed no significant differences between the PSS and non-PSS groups. In a landmark analysis, the rate of TLR within 1 year was significantly higher in the SF group than in the non-SF group (44.8% vs. 7.2%), but beyond 1 year showed no significant difference (6.3% vs 6.7%).
The 5-year clinical outcomes suggested that SF after EES implantation is related to increased risk of MACE and TLR, especially within 1 year after the procedure, but PSS after EES implantation is unrelated.
支架断裂（SF）和支架内对比染色（PSS）是雷帕霉素洗脱支架植入后的不良事件的危险因素。然而，依维莫司洗脱支架（EES）植入后的这些因素对长期结果的影响尚不清楚。
本研究纳入了 2010 年接受 EES 植入术并在 1 年内进行随访血管造影的 636 例患者（1081 处病变）。比较了有和无 SF 或 PSS 的患者之间的靶病变血运重建（TLR）和主要不良心脏事件（MACE：全因死亡、心肌梗死和 TLR 的组合）的 5 年累积发生率。SF 发生率为 2.7%，PSS 发生率为 3.0%。SF 组的 MACE 和 TLR 的累积发生率明显高于非 SF 组（分别为 51.7% vs. 27.5%和 48.3% vs. 13.4%），但 PSS 组与非 PSS 组之间无显著差异。在一个时间点分析中，SF 组在 1 年内的 TLR 发生率明显高于非 SF 组（44.8% vs. 7.2%），但在 1 年以后无显著差异（6.3% vs 6.7%）。
EES 植入后 5 年的临床结果表明，EES 植入后的 SF 与 MACE 和 TLR 风险增加相关，尤其是在术后 1 年内，但 EES 植入后的 PSS 与风险增加无关。
