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Incidence and predictors of early and late target lesion revascularization after everolimus‐eluting stent implantation in unselected patients in japan
Author(s) -
Kurihara Ken,
Ashikaga Takashi,
Sasaoka Taro,
Yoshikawa Shunji,
Isobe Mitsuaki
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26964
Subject(s) - medicine , incidence (geometry) , everolimus , lesion , revascularization , stent , cardiology , target lesion , radiology , surgery , myocardial infarction , percutaneous coronary intervention , physics , optics
Objective The objective of this study was to clarify the incidence and predictors of early and late target lesion revascularization (TLR) after everolimus‐eluting stent (EES) implantation in actual clinical practice. Background Several clinical studies have reported the incidence and predictors of TLR after EES implantation. However, detailed features of early and late TLR are unknown. Methods We analyzed the clinical data of patients who underwent EES implantation between January 2010 and December 2011 at 22 institutions in Japan (Tokyo‐MD PCI study). Patients who underwent ischemia‐driven TLR (ID‐TLR) were grouped according to the number of years elapsed since stent placement, and incidence and correlations between clinical factors were analyzed. Results Statistical analysis was performed for 1,899 patients and 2,305 lesions. The mean age was 70.0 ± 9.9 years, and the median follow‐up period was 1,281 days (IQR: 762–1,440 days). The incidence of ID‐TLR was 2.7% at 1 year and 5.4% at 4 years. After 2 years, the ID‐TLR rates plateaued. The independent predictors of ID‐TLR occurring within 2 years were hemodialysis, triple vessel disease, restenotic lesion, and ostial lesions. The independent predictors of ID‐TLR between 2 and 4 years were diabetes mellitus and peripheral artery disease. Conclusion The ID‐TLR rates leveled off after 2 years. Furthermore, the predictors of ID‐TLR that occurred within 2 years of EES implantation differed from those that occurred later than 2 years. © 2017 Wiley Periodicals, Inc.