Post-intervention minimal stent area as a predictor of target lesion revascularization after everolimus-eluting stent implantation for in-stent restenosis: a single-center observational study

Background
Everolimus-eluting stent (EES) is effective for treating in-stent restenosis (ISR). However, the long-term incidence of target lesion revascularization (TLR) is unknown. Further, the role of post-intervention minimal stent area (MSA) measured by intravascular ultrasound (IVUS) in TLR is unknown in this setting.
Patients and methods
Overall, 223 ISR lesions (192 patients) that were treated with EES between 2010 and 2016 were analyzed retrospectively. Lesions were divided into two groups according to the post-intervention MSA [ ≤ 5.3 mm2: 72 lesions (67 patients), and> 5.3 mm2: 151 lesions (138 patients)]. The cut-off point was determined on the basis of receiver operating characteristic curve analysis.
Results
The cumulative 5-year incidence of TLR was significantly higher in the group with MSA of 5.3 mm2 or less than in the group with MSA more than 5.3 mm2 (15.8 and 7.2%, P = 0.01). After adjusting for confounders, the excess risk of the group with MSA of 5.3 mm2 or less relative to the group with MSA more than 5.3 mm2 for TLR remained significant [hazard ratio: 3.07, 95% confidence interval (CI): 1.17–8.51, P = 0.02]. Using multivariate logistic regression analysis, we identified female sex (odds ratio: 2.39, 95% CI: 1.06–5.49, P = 0.04) and stent size of 3.0 mm or less (odds ratio: 13.43, 95% CI: 6.23–32.38, P

Source: Coronary Artery Disease - August 6, 2019 Category: Cardiology Tags: PCI Source Type: research