Incidence and Risk Factors of Late Target Lesion Revascularization After Sirolimus-Eluting Stent Implantation (3-Year Follow-Up of the j-Cypher Registry)

Nakagawa, Yoshihisa; Kimura, Takeshi; Morimoto, Takeshi; Nomura, Masanori; Saku, Keijiro; Haruta, Seiichi; Muramatsu, Toshiya; Nobuyoshi, Masakiyo; Kadota, Kazushige; Fujita, Hiroshi; Tatami, Ryozo; Shiode, Nobuo; Nishikawa, Hideo; Shibata, Yoshisato; Miyazaki, Shunichi; Murata, Yoshiharu; Honda, Takashi; Kawasaki, Tomohiro; Doi, Osamu; Hiasa, Yoshikazu; Hayashi, Yasuhiko; Matsuzaki, Masunori; Mitsudo, Kazuaki; j-Cypher Registry Investigators,

doi:10.1016/j.amjcard.2010.03.031

« Previous Next »American Journal of Cardiology
Volume 106, Issue 3 , Pages 329-336, 1 August 2010

Incidence and Risk Factors of Late Target Lesion Revascularization After Sirolimus-Eluting Stent Implantation (3-Year Follow-Up of the j-Cypher Registry)

Yoshihisa Nakagawa, MD
- Division of Cardiology, Tenri Hospital, Tenri, Japan
- Corresponding author: Tel: 81-743-63-5611; fax: 81-743-63-1530
Takeshi Kimura, MD
- Department of Cardiovascular of Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Takeshi Morimoto, MD
- Center for Medical Education and Clinical Epidemiology Unit, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Masanori Nomura, MD
- Fujita Health University, Banbuntane Houtokukai Hospital, Aichi, Japan
Keijiro Saku, MD
- Fukuoka University Hospital, Fukuoka, Japan
Seiichi Haruta, MD
- Fukuyama Cardiovascular Hospital, Fukuyama, Japan
Toshiya Muramatsu, MD
- Kawasaki Social Insurance Hospital, Kawasaki, Japan
Masakiyo Nobuyoshi, MD
- Kokura Memorial Hospital, Kokura, Japan
Kazushige Kadota, MD
- Kurashiki Central Hospital, Kurashiki, Japan
Hiroshi Fujita, MD
- Kyoto Second Red Cross Hospital, Kyoto, Japan
Ryozo Tatami, MD
- Maizuru Kyosai Hospital, Maizuru, Japan
Nobuo Shiode, MD
- Matsue Red Cross Hospital, Matsue, Japan
Hideo Nishikawa, MD
- Mie Heart Center, Mie, Japan
Yoshisato Shibata, MD
- Miyazaki Ishikai Hospital, Miyazaki, Japan
Shunichi Miyazaki, MD
- National Cardiovascular Center, Suita, Japan
Yoshiharu Murata, MD
- Noto General Hospital, Nanao, Japan
Takashi Honda, MD
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
Tomohiro Kawasaki, MD
- Shin-Koga Hospital, Kurume, Japan
Osamu Doi, MD
- Shizuoka General Hospital, Shizuoka, Japan
Yoshikazu Hiasa, MD
- Tokushima Red Cross Hospital, Tokushima, Japan
Yasuhiko Hayashi, MD
- Tsuchiya General Hospital, Hiroshima, Japan
Masunori Matsuzaki, MD
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University, Graduate School of Medicine, Ube, Japan
Kazuaki Mitsudo, MD
- Kokura Memorial Hospital, Kokura, Japan
j-Cypher Registry Investigators

Received 21 January 2010; received in revised form 17 March 2010; accepted 17 March 2010. published online 21 June 2010.

It yet has not been clarified whether there is a late catch-up phenomenon in target lesion revascularization (TLR) after sirolimus-eluting stent (SES) compared to bare metal stent (BMS) implantation. In 12,824 patients enrolled in the j-Cypher Registry, incidences of early (within first year) and late (1 year to 3 years) TLR were compared between 17,050 lesions treated with SESs and 1,259 lesions treated with BMSs. Incidences of TLR in SES-treated lesions were 5.7% at 1 year, 8.1% at 2 years, and 10.0% at 3 years, whereas those in BMS-treated lesions were 14.2%, 15.5%, and 15.5%, respectively (p <0.0001, log-rank test). Incidences of late TLR were significantly higher with SESs compared to BMSs (2.6% vs 1.4% at 2 years and 4.5% vs 1.4% at 3 years, p = 0.0007, log-rank test). A multivariable logistic regression model identified 7 independent risk factors for late TLR at 3 years after SES implantation: hemodialysis, low estimated glomerular filtration rate, ostial right coronary artery, lesion length ≥30 mm, 2 stents for bifurcation, American Heart Association/American College of Cardiology type B2/C, and vessel size <2.5 mm. Of these, 5 factors were common to those for early TLR. In conclusion, a late catch-up phenomenon was observed as indicated by the increasing incidence of late TLR after SES, but not after BMS, implantation. Risk factors for late TLR were generally common to those for early TLR.