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European Heart Journal Advance Access originally published online on April 27, 2006
European Heart Journal 2006 27(11):1305-1310; doi:10.1093/eurheartj/ehi882
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Intravascular ultrasound predictors of angiographic restenosis after sirolimus-eluting stent implantation

Myeong-Ki Hong1, Gary S. Mintz2, Cheol Whan Lee1, Duk-Woo Park1, Bong-Ryong Choi1, Kyoung-Ha Park1, Young-Hak Kim1, Sang-Sig Cheong3, Jae-Kwan Song1, Jae-Joong Kim1, Seong-Wook Park1 and Seung-Jung Park1,*

1 Department of Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea
2 Cardiovascular Research Foundation, New York, NY, USA
3 Department of Medicine, University of Ulsan College of Medicine, Asan Medical Center, GangNeung, Korea

Received 13 November 2005; revised 2 March 2006; accepted 23 March 2006; online publish-ahead-of-print 27 April 2006.

* Corresponding author. fax: +82 2 475 6898. E-mail address: sjpark{at}amc.seoul.kr

Aims In many countries, drug-eluting stent implantation is the dominant interventional strategy. We evaluated the clinical, angiographic, procedural, and intravascular ultrasound (IVUS) predictors of angiographic restenosis after sirolimus-eluting stent (SES) implantation.

Methods and results SES implantation was successfully performed in 550 patients with 670 native coronary lesions. Six-month follow-up angiography was performed in 449 patients (81.6%) with 543 lesions (81.1%). Clinical, angiographic, procedural, and IVUS predictors of restenosis were determined. Using multivariable logistic regression analysis, the only independent predictors of angiographic restenosis were post-procedural final minimum stent area by IVUS [odds ratio (OR)=0.586, 95% confidence interval (CI) 0.387–0.888, P=0.012] and IVUS-measured stent length (OR=1.029, 95% CI 1.002–1.056, P=0.035). Final minimum stent area by IVUS and IVUS-measured stent length that best separated restenosis from non-restenosis were 5.5 mm2 and 40 mm, respectively. Lesions with final minimum stent area <5.5 mm2 and stent length >40 mm had the highest rate of angiographic restenosis [17.7% (11/62)], P<0.001 compared with other groups.

Conclusion Independent predictors of angiographic restenosis after SES implantation were post-procedural final minimum stent area by IVUS and IVUS-measured stent length. The angiographic restenosis rate was highest in lesions with stent area <5.5 mm2 and stent length >40 mm.

Key Words: Ultrasonics • Stent • Coronary disease


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