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European Heart Journal Advance Access published online on April 27, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi882
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European Heart Journal © The European Society of Cardiology 2006; All rights reserved
Received November 13, 2005
Revised March 2, 2006
Accepted March 23, 2006

Clinical research

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

Myeong-Ki Hong 1, Gary S. Mintz 2, Cheol Whan Lee 1, Duk-Woo Park 1, Bong-Ryong Choi 1, Kyoung-Ha Park 1, Young-Hak Kim 1, Sang-Sig Cheong 3, Jae-Kwan Song 1, Jae-Joong Kim 1, Seong-Wook Park 1, and Seung-Jung Park 1 *

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

* To whom correspondence should be addressed.
Seung-Jung Park, E-mail: sjpark{at}amc.seoul.kr


  Abstract

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.

Keywords: Ultrasonics; Stent; Coronary disease.
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