Do drug elution components increase the risk of fracture of sirolimus-eluting stents?

Tomoko Kawai, Hisashi Umeda, Masaya Ota, Kousuke Hattori, Makoto Ishikawa, Masanori Okumura, Shino Kan, Tadashi Nakano, Hiroyuki Naruse, Shigeru Matsui, Junichi Ishii, Hitoshi Hishida, Yukio Ozaki

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: Stent fracture (SF) of sirolimus-eluting stents (SES) has emerged recently in the literature and shown to be associated with an increased risk of restenosis; however, little is known regarding SF after bare-metal stent implantation. We sought to assess whether the use of SES was associated with an increased risk of SF compared with its bare-metal platform, the Bx-velocity stent (BX-BMS). Methods: A total of 478 lesions in 416 patients undergoing SES implantation and subsequent angiography 6-9 months after the index procedure were compared with 152 lesions in 142 consecutive patients treated with BX-BMS. Stented lesions with total stent-length greater than 40 mm were excluded. Results: There were no significant differences in overall baseline clinical and anatomic features between the SES and BX-BMS groups, or in SF frequencies at 6-9 month follow-up (4.4% for SES and 1.3% for BX-BMS, P=0.078). In-stent restenosis was observed more often in SF lesions versus non-SF lesions (34.8 vs. 7.7%, P<0.001) in association with a higher 3-year adverse events rate (27.3 vs. 13.6%, P=0.076). The risk of SF at 6-9 months was independently associated with total stent length [odds ratio (OR), 2.13; 95% confidence interval (CI), 1.18-3.83; P=0.012], angulated lesions (OR, 4.25; 95% CI, 1.80-10.00; P=0.001), and right coronary artery lesions (OR, 3.55; 95% CI, 1.46-8.62; P=0.005) but not with SES use. Conclusion: Stent implantation in right coronary artery lesions, tortuous lesions, and/or longer lesions covered with longer stents, and not SES versus BX-BMS use, may be associated with increased likelihood of SF.

Original languageEnglish
Pages (from-to)298-303
Number of pages6
JournalCoronary Artery Disease
Volume21
Issue number5
DOIs
Publication statusPublished - 01-08-2010

Fingerprint

Sirolimus
Stents
Pharmaceutical Preparations
Odds Ratio
Confidence Intervals
Coronary Vessels
Metals

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kawai, Tomoko ; Umeda, Hisashi ; Ota, Masaya ; Hattori, Kousuke ; Ishikawa, Makoto ; Okumura, Masanori ; Kan, Shino ; Nakano, Tadashi ; Naruse, Hiroyuki ; Matsui, Shigeru ; Ishii, Junichi ; Hishida, Hitoshi ; Ozaki, Yukio. / Do drug elution components increase the risk of fracture of sirolimus-eluting stents?. In: Coronary Artery Disease. 2010 ; Vol. 21, No. 5. pp. 298-303.
@article{7c8352ed3e3c49b6a9f81ef68126bb9c,
title = "Do drug elution components increase the risk of fracture of sirolimus-eluting stents?",
abstract = "Objectives: Stent fracture (SF) of sirolimus-eluting stents (SES) has emerged recently in the literature and shown to be associated with an increased risk of restenosis; however, little is known regarding SF after bare-metal stent implantation. We sought to assess whether the use of SES was associated with an increased risk of SF compared with its bare-metal platform, the Bx-velocity stent (BX-BMS). Methods: A total of 478 lesions in 416 patients undergoing SES implantation and subsequent angiography 6-9 months after the index procedure were compared with 152 lesions in 142 consecutive patients treated with BX-BMS. Stented lesions with total stent-length greater than 40 mm were excluded. Results: There were no significant differences in overall baseline clinical and anatomic features between the SES and BX-BMS groups, or in SF frequencies at 6-9 month follow-up (4.4{\%} for SES and 1.3{\%} for BX-BMS, P=0.078). In-stent restenosis was observed more often in SF lesions versus non-SF lesions (34.8 vs. 7.7{\%}, P<0.001) in association with a higher 3-year adverse events rate (27.3 vs. 13.6{\%}, P=0.076). The risk of SF at 6-9 months was independently associated with total stent length [odds ratio (OR), 2.13; 95{\%} confidence interval (CI), 1.18-3.83; P=0.012], angulated lesions (OR, 4.25; 95{\%} CI, 1.80-10.00; P=0.001), and right coronary artery lesions (OR, 3.55; 95{\%} CI, 1.46-8.62; P=0.005) but not with SES use. Conclusion: Stent implantation in right coronary artery lesions, tortuous lesions, and/or longer lesions covered with longer stents, and not SES versus BX-BMS use, may be associated with increased likelihood of SF.",
author = "Tomoko Kawai and Hisashi Umeda and Masaya Ota and Kousuke Hattori and Makoto Ishikawa and Masanori Okumura and Shino Kan and Tadashi Nakano and Hiroyuki Naruse and Shigeru Matsui and Junichi Ishii and Hitoshi Hishida and Yukio Ozaki",
year = "2010",
month = "8",
day = "1",
doi = "10.1097/MCA.0b013e32833aa6a1",
language = "English",
volume = "21",
pages = "298--303",
journal = "Coronary Artery Disease",
issn = "0954-6928",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

Kawai, T, Umeda, H, Ota, M, Hattori, K, Ishikawa, M, Okumura, M, Kan, S, Nakano, T, Naruse, H, Matsui, S, Ishii, J, Hishida, H & Ozaki, Y 2010, 'Do drug elution components increase the risk of fracture of sirolimus-eluting stents?', Coronary Artery Disease, vol. 21, no. 5, pp. 298-303. https://doi.org/10.1097/MCA.0b013e32833aa6a1

Do drug elution components increase the risk of fracture of sirolimus-eluting stents? / Kawai, Tomoko; Umeda, Hisashi; Ota, Masaya; Hattori, Kousuke; Ishikawa, Makoto; Okumura, Masanori; Kan, Shino; Nakano, Tadashi; Naruse, Hiroyuki; Matsui, Shigeru; Ishii, Junichi; Hishida, Hitoshi; Ozaki, Yukio.

In: Coronary Artery Disease, Vol. 21, No. 5, 01.08.2010, p. 298-303.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Do drug elution components increase the risk of fracture of sirolimus-eluting stents?

AU - Kawai, Tomoko

AU - Umeda, Hisashi

AU - Ota, Masaya

AU - Hattori, Kousuke

AU - Ishikawa, Makoto

AU - Okumura, Masanori

AU - Kan, Shino

AU - Nakano, Tadashi

AU - Naruse, Hiroyuki

AU - Matsui, Shigeru

AU - Ishii, Junichi

AU - Hishida, Hitoshi

AU - Ozaki, Yukio

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Objectives: Stent fracture (SF) of sirolimus-eluting stents (SES) has emerged recently in the literature and shown to be associated with an increased risk of restenosis; however, little is known regarding SF after bare-metal stent implantation. We sought to assess whether the use of SES was associated with an increased risk of SF compared with its bare-metal platform, the Bx-velocity stent (BX-BMS). Methods: A total of 478 lesions in 416 patients undergoing SES implantation and subsequent angiography 6-9 months after the index procedure were compared with 152 lesions in 142 consecutive patients treated with BX-BMS. Stented lesions with total stent-length greater than 40 mm were excluded. Results: There were no significant differences in overall baseline clinical and anatomic features between the SES and BX-BMS groups, or in SF frequencies at 6-9 month follow-up (4.4% for SES and 1.3% for BX-BMS, P=0.078). In-stent restenosis was observed more often in SF lesions versus non-SF lesions (34.8 vs. 7.7%, P<0.001) in association with a higher 3-year adverse events rate (27.3 vs. 13.6%, P=0.076). The risk of SF at 6-9 months was independently associated with total stent length [odds ratio (OR), 2.13; 95% confidence interval (CI), 1.18-3.83; P=0.012], angulated lesions (OR, 4.25; 95% CI, 1.80-10.00; P=0.001), and right coronary artery lesions (OR, 3.55; 95% CI, 1.46-8.62; P=0.005) but not with SES use. Conclusion: Stent implantation in right coronary artery lesions, tortuous lesions, and/or longer lesions covered with longer stents, and not SES versus BX-BMS use, may be associated with increased likelihood of SF.

AB - Objectives: Stent fracture (SF) of sirolimus-eluting stents (SES) has emerged recently in the literature and shown to be associated with an increased risk of restenosis; however, little is known regarding SF after bare-metal stent implantation. We sought to assess whether the use of SES was associated with an increased risk of SF compared with its bare-metal platform, the Bx-velocity stent (BX-BMS). Methods: A total of 478 lesions in 416 patients undergoing SES implantation and subsequent angiography 6-9 months after the index procedure were compared with 152 lesions in 142 consecutive patients treated with BX-BMS. Stented lesions with total stent-length greater than 40 mm were excluded. Results: There were no significant differences in overall baseline clinical and anatomic features between the SES and BX-BMS groups, or in SF frequencies at 6-9 month follow-up (4.4% for SES and 1.3% for BX-BMS, P=0.078). In-stent restenosis was observed more often in SF lesions versus non-SF lesions (34.8 vs. 7.7%, P<0.001) in association with a higher 3-year adverse events rate (27.3 vs. 13.6%, P=0.076). The risk of SF at 6-9 months was independently associated with total stent length [odds ratio (OR), 2.13; 95% confidence interval (CI), 1.18-3.83; P=0.012], angulated lesions (OR, 4.25; 95% CI, 1.80-10.00; P=0.001), and right coronary artery lesions (OR, 3.55; 95% CI, 1.46-8.62; P=0.005) but not with SES use. Conclusion: Stent implantation in right coronary artery lesions, tortuous lesions, and/or longer lesions covered with longer stents, and not SES versus BX-BMS use, may be associated with increased likelihood of SF.

UR - http://www.scopus.com/inward/record.url?scp=77954660743&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77954660743&partnerID=8YFLogxK

U2 - 10.1097/MCA.0b013e32833aa6a1

DO - 10.1097/MCA.0b013e32833aa6a1

M3 - Article

C2 - 20617542

AN - SCOPUS:77954660743

VL - 21

SP - 298

EP - 303

JO - Coronary Artery Disease

JF - Coronary Artery Disease

SN - 0954-6928

IS - 5

ER -