Frequency, predictors and outcome of stent fracture after sirolimus-eluting stent implantation

Hisashi Umeda, Tomoko Gochi, Mitsunori Iwase, Hideo Izawa, Takeshi Shimizu, Ryoji Ishiki, Haruo Inagaki, Junji Toyama, Mitsuhiro Yokota, Toyoaki Murohara

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Abstract

Background: Recently, stent fracture (SF) of sirolimus-eluting stents (SES) has been shown to be associated with an increased risk of in-stent restenosis. We sought to evaluate the incidence, predictors and clinical outcome of SF after SES implantation in comparable unselected lesions. Methods: A total of 430 lesions of 382 patients treated with SES were analyzed. SF was defined as single or multiple stent strut fracture as well as complete separation of stent segments. Results: At follow-up, SF was identified in 33 of 430 lesions (7.7%). In lesions with SF, the in-stent restenosis was observed more frequently than non-SF lesions (15.2% vs. 4.0%, P = 0.004). At 450 days, however, the cumulative rate of major cardiac events was not significantly different between lesions with and without SF (9.1% vs. 7.1%, P = 0.722). The risk of SF was independently associated with total stent length (OR 2.22; 95% CI, 1.25 to 3.95; P = 0.007), the change in the angulation of the lesion after stenting (OR 1.55; 95% CI, 1.07 to 2.25; P = 0.020), and the right coronary artery lesions (OR 3.26; 95% CI, 1.18 to 8.96; P = 0.022). Conclusions: The occurrence of SF after SES implantation, was found to be relatively common in the particular population, however, did not lead to an increased risk of adverse cardiac events at 450 days, despite a higher incidence of in-stent restenosis.

Original languageEnglish
Pages (from-to)321-326
Number of pages6
JournalInternational Journal of Cardiology
Volume133
Issue number3
DOIs
Publication statusPublished - 17-04-2009

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Sirolimus
Stents
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Umeda, Hisashi ; Gochi, Tomoko ; Iwase, Mitsunori ; Izawa, Hideo ; Shimizu, Takeshi ; Ishiki, Ryoji ; Inagaki, Haruo ; Toyama, Junji ; Yokota, Mitsuhiro ; Murohara, Toyoaki. / Frequency, predictors and outcome of stent fracture after sirolimus-eluting stent implantation. In: International Journal of Cardiology. 2009 ; Vol. 133, No. 3. pp. 321-326.
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title = "Frequency, predictors and outcome of stent fracture after sirolimus-eluting stent implantation",
abstract = "Background: Recently, stent fracture (SF) of sirolimus-eluting stents (SES) has been shown to be associated with an increased risk of in-stent restenosis. We sought to evaluate the incidence, predictors and clinical outcome of SF after SES implantation in comparable unselected lesions. Methods: A total of 430 lesions of 382 patients treated with SES were analyzed. SF was defined as single or multiple stent strut fracture as well as complete separation of stent segments. Results: At follow-up, SF was identified in 33 of 430 lesions (7.7{\%}). In lesions with SF, the in-stent restenosis was observed more frequently than non-SF lesions (15.2{\%} vs. 4.0{\%}, P = 0.004). At 450 days, however, the cumulative rate of major cardiac events was not significantly different between lesions with and without SF (9.1{\%} vs. 7.1{\%}, P = 0.722). The risk of SF was independently associated with total stent length (OR 2.22; 95{\%} CI, 1.25 to 3.95; P = 0.007), the change in the angulation of the lesion after stenting (OR 1.55; 95{\%} CI, 1.07 to 2.25; P = 0.020), and the right coronary artery lesions (OR 3.26; 95{\%} CI, 1.18 to 8.96; P = 0.022). Conclusions: The occurrence of SF after SES implantation, was found to be relatively common in the particular population, however, did not lead to an increased risk of adverse cardiac events at 450 days, despite a higher incidence of in-stent restenosis.",
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Umeda, H, Gochi, T, Iwase, M, Izawa, H, Shimizu, T, Ishiki, R, Inagaki, H, Toyama, J, Yokota, M & Murohara, T 2009, 'Frequency, predictors and outcome of stent fracture after sirolimus-eluting stent implantation', International Journal of Cardiology, vol. 133, no. 3, pp. 321-326. https://doi.org/10.1016/j.ijcard.2007.12.067

Frequency, predictors and outcome of stent fracture after sirolimus-eluting stent implantation. / Umeda, Hisashi; Gochi, Tomoko; Iwase, Mitsunori; Izawa, Hideo; Shimizu, Takeshi; Ishiki, Ryoji; Inagaki, Haruo; Toyama, Junji; Yokota, Mitsuhiro; Murohara, Toyoaki.

In: International Journal of Cardiology, Vol. 133, No. 3, 17.04.2009, p. 321-326.

Research output: Contribution to journalArticle

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T1 - Frequency, predictors and outcome of stent fracture after sirolimus-eluting stent implantation

AU - Umeda, Hisashi

AU - Gochi, Tomoko

AU - Iwase, Mitsunori

AU - Izawa, Hideo

AU - Shimizu, Takeshi

AU - Ishiki, Ryoji

AU - Inagaki, Haruo

AU - Toyama, Junji

AU - Yokota, Mitsuhiro

AU - Murohara, Toyoaki

PY - 2009/4/17

Y1 - 2009/4/17

N2 - Background: Recently, stent fracture (SF) of sirolimus-eluting stents (SES) has been shown to be associated with an increased risk of in-stent restenosis. We sought to evaluate the incidence, predictors and clinical outcome of SF after SES implantation in comparable unselected lesions. Methods: A total of 430 lesions of 382 patients treated with SES were analyzed. SF was defined as single or multiple stent strut fracture as well as complete separation of stent segments. Results: At follow-up, SF was identified in 33 of 430 lesions (7.7%). In lesions with SF, the in-stent restenosis was observed more frequently than non-SF lesions (15.2% vs. 4.0%, P = 0.004). At 450 days, however, the cumulative rate of major cardiac events was not significantly different between lesions with and without SF (9.1% vs. 7.1%, P = 0.722). The risk of SF was independently associated with total stent length (OR 2.22; 95% CI, 1.25 to 3.95; P = 0.007), the change in the angulation of the lesion after stenting (OR 1.55; 95% CI, 1.07 to 2.25; P = 0.020), and the right coronary artery lesions (OR 3.26; 95% CI, 1.18 to 8.96; P = 0.022). Conclusions: The occurrence of SF after SES implantation, was found to be relatively common in the particular population, however, did not lead to an increased risk of adverse cardiac events at 450 days, despite a higher incidence of in-stent restenosis.

AB - Background: Recently, stent fracture (SF) of sirolimus-eluting stents (SES) has been shown to be associated with an increased risk of in-stent restenosis. We sought to evaluate the incidence, predictors and clinical outcome of SF after SES implantation in comparable unselected lesions. Methods: A total of 430 lesions of 382 patients treated with SES were analyzed. SF was defined as single or multiple stent strut fracture as well as complete separation of stent segments. Results: At follow-up, SF was identified in 33 of 430 lesions (7.7%). In lesions with SF, the in-stent restenosis was observed more frequently than non-SF lesions (15.2% vs. 4.0%, P = 0.004). At 450 days, however, the cumulative rate of major cardiac events was not significantly different between lesions with and without SF (9.1% vs. 7.1%, P = 0.722). The risk of SF was independently associated with total stent length (OR 2.22; 95% CI, 1.25 to 3.95; P = 0.007), the change in the angulation of the lesion after stenting (OR 1.55; 95% CI, 1.07 to 2.25; P = 0.020), and the right coronary artery lesions (OR 3.26; 95% CI, 1.18 to 8.96; P = 0.022). Conclusions: The occurrence of SF after SES implantation, was found to be relatively common in the particular population, however, did not lead to an increased risk of adverse cardiac events at 450 days, despite a higher incidence of in-stent restenosis.

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