Late Adverse Events After Implantation of Sirolimus-Eluting Stent and Bare-Metal Stent

• DOI: 10.1161/circinterventions.113.000987
• Publication Date: 2014-02-19T05:38:28Z
• Authors: Masahiro Natsuaki; Takeshi Morimoto; Yutaka Furukawa; Yoshihisa Nakagawa; Kazushige Kadota; Kyohei Yamaji; Kenji Ando; Satoshi Shizuta; Hiroki Shiomi; Tomohisa Tada; Junichi Tazaki; Yoshihiro Kato; Mamoru Hayano; Mitsuru Abe; Takashi Tamura; Manabu Shirotani; Shinji Miki; Mitsuo Matsuda; Mamoru Takahashi; Katsuhisa Ishii; Masaru Tanaka; Takeshi Aoyama; Osamu Doi; Ryuichi Hattori; Masayuki Kato; Satoru Suwa; Akinori Takizawa; Yoshiki Takatsu; Eiji Shinoda; Hiroshi Eizawa; Teruki Takeda; Jong-Dae Lee; Moriaki Inoko; Hisao Ogawa; Shuichi Hamasaki; Minoru Horie; Ryuji Nohara; Hirofumi Kambara; Hisayoshi Fujiwara; Kazuaki Mitsudo; Masakiyo Nobuyoshi; Toru Kita; Takeshi Kimura
• Keywords: Cumulative incidence; Sirolimus; Bare-metal stent

Late adverse events such as very late stent thrombosis (VLST) or target-lesion revascularization (TLR) after first-generation sirolimus-eluting stents (SES) implantation have not been yet fully characterized at long term in comparison with those bare-metal (BMS) implantation.Among 13 058 consecutive patients undergoing first percutaneous coronary intervention the Coronary REvascularization Demonstrating Outcome study-Kyoto registry Cohort-2, 5078 were treated SES only, and 5392 BMS only. During 7-year follow-up, VLST TLR beyond 1 year occurred constantly without attenuation 0.24% per 2.0% year, respectively. Cumulative incidence of was significantly higher group than that (1.43% versus 0.68%, P<0.0001). However, there no excess all-cause death compared (20.8% 19.6%, P=0.91). incidences (both overall clinically driven) also (12.0% 4.1%, P<0.0001 8.5% 2.6%, P<0.0001, respectively), leading to catch-up regarding through entire follow-up (18.8% 25.2%, 10.6% 10.2%, respectively). Clinical presentation acute syndrome more common time early (21.2% 10.0%).Late phenomenon pronounced BMS. This limitation should remain target for improvements DES technology.