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Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation

Authors
 Chul-Min Ahn  ;  Bum-Kee Hong  ;  Jong-Youn Kim  ;  Pil-Ki Min  ;  Young W. Yoon  ;  Byoung K. Lee  ;  Hyuck M. Kwon  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang  ;  Won-Heum Shim  ;  Seung-Yun Cho  ;  Byeong-Keuk Kim  ;  Seongjin Oh  ;  Dong W. Jeon  ;  Joo Y. Yang  ;  Jae-Hun Jung 
Citation
 American Heart Journal, Vol.160(5) : 987-994, 2010 
Journal Title
 American Heart Journal 
ISSN
 0002-8703 
Issue Date
2010
MeSH
Coronary Aneurysm/diagnosis ; Coronary Aneurysm/epidemiology* ; Coronary Aneurysm/etiology ; Coronary Angiography ; Coronary Stenosis/surgery* ; Drug-Eluting Stents/adverse effects* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Time Factors
Abstract
AIMS: There is a growing concern about the occurrence of coronary artery aneurysms (CAAs) after drug-eluting stent (DES) implantation and their long-term course. We assessed the occurrence and the factors affecting the long-term outcome of DES-associated CAA. METHODS AND RESULTS: We analyzed 3,612 consecutive patients (4,419 lesions) who underwent follow-up angiography after DES implantation. All 34 CAAs (0.76% per lesion) in 29 patients (0.8% per patient) were detected at follow-up, and the mean elapsed time from DES implantation to CAA diagnosis was 414 ± 213 days. Angiographically, CAAs developed almost exclusively in complex (type B2/C) de novo lesions (30 [88.2%] of 34 lesions), and lesion length was significantly greater in patients with CAA than without CAA (26.9 ± 9.03 vs 23.1 ± 7.14 mm; P = .004). Myocardial infarction with stent thrombosis occurred in 5 patients with CAA (17.2%), 4 of whom were on aspirin only without clopidogrel. CONCLUSION: Although CAAs rarely develop after DES implantation and show mostly favorable clinical courses, long-term maintenance of clopidogrel therapy might be required to minimize occurrence of adverse clinical events resulting from stent thrombosis.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002870310006526
DOI
10.1016/j.ahj.2010.07.013
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kwon, Hyuck Moon(권혁문) ORCID logo https://orcid.org/0000-0001-9901-5015
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Shim, Won Heum(심원흠)
Yoon, Young Won(윤영원) ORCID logo https://orcid.org/0000-0002-0907-0350
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Cho, Seung Yun(조승연)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Bum Kee(홍범기) ORCID logo https://orcid.org/0000-0002-6456-0184
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102423
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