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Long-Term Clinical Outcomes of Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation

Authors
 Eui Im  ;  Sung‐Jin Hong  ;  Chul‐Min Ahn  ;  Jung‐Sun Kim  ;  Byeong‐Keuk Kim  ;  Young‐Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong‐Ki Hong 
Citation
 JOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol.8(7) : e011817, 2019 
Journal Title
 JOURNAL OF THE AMERICAN HEART ASSOCIATION 
Issue Date
2019
Keywords
coronary disease ; drug‐eluting stents ; optical coherence tomography
Abstract
Background The relationship between late stent malapposition ( LSM ) and adverse cardiovascular events is controversial. Studies are needed to evaluate long-term (>5 years) clinical outcomes of LSM detected by optical coherence tomography ( OCT ) after drug-eluting stent implantation. Methods and Results We investigated long-term clinical outcomes of OCT -detected LSM in 351 patients who received drug-eluting stents and were examined by both poststent and follow-up OCT (175±60 days after drug-eluting stent implantation) from January 2009 to December 2011. LSM was observed in 99 patients (28%). We evaluated the cumulative rate of composite events (cardiovascular death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis). During 80.1±24.5 months of follow-up, very late stent thrombosis did not occur in any patients with LSM . The cumulative 8-year rate of composite events was 7.3% in patients with LSM and 10.5% in patients without LSM ( P=0.822, log-rank test). We further divided patients into the following 4 groups: patients with both late-persistent and late-acquired stent malapposition (n=23), patients with late-persistent stent malapposition alone (n=45), patients with late-acquired stent malapposition alone (n=31), and patients without LSM (n=252). The cumulative 8-year rates of composite events were similar among these 4 groups (0%, 9.6%, 9.7%, and 10.5%, respectively; P=0.468 by log-rank test). Conclusions During long-term follow-up (>5 years), very late stent thrombosis did not occur in patients with OCT -detected LSM . The rates of adverse clinical events were similar between patients with LSM versus those without LSM . Presence of OCT -detected LSM was not associated with unfavorable clinical outcomes.
Files in This Item:
T201901550.pdf Download
DOI
10.1161/JAHA.118.011817
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
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Im, Eui(임의) ORCID logo https://orcid.org/0000-0002-5333-7593
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
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, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169941
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