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Severe Acute Stent Malapposition After Drug-Eluting Stent Implantation: Effects on Long-Term Clinical Outcomes

 Seung‐Yul Lee  ;  Eui Im  ;  Sung‐Jin Hong  ;  Chul‐Min Ahn  ;  Jung‐Sun Kim  ;  Byeong‐Keuk Kim  ;  Young‐Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong‐Ki Hong 
 Journal of the American Heart Association, Vol.8(13) : e012800, 2019 
Journal Title
 Journal of the American Heart Association 
Issue Date
drug‐eluting stent ; optical coherence tomography ; percutaneous coronary intervention
Background The effects of severe acute stent malapposition ( ASM ) after drug-eluting stent implantation on long-term clinical outcomes are not clearly understood. We evaluated long-term clinical outcomes of severe ASM using optical coherence tomography. Methods and Results We pooled patient- and lesion-level data from 6 randomized studies. Five studies investigated follow-up drug-eluting stent strut coverage and one investigated ASM . In this data set, a total of 436 patients with 444 lesions underwent postintervention optical coherence tomography examination and these data were included in the analysis. Severe ASM was defined as lesions with ≥400 μm of maximum malapposed distance or ≥1 mm of maximum malapposed length. Composite events (cardiac death, target lesion-related myocardial infarction, target lesion revascularization, and stent thrombosis) were compared between patients with and without severe ASM . The postintervention optical coherence tomography findings indicated that 62 (14.2%) patients had lesions with ≥400 μm of maximum malapposed distance and 186 (42.7%) patients had lesions with ≥1 mm of maximum malapposed length. The 5-year clinical follow-up was completed in 371 (86.1%) of the eligible 431 patients. The cumulative rate of composite events was similar among the patients in each group during 5-year follow-up: 3.3% in patients with ASM ≥400 μm of maximum malapposed distance versus 3.1% in those with no ASM or ASM <400 μm of maximum malapposed distance ( P=0.89), and 1.2% in patients with ASM ≥1 mm of maximum malapposed length versus 4.6% in those with no ASM or ASM <1 mm of maximum malapposed length ( P=0.06). Conclusions During the 5-year follow-up, ASM severity was not associated with long-term clinicaloutcomes in patients treated with drug-eluting stents.
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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
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