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Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation
BACKGROUND: Stent edge dissection (SED) is a well-known predictor of worse clinical outcomes. However, impact of SED after current-generation drug-eluting stent (DES) implantation remains unknown since there was no study using only current-generation DES to assess impact of SED. This study aimed to...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568188/ https://www.ncbi.nlm.nih.gov/pubmed/34735528 http://dx.doi.org/10.1371/journal.pone.0259693 |
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author | Jinnouchi, Hiroyuki Sakakura, Kenichi Yanase, Tomonobu Ugata, Yusuke Tsukui, Takunori Taniguchi, Yosuke Yamamoto, Kei Seguchi, Masaru Wada, Hiroshi Fujita, Hideo |
author_facet | Jinnouchi, Hiroyuki Sakakura, Kenichi Yanase, Tomonobu Ugata, Yusuke Tsukui, Takunori Taniguchi, Yosuke Yamamoto, Kei Seguchi, Masaru Wada, Hiroshi Fujita, Hideo |
author_sort | Jinnouchi, Hiroyuki |
collection | PubMed |
description | BACKGROUND: Stent edge dissection (SED) is a well-known predictor of worse clinical outcomes. However, impact of SED after current-generation drug-eluting stent (DES) implantation remains unknown since there was no study using only current-generation DES to assess impact of SED. This study aimed to investigate a relationship between SED detected by optical coherence tomography (OCT) and clinical outcomes after current-generation DES implantation. METHODS: This study enrolled 175 patients receiving OCT after current-generation DES implantation. The SED group was compared with the non-SED group in terms of the primary study endpoints which was the cumulative incidence of major adverse cardiac event (MACE) composed of cardiac death, target vessel myocardial infarction (TV-MI), and clinically-driven target lesion revascularization (CD-TLR). RESULTS: Of 175 patients, SED detected by OCT was observed in 32 patients, while 143 patients did not show SED. In the crude population, the SED group showed a significantly higher incidence of CD-TLR, definite stent thrombosis, TV-MI and cardiac death relative to the non-SED group. After adjustment by an inverse probability weighted methods, the SED group showed a significantly higher incidence of MACE compared with the non-SED group (hazard ratio 3.43, 95% confidence interval 1.09–10.81, p = 0.035). Fibrocalcific or lipidic plaques, greater lumen eccentricity, and stent-oversizing were the predictors of SED. CONCLUSIONS: SED detected by OCT after the current-generation DES implantation led to unfavorable outcomes. Aggressive post-dilatation around the stent edge might worse clinical outcomes due to SED, although achievement of optimal stent expansion is strongly encouraged to improve clinical outcomes. |
format | Online Article Text |
id | pubmed-8568188 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-85681882021-11-05 Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation Jinnouchi, Hiroyuki Sakakura, Kenichi Yanase, Tomonobu Ugata, Yusuke Tsukui, Takunori Taniguchi, Yosuke Yamamoto, Kei Seguchi, Masaru Wada, Hiroshi Fujita, Hideo PLoS One Research Article BACKGROUND: Stent edge dissection (SED) is a well-known predictor of worse clinical outcomes. However, impact of SED after current-generation drug-eluting stent (DES) implantation remains unknown since there was no study using only current-generation DES to assess impact of SED. This study aimed to investigate a relationship between SED detected by optical coherence tomography (OCT) and clinical outcomes after current-generation DES implantation. METHODS: This study enrolled 175 patients receiving OCT after current-generation DES implantation. The SED group was compared with the non-SED group in terms of the primary study endpoints which was the cumulative incidence of major adverse cardiac event (MACE) composed of cardiac death, target vessel myocardial infarction (TV-MI), and clinically-driven target lesion revascularization (CD-TLR). RESULTS: Of 175 patients, SED detected by OCT was observed in 32 patients, while 143 patients did not show SED. In the crude population, the SED group showed a significantly higher incidence of CD-TLR, definite stent thrombosis, TV-MI and cardiac death relative to the non-SED group. After adjustment by an inverse probability weighted methods, the SED group showed a significantly higher incidence of MACE compared with the non-SED group (hazard ratio 3.43, 95% confidence interval 1.09–10.81, p = 0.035). Fibrocalcific or lipidic plaques, greater lumen eccentricity, and stent-oversizing were the predictors of SED. CONCLUSIONS: SED detected by OCT after the current-generation DES implantation led to unfavorable outcomes. Aggressive post-dilatation around the stent edge might worse clinical outcomes due to SED, although achievement of optimal stent expansion is strongly encouraged to improve clinical outcomes. Public Library of Science 2021-11-04 /pmc/articles/PMC8568188/ /pubmed/34735528 http://dx.doi.org/10.1371/journal.pone.0259693 Text en © 2021 Jinnouchi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Jinnouchi, Hiroyuki Sakakura, Kenichi Yanase, Tomonobu Ugata, Yusuke Tsukui, Takunori Taniguchi, Yosuke Yamamoto, Kei Seguchi, Masaru Wada, Hiroshi Fujita, Hideo Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation |
title | Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation |
title_full | Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation |
title_fullStr | Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation |
title_full_unstemmed | Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation |
title_short | Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation |
title_sort | impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568188/ https://www.ncbi.nlm.nih.gov/pubmed/34735528 http://dx.doi.org/10.1371/journal.pone.0259693 |
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