Author + information
- Received October 19, 2009
- Accepted November 13, 2009
- Published online February 1, 2010.
- Shinichi Shirai, MD⁎,
- Takeshi Kimura, MD†,⁎ (, )
- Masakiyo Nobuyoshi, MD⁎,
- Takeshi Morimoto, MD‡,
- Kenji Ando, MD⁎,
- Yoshimitsu Soga, MD⁎,
- Kyohei Yamaji, MD⁎,
- Katsuhiro Kondo, MD⁎,
- Koyu Sakai, MD⁎,
- Takeshi Arita, MD⁎,
- Masahiko Goya, MD⁎,
- Masashi Iwabuchi, MD⁎,
- Hiroyoshi Yokoi, MD⁎,
- Hideyuki Nosaka, MD⁎,
- Kazuaki Mitsudo, MD§,
- j-Cypher Registry Investigators
- ↵⁎Reprint requests and correspondence:
Dr. Takeshi Kimura, Department of Cardiovascular of Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
Objectives Our aim was to study the relationships between total stent length (TSL) and long-term clinical outcomes after sirolimus-eluting stent (SES) implantation.
Background SES compared with bare-metal stent use for long lesion treatment is associated with reduced restenosis rates.
Methods Three-year follow-up data were available for 10,773 patients (14,651 lesions) that had been treated with only SES (Cypher, Cordis Corp., Warren, New Jersey) in the j-Cypher registry. Patients and lesions were divided into quartile groups: TSL per patient (Q1: 8 to 23 mm, Q2: 24 to 36 mm, Q3: 37 to 54 mm, Q4: 55 to 293 mm), and TSL per lesion (QA: 8 to 18 mm, QB: 19 to 23 mm, QC: 24 to 33 mm, QD: 34 to 150 mm).
Results In per-lesion data, longer TSL increased target lesion revascularization (TLR) rates but did not increase stent thrombosis rates (p = 0.2324). In per-patient data, the incidences of TLR remarkably increased with increasing TSL. Incidence of composite of death and myocardial infarction also increased with increasing TSL; however, after adjustment for baseline differences, there was no statistical significance. Definite stent thrombosis rate in group Q4 was significantly higher than in other groups, both unadjusted (hazard ratio: 1.770, p = 0.0081) and adjusted (hazard ratio: 1.727, p = 0.0122) for baseline differences.
Conclusions TSL per lesion and patient had significantly impacts on TLR rates. Longer TSL per patient was associated with increased incidence of stent thrombosis through 3 years.
Supported by Cordis Cardiology Japan and Johnson & Johnson K.K. Dr. Kimura is an advisory board member, speaker, and has received honoraria from Johnson & Johnson K.K. Dr. Mitsudo has received honoraria from Johnson & Johnson K.K.
- Received October 19, 2009.
- Accepted November 13, 2009.
- American College of Cardiology Foundation