학술대회안내사전등록초록등록안내초록등록/관리숙박 및 교통
초록심사

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ǥ : ȣ - 480237   11 
Clinical Outcomes of Three or More Sirolimus-eluting Stent versus Single Sirolimus-eluting Stent Implantations
Cardiovascular Center, Korea University Guro Hospital¹ , Washington Hospital Center, Washington DC²
Seung-Woon Rha¹, Soon Yong Suh¹ , Byoung Won Cheon¹ , Soon Jun Hong¹ , Jin Won Kim¹ , Chang Gyu Park¹ , Hong Seog Seo¹ , Dong Joo Oh¹ , Young Moo Ro¹ , Ron Waksman²

Background: Performance of multivessel or multilesion dilation is generally known to be associated with increased complexity of the procedure and unfavorable prognosis. Sirolimus-eluting Stent (SES; CypherTM) implantation for single vessels is proven to be effective and durable but not for multivessel disease. This study aimed to compare the clinical outcomes of 3 or more SES implantations to those of single SES implantation.
Methods: A total 29 patients (pts) with 64 lesions were implanted with 3 or more SES and 1046 pts with 1080 lesions with single SES (the Single SES group) in a variety of coronary lesions. Standard anticoagulation with either bivalirudin or heparin was maintained during the procedure. The in-hospital, 30-day and 6-month clinical outcomes of both groups were compared.
Results: Baseline characteristics were similar between the two groups except history of diabetes mellitus and renal insufficiency were higher in the Multiple SES group. The Multiple SES group had higher incidence of periprocedural CK-MB elevation (>2X normal; 39.3% vs. 19.2%, P=0.008), abrupt closure (4.0% vs. 0.1%, P<0.001), dissection (8.2% vs. 1.2%, P<0.001), prophylactic intra-arterial balloon pump use (3.4% vs. 0.4%, P=0.02) and lower angiographic success (92.1% vs. 97.2%, P=0.02). At 30 days, the Multiple SES group had higher death (4.0% vs. 0.1%, P<0.001), Q-wave myocardial infarction (MI; 8.0% vs. 0.5%, P<0.001) and TVR-MACE (8.0% vs. 1.3%, P=0.001) compared to the single SES group. At 6 months, the Multiple SES group had higher Q-wave MI (25.0% vs. 1.5%, P<0.001), Non-Q wave MI (41.7% vs. 13.9%, P=0.007) and TVR-MACE (25.5% vs. 6.2%, P=0.009). The incidence of subacute stent thrombosis and late thrombosis was similar between the two groups.
Conclusion: Treatment of multivessels or multilesions with 3 or more SES is associated with increased periprocedural, in-hospital complications and worse adverse clinical outcomes at 30 days and 6 months follow-up. These unfavorable outcomes of the Multiple SES group suggest that special caution should be exercised when SES are used for multivessel disease.


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