| 김정현, 김기식, 박해성, 김병호, 김병규, 하근진, 배경윤, 성명준, 정진욱, 이영수, 이진배, 류재근, 최지용, 장성국 |
Background: The adverse process including aneurysm, stent thrombosis, restenosis and new lesion related the target vessel after successful implantation of drug-eluting stent (DES) or bare-metal stent (BMS) is a potentially life-threatening consequence of coronary stenting. The late thrombosis, formation of aneurysm and restenosis in the coronary stent may have been contributed by the similar pathogeny of local inflammation. In this study, we evaluated the predictor of the adverse process including aneurysm, stent thrombosis, restenosis and new lesion related the target vessel after successful implantation of DES or BMS. Method: The study population comprised 804 patients with follow-up angiography from May 2006 to April 2009. We defined that the adverse process of target vessel is aneurysm, stent thrombosis, restenosis and new lesion related the target vessel after implantation of DES or BMS. Patient’s clinical information, lesion characteristics and intervention details were evaluated in adverse process group (AP) and non adverse process group (NAP). Result: Of 804 patients (55.3 % males and aged 62.99±10.7years) treated with either a bare-metal(n= 50) or drug-eluting stent(n=754), 226 patients (56.8% males and aged 64.48±10.9years) presented with a defined adverse process; aneurysm in 17, stent thrombosis in 18, restenosis in 151 and new lesion in 79. There were higher incidence of BMS implantation, diabetes and ACS at initial presentation in AP group. Also, lower stent diameter, longer stent length, less post-stenting minimal lumen diameter in AP group were seen than NAP group. The lower HDL level and higher lipoprotein level were showed in AP group. In multivariate logistic regression analysis, independent predictors of the adverse process of target lesion were initial presentation as acute coronary syndrome (HR 3.98, p < 0.001) and BMS over DES (42.0% vs 27.5%, HR 2.855, p=0.025) and longer stent length (HR 1.014, p=0.038). Conclusion: Stent length, acute coronary syndrome and BMS over DES could predict the adverse process of the target vessel.
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