Ten-year clinical follow-up after sirolimus-eluting stent implantation

Am Heart J. 2014 Jun;167(6):893-9. doi: 10.1016/j.ahj.2013.12.013. Epub 2014 Jan 4.

Abstract

Background: Little is known on the "very" long-term incidence of major adverse cardiac events (MACE), target-lesion revascularization (TLR), target-vessel revascularization and stent thrombosis after sirolimus-eluting stent (SES) implantation. We present the first study to provide a 10-year clinical follow-up in an unselected patient population who underwent SES implantation.

Methods and results: We ran a systematic 10-year clinical follow-up in a series of 200 consecutive patients treated with unrestricted SES implantation between April 2002 and April 2003 in two Swiss hospitals. Outcomes and follow-up were obtained in all 200 patients. The cumulative 10-year MACE rate was 47% with all-cause death of 20%, cardiac death of 9%, myocardial infarction of 7%, TLR and target-vessel revascularization of 8% and 11% respectively. Academic Research Consortium-defined "definite and probable" stent thrombosis-rate was 2.5%. TLR risk was maximal between 3 to 6 years. New lesion revascularization increased throughout the study period.

Conclusion: Incidence of TLR was maximal 3 to 6 years after SES implantation and decreased thereafter. MACE and non-TLR revascularization rates steadily increased during the complete follow-up underlining the progression of coronary artery disease.

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Coronary Artery Disease / therapy*
  • Coronary Restenosis
  • Drug-Eluting Stents*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / prevention & control*
  • Myocardial Revascularization / statistics & numerical data
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Prospective Studies
  • Prosthesis Failure
  • Sirolimus*
  • Thrombosis
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors
  • Sirolimus