Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation

<h4>Background</h4> 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....

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hiroyuki Jinnouchi, Kenichi Sakakura, Tomonobu Yanase, Yusuke Ugata, Takunori Tsukui, Yosuke Taniguchi, Kei Yamamoto, Masaru Seguchi, Hiroshi Wada, Hideo Fujita
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/62e7721f38464e9b938f10897785f928
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:62e7721f38464e9b938f10897785f928
record_format	dspace
spelling	oai:doaj.org-article:62e7721f38464e9b938f10897785f9282021-11-11T07:14:38ZImpact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation1932-6203https://doaj.org/article/62e7721f38464e9b938f10897785f9282021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568188/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> 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. <h4>Methods</h4> 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). <h4>Results</h4> 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. <h4>Conclusions</h4> 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.Hiroyuki JinnouchiKenichi SakakuraTomonobu YanaseYusuke UgataTakunori TsukuiYosuke TaniguchiKei YamamotoMasaru SeguchiHiroshi WadaHideo FujitaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hiroyuki Jinnouchi Kenichi Sakakura Tomonobu Yanase Yusuke Ugata Takunori Tsukui Yosuke Taniguchi Kei Yamamoto Masaru Seguchi Hiroshi Wada Hideo Fujita Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation
description	<h4>Background</h4> 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. <h4>Methods</h4> 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). <h4>Results</h4> 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. <h4>Conclusions</h4> 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	article
author	Hiroyuki Jinnouchi Kenichi Sakakura Tomonobu Yanase Yusuke Ugata Takunori Tsukui Yosuke Taniguchi Kei Yamamoto Masaru Seguchi Hiroshi Wada Hideo Fujita
author_facet	Hiroyuki Jinnouchi Kenichi Sakakura Tomonobu Yanase Yusuke Ugata Takunori Tsukui Yosuke Taniguchi Kei Yamamoto Masaru Seguchi Hiroshi Wada Hideo Fujita
author_sort	Hiroyuki Jinnouchi
title	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_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_sort	impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/62e7721f38464e9b938f10897785f928
work_keys_str_mv	AT hiroyukijinnouchi impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT kenichisakakura impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT tomonobuyanase impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT yusukeugata impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT takunoritsukui impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT yosuketaniguchi impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT keiyamamoto impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT masaruseguchi impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT hiroshiwada impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation AT hideofujita impactofstentedgedissectiondetectedbyopticalcoherencetomographyaftercurrentgenerationdrugelutingstentimplantation
_version_	1718439404793495552

Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation

Ejemplares similares