Impact of early target lesion revascularization on long-term clinical outcomes after sirolimus-eluting stent implantation

Abstract

Backgrounds: Whether early Target Lesion Revascularization (TLR) after percutaneous coronary intervention influences long-term clinical outcomes is little known. In this study, we evaluated the impact of TLR within one year after Sirolimus-Eluting Stent (SES) implantation on the long-term clinical outcomes. Methods: From January 2003 to August 2007, consecutive 2203 patients, excluding hemodialysis patients, underwent the first SES implantation. Of these patients, we evaluated 2101 patients who were able to be followed since one year after SES implantation, and compared the long-term clinical outcomes, including cardiac death, Myocardial Infarction (MI), any revascularization, TLR, and non-TLR revascularization, between the TLR within one year (1-year TLR, 218 patients) group and the non-TLR within one year (1-year non-TLR, 1883 patients) group. Results: The median follow-up duration was 2320 days (interquartile range, 2024-2544 days). There was no difference in the incidence of cardiac death between the 1-year TLR group and the 1-year non-TLR group (6.6% vs. 5.3%, p = 0.34; Figure A). The incidence of MI was also similar between the two groups (5.3% vs. 2.5%, p = 0.17; Figure A). All of the incidences of any revascularization, TLR, and non-TLR revascularization were much higher in the 1-year TLR group than in the 1-year non-TLR group (58.9% vs. 32.6%, p < 0.001; 48.1% vs. 19.4%, p < 0.001; 40.0% vs. 24.4%, p < 0.001; respectively; Figure B). ![Figure][1] Conclusions: Early TLR within one year after SES implantation was not associated with hard clinical outcomes including cardiac death and MI, but with the higher incidences of the following revascularization. [1]: pending:yes