Background-We investigated the pattern of late luminal loss after sirolimus- eluting or bare stem implantation. Methods and Results -The study population co mprised 238 patients treated with sirolimus-eluting stents a...Background-We investigated the pattern of late luminal loss after sirolimus- eluting or bare stem implantation. Methods and Results -The study population co mprised 238 patients treated with sirolimus-eluting stents and 526 patients tre ated with conventional stents. The distribution of late loss of sirolimus stents was largely skewed to the right and differed from the distribution for bare ste nts. When divided according to the presence of binary restenosis(diameter stenos is >50%), restenotic lesions in the bare stem group(26.0%) had a late loss of 1.40±0.64 mm and in the sirolimus group(7.9%) of 1.16±0.76 mm. Nonrestenotic lesions in the bare stent group had a late loss of 0.58±0.44 mm, whereas the la te loss of nonrestenotic lesions in the sirolimus group remained close to zero( -0.05±0.33 mm). Differences between poststenting and follow-up measurements i n the sirolimus group(late loss) resembled variations observed in repeated angio graphic measurements, as assessed from a random sample of 30 segments measured r epeatedly. After multivariate adjustment, stent type did not influence the degre e of late loss in restenotic lesions. However, nonrestenotic bare stents had a s ignificantly larger estimated luminal loss (0.58 mm; 95%CI, 0.52 to 0.65) than sirolimus-eluting stents, for which the predicted late loss was almost 0(-0.04 mm; 95%CI, -0.10 to 0.02). Conclusions -The pattern of late loss after sirol imus-eluting stent implantation follows a peculiar behavior, different from les ions treated with conventional stents. Whether this is explained by an unusual s tatistical distribution or a biological all-or-none response of restenosis aft er sirolimus-eluting stenting remains to be investigated.展开更多
文摘Background-We investigated the pattern of late luminal loss after sirolimus- eluting or bare stem implantation. Methods and Results -The study population co mprised 238 patients treated with sirolimus-eluting stents and 526 patients tre ated with conventional stents. The distribution of late loss of sirolimus stents was largely skewed to the right and differed from the distribution for bare ste nts. When divided according to the presence of binary restenosis(diameter stenos is >50%), restenotic lesions in the bare stem group(26.0%) had a late loss of 1.40±0.64 mm and in the sirolimus group(7.9%) of 1.16±0.76 mm. Nonrestenotic lesions in the bare stent group had a late loss of 0.58±0.44 mm, whereas the la te loss of nonrestenotic lesions in the sirolimus group remained close to zero( -0.05±0.33 mm). Differences between poststenting and follow-up measurements i n the sirolimus group(late loss) resembled variations observed in repeated angio graphic measurements, as assessed from a random sample of 30 segments measured r epeatedly. After multivariate adjustment, stent type did not influence the degre e of late loss in restenotic lesions. However, nonrestenotic bare stents had a s ignificantly larger estimated luminal loss (0.58 mm; 95%CI, 0.52 to 0.65) than sirolimus-eluting stents, for which the predicted late loss was almost 0(-0.04 mm; 95%CI, -0.10 to 0.02). Conclusions -The pattern of late loss after sirol imus-eluting stent implantation follows a peculiar behavior, different from les ions treated with conventional stents. Whether this is explained by an unusual s tatistical distribution or a biological all-or-none response of restenosis aft er sirolimus-eluting stenting remains to be investigated.
