Comparison Of Repeated Drug Eluting Stent For Treatment Of Early And Late In-stent Restenosis After Drug Eluting Stent Implantation

Objective:To compare the efficiency and safety of repeated drug eluting stent (DES) for treatment of early and late DES in-stent restenosis(ISR).Methods:Patients treated with repeated DES for DES ISR in Beijing anzhen hospital between October 2008 and December 2011 were followed up. All lesions were divided into early ISR group(within 1 year) (43 cases)and late ISR group (in>1 year) (64 cases) by the period ISR occurred after initial DES implantation. Major adverse cardiovascular events (MACE) including all-cause death, myocardial infarction and clinical target lesion revascularization (TLR) were the primary endpoints.Results:There were not different between early ISR group and late ISR group in clinical and angiographic characteristics(P>0.05), but the rate of diabetes mellitus in early ISR group was less than in late ISR group [22.7%(10/44) vs 42.9%(27/63),P<0.01]. The rate of TLR and MACE in early ISR group was higher than that in late ISR group [12.7%(8/63)) vs 43.2%(19/44); 15.9(10/63)% vs 47.7%(21/44); all P<0.01]. The risk factors for TLR by a logistic regression model were analyzed, and showed that the significant predictors of TLR was early ISR (OR=6.47,95%CI:2.262-18.504;P<0.001) after implantation of repeated DES.Conclusion:Repeated DES implantation is safe and efficient for treatment of late ISR patients, but the rate of TLR is more higher when used for treatment of early ISR patients.