経皮的冠動脈ステント留置術施行後の再狭窄に影響を及ぼす臨床的因子の検討  [in Japanese] Analysis of Clinical Factors that Influence Re-stenosis after Percutaneous Coronary Stenting  [in Japanese]

Evidence has recently been accumulating that a sirolimus-eluting stent (DES) is superior to a bare-metal stent (BMS) in preventing restenosis after percutaneous coronary intervention (PCI), and an increasing number of Japanese hospitals have been adopting DES. We conducted a retrospective study to identify clinical factors that influence the risk of restenosis after PCI, including stent types, by analyzing the data of 49 continuous patients who received PCI and follow-up coronary angiography in Hiratsuka City Hospital between March, 2004 and March, 2005. Age, sex, body mass index, smoking, complications, clinical diagnosis before PCI, the site and number of stenoses, implanted stent type (BMS or DES), the number of stents used, maximum inflating pressure and withdrawal of ticlopidine due to its adverse drug reactions were chosen as potential factors that may influence the risk of restenosis, and the correlation between these factors and restenosis was tested by Student's t-test or chi-square test. Coronary restenosis developed in 10 out of 49 patients, and factors having significant correlation with restenosis were age (73±7 in the restenosis group (R) and 64±12 in the non-restenosis group (N) (p<0.05)) and the type of stent (DES used in only one of 10 cases in R whereas in 24 of 39 in N (p<0.001)). Multivariate analysis showed older age (odds ratio (OR):1.200 (95% CI: 1.038-2.823)) and the use of DES are independent predictors for restenosis (OR: 0.015 (95%CI: 0.001-0.249)). Our study further supports the efficacy of DES in PCI, but its long-term outcome is yet to be confirmed.