Long-term outcomes following very late stent XXXX of drug-eluting stent.

@entity1 @entity715 @entity299
BACKGROUND: Long-term outcomes of very late stent @entity715 (VLST) after implantation of drug-eluting stents (DES) are still unclear. The aim was to evaluate the long-term outcomes after VLST of DES, and to analyze the related factors of long-term outcomes in these @entity1 . METHODS: From January 2006 to February 2013, @entity1 with angiographically defined VLST were studied. The clinical characteristics, angiography and interventional data, and anti-platelet therapy protocols were analyzed. The @entity1 were divided into two groups according to the occurrence of major adverse @entity299 (MACE) during follow-up. The clinical and interventional data between the two groups were compared. RESULTS: Sixty-two @entity1 were enrolled consisting of 55 males and 7 females with an average age of 58.6  10.2 (41-82) years. The mean time from first implantation of DES to occurrence of VLST was 38.7  18.1 (12.5-84) months. One @entity1 died in hospital. Sixty-one @entity1 survived to discharge, and MACE occurred in 17 @entity1 after a median follow-up of 32.1  19.1 (median: 44, range 5-88) months. The total MACE rate was 29.0% (18/62), and Kaplan-Meier survival analysis showed the estimated MACE-free survival was 45.1%. The rate of implantation of an additional first-generation DES during the first VLST in the group with events was higher (44.4% vs.11.4%, respectively, p=0.007). The percentage of continuous dual antiplatelet therapy (DAPT) at the longest available follow-up was higher in the event-free group (27.8% vs. 75.0%, respectively, p=0.001). Multivariable Cox regression analysis revealed that the only independent predictors for freedom of MACE during long-term follow-up was continuous DAPT at the longest available follow-up [hazard ratio (HR)=0.30, 95% CI: 0.09-0.97, p=0.04]. CONCLUSIONS: Long-term outcomes after VLST were unfavorable. Implantation of an additional first-generation DES might be avoided, and DAPT should be continued.
