Cardiovascular Intervention and Therapeutics

, Volume 25, Issue 1, pp 29–39

Incidence and outcome of surgical procedures after sirolimus-eluting stent implantation: a report from the j-Cypher registry

Authors

    • Department of Cardiovascular of Medicine, Graduate School of MedicineKyoto University
  • Takaaki Isshiki
    • Teikyo University Hospital
  • Yasuhiko Hayashi
    • Tsuchiya General Hospital
  • Shigeru Oshima
    • Gunma Prefectural Cardiovascular Center
  • Masanobu Namura
    • Kanazawa Cardiovascular Hospital
  • Hitoshi Nakashima
    • National Hospital Organization Kagoshima Medical Center
  • Kazuya Kawai
    • Chikamori Hospital
  • Takahito Sone
    • Ogaki Municipal Hospital
  • Ryozo Tatami
    • Maizuru Kyosai Hospital
  • Taiichiro Meguro
    • Sendai Health Hospital
  • Masakiyo Nobuyoshi
    • Kokura Memorial Hospital
  • Kazuaki Mitsudo
    • Kurashiki Central Hospital
Original Article

DOI: 10.1007/s12928-009-0005-4

Cite this article as:
Kimura, T., Isshiki, T., Hayashi, Y. et al. Cardiovasc Interv and Ther (2010) 25: 29. doi:10.1007/s12928-009-0005-4

Abstract

The incidence of surgical procedures after sirolimus-eluting stent (SES) implantation and, more importantly, the rate of perioperative stent thrombosis (ST) and/or other adverse events have not yet been adequately addressed. The incidence and outcome of the surgical procedures after SES implantation were prospectively evaluated in a large-scale multicenter registry of patients undergoing SES implantation. Among 12,824 patients enrolled in the registry, cumulative incidences of surgical procedures were 0.7% at 60 days, 5.1% at 1 year and 14.7% at 3 years. Surgical procedures were performed in 1,430 patients including non-coronary artery bypass graft (CABG) surgery in 1,275 patients and CABG in 189 patients. The incidences of death/myocardial infarction/ST (definite or probable) and ST (definite or probable) at 30 days after surgical procedures were 2.7 and 0.35%, respectively. Surgery performed within 60 days after SES implantation as compared with that performed beyond 60 days was associated with significantly higher incidences of death/myocardial infarction/ST (definite or probable) and ST (definite or probable) at 30 days after surgical procedures (6.4 vs. 2.5%: P = 0.02 and 2.2 vs. 0.23%: P = 0.002, respectively). Surgery within 60 days as well as hemodialysis and small body mass index were independent risk factors of death/myocardial infarction/ST (definite or probable) identified by multivariable analysis. Surgical procedures were required fairly often after SES implantation. The incidences of adverse cardiac events including ST after surgical procedures were acceptably low. Surgery within 60 days after SES implantation carried significantly higher risks as compared with those beyond 60 days.

Keywords

Stent Thrombosis Revascularization Surgery Aspirin

Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2009