TY  - BOOK
AU  - Baker, Nevin C
AU  - Chen, Fang
AU  - Escarcega, Ricardo O
AU  - Kitabata, Hironori
AU  - Lipinski, Michael J
AU  - Loh, Joshua P
AU  - Magalhaes, Marco A
AU  - Minha, Sa'ar
AU  - Omar, Al Fazir
AU  - Ota, Hideaki
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Suddath, William O
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Clinical presentation and outcomes of coronary in-stent restenosis across 3-stent generations
SN  - 1941-7640
KW  - *Acute Coronary Syndrome/th [Therapy]
KW  - *Angina, Unstable/th [Therapy]
KW  - *Coronary Artery Disease/th [Therapy]
KW  - *Coronary Stenosis/et [Etiology]
KW  - *Myocardial Infarction/th [Therapy]
KW  - *Percutaneous Coronary Intervention/ae [Adverse Effects]
KW  - *Percutaneous Coronary Intervention/is [Instrumentation]
KW  - *Stents
KW  - Acute Coronary Syndrome/di [Diagnosis]
KW  - Acute Coronary Syndrome/mo [Mortality]
KW  - Aged
KW  - Angina, Unstable/di [Diagnosis]
KW  - Angina, Unstable/mo [Mortality]
KW  - Chi-Square Distribution
KW  - Coronary Artery Disease/di [Diagnosis]
KW  - Coronary Artery Disease/mo [Mortality]
KW  - Coronary Stenosis/di [Diagnosis]
KW  - Coronary Stenosis/mo [Mortality]
KW  - Coronary Stenosis/pc [Prevention & Control]
KW  - Drug-Eluting Stents
KW  - Female
KW  - Humans
KW  - Kaplan-Meier Estimate
KW  - Logistic Models
KW  - Male
KW  - Metals
KW  - Middle Aged
KW  - Multivariate Analysis
KW  - Myocardial Infarction/di [Diagnosis]
KW  - Myocardial Infarction/mo [Mortality]
KW  - Odds Ratio
KW  - Percutaneous Coronary Intervention/mo [Mortality]
KW  - Proportional Hazards Models
KW  - Prosthesis Design
KW  - Protective Factors
KW  - Retrospective Studies
KW  - Risk Assessment
KW  - Risk Factors
KW  - Time Factors
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Comparative Study
KW  - Journal Article
KW  - Observational Study
N1  - Available online from MWHC library: 2008 - present
N2  - BACKGROUND: Clinical presentation of bare metal stent in-stent restenosis (ISR) in patients undergoing target lesion revascularization is well characterized and negatively affects on outcomes, whereas the presentation and outcomes of first- and second-generation drug-eluting stents (DESs) remains under-reported; CONCLUSIONS: ISR clinical presentation is similar irrespective of stent type. MI as ISR presentation seems to be associated with patient and not device-related factors. ACS as ISR presentation has an independent effect on major adverse cardiac events, suggesting that ISR remains a hazard and should be minimized.Copyright � 2014 American Heart Association, Inc; METHODS AND RESULTS: The study included 909 patients (1077 ISR lesions) distributed as follows: bare metal stent (n=388), first-generation DES (n=425), and second-generation DES (n=96), categorized into acute coronary syndrome (ACS) or non-ACS presentation mode at the time of first target lesion revascularization. ACS was further classified as myocardial infarction (MI) and unstable angina. For bare metal stent, first-generation DES and second-generation DES, ACS was the clinical presentation in 67.8%, 71.0%, and 66.7% of patients, respectively (P=0.470), whereas MI occurred in 10.6%, 10.1%, and 5.2% of patients, respectively (P=0.273). The correlates for MI as ISR presentation were current smokers (odds ratio, 3.02; 95% confidence interval [CI], 1.78-5.13; P<0.001), and chronic renal failure (odds ratio, 2.73; 95% CI, 1.60-4.70; P<0.001), with a protective trend for the second-generation DES ISR (odds ratio, 0.35; 95% CI, 0.12-1.03; P=0.060). ACS presentations had an independent effect on major adverse cardiac events (death, MI, and re-target lesion revascularization) at 6 months (MI versus non-ACS: adjusted hazard ratio, 4.06; 95% CI, 1.84-8.94; P<0.001; unstable angina versus non-ACS: adjusted hazard ratio, 1.98; 95% CI, 1.01-3.87; P=0.046)
UR  - http://dx.doi.org/10.1161/CIRCINTERVENTIONS.114.001341
ER  -