Intravascular ultrasound predictors of angiographic restenosis after sirolimus-eluting stent implantation

Aims In many countries, drug-eluting stent implantation is the dominant interventional strategy. We evaluated the clinical, angiographic, procedural, and intravascular ultrasound (IVUS) predictors of angiographic restenosis after sirolimus-eluting stent (SES) implantation. Methods and results SES implantation was successfully performed in 550 patients with 670 native coronary lesions. Six-month follow-up angiography was performed in 449 patients (81.6%) with 543 lesions (81.1%). Clinical, angiographic, procedural, and IVUS predictors of restenosis were determined. Using multivariable logistic regression analysis, the only independent predictors of angiographic restenosis were post-procedural final minimum stent area by IVUS [odds ratio (OR) = 0.586, 95% confidence interval (Cl) 0.387-0.888, P = 0.012] and IVUS-measured stent length (OR = 1.029, 95% Cl 1.002-1.056, P = 0.035). Final minimum stent area by IVUS and IVUS-measured stent length that best separated restenosis from non-restenosis were 5.5 mm(2) and 40 mm, respectively. Lesions with final minimum stent area < 5.5 mm(2) and stent length > 40 mm had the highest rate of angiographic restenosis [17.7% (11/62)], P < 0.001 compared with other groups. Conclusion Independent predictors of angiographic restenosis after SES implantation were post-procedural final minimum stent area by IVUS and IVUS-measured stent length. The angiographic restenosis rate was highest in lesions with stent area < 5.5 mm(2) and stent length > 40 mm.