0387 : Incidence and predictors of the late catch-up phenomenon after drug-eluting stent implantation

PurposeAlthough clinical restenosis within 1year after percutaneous coronary intervention has been remarkably reduced with the advent of drugeluting stents (DES), the late catch-up (LCU) phenomenon remains an issue despite medical advances. The aim of this study was to investigate the incidence and predictive factors of the LCU phenomenon in an unselected population treated with DES.Materials and MethodsA total of 936 lesions treated with DES between June 2002 and June 2010 were analyzed. The LCU phenomenon was defined as secondary revascularization 1 year after index stenting.ResultsIncidence of the LCU phenomenon was seen in 103 lesions (11,04%). In the multivariate analysis, severe calcifications [odds ratio (OR) 6.07, p=0.017], restenosis lesion (OR 1.58, p=0.003), and long lesions (OR 2.06, p=0.031) were identified as independent predictors of the LCU phenomenon.ConclusionThe LCU phenomenon is associated with serious consequences and adverse events and remains an important issue in modern practice, despite medical advances. Special consideration must be given to patients with restenosis lesion, long lesions and severe calcifications

0495: Clinical impact of second-generation everolimus eluting stent compared with first-generation sirolimus-eluting stent in diabetes mellitus patients

PurposeThis study sought to study the second-generation everolimuseluting stent (EES) as compared with first-generation sirolimus-eluting (SES) in diabetes mellitus (DM) patients.MethodsAll DM patients treated with EES or SES from January 2010, to December 2011 were included. The EES was compared with SES for the primary composite endpoint of clinically driven detected restenosis, definite stent thrombosis (ST), and all-cause mortality.ResultsIn 226 percutaneous coronary intervention-treated DM patients, 353 stents were implanted (EES 118, SES 235). The EES was associated with significantly lower restenosis rates compared with SES (SES vs. EES: 16.7% vs. 2.8%, p=0,001, OR: 2.96; 95% CI: 1.57 to 5.57). Lower incidence of ST (SES vs. EES: 2,1% vs 0,8%, p=0,38) and mortality (SES vs. EES: 1,7 % vs 0%, p=0,15) was noted but did not reach statistical significance.ConclusionsIn all-comer DM patients the use of EES was associated with improved outcomes compared with SES mainly driven by lower rates of clinically driven detected restenosis